Endothelial Health Program

August 26, 2009 at 7:51am

Here is the original program I wrote up for Jeff in 2008 and shared on ThisIsMS.  This was before we'd read Dr. Zamboni's research.  I sent it to Dr. John Cooke at Stanford University. Dr. Cooke's endothelial research and his book, The Cardiovascular Cure, were highly inspirational to me, and I wanted to get his thoughts on MS as a disease of endothelial dysfunction.  It is suggested for healthy vascular living for MS patients.  I knew that there was a connection between Jeff's hypercoagulated blood, high liver enzymes, c-reactive protein, petechiae and inflammation--and thought maybe the program might help others with MS.

There is a shortened version hosted on the CCSVI Alliance site-

http://www.ccsvi.org/index.php/helping-myself/endothelial-health

For those who want to read more, here's the full paper:

Overwhelmed:

Reversing Endothelial Dysfunction 

By Joan Beal

I am not a doctor. Not even close. I took chemistry in high school, but I didnʼt like my teacher and chatted my way through labs. That was the end of my science career. I majored in music in college, and have spent my adult life pursuing the creative arts. Although math and science were never to be my forté, I do enjoy puzzles. I cannot walk away from an unfinished Sudoku, and much to my husbandʼs frustration, I always shout out “I know who did it!” before the first act of a mystery is completed. I guess Iʼm a “big picture” gal- I like to step back and find the connections between seemingly disparate things. You could also call me a “holistic” person, because I enjoy finding commonalities and patterns. Just like the nine digits in the Sudoku box.

Multiple Sclerosis is not a puzzle I was prepared for. By the time my husband finally went to the doctor, after a month of my pleading and cajoling, he was really sick. He was numb on his left side and his feet were burning. He went in for an MRI and the technician added the contrast dye to his veins. We knew he was in trouble.   When we went to meet with the neurologist, I noticed under the harsh fluorescent lights his skin had a jaundiced pallor. And what were those strange red dots up and down his shins? I hadnʼt seen him in shorts recently...what were those?

His neurologist said that had nothing to do with his illness. He had multiple sclerosis.  It was an autoimmune disease. My husbandʼs t- cells were attacking the myelin on his brain and spine, and he had 20 cerebral lesions to show for it. His blood labs had come back with some irregularities;  he had extremely high liver enzymes, high coagulation numbers and high c-reactive protein,  and once again the neuro said, “But that has nothing to do with his MS.” She recommended a disease modifying treatment- a daily shot called glatiramer acetate or Copaxone,  to retrain his t-cells- She also gave us a list of some nutritional supplements that she said “might help”, and sent us on our way.

I was incredulous. How could my healthy husband one day just wake up with an immune system in attack mode? And why werenʼt things like those spots (Iʼd later learn they were called petechiae) and his liver enzymes and jaundice related to this new illness?

So I went to work deciphering this new code. I read medical journals on line, and the more I read, the more questions I had. Because MS is incurable and no one really knows what causes it, it is open to more theories and less concrete evidence than almost any other disease. And it can be a variable illness, causing disability and paralysis in some, while remaining relatively benign in others. It has been almost two years since my husbandʼs diagnosis, and he is still stable and in remission from his first flare. We thank God everyday for his health and ability to carry on with his life.   Jeff has radically changed his diet, maintains a healthy weight through exercise, and takes supplements. He has also worked on lessening the stress in his life and finding ways to deal with neuropathic pain and fatigue, the nasty reminders of his disease. He is fortunate, and he is determined. But we realize that nothing is guaranteed.

I am not writing about curing MS. I do not believe I have the abilities or knowledge to cure anyone. I am only addressing ways to minimize the affects of disease and to help people feel better and perhaps remain in remission. For now, my husbandʼs MS is not progressing, but I do not know how to stop his MS for good. Right now, it appears that only God can do that. Let me be clear, I am also not about blaming people for becoming sick. There is a genetic component to each of these diseases that no one would ever ask for or bring upon themselves. The reasons why people develop specific diseases goes beyond my limited understanding. But there is hope and relief through lessening the external factors which contribute to disease.

24 million Americans suffer from some form of autoimmune disease. These diseases, in which the immune system appears to turn on the self, include diabetes, MS, rheumatoid arthritis, and lupus. The number of afflicted is growing at an astounding rate. I believe all autoimmune diseases are related. Inflammation, vascular problems, coagulation issues, neuropathic pain and suffering are common to each affliction, although the specific area that is affected is different. In MS, itʼs a breech in the blood brain barrier of the central nervous system. In rheumatoid arthritis, itʼs the joints. If we step back far enough from the names of individual diseases and all the various specialists who treat them, we can begin to see the big picture; and I believe it all begins inside each and every one of us with our blood.

The Circulatory System

Our hearts beat around 72 times per minute, over one hundred thousand times each day....transporting our blood throughout a vast network of vessels. Over a lifetime, the heart pumps one million barrels of blood.

Arteries are the vessels that carry blood from the heart to the organs and tissues of the body. They begin at the base of the heart and branch like tree trunks, becoming smaller limbs and yet smaller twigs. Finally, when they reach the tissue cells of the body, they are so tiny that only one blood cell can get through them at a time. When the blood vessels are this small they are called capillaries. There are more capillaries (and more miles of capillaries) than any other kind of blood vessel. Tiny capillaries are the smallest arteries in the human body, and ten of these equal the thickness of one strand of human hair.

Veins are the vessels that drain the blood from the capillaries and carry it back to the heart. The tiny veins that drain the capillaries flow into larger and larger vessels. When they deliver the blood back to the heart, the heart pumps the blood back to the arteries so it can make its journey once again.

In contrast to the vascular system, the lymphatic system is a complex network of conduits and nodes that carry a fluid called lymph. Lymph is a clear to yellowish watery fluid which forms in between cells of the body. This watery fluid travels in the lymph channels, through various lymph glands and eventually drains into the bloodstream. It is formed when interstitial fluid (the fluid that bathes cells and tissues) enters the conduits of the lymphatic system. The interstitial fluid is in turn formed because of filtration of blood. This clear fluid contains white blood cells, known as lymphocytes, along with a small concentration of red blood cells and proteins. Because white blood cells are smaller than red blood cells, they can pass easily through membranes which red blood cells cannot penetrate. It circulates through body tissues picking up fats, bacteria, and other unwanted materials, removal of excess tissue fluid, filtering these substances out through the lymphatic system to produce immune cells such as lymphocytes (antibody producing plasma cells) and monocytes.

The flow of our blood is a microcosm of the cycle of water on our planet. Tiny streams join larger and larger rivers which eventually flow to the sea.  The clouds draw moisture from the oceans, and create precipitation which then falls to earth and is stored in ice and snow, melting to rejoin the streams. So too, our bodies absorb all that is around us and all that we ingest; the good we find in our nutrition, air, and water, and all of the waste and toxins which we do not need. Our blood absorbs the good and bad without prejudice and relies on our lymph system to filter for us.

The Endothelium

There are approximately 60,000 miles of blood vessels in an adult human body. And lining these vessels is a single layer of flat cells called the endothelium; from the Greek “endo” meaning within and “thele” meaning nipple. Within our body, deep inside our breast, this vast network of arteries, veins and capillaries is kept whole and maintained by a healthy protective layer of microscopic endothelial cells. The endothelium is the inner lining of blood vessels and lymph vessels. It functions as an interface between the vessels and the blood.

EDRF- Nitric Oxide

In 1998 Robert F. Furchgott, Louis J. Ignarro and Ferid Murad were awarded the Nobel Prize in medicine for the important discovery that the endothelium is more than just a "Teflon like” lining of the vessels – itʼs actually the largest secreting organ in the body. The endothelium is a highly active organ which is involved in regulating your circulatory stability through numerous functions such as blood pressure, inflammatory processes and coagulation. These doctors sought to find what they called EDRF, or endothelium-derived relaxing factor.

Together, they discovered that the healthy endothelium secretes substances which protect vascular health. Chief among these substances is nitric-oxide – a two atom molecule, which is considered to be the hallmark of normal endothelial function, and the signaling factor they had been searching for.

Nitric Oxide is involved in locally regulating processes such as

• Vascular tone

• Inflammation

• Coagulation

• Oxidation

If these processes are not strictly regulated, they can lead to impairment of vascular health, creating atherosclerosis, cardiovascular and autoimmune disease.

Nitric oxide protects the heart, stimulates the brain, and kills bacteria. Because NO was previously considered merely a common air pollutant formed when nitrogen burns, (for instance in automobile exhaust fumes) scientists were surprised to learn that NO could exert important functions in the body. It was particularly surprising since NO is totally different from any other known signal molecule and so unstable that it is converted to nitrate and nitrite within 10 seconds. NO was known to be produced in bacteria but this simple molecule was not expected to be important in higher animals such as mammals---but it is.

If the endothelial lining of our blood vessels becomes damaged and the NO levels are changed, the vessel walls become permeable, and cells which are supposed to remain in our blood can leak into our body tissue. Some of the cells can be proteins, such as C-Reactive protein, which is produced by the liver and causes inflammation. Signaling can become impaired, and disease results.

Current research on the endothelium

Dr. Berislav Zlokovic of the University of Rochester Center for Neurodegenerative and Vascular Brain Disorders has written many papers on the effect of endothelial dysfunction on the neurovascular system:

“The blood-brain barrier (BBB) is a highly specialized brain endothelial structure of the fully differentiated neurovascular system. In concert with pericytes, astrocytes, and microglia, the BBB separates components of the circulating blood from neurons. Moreover, the BBB maintains the chemical composition of the neuronal "milieu," which is required for proper functioning of neuronal circuits, synaptic transmission, synaptic remodeling, angiogenesis, and neurogenesis in the adult brain. BBB breakdown, due to disruption of the tight junctions, altered transport of molecules between blood and brain and brain and blood, aberrant angiogenesis, vessel regression, brain hypoperfusion, and inflammatory responses, may initiate and/or contribute to a "vicious circle" of the disease process, resulting in progressive synaptic and neuronal dysfunction and loss in disorders such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, and others. These findings support developments of new therapeutic

approaches for chronic neurodegenerative disorders directed at the BBB and other nonneuronal cells of the neurovascular unit.”

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“Endothelial dysfunction is characterized by a shift of the actions of the endothelium toward reduced vasodilation, a proinflammatory state, and prothrombic properties. It is associated with most forms of cardiovascular disease, such as hypertension, coronary artery disease, chronic heart failure, peripheral artery disease, diabetes, and chronic renal failure. Mechanisms that participate in the reduced vasodilatory responses in endothelial dysfunction include reduced nitric oxide generation, oxidative excess, and reduced production of hyperpolarizing factor.”

Endemann DH, Schiffrin EL.

Canadian Institutes of Health Research Multidisciplinary Research Group

on Hypertension and Hypertension Clinical Research Institute of Montréal

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The following Diseases have been linked to Endothelial Dysfunction:

Diabetes

Atherosclerosis

Heart Attack and Stroke

Hypertension

Multiple sclerosis

Lupus

Scleraderma

Rheumatory arthritis

Alzheimerʼs

ALS

Parkinsonʼs

Hypercoagulation of blood, thrombosis, clotting disorders

Renal Failure

Metabolic Syndrome- abdominal obesity, hypertension, insulin resistance

Sleep Apnea

Glaucoma

Now that we understand how the endothelium works, the role of nitric oxide, and why it is so important to the health of the entire body, we need to find out how the endothelium can be damaged. Aside from genetic mutations which contribute to endothelial dysfunction, what outside factors could make our blood vessel walls break down, so that particles which should go through the filtering system now instead enter into our tissue, creating havoc and disease?

Fortunately, we now know through clinical trials and studies which outside influences can damage the endothelium- and we also know how to counteract and avoid them.

One or two of these assaults on the endothelium might not cause damage. Our bodies were created to remove waste and toxins through our liver, kidneys and lymphatic system. Sadly, our lifestyles are exposing our bodies to more than we can handle. The cumulative effect is creating more and more chronic disease. Our modern, industrialized lifestyles expose all of us to several of these outside factors:

I truly believe endothelial dysfunction and NO imbalance is the disease of modern man, and is responsible for the increasing rates of chronic disease in the industrialized nations.

To provide a contrast and by means of example, I present a day in the life of two women, separated by only 200 years in time.

19th Century- Life as it been lived for thousands of years-

You and your husband get up from bed as the sun rises and the rooster crows. You both get dressed and head outside together to milk the cows and feed the livestock. You work the pump at the well, get a drink of water, which comes from a fresh spring underground. The physical exertion of pumping water and carrying it, lifting the feed and milking the cows has worked up a good sweat. You gather some fresh eggs from the henhouse, and head inside to cook breakfast. The meal includes coffee or tea made with spring water, fresh milk from the cow, eggs and toast with apple preserves, jarred last fall.

The children rise, get dressed, eat and are soon out the door to walk to school. Your husband heads off to his work in the barn. There is laundry to be washed and hung on the line and gardening to do. You spend over two hours out doors, in the sunshine.  Again, hard work and more exercise. This is not a life of leisure!

Fresh fruits and vegetables are eaten in season and canned and jarred for off season.  There isnʼt much meat, but an occasional fish from the stream or chicken from the henhouse. Grains are whole, and you add flaxseed to the bread. Root vegetables and greens are plentiful. Mealtime is spent together as a family. After dinner, and after the dishes pots and pans are cleaned, the family sits together and reads or plays board games. Soon the sun sets and itʼs time for bed. Everyone is tired from the dayʼs activities and ready to sleep.

21st Century--Our Modern Life

You rise in the dark to the incessant buzz of the alarm clock. Itʼs a quick shower in chlorinated city water and blow dry before heading to the kitchen to make a pot of coffee. You get your water from the tap and microwave a breakfast sandwich of processed ham and cheese to go. You check your e-mail on the laptop and holler to wake your husband and the kids and hurry them up- thereʼs no time to waste! They get dressed, grab their backpacks and eat their microwaved breakfasts as everyone piles into the van.

Itʼs off to school where you drop them at the door. Then you get back on the freeway to sit in traffic. Love those fumes! Youʼre starting to get a headache. Trapped on the road, you try to make good use the time by calling clients and checking your phone. Your stress levels are now through the roof of the van. You get to the office late and have to deal with everything that has been piled on your desk. No time for the gym, and lunch is going to be a bag of peanut M&Ms and a can of Coke. You never see the light of day, except through your office windows. By the time you get home, itʼs dark and the kids are fighting over the Playstation.

You still need to make dinner. Your husband has texted you, heʼs running late and will miss dinner...again.

You pile the kids back in the van and head to a fast food place. Itʼs drive through and the kids donʼt mind. Youʼre famished and get a double cheeseburger, since you skipped lunch, how could it hurt? You get everyone home and get the kids doing their homework. Itʼs nine pm before you know it, and your husband finally gets home. He walks in and just wants to sit in front of the TV, heʼs exhausted. You get the kids bathed and into bed. Itʼs 11pm before you fall into bed, head pounding. You have trouble sleeping, and it seems like by the time you finally drift off, the damn alarm is ringing again!

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I do not mean to over-romaticize or idealize the lives of men and women from centuries ago. Theirs was a very different experience, and it was physically and emotional demanding. People got sick then, very sick, and many died premature deaths. But not many suffered from chronic diseases. Our modern lifestyle is much easier in many ways-- we have automated appliances to do our labor, vehicles to transport us, and conveniences our great, great grandparents could only have dreamed of. 

Our modern lifestyle has disrupted many natural and hormonal patterns; such as the circadian rhythm. We no longer use the sun to tell us when to rise and set. And doctors are seeing a deficiency of vitamin D (the sunshine vitamin made by our skin when exposed to sunlight) linked to many diseases. Not coincidentally, lack of vitamin D is one of the causes of endothelial dysfunction.

Here are some of the modern issues which are harming our endothelium-

Causes of endothelial dysfunction:

1. Oxidative stress- Our bodies constantly react with oxygen as we breathe and as our cells produce energy. Our utilization of oxygen is a two-edged sword.  We need oxygen to survive, but as a consequence of using oxygen, highly reactive molecules are produced known as free radicals. These are electrons which have lost their partner in our breathing or energy process, or from outside influences, and they are now on their own. Unpaired, these free radical electrons damage the endothelium wall and make it permeable. Free radicals disrupt the balance of nitric oxide. In most instances, our body has enough of a supply of antioxidants from food to neutralize these molecules, but if the body is depleted, or there are too many coexistent factors, there is injury to the endothelium and a change in the balance of NO.

Some external factors which can dramatically increase the number of free radicals in our bodies and influence NO when we ingest, inhale or come in contact with them are:

Plastics, especially PCBs and BPA (1)

Smoking and second hand smoke

Smoking reduces nitric oxide in the blood vessels and causes an increase in ADMA, the modified amino acid which puts strain on the heart. Nicotine also causes vessels to narrow, so that less oxygen is delivered to the heart. Platelets become stickier, and therefore clot formation is increased. Smoking raises the level of carbon monoxide in the blood, which increases the risk of injury to endothelial cells. (2/13)

Metals exposure such as mercury and cadmium (3)

Air pollution, especially diesel exhaust (4)

Chlorine found in public drinking water (5)

2. Eating Bad fats

Itʼs really true....some fats are just not good for our bodies and should be avoided. Heavily saturated animal and dairy fats, trans fats, hydrogenated fats and chemically-altered fats from vegetable shortening and oils damage the endothelium. (6)

3. Stress:

Cortisol, the hormone released into the body when we are under acute stress, impairs endothelial production. (7)

4. Sleep deprivation- Lack of restful sleep, due to obstructive sleep apnea or simply not enough time in bed, creates endothelial dysfunction and constricts blood flow.

5. Acute Bacterial or Viral infections -

Chlamydia pneumonia, Lyme disease, Sepsis, Staph, EBV

All of these infections can become chronic as the endothelium is weakened, bacteria and viruses enter the tissues and the immune system is unable to fight (8)

6. Low Vitamin D levels-

A lack of sunshine and dietary vitamin D injures the endothelium (9)

7. Low Vitamin B12 levels-

Anemia/low vit. B12 creates high levels of homocysteine in the blood (a sulfur containing amino acid) which damages the endothelium A strict vegetarian diet that excludes all meat, fish, dairy and eggs, or an unbalanced diet of processed foods could create low vit. B12 levels and damage the endothelium (10)

8. High intake of glucose-

Ingesting too much glucose in the form of simple sugars increases endothelial cell death and increases oxidative stress (11)

9. Sedentary Lifestyle

Lack of physical exertion, especially cardio-vascular exercise, damages the endothelium (12)

10. Overexposure to Electro Magnetic Fields

Electro-magnetic fields change the endothelium (13)

Because it this is a relatively new area of study, and there are so many things we do not understand about how electromagnetic fields affect our bodies, it is almost impossible to point to one source of electromagnetism as harmful to our health. I believe, after reading the ground-breaking work of Dr. Robert O. Becker, that we must be aware of the amount of EMF fields we expose ourselves to, and find ways to limit their influence on our lives.

If you go back and re-read the daily lifestyle changes of 19th century woman vs. 21st century woman, with the above in mind, you might be able to see how many changes affect endothelial health and are at play in our lives today.

I believe it is the cumulative effect of these influences that is creating unprecedented levels of autoimmune disease today.

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Ways to reverse endothelial dysfunction and return endothelial health-

There are ways to restore the endothelium to its healthy natural state. Doing this will relieve inflammation, normalize blood pressure, stop C- reactive protein from harming the body. There is not one pill to take, or a

simple cure. This process of restoration of the endothelium is multi- faceted, and will take discipline and dedication. But it will work....

1. Physical Activity is shown to stop endothelial dysfunction, especially exercise of the cardiovascular kind- Inactivity increases the breakdown of the blood vessels. A sedentary lifestyle will damage the endothelium.

Daily moderate exercise is recommended.  Cardiovascular exercise is best.

2. Stress reduction:

Reducing cortisol levels through lifestyle changes, including meditation, visualization, prayer and intentional breathing and practices such as tai chi and yoga.

3. A functioning Liver-

I recommend a monthly liver cleanse by utilizing a milk thistle supplement. The active ingredient, or liver-protecting compound in milk thistle is known as silymarin. This substance, which actually consists of a group of compounds called flavonolignands, helps repair liver cells damaged by toxic substances. Silymarin also keeps new liver cells from being destroyed by these same substances, reduces inflammation and has potent antioxidant effects. It has been shown to protect the endothelium.

4. Let the sun shine-

Find time to spend outdoors. It only takes fifteen minutes of sun on the skin and eyes to generate adequate daily vitamin D intake. Skin makes vitamin D when exposed to ultraviolet B (UVB) radiation from the sun. A light-skinned person will synthesize 20,000 IU (international units) of vitamin D in 20 minutes sunbathing on a Caribbean beach. Because of sunscreen and our indoor lives, we are not receiving enough of this potent vitamin. Vitamin D acts as a hormone in our bodies, working with the parathyroid to keep proper levels of calcium in our blood. It can also be taken as a supplement, D3, in 2,000IU daily.

5. Laughter!

A University of Maryland study showed that healthy men and women who were shown a funny movie increased blood flow by 22% and improved vascular and endothelial health. The effects of laughter lasted for 45 minutes after the movie had finished.

6. Nutrition and supplements-

Antioxidants- these are found in foods and can also be taken as supplements to reach optimal levels. Antioxidants bind with free radicals and stop the damage they cause to the endothelium.

Vitamin A and Carotenoids -Carrots, squash, broccoli, sweet potatoes, tomatoes, kale, collards, cantaloupe, peaches and apricots (brightly-colored fruits and vegetables)

Vitamin B -Fish, meat and dairy products

Vitamin B12 is frequently used in combination with other B vitamins in a vitamin B complex formulation. It helps maintain healthy nerve cells and red blood cells and is also needed to make DNA, the genetic material in all cells.

Vitamin C -Citrus fruits like oranges and lime, green peppers, broccoli, green leafy vegetables, strawberries and tomatoes

Vitamin E - Nuts & seeds, whole grains, green leafy vegetables, olive oil

Flavonoids -specific kind of antioxidants from plant pigments, which also reduce inflammation and improve vascular health, such as:

-quercetin found in apple skin, red onion, red grapes

-EGCG found in green tea

-bromelain from pineapple

Healthy fats

Salmon, trout, herring, avocados, olives, walnuts and olive oil. An omega 3 fish oil supplement is essential, especially if you do not have fish in your diet- Recently, the scientific community has been concentrating on the benefits of these fatty acids. The most important fish oil fatty acid is one called docosahexaenoic acid (DHA). We have long known that fish is healthy, but it is now proven that the omega-3s in fish fat improve

endothelial function by enhancing Nitric Oxide production, increasing HDL (good) cholesterol levels and reducing LDL and triglyceride levels.

Further, fish oils have been shown to reduce production of free radicals and substances that cause inflammation in the body. (13)

Healthy Proteins-

Reducing red meat proteins in your diet with vegetable and soy proteins will help the endothelium.. Animal proteins contain mixtures of aminoacids that produce more of the aminoacid methionine, which is the precursor for homocysteine, which can damage the endothelium. Vegetable proteins are healthier because they contain no saturated fat and less methionine.

Vegetable proteins also have more fiber and nutrients, called phytonutrients. Soy proteins produce a mixture of aminoacids that have more L-arginine. L-arginine is essential for the production of NO. Soy proteins also contain other phytochemicals, the biochemical products of plants, which are healthy for the endothelium. Other L-arginine sources include fish, nuts, legumes, beans and chicken (13)

Probiotics-

Probiotics are live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut. They are also called "friendly bacteria" or "good bacteria." Probiotics are available to consumers mainly in the form of dietary supplements and foods like yogurt.

Essential Minerals-

Studies have shown that magnesium, zinc and calcium are all important to preserving endothelial health. There are supplements which contain all three of the minerals in balance. (14)

Antithrombic and AntiInflammatory Herbs-

Curcumin, Salvia, Ginko, and Garlic are all shown to decrease inflammation and regulate blood viscosity, preventing hypercoagulation.

Proteolytic Enzymes-

Both serrapeptase and nattokinase are enzymes which reduce inflammation and pain and help blood viscosity by regulating clotting. Bromelain- pineapple is one of the best anti-inflammatories on the planet.

7. Lessening of Electro-Magnetic Field Pollution-

This is a controversial issue, but I recommend that each individual find ways to lessen the intake of electropollution in their own lives. It could be as simple as moving the plug in alarm clock away from your head, using a hands free device on your cell phone, living without the blow dryer and microwave or as complex as moving to a rural area, away from high power lines. We do know that electromagnetic pollution changes the endothelial surface, but I am certainly not capable of defining a process that has not been adequately researched. Perhaps the future will provide more answers.

So, how have I put this knowledge to work for Jeff, my inspiration and my muse?

I now understand that the red spots on his shins that first appeared were “petechiae” and they were caused by damaged blood vessels leaking out pinpoint drops of blood into his skin.  Dr. Roy Swank noticed these spots in the 1950s.  Dr. Swank was many in a long line to notice the connection of the blood to MS.  He called endothelial dysfunction "blood vessel fragility."

Additional evidence that blood vessel fragility may be an important aspect of MS derives from Swank's study in which he concluded that MS is not confined primarily in or localized to the CNS: He observed small cutaneous hemorrhages in 77.4% of female patients observed repeatedly over a 5-9 year period. In 66.7% of these patients, the hemorrhages were spontaneous. `Biopsies of 5 spontaneous hemorrhages, where trauma could be confidently ruled out, revealed extravasated red blood cells infiltrating the deeper layers of the derma and the subcutaneous fat.' Swank goes on to state that `a number of patients have described petechial hemorrhages in large numbers after having their blood pressure taken both under and distal to the cuff.' He notes that the petechial hemorrhages are similar to subcutaneous hemorrhages seen in capillary resistance studies. 

Jeff's high liver enzymes and jaundice were screaming signs that his liver was completely overwhelmed, and unable to process the toxins in his body. This process created the damage to his endothelium, and I believe this also contributed to the breaking of his blood brain barrier and the creation of the lesions in his central nervous system.

Other researchers had also noted the link of elevated liver enzymes in people with MS:

http://www.neurology.org/content/67/7/1291.abstract

Now that we have returned his body to a functional level of health, the petechiae are gone, his liver enzymes have resolved, and his MS is in remission. As we add antioxidants such as quercetin and EGCG, we are finding his fatigue is relenting a bit, as damaging free radicals are bound up, and his circulation is improving. His blood has shown signs of hypercoagulation or “sticky blood”- also from endothelial damage, but this is slowly reversing with the addition of proteolytic enzymes.

We continue to live in this modern society. Our southern Californian home is one mile from the busiest freeway in the world, Jeff works in a room full of computers, and our city water isnʼt great. Jeff finds he feels even better when we visit our country house; with well water, no diesel fumes, no power lines, and less commotion. Perhaps weʼll be able to live there someday, but until that time, Jeffʼs regimen is mitigating the negative factors on his endothelial health.

I have benefitted from this research, as well. I have stroke and heart disease in my family, and I have been a lifelong sufferer of migraines and low blood pressure, exacerbated by what I now believe was poor endothelial health. I am no longer dizzy when I stand up, my heart doesnʼt race, and my hands and feet are warm (for the first time in my life!) and no migraines in over a year. My vascular health has improved by changing diet, regular exercise, stress reduction and a bunch of supplements.

Jeff continues to take his prescribed daily injection of Copaxone for his MS. As I stated earlier, I am not a doctor, and I trust his neurologistʼs diagnosis. Jeffʼs t-cells are indeed breaking through his blood/brain barrier and attacking the myelin in his central nervous system. What I offer is complimentary medicine...another way for his body to heal and help return him to balance. I do not think our lifestyle created MS or other autoimmune diseases, but I do believe it is making them worse.

JEFFʼs PROGRAM-

His specific regimen for a return to endothelial health-

Diet- Jeff follows Dr. Swankʼs MS Diet, which means no red meat or chemically altered or processed fats. He eats fish at least once a week, and still enjoys chicken, turkey, and eggs.  He does not eat “white foods” or simple carbohydrates like bread or pasta, or chemically processed foods. No more simple sugars or artificial sweeteners. I purchase organic fruits and vegetables and cook with olive oil. We love to eat edamame (soy pods) and snack on blueberries and walnuts. Jeffʼs adapted quite well to his new eating habits.

Exercise- Jeff exercises three to five times every week for 45 minutes to an hour. His routine varies between mountain bike riding on the trails, walking the dog, using an elliptical machine and weight machine. He gets a good cardio workout and continues to build muscle strength with resistance training.  He also gets outside and enjoys some sunshine.

Stress Reduction- Jeffʼs learned how to say no to too many work projects, and is enjoying spending more time with all of his family members. He takes meetings on his computer and has reduced his time on the freeway.

Mitigating toxins- Weʼve recently added air filters to our home, to keep pollen, pollution and dust levels down. Jeff has many allergies, and this seems to help him. We have filters on our drinking water.

Daily Nutritional Supplements:

CO-Q10 200 mg.

B-12 sublingual (lozenge under the tongue) 5 mg.

Alpha Lipoic Acid 300 mg.

Vitamin D 4000 IU

Glutathione (antioxidant) 1000 mg

Omega 3 (DHA/EPA) 1000 mg. 

EGCG (green tea extract) 600mg

Quercetin 400mg

bromelain 400mg

Serrapeptase-enzyme 500mg

Nannokinase-enzyme 2000FU

A daily Probiotic 40 billion good bacteria!

Calcium/Magnesium/ Zinc (essential minerals) 1000/500/50 mg.

Milk Thistle (liver tonic) 350 mg. everyday for one week out of the month

Curcumin 500mg

NOTES:

Where sources are not indicated, please know that I researched to get my facts straight- especially regarding the circulatory and lymphatic systems, and Iʼve compiled this paper from a variety of web textbooks and sources- but as stated earlier, I am NOT a doctor.  Please consult with your own GP or health practitioner before begin a new health regimen.

Here are the studies I cite:

1. International Journal of Hygiene and Environmental Health, volume 205, March 2002 pp. 95-102

2.”Acute smoking induces endothelium dysfunction” -Kalliopi Karatzi, MSc, Christos Papamichael, MD, Emmanouil Karatzis, MD, Theodore G. Papaioannou, PhD, Paraskevi Th. Voidonikola, MD, John Lekakis, MD and Antonis Zampelas, PhD Department of Nutrition and Dietetics, Harokopio University, Athens, GREECE (K.K., A.Z.) Vascular Laboratory, Department of Clinical Therapeutics, Alexandra University Hospital, Athens, GREECE 

3.The role of mercury and cadmium heavy metals in vascular disease, hypertension, coronary heart disease, and myocardial infarction. Houston MC. Vanderbilt University School of Medicine, USA.

4. Persistent Endothelial Dysfunction in Humans after Diesel Exhaust Inhalation Håkan Törnqvist1,*, Nicholas L. Mills2,*, Manuel Gonzalez3, Mark R. Miller2, Simon D. Robinson2, Ian L. Megson4, William MacNee5, Ken Donaldson5, Stefan Söderberg3, David E. Newby2, Thomas Sandström1 and Anders Blomberg1

1 Department of Respiratory Medicine and Allergy, Umeå University, Umeå, Sweden; 2 Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom; 3 Department of Medicine, Umeå University, Umeå, Sweden; 4 Free Radical Research Facility, UHI Millennium Institute, Inverness, United Kingdom; and 5 ELEGI Colt Laboratory, Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom

5.Association between arsenic exposure from drinking water and plasma levels of soluble cell adhesion molecules Environmental Health Perspectives, Oct, 2007 by Yu Chen, Regina M. Santella, Muhammad G. Kibriya, Qiao Wang, Maya Kappil, Wendy J. Verret, Joseph H. Graziano, Ahsan Habibul

6. Cholesterol-independent endothelial dysfunction in virgin and pregnant rats fed a diet high in saturated fat

Authors: Robert T. Gerber;Kathleen Holemans;Ivan O'Brien-Coker;Anthony I. Mallet;Rita Bree;F. André Assche;Lucilla Poston Source: The Journal of Physiology, Volume 517,Number 2, June 1999 , pp. 607-616(10)

Publisher: Blackwell Publishing

7. Metyrapone Improves Endothelial Dysfunction in Patients With Treated Depression Andrew J.M.Broadley, MRCP, AniaKorszun, MRCPsych†, EltiganiAbdelaal, MRCP, ValentinaMoskvina, PhD‡, JohnDeanfield, FRCP§, Christopher J.H.Jones, FRCP†, Michael P.Frenneaux, FRCP, FACC Received 18 August 2004; received in revised form 11 November 2005; accepted 14 December 2005. published online 08 June 2006.

8. Psychoneuroimmunology by Robert Adler. pp 958-960

9. Effect of vitamin D replacement on endothelial function and oxidative stress in vitamin D deficient subjects

by: Ozlem Tarcin, Dilek Yavuz, Ahmet Toprak, Ahu Telli, Meral Yuksel, Dilek Yazici, Seda Sancak, Oguzhan Deyneli, Goncagul Haklar, Sema Akalin1 Endocrine Abstracts, Vol. 14 (2007), 275.

10. http://www.americanheart.org/presenter.jhtml?identifier=535

11.Constant and intermittent high glucose enhances endothelial cell apoptosis through mitochondrial superoxide overproduction Ludovica Piconi 1, Lisa Quagliaro 1, Roberta Assaloni 2, Roberto Da Ros 2, Amabile

Maier 2, Gianni Zuodar 2, Antonio Ceriello 2 * 1Morpurgo-Hofman Research Laboratory on Aging, Udine, Italy

2Department of Pathology and Medicine, Experimental and Clinical, University of Udine, Chair of Internal Medicine, Udine, Italy

12.Physical inactivity increases oxidative stress, endothelial dysfunction, and atherosclerosis

LAUFSUlrich (1) ; WASSMANNSven (1) ; CZECHThomas (1) ; MÜNZELThomas (2) ; EISENHAUERMarco (1) ; BÖHMMichael (1) ; NICKENIGGeorg (1) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s) (1) Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, ALLEMAGNE (2) Med. Klinik und Poliklinik II, Johannes Gutenberg -Universitat, Mainz, ALLEMAGNE

13. Int Med Res 2005;33 (5):545-554

Electromagnetic Fields Inhibit Endothelin-1 Production Stimulated by Thrombin in Endothelial Cells

S Morimoto1, T Takahashi2, K Shimizu3, T Kanda4, K Okaishi5, M Okuro6, H Murai7, Y Nishimura8, K Nomura9, H Tsuchiya10, I Ohashi11, M Matsumoto12 1,5,6,7,8,9,10,11,12Departmen of Geriatric Medicine and 2,4Department of General Medicine, Kanazawa Medical University, Ishikawa, Japan; 3Health Science Research Laboratory, Matsushita Electric Works Ltd, Osaka, Japan

14. How to Promote and Maintain a Healthy Endothelium, article 14- by Dr. Ed G. Lakatta

15. Zinc protects against apoptosis of endothelial cells induced by linoleic acid and tumor necrosis factor 1,2,3

P Meerarani, P Ramadass, Michal Toborek, Hans-Christian Bauer, Hannelore Bauer and

Bernhard Hennig 1 From the Departments of Nutrition and Food Science and Surgery, University of

Kentucky, Lexington, and the Molecular Biology Institute, Austrian Academy of Sciences, Salzburg.

Magnesium intake and plasma concentrations of markers of systemic inflammation and endothelial dysfunction in women1,2,3 Yiqing Song, Tricia Y Li, Rob M van Dam, JoAnn E Manson and Frank B Hu 1 From the Division of Preventive Medicine (YS and JEM) and the Channing Laboratory (TYL, RMvD, and FBH), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and the Departments of Nutrition (TYL, RMvD, and FBH) and Epidemiology (JEM and FBH), Harvard School of Public Health; Boston, MA