The Endothelial Health Program

The neuroprotective lifestyle program I created for Jeff in 2008, and would share with university researchers, grew out of a year of in-depth study; plowing through pubmed, and reading every book on the history and etiology of MS I could find at my public library or on the internet.

I call it The Endothelial Health Program, and it changed our lives. 

I am happy to see there are many more published papers on PubMed years later.  Finally, the discussion of endothelial health is becoming mainstream, and the Nobel Prize winning science of Nitric Oxide (EDRF) is reaching doctors' offices.

Highly regarded MS and Alzheimer's researchers are now actively looking at the endothelium, nitric oxide and hypoperfusion in neurodegeneration, and encouraging other researchers to do the same.  This gives me great hope.

Although multiple sclerosis (MS) has traditionally been viewed and researched as an immune-mediated demyelinating and neurodegenerative disease of the human central nervous system (CNS), its highly complex pathogenesis clearly includes a significant vascular inflammatory component and many therapeutic approaches achieve benefit by direct or indirect effects on cerebrovascular endothelial cells.
link to research

Substantial evidence suggests that the neurodegenerative process is initiated by chronic cerebral hypoperfusion (CCH) caused by ageing and cardiovascular conditions. CCH causes reduced oxygen, glucose and other nutrient supply to the brain, with direct damage not only to the parenchymal cells, but also to the blood-brain barrier (BBB), a key mediator of cerebral homeostasis. BBB dysfunction mediates the indirect neurotoxic effects of CCH by promoting oxidative stress, inflammation, paracellular permeability, and dysregulation of nitric oxide, a key regulator of regional blood flow
link to research

The Endothelial Health Program is not a diet,  or a "don't do this" approach.  It's not about following specific rules.   It's proactive.   It's about living in a way which reverses damage and protects the six trillion endothelial cells inside every human body.
Why?   Because these cells maintain the health of all your organs and your immune system.

The endothelium is actually your largest organ.  It is the lining of 60,000 miles of blood and lymph vessels, and it communicates with all of your other organs.  It is also the interface between your immune system and your vascular system, and is what controls the blood brain barrier and keeps harmful plasmic particles out of delicate brain tissue.  It controls how much blood, oxygen and nutrition your neurons receive. Maintaining endothelial health is neuroprotective.  link to recent pub science from Columbia University

This communicative lining is made up of trillions of endothelial cells, and if these cells become damaged or die, this vital, protective network disintigrates.   This is a problem in ALL diseases of neurodegeneration, such as Alzheimer's, Parkinson's,  and dementia.   PubMed now has hundreds of scientific papers on endothelial dysfunction and each these diseases.   But endothelial cell death and dysfunction can be reversed.

I had been hugely inspired by Dr. John Cooke's book, The Cardiovascular Cure,  Link to book  and reached out to him.  That's how Jeff and I originally connected with Stanford University.   The information was out there,  I was just compiling and connecting the heart to brain health.    This is a complete lifestyle, a new way of looking at rising rates of neurodegenerative disease as a result of our westernized, industrialized lives.  It was an attempt to reverse cell-damaging practices that had become part of our modern routines, and to return to our inherent nature, to allow for balance and healing.

It was an attempt to connect the heart and brain, to understand the vascular connection to MS.  And I did it for Jeff.



The basic tenets of the lifestyle program are:

1.  Movement.  Daily cardiovascular pursuits are essential and healing. Shear stress, created by an active heart pumping flowing blood over endothelial cells, maintains their integrity by increasing nitric oxide release.  Inactivity allows endothelial cells to die.

2.  Stress reduction. The acts of deep breathing, the practice of meditation, yoga, prayer, all reduce endothelial cell damaging cortisol and increase healing, vasodilating nitric oxide.

3.  Liver health. Decreasing liver damaging toxins--like alcohol, plastics exposure, chemicals, pesticides, heavy metals, drugs--and increasing liver protecting flavonolignans (like silymarin) and antioxidants found in fruits and vegetables, maintains endothelial cell health.

4.  Vitamin D/UV ray increase. Skin makes vitamin D when exposed to ultraviolet B (UVB) rays from the sun. Because of sunscreen and our indoor lives, many people are not receiving enough of this potent hormone.  And our circadian rhythm is affected.  Vitamin D creates endothelial cell health by increasing nitric oxide.  UV rays release nitrates from the skin, creating vasodilation. 

5.  Sleep.  Sleep deprivation creates endothelial dysfunction and cell death.

6.  Eating whole, organic foods.  Eating a diet of whole foods (unprocessed foods; foods that retain the natural state) provide ample levels of nutrition, vitamins and antioxidants. Antioxidants bind with free radicals to minimize the damage they cause to the endothelium.  Vitamins B and C are hugely protective of endothelial cells.  A lack of B vitamins increases homocysteine, which kills endothelial cells.

7.  Eating healthy fats   Increasing omega 3 (DHA) fats found in fish, olives, flax seed, avocados, walnuts, etc.  and decreasing transfats and highly saturated animal fats improves endothelial cell health. 

8.  Probiotics and gut health.  The endothelial cells of the gut's lining communicate with the rest of the body and rely on "good" bacteria.  

9.  Essential minerals.  Magnesium, calcium and zinc are all important in the preservation of endothelial cells.

10. Anti-inflammatory food sources, spices and herbs. Curcumin, Salvia, Ginko, and Garlic are all shown to decrease inflammation and regulate blood viscosity, preventing hypercoagulation, allowing for better shear stress.  Proteolytic Enzymes, both serrapeptase and nattokinase, are enzymes which reduce inflammation and pain and help blood viscosity by regulating clotting. Bromelain, found in pineapple, is one of the best anti-inflammatory substances known.

11.  Reducing glucose and gluten.  Sugary baked goods, simple breads, pastas and snack foods are damaging to endothelial cells. 

12.  Smoking cessation.  Please quit...smoking kills endothelial cells.

13.  Laughter, joy, community, purpose, loving relationships.  All of these things increase nitric oxide and improve endothelial health.

That's it.  Simple, right?  Yes and No.  It took our family a couple of years to utilize all of the strategies.  Jeff was NOT thrilled that I changed our meal plans.  He was resistant at first, but after the first several months of MS disease stability, he embraced his new life.  

And then he went even further.  Jeff has added his own twist on endothelial health by incorporating neuroplasticity.  He has become an expert in the dictum of "use it or lose it."  He got back on his bike, back on skis, back to composing, conducting, performing and public speaking.  The things that had become challenging, like balancing or staying up all day, became an activity to face head on and in doing so, rewire his brain.   Receiving his venoplasty treatment at Stanford allowed for increased perfusion of his brain and healing.  But he kept that shear stress going by remaining active and engaged.   His grey matter looks normal on MRI, and he's had remyelination of MS lesions.  He is my hero.

This model for health is called "a systems approach." as opposed to a mono-therapeutic approach utilized by pharmaceutical companies.  It is much more expensive and difficult to clinical trial a lifestyle when compared to a singular drug or supplement,  but it can be done.  UCLA recently published on a systems approach in disease reversal in Alzheimer's.   https://www.aging-us.com/article/100690/text    My dream would be to fund a gold standard clinical trial of this program.  Maybe someday.

What's ahead?  God willing, more of this.   We have no idea of what tomorrow may bring, but we consider the gift of this lifestyle program to be our message of hope. 

So please, share the program.  Try it out, let me know how you're doing.  Always work with your own physician, to modify the program to suit your individualized needs.  I don't have a book to hand you, but I think that's OK.  I was given this direction as an answer to prayer, and will continue to share it for free.

Be encouraged, 

Joan

bounty from our organic garden---full of colorful phytonutrients (nutrients from plants!)

hiking provides UV ray exposure, calming nature, and exercise

Neuroprotection--it's here. Today.

These are things you can do today, which have published, peer-reviewed scientific research behind them, shown to protect neurons and help maintain your brain mass.

Pharmaceutical companies know that current MS drug treatments do not stop progression, nor do they stop disability.  Because the MS brain continues to lose neurons.  "Neuroprotection" has become the new target.

"Multiple sclerosis as the most common inflammatory demyelinating disease in Western countries, major therapeutic success has been achieved with regard to strategies targeting immunological master switches. These approaches effectively reduce inflammatory disease activity but fail to address ongoing neurodegeneration or disturbed regeneration. However, intense research efforts investigating molecular mechanisms of disease have identified 'druggable' targets for prevention of inflammatory neurodegeneration and disturbed regeneration. " link

While pharmaceutical companies search for "druggable targets" in order to sell the next wave of "neuroprotective" MS drugs, you can take matters into your own hands.

These are all scientifically proven means of maintaining gray matter, or neuronal mass, in the human MS brain, and they are available today.  I've made sure to weed through animal models, to find actual evidence of gray matter maintenance in people with MS.

1. Exercise---move as much as you are able.  The science is in, there is no doubt that it maintains gray matter.  Get help if necessary, physical therapy or modified programs for people with limited mobility.  But do all you can.

Brain-derived neurotropic factor (BDNF) is a very important cerebrovascular protein which protects neurons and allows for neurogenesis, or the growth of new neurons.   BDNF is created by shear stress, or the action of blood whooshing over the cells which line our blood vessels, called the endothelium.  link  BDNF is released into the blood stream when the cardiovascular system is most active by vascular endothelial cells.  BDNF is vital to learning, memory and executive function.

BDNF is low in people with MS, but showed a huge improvement after 24 weeks of an exercise program.
link

Daily personalized physical therapy and exercise programs designed for people with MS increases BDNF, supports cell survival and brain mass, increases neuroprotective antioxidants, decreases inflammation and improves well-being.
link

Aeorobic exercise plus strength training designed for people with MS reduces inflammatory cytokines and is shown to be neuroprotective
link

Aerobic exercise helps people with MS maintain the volume of their hippocampus, and improves memory.
link

Exercise is neuroprotective for children with MS
link

2.  Nutrition---  a whole food diet, full of long-chain omega 3 fatty acids from fish, olives and nuts and nutrients and antioxidants from leafy greens, colorful fruits and vegetables (phytonutrients) helps maintain brain volume.  Removing processed food products with nitrates, salt and sugar and replacing them with nature-made food protects neurons.  Maintaining a healthy weight is important.

link

link

link


3.  Vitamin D--low levels of Vitamin D are correlated to loss of brain matter in MS, higher levels  are shown to be neuroprotective.  Clinical trials are ongoing.
link

link


                                            +++++++++++++++++++++

That's it for studies in actual people with MS---  The following studies were done in healthy people, elderly and people with other neurological diseases, as well as animals---so we do not know if the benefits will confer for people with MS, but it's worth considering these studies---because gray matter was preserved.

1. Curcumin/Turmeric---- this orange spice used in Indian cuisine has been shown to be neuroprotective.

Curcumin is anti-inflammatory, anti-oxidant and anti-protein aggregate.
http://www.ncbi.nlm.nih.gov/pubmed/17569212

Curcumin modulates mitochondrial dysfunction, reduces oxidative stress, and reduces inflammatory cytokines.  http://www.ncbi.nlm.nih.gov/pubmed/22742420


2. Magnesium --this vital mineral is low in most humans.  It has been shown to be neuroprotective, due to its affect on the endothelium.

Magnesium sulfate is neuroprotective for pre-term infants.
https://www.ncbi.nlm.nih.gov/pubmed/26735551

Magnesium status is low in those with Alzheimer's
https://www.ncbi.nlm.nih.gov/pubmed/26351088

Magnesium is neuroprotective in cerebral/ischemic injury in rats
https://www.ncbi.nlm.nih.gov/pubmed/25560670

3. Anti-oxidants found in all kinds of fruits, vegetables and herbs are neuroprotective.
http://www.ncbi.nlm.nih.gov/pubmed/17017945
There are hundreds of studies on pub med on anti-oxidants found in food which are neuroprotective.
I love what Dr. Wahls says about picking fruits and veggies to eat.  The darker the color, the more powerful the antioxidants.  This is why blueberries, leafy greens, and beets pack so much anti-oxidant power.

In the interest of time--I'll list some of the anti-oxidants found in nature, and you can do the googling, and see what suits you.    Here are some more antioxidants:

bromelain (found in pineapple), ECGC (in green tea), quercetin (found in red apples and red onions)  garlic, ginsing, ginko biloba, cannabinoids, caffeine, resveratrol, silymarin (milk thistle)

4. Yoga--those who practice yoga, which combines posture, breathing and meditation, have healthier gray matter and more brain volume.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428135/

5. Lifelong learning.  Learning a new, mentally challenging skill provides neuroprotection and returns brain to youth-like status, encouraging neuronal health.
http://content.iospress.com/articles/restorative-neurology-and-neuroscience/rnn150533

6.  Probiotics.  The gut-brain link is being studied.  Probiotics have been shown in animal studies to protect neuronal integrity.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0106503

7. B Vitamins --studies are ongoing looking at how folic acid and vitamin B12 are neuroprotective in humans.  Plasmic levels of homocysteine, which become high when there is not enough Vitamin B, increases neurodegeneration.  Higher levels of B vitamins in the blood are linked to neuroprotection.
http://www.ncbi.nlm.nih.gov/pubmed/22419558
https://diagnosticpathology.biomedcentral.com/articles/10.1186/1746-1596-8-123

This is why the current studies of high dosages of biotin (vitamin B7) has been shown to be protective in progressive MS.  Studies are ongoing.
http://www.ncbi.nlm.nih.gov/pubmed/25787192



As I've said many time before, and will no doubt be saying again, it's difficult to trial a lifestyle---which is why published research focuses on one particular compound at a time.  Be that a drug, or a supplement, or a particular exercise program,  it's easier to test one specific thing against placebo and thereby have a "gold-standard" clinical trial.

It's much more difficult and costly to test a systems approach to MS treatment.  Dr. Roy Swank, Dr. George Jelinek and Dr. Terry Wahls have come up against this bias in MS research--which is rigged in favor of pharmaceuticals.

Don't let this mentality stop you from doing all you can to heal your own brain, and provide neuroprotection for yourself!  While we wait for science to figure out the disease aetiology of MS, there are things that are scientifically proven to provide neuroprotection.  Today.

Be well!
Joan

MS Society research funding '16

The vascular connection to MS is reluctantly being acknowledged by mainstream neurological researchers. All you have to do is look at the latest batch of funding by the National MS Society. Many of the studies involve research we've discussed on this blog, and involve looking at this disease in a new way.

Here's the MS Society press release and announcement on their $25 million dollar research funding commitments. There is a link on this release to all of the funded studies:

http://www.prnewswire.com/news-releases/national-ms-society-invests-over-25-million-in-new-research-and-clinical-training-to-stop-multiple-sclerosis-restore-function-and-end-ms-forever-300245933.html

Some of the funded studies (with my prior blog posts linked below them)

Monitoring loss of gray matter in the thalamus
http://ccsviinms.blogspot.com/2016/01/thalamic-atrophy-and-ms-progression.html
Fibrinogen in the blood,
http://ccsviinms.blogspot.com/2015/10/a-single-drop-of-blood.html
The protective role of Vitamin D,
http://ccsviinms.blogspot.com/2015/12/vitamin-d-news-it-boosts-remyelination.html

Microvessels and circulation of the eye,
http://ccsviinms.blogspot.com/2012/03/vascular-health-and-brain-eyes-have-it.html
and "wellness strategies"
(pretty much most of this blog)

Looks familiar, right?  Certainly not ground-breaking or "cutting edge" research to those of us following the vascular connection for the past decade.

Sadly, there is no funded research on the newly discovered lymphatic system of the brain or the venous drainage of the CNS.  Nothing on the heart-brain axis or cardiovascular exercise. Nothing on nutrition. That's what I would call "cutting edge!"
But there is a shift which is happening, and it's very important to point this out.


There's a mention of funding research into "sparing important, protective parts of the immune system" in MS treatment---which seems to be an about-face from the second generation immune ablating and lymphocyte sequestering drugs recently foisted on people with MS---and actually admitting that the brain has an immune system and needs immune cells.


The latest "Second Generation MS drugs" destroy or inhibit the immune response in the CNS, leaving the brain unprotected. Immune cell "sparing" research comes a bit late for the thousands of people with PML, cancer or new autoimmune conditions from these drugs. MS drug treatment remains a $20 billion dollar a year industry, and the second generation drugs are far too profitable to shelve. They just all have black box warnings now. Thanks, FDA!

Here's what the NMSS says about these disastrous FDA approved drugs in their press release.


There are FDA-approved therapies that can impact the underlying disease course in people with the more common forms of MS. However, none of these can stop progression or reverse the damage to restore function.

That's right. They've done studies now on whether or not the drugs stop progression or restore function. And there is no empirical evidence that any of the new treatments do either. MS patients need to understand these facts. They are still peddling these FDA approved drugs with diasterous and deadly side-effects, because that's what they've got.

MS Societies---You really want to finish MS?

Look to the neurovascular connection: the endothelium, the lymphatic drainage system, the newly discovered CNS immune system, and the heart brain axis. Lots of researchers outside of neuroimmunology are doing just that.

These researchers could really use some funding.

You might want to check out their conference at the Academy of Sciences, near your headquarters in New York City, at the end of this month.

http://isnvd.org/newyork



Joan