Environmental Medicine

Environmental MedicineEnvironmental Medicine

Dr shabeel pnDr shabeel pn

Environmental MedicineEnvironmental Medicine

One’s sensitization to their environmentOne’s sensitization to their environment Exposure does not lead to consistent Exposure does not lead to consistent

symptomssymptoms– Randomization of symptoms can confuse the Randomization of symptoms can confuse the

practitionerpractitioner

Drug prescription can add to the problemDrug prescription can add to the problem

The Cause of DiseaseThe Cause of Disease

GeneticGenetic PsychogenesisPsychogenesis EnvironmentalEnvironmental Nutrient DeficiencyNutrient Deficiency

Food Induced DiseaseFood Induced Disease

ArthritisArthritis– Stay away from vegetables in Nightshade Stay away from vegetables in Nightshade

categorycategory Prescribe NSAIDs lead to LGSPrescribe NSAIDs lead to LGS

– Celiac DiseaseCeliac Disease Wheat intoleranceWheat intolerance

– MSGMSG Retinal degenerationRetinal degeneration

– Milk induced hypochlorhydriaMilk induced hypochlorhydria Leads to nutrient deficiencyLeads to nutrient deficiency

Food ToxinsFood ToxinsFishFish ParasitesParasites

MercuryMercury

Malachite greenMalachite green

Systemic ToxicitySystemic Toxicity

CNS, Kidney and GI for CNS, Kidney and GI for inorganic mercuryinorganic mercury

MutagenMutagen

Junk FatsJunk Fats AcrylamideAcrylamide

Trans fatsTrans fats

CancerCancer

CVDCVD

Meat/DairyMeat/Dairy rBGHrBGH

AntibioticAntibiotic

CancerCancer

Antibiotic ResistanceAntibiotic Resistance

Fruits/VegetableFruits/Vegetable PesticidesPesticides Liver damage, cancerLiver damage, cancer

Neuromuscular Neuromuscular DisordersDisorders

Artificial SweetenersArtificial Sweeteners AspartameAspartame

SucraloseSucralose

SaccharinSaccharin

ExcitotoxinExcitotoxin

Tichlorinated sugarTichlorinated sugar

Maybe safeMaybe safe

PlasticsPlastics DioxinsDioxins

PlasticizerPlasticizer

CancerCancer

Illness Induced by ChemicalsIllness Induced by Chemicals

Plasticizers TMA (trimellitic anhydride)…Plasticizers TMA (trimellitic anhydride)…complex antigenscomplex antigens

Dry Cleaning Fluids…CVSDry Cleaning Fluids…CVS Solvents..panic disordersSolvents..panic disorders Hydrocarbons...glomerulonephritisHydrocarbons...glomerulonephritis Formaldehyde..fatigue-cancerFormaldehyde..fatigue-cancer Pesticides..brain fog (loss concentration, Pesticides..brain fog (loss concentration,

poor memory, irritability, depression)poor memory, irritability, depression)

Chemicals EverywhereChemicals Everywhere

Chemical exposure is ubiquitous and ever Chemical exposure is ubiquitous and ever increasingincreasing

Sources other than work and environmentSources other than work and environment– Bedroom – Fabric softeners, flame retardants, dry Bedroom – Fabric softeners, flame retardants, dry

cleaning chemicalscleaning chemicals– Bathroom – chlorine, cosmetics, shampoos, toothpaste, Bathroom – chlorine, cosmetics, shampoos, toothpaste,

hair products, colognes, and the likehair products, colognes, and the like– Kitchen – pesticides, hormones, antibiotics, cookware, Kitchen – pesticides, hormones, antibiotics, cookware,

plastics, petroleum residues, trans fats, flavorings, plastics, petroleum residues, trans fats, flavorings, sweetenerssweeteners

Heavy metalsHeavy metals

MetalMetal SourceSource EffectsEffects

MercuryMercury Amalgams, fish and Amalgams, fish and vaccinesvaccines

Neurotoxin – more toxic in Neurotoxin – more toxic in childrenchildren

LeadLead Water, industry and Water, industry and chocolatechocolate

Cognitive, hypertension, Cognitive, hypertension, kidney diseasekidney disease

AluminumAluminum Antiperspirants, Antiperspirants, cookware, antacids, cookware, antacids, baking powderbaking powder

Neurotoxin, Osteoporosis, Neurotoxin, Osteoporosis, Anemia, Liver and Kidney Anemia, Liver and Kidney damagedamage

ArsenicArsenic Pesticides, lumber and Pesticides, lumber and well waterwell water

Cancer, Vomiting, Cancer, Vomiting, Anemia, Arrhythmias, Anemia, Arrhythmias, Pins and Needle Pins and Needle sensitivitysensitivity

CadmiumCadmium Food, water, Cigarette Food, water, Cigarette smoke, Batteriessmoke, Batteries

Cancer, Kidney, Liver, Cancer, Kidney, Liver, Lung and Bone damageLung and Bone damage

Every Day ExposuresEvery Day Exposures

Flame Flame RetardantsRetardants

PDBE (penta- and octa- PDBE (penta- and octa- polybrominated diphenyl polybrominated diphenyl ether)ether)

Brain and Thyroid Brain and Thyroid impaired developmentimpaired development

Fabric SoftenerFabric Softener Alphaterpineol, Alphaterpineol, chloroform, benzyl chloroform, benzyl alcohol, pentanealcohol, pentane

CNS, Mucous CNS, Mucous membranesmembranes

WaterWater ChlorineChlorine

FluorideFluoride

TrihalomethanesTrihalomethanes

Impact to endothelial cell Impact to endothelial cell layer within arteries, layer within arteries, possible carcinogenpossible carcinogen

ShampooShampoo Ammonium lauryl sulfateAmmonium lauryl sulfate

Ammonium xylene Ammonium xylene sulfonate, formaldehydesulfonate, formaldehyde

CNS, Respiration, CNS, Respiration, Lachrymators, DeathLachrymators, Death

CosmeticsCosmetics Phthalates, cadmium, Phthalates, cadmium, ArsenicArsenic

Birth deficiencies, Male Birth deficiencies, Male repro, Cancerrepro, Cancer


Air FreshenersAir Fresheners FormaldehydeFormaldehyde

PhenolPhenol

Cancer; Circulatory Cancer; Circulatory collapse, comma, deathcollapse, comma, death

Carpet ShampooCarpet Shampoo PerchloroethylenePerchloroethylene

Ammonium HydroxideAmmonium Hydroxide

CancerCancer

Irritant/lachrymatorIrritant/lachrymator

Dishwasher DetergentsDishwasher Detergents Chlorine – dry,Chlorine – dry,

concentrateconcentrate

Currently the #1 cause of Currently the #1 cause of child poisoningchild poisoning

Furniture PolishFurniture Polish Petroleum Distillates, Petroleum Distillates, PhenolPhenol

NitrobenzeneNitrobenzene

Pneumonitis if aspirated Pneumonitis if aspirated to lungsto lungs

GI InjuryGI Injury

Toilet CleanersToilet Cleaners Hydrochloric AcidHydrochloric Acid

HypochloriteHypochlorite

Tissue InjuryTissue Injury

Irritant gas give rise to Irritant gas give rise to cough, sputum, cough, sputum, breathlessness - infectionbreathlessness - infection

AntibacterialAntibacterial TriclosanTriclosan Liver damageLiver damage


PesticidesPesticides DiazinonDiazinon

Chlorinated HCChlorinated HC

OrganophosphatesOrganophosphates

NeurotoxinNeurotoxin

carcinogeniccarcinogenic

Flea PowderFlea Powder Carbaryl, ChlordaneCarbaryl, Chlordane

dicholorphenedicholorphene

Spermatotoxicity,Spermatotoxicity,

Liver, kidney, lung, eye Liver, kidney, lung, eye injuryinjury

Lice ShampooLice Shampoo LindaneLindane Vomiting, diarrhea, Vomiting, diarrhea, convulsionsconvulsions

Car Wash/PolishCar Wash/Polish Petroleum DistillatesPetroleum Distillates LachrymatorLachrymator

Pulmonary edemaPulmonary edema

Skin and lung cancerSkin and lung cancer

Drain CleanerDrain Cleaner TCA, HCl, LyeTCA, HCl, Lye Irritants, caustic Irritants, caustic StrictureStricture

Mold/Mildew CleanerMold/Mildew Cleaner HypochloriteHypochlorite

FormaldehydeFormaldehyde

Irritant, deathIrritant, death

Nasal sarcomasNasal sarcomas

Chemical Illness Chemical Illness

Free RadicalsFree Radicals– Phase I detoxificationPhase I detoxification– Highly reactive and destructiveHighly reactive and destructive– Will rip the electron from anything in its path…cell Will rip the electron from anything in its path…cell

enzymes and cell membraneenzymes and cell membrane– Membranes attackedMembranes attacked

Dictates what goes on in the cellDictates what goes on in the cell Regulate calcium channelsRegulate calcium channels Regulate sodium pumpRegulate sodium pump Provide access to genetic materialProvide access to genetic material Where endoplasmic reticulum existsWhere endoplasmic reticulum exists

Chemical SensitivityChemical Sensitivity

Information Information – does not alert the practitionerdoes not alert the practitioner– live with chronic conditionslive with chronic conditions

Frustrated Frustrated – symptoms are compounded by other symptomssymptoms are compounded by other symptoms

Sick Building SyndromeSick Building Syndrome– Chronic Fatigue SyndromeChronic Fatigue Syndrome

Work efficiency plummetsWork efficiency plummets

SuspicionSuspicion

WHY IS EVERYONE NOT AFFECTED WHY IS EVERYONE NOT AFFECTED EQUALLY?EQUALLY?

Depends On:Depends On:– GeneticsGenetics– Sensitization:Sensitization:

How much of what?How much of what?

Unexpected DeathUnexpected Death

The body is equipped with detox The body is equipped with detox mechanismsmechanisms

The detox mechanisms do failThe detox mechanisms do fail– Upon failure disease occursUpon failure disease occurs– Drugs can contribute to failureDrugs can contribute to failure

Proteins and enzymes break downProteins and enzymes break down Leads to tissue deathLeads to tissue death Leads to over all deathLeads to over all death

7 Principles of Environ Medicine7 Principles of Environ Medicine

1. Biochemical individuality1. Biochemical individuality 2. Total load2. Total load 3. Spreading phenomenon3. Spreading phenomenon 4. Adaptation4. Adaptation 5. De-adaptation5. De-adaptation 6. Bi-polarity6. Bi-polarity 7. Switch phenomenon7. Switch phenomenon

Total LoadTotal Load

Conjugates (sulfur containing compounds Conjugates (sulfur containing compounds that facilitate removal of xenobiotics)that facilitate removal of xenobiotics)– Genetic predispositionGenetic predisposition

e.g. brown eyed individuals are mineral deficiente.g. brown eyed individuals are mineral deficient– In turn enzymes are not functional in purported activityIn turn enzymes are not functional in purported activity

33rdrd Principle Principle

Spreading phenomenonSpreading phenomenon– Patients are reactive to xenobiotics that never before Patients are reactive to xenobiotics that never before

bothered them.bothered them.– Doctors unfamiliar with chemistry of detoxification begin:Doctors unfamiliar with chemistry of detoxification begin:

To doubt patient motivesTo doubt patient motives Sanity of the individualSanity of the individual

– The allopathic paradigmThe allopathic paradigm Suppress symptoms with drugsSuppress symptoms with drugs Chronic use of drugs no longer effectiveChronic use of drugs no longer effective

– Recommend surgeryRecommend surgery

44thth Principle Principle

ADAPTATIONADAPTATION– Chronic DiseaseChronic Disease– The sick get sickerThe sick get sicker– Body mechanismBody mechanism

More load…more need of enzymesMore load…more need of enzymes Enzyme inductionEnzyme induction

– Non-sedative antihistaminesNon-sedative antihistamines Enzyme induction leads to neoplasmEnzyme induction leads to neoplasm


De-AdaptationDe-Adaptation– Phenol exposurePhenol exposure

Preservative in medicinesPreservative in medicines Found in home office furnishing and cleanersFound in home office furnishing and cleaners Picked up readily by the bodyPicked up readily by the body Overwhelms enzyme network for removalOverwhelms enzyme network for removal Shifted to other pathways where not completely Shifted to other pathways where not completely

metabolizedmetabolized


BipolarityBipolarity– Same agent can cause opposite effectsSame agent can cause opposite effects– e.g. alcohole.g. alcohol

Initially it is stimulatoryInitially it is stimulatory Once the aldehyde is produced it causes the body to Once the aldehyde is produced it causes the body to

become depressedbecome depressed

– Outcome depends on:Outcome depends on: DoseDose Time frameTime frame Adaptive enzymesAdaptive enzymes


Switch PhenomenonSwitch Phenomenon– Target organ switches from one to anotherTarget organ switches from one to another– e.g. asthmatic person with cardiac e.g. asthmatic person with cardiac

abnormalities, or IBSabnormalities, or IBS One disease is active while the other is quiescent One disease is active while the other is quiescent

and visa versaand visa versa

– Secondary importance are the symptomsSecondary importance are the symptoms– Primary importance is to find causePrimary importance is to find cause

Drug ComplicationsDrug Complications

Environmental MedicineEnvironmental Medicine– Drugs contribute to symptomsDrugs contribute to symptoms

Cumulative biochemical effectCumulative biochemical effect Cause nutrient deficienciesCause nutrient deficiencies

– Diuretics cause hypokalemia and magnesium deficiencyDiuretics cause hypokalemia and magnesium deficiency Both deficiencies lead to hypertensionBoth deficiencies lead to hypertension Mg deficiency leads to lipidemia and reduction of delta-6-Mg deficiency leads to lipidemia and reduction of delta-6-

desaturasedesaturase– D-6D is crucial in fatty acid metabolism; damage D-6D is crucial in fatty acid metabolism; damage

endoplasmic reticulum where detoxification takes place endoplasmic reticulum where detoxification takes place

– Spreading PhenomenonSpreading Phenomenon

ComplicationsComplications

What about hobbies, chemical applications What about hobbies, chemical applications in the home, exposures during traffic, etc.?in the home, exposures during traffic, etc.?– Needless to say a plethora of minutia needs to Needless to say a plethora of minutia needs to

be sifted through if one is to uncover the causebe sifted through if one is to uncover the cause– Uncover the causeUncover the cause

Reverse the symptomsReverse the symptoms

Physical SignsPhysical Signs

Common findings not reported:Common findings not reported:– White fury tongueWhite fury tongue– Dark spots under the eyesDark spots under the eyes– White, splitting nailsWhite, splitting nails– SwellingSwelling– Skin temperatureSkin temperature– Tooth loss, amalgams, mixed oral metalsTooth loss, amalgams, mixed oral metals– Body odorBody odor– Abnormal eye movementsAbnormal eye movements– Poor focusing, memoryPoor focusing, memory– Inability to stand on one leg or tip toes with eyes closed Inability to stand on one leg or tip toes with eyes closed

(common malfunction due to pesticide exposure).(common malfunction due to pesticide exposure).

ReversalReversal

Bowel studies are necessaryBowel studies are necessary– Rule out unsuspected inflammationRule out unsuspected inflammation– Malabsorption with insufficient break down of Malabsorption with insufficient break down of

proteinprotein– Abnormal floraAbnormal flora– Insufficient beneficial floraInsufficient beneficial flora

Bowel flora play role in metabolizing vitamins, drugs, Bowel flora play role in metabolizing vitamins, drugs, hormones, carcinogens, and xenobiotics.hormones, carcinogens, and xenobiotics.

Patient EducationPatient Education

Through knowledge we are now able to Through knowledge we are now able to recommend:recommend:– Remove smelly plastic mattress coversRemove smelly plastic mattress covers– Foam pillowsFoam pillows– Water bedsWater beds– Air cleaners with particle board cabinetsAir cleaners with particle board cabinets– Furnishings that out-gas phenol and Furnishings that out-gas phenol and

formaldehydeformaldehyde

Physician AwarenessPhysician Awareness

Minimize the use of drugs to treat symptomsMinimize the use of drugs to treat symptoms– e.g. use of NSAIDs for osteoarthritise.g. use of NSAIDs for osteoarthritis

Can actually lead to rheumatoid conditionsCan actually lead to rheumatoid conditions

– Arthritics are to abstain from red meat and Arthritics are to abstain from red meat and vegetables in nightshade categoryvegetables in nightshade category Potatoes, tomatoes, peppers, eggplant, chili, paprikaPotatoes, tomatoes, peppers, eggplant, chili, paprika

– Also, abstain from tobaccoAlso, abstain from tobacco

Physician AwarenessPhysician Awareness

Common causes of fatigue and Common causes of fatigue and depression…eating foods under the ferment depression…eating foods under the ferment category:category:– Bread, cheese, vinegar, catsup, mustard, Bread, cheese, vinegar, catsup, mustard,

mayonnaise, salad dressing, alcohol, chocolate, mayonnaise, salad dressing, alcohol, chocolate, anything aged, pickled, or fermentedanything aged, pickled, or fermented

New Medical paradigmNew Medical paradigm

Include environmental toxins Include environmental toxins Correct the cause rather than the symptomCorrect the cause rather than the symptom Remove food intolerancesRemove food intolerances Laboratory analysis of the bowel and intracellular Laboratory analysis of the bowel and intracellular

Zn, Se, Mo, Cr, Mn, K, Cu, and folateZn, Se, Mo, Cr, Mn, K, Cu, and folate Recalcitrant conditions may be from amino acid Recalcitrant conditions may be from amino acid

deficiencydeficiency

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Environmental Medicine