R. SHOEMAKERIN LUENTO

[Bb]

Lähettäjä: Soijuv Lähetetty: 18.10.2004 12:51

R. Shoemaker puhui neurotoksiinien merkityksestä
ja hoidosta esim. borrelioosissa:


Dr. Ritchie Shoemaker's talk in Wisconsin

.....Ritchie Shoemaker MD, in my opinion, is in a class by himself, doing some
very innovative work. He talked about the history of his involvement
with a range of multiple-symptom conditions that turned out to involve
neurotoxins. It started with an outbreak of pfiesteria near Pocomoke,
Maryland, where he practices. A woman came in with a serious case of
secretory diarrhea. He have her cholestyramine, because it was the most
constipating drug he knew of. It not only stopped the diarrhea, but took
away her headache, cough, and loss of memory. This caused Shoemaker to
suspect that a toxin was involved, that cholestyramine was able to bind.
He tried cholestyramine on some other patients, and it worked on them,
too.
He also tried it on people in Florida who lived near nurseries that used
a lot of fungicides. It also worked on people living near some polluted
lakes close-by, who were sick.

He didn't have a lab test that would show whether people had
neurotoxins. Then he met Ken Hudnell from the EPA, who had been using a
visual contrast sensitivity test, and he found that people with
pfiesteria had a positive result on this test. It also worked on people
who had mold sensitivities from buildings. Shoemaker mentioned that he
himself is sensitive to molds, and he can tell within 5 minutes whether
they are present in a building. In fact, he said there were molds in the
building in which we were meeting!
He recommended that if there were others like him present, they should
get some cholestyramine.

Next, he talked about Lyme patients. He said that they had had
antibiotics, but they were still sick. He gave them the visual contrast
sensitivity test, and they came up positive, indicating that they had
neurotoxins. When he gave cholestyramine to people who had Lyme disease,
he found that 53% of them became much sicker.
He hypothesized that this must have resulted from a mobilization of
toxins that caused cytokine production by fat cells, activated by
toxins. The toxins have an ionophore structure, which enables them to
bind to fat cells. So he started measuring cytokines, and found that
some were elevated. He then started giving them the diabetes drugs Actos
or Avandia first, which block cytokine production, and then they didn't
have the bad response to cholestyramine.

He found that using this same treatment topically works with brown
recluse spider bites, which then heal in 10 to 21 days.

The next thing he talked about was vascular endothelial growth factor
(VEGF). He found that people with chronic fatigue who did not get better
from these earlier mentioned treatments were low in VEGF. He found that
a big fraction of these people had Ehlers-Danlos type 3 syndrome, with a
wingspan greater than their height. He found that quite a few had
genetic characteristics similar to people with celiac disease. He found
that many had antibodies to cardiolipin, gliadin and endomysial protein.
He found that these genetic differences explained why some people got
sick and some didn't, in the same environment. He began characterizing
the HLA (I thought this stood for human leukocyte antigen, but he said
it stands for histocompatibility locus A) genetics of the patients,
because this controls immune response. He found different HLA types for
the Pfiesteria patients, the mold patients and the post-Lyme patients.

After following patients for 5 years, he found that there were still
some who were not well, after fixing all the above problems.
Something was missing, and he found that there was a problem with
complement, which is part of the innate immune response. He said he has
a model of chronic fatigue in which the acquired immune response goes to
zero, and the more primordial innate immune response is compromised. He
noted that the oldest organisms, such as the blue- green algae, the
fungi and the spirochetes, all make toxins.

He passed out a handout called "The Biotoxin Pathway." The handout
showed biological toxins producing a cytokine response from fat cells by
means of an activation of toll receptors. The biotoxins also have direct
effects on nerve cells, which give the poor performance on contrast
sensitivity tests. The cytokines also have effects on capillaries,
leading to restricted blood flow and lower oxygen levels.

Reduced VEGF leads to fatigue, muscle cramps and shortness of breath,
but can be overridden by replacement with erythropoeitin.
People with certain HLA genotypes may develop inappropriate immune
response, including autoimmune response to myelin basic protein, or to
gliadin, or to cardiolipin.

The cytokines themselves produce a variety of symptoms, including
headache, muscle aches, fatigue, unstable temperature, difficulty
concentrating. They also raise TNF, MMP-9, IL-1B, and PAI-1. MMP-9
delivers inflammatory elements from blood to brain, nerve, muscle,
lungs, and joints. It combines with PAI-1 in increasing clot formation
and arterial blockage.

The cytokines from the fat cells can damage leptin receptors in the
hypothalamus. Fat cells then produce more leptin, leading to obesity
(which doesn't respond to exercise and diet).

Damaged leptin receptors in the hypothalamus lead to reduced MSH leads
to sleep disturbance via reduction of melatonin production, to chronic
pain via suppression of endorphins, to gastrointestinal problems, to
prolonged illness, to resistant staph bacteria, to changes in ACTH and
cortisol levels, to reduced sex hormones, and to reduced antidiuretic
hormone.

He said that some PWCs are very dehydrated because they urinate water
out so rapidly. The osmolality of their blood thus runs very high, and
their sweat is more concentrated in salts than that of cystic fibrosis
patients, which were thought to be the highest of all. He said this
causes them to conduct electricity very well, and accounts for why they
experience static electricity shocks from light switches. He said they
use their elbows to turn on light switches to avoid these shocks. They
are able to stop Palm Pilots and watches by touching them.

He said that multiply antibiotic resistant staph organisms develop
biofilms in the nasal passages, but don't usually invade. But in
MSH-deficient patients only, these bacteria release hemolysins to help
harvest iron they need from blood cells, and these hemolysins turn on a
cytokine response. Therefore, the MSH will never rise if these bacteria
are present. It takes a special test to find these bacteria, called an
API-staph culture. They also make exotoxins, which destroy MSH.

He said that he recommends that people get some additional tests run to
see if they have a biotoxin illness. He also recommends that people look
at the history of their onset and consider whether it might be a
biotoxin illness. Not all chronic fatigue is produced by biotoxins, but
some is. Not all biotoxin illnesses produce chronic fatigue.

He talked about his "HLA Rosetta Stone." This involves measuring the
genotypes of HLA, using a PCR test, rather than a serology test. He can
tell from these LabCorp tests what illnesses people will be vulnerable
to. Those who are homozygous for certain genotypes are particularly
vulnerable. He is doing detailed studies of these people.

He recommends testing for MSH, biofilm-forming multiple antibiotic
resistant staph, VEGF, C3a (Quest will do it, but you have to use the
right code), and MMP-9. Since there are some details involved in taking
proper samples and specifying the tests, I think it would be best if
people check with Dr. Shoemaker before ordering them.

He talked about the problem of construction of concrete buildings in
which the interior walls are built too soon, sealing water in the
concrete that doesn't get a chance to evaporate. This produces
conditions ripe for growing mold in the building.

He said that chronic fatigue is the end result of multiple different
processes. There is no one single weapon against it. We need to tease
out subsets.

He said that C3a is a good marker for Lyme disease. Lyme disease causes
C3a to go way up. If a person gets "sick as hell" from cholestyramine,
they might have Lyme disease. If they have a history that suggests tick
exposure, then even if the Lyme tests are negative, he will give 3 weeks
of doxycycline and see what the response is.

He talked about the satisfaction he gets from treating patients with
neurotoxin illnesses. He charges everyone who can pay an extra $50 which
goes to his foundation. Among other things, this covers treatment of
people who cannot pay. He emphasized the value of the visual contrast
sensitivity test. He has results from 3,000 patients now. This test
shows whether treatment is helping, as well as diagnosing the neurotoxin
illnesses initially. Rows C and D in the test are the most sensitive for
detecting neurotoxins.

Dr. Shoemaker has a new book coming out in about six weeks, called Bold
Warriors. For those who want to know more about his ideas and
treatments, I suggest that you consider getting a copy when it comes
out. His website is www.chronicneurotoxins.com.