Dr. Oz’s Pain: Constipation and Bursitis

Dr. Oz has complained several times about his constipation and the pain he feels in his shoulders during surgery.  He has recommended numerous treatments.  Since I feel a friendly affection toward Mehmet after talking/shouting at his image on the screen for hours, I think that I should give him some advice to relieve his pain.

Hot, Cold, Topical Treatments Are Effective, but Don’t Penetrate Themselves

Dr. Oz keeps talking about how various topical applications penetrate the skin.  He has even recommended the use of an electrical system to carry pain relieving steroids into his tissue by what looks to be electrophoresis.  This is dubious.  I would recommend that he stick to the topical chemicals, e.g. capsaicin, menthol, that target the hot and cold sensors of the superficial layers of the skin and result in deep penetrating nerve signals that trigger anti-inflammatory responses in the underlying bursa.

Constipation Is Caused by Damaged Gut Flora or Dysbiosis

Dr. Oz, like most physicians, does not usually explain the causes of diseases, such as bursitis.  Unfortunately, when he tries to explain problems, such as constipation, he overlooks important aspects of the problem for a facile physical model.  In the case of bursitis, it is important to realize that the patient, Dr. Oz, is also constipated.  Constipation can be aggravated by dehydration or “holding it”, but in Dr. Oz’s case, the combination of bursitis, an autoimmune disease, with constipation (and gas) suggests the more complete explanation of dysbiosis or damaged gut flora.  Dysbiosis is what causes constipation, because bowel stools, poop, is mostly packed, hydrated bacteria that grow in the colon by digesting soluble fiber.  If you eat an apple a day, there is enough pectin and other plant polysaccharides, i.e. soluble fiber, to increase the volume of the stools to make one regular.  [Don’t be confused by the misconception promoted by Dr. Oz that the volume of stools results from insoluble fiber, such as in whole grains.  The husk part of whole grains is useless or unhealthy and grains in general are not needed for a healthy diet.]  

Flush Toilet Hero

Dr. Oz’s constipation suggests a damaged gut flora.  Since he is a physician, one would suspect that he has used antibiotics in the past few years and wiped out essential types of gut bacteria.  Dr. Oz probably followed his own advice and attempted to patch up his damaged gut flora with probiotics.  Unfortunately, as I have repeatedly explained, dairy probiotics don’t survive in the gut and cannot repair damaged gut flora.  But Dr. Oz is even harder on his gut flora.  He has recommended the use of colloidal silver throat spray when he has been exposed contagious germs.  Silver, although ineffective for its intended use, is very toxic to gut flora after it is swallowed.  Dr. Oz also subscribes to numerous approaches to house and body hygiene, which are probably occupational hazards for surgeons.  Hygiene is the enemy when it comes to ingesting bacteria lost to antibiotics.  The atomizing flush toilet is my gut flora hero for spreading contagious health.

Damaged Gut Flora = Damaged Immune System

Constipation is bad enough, but damaged gut flora can mean that some of the bacteria needed for the gut-based development of cells regulatory T-cells (Tregs) that keep the immune system under control, are missing.  Constipation can lead to deficient Tregs and that means a major predisposition to autoimmune disease and allergies.  [Fecal transplants cure autoimmune diseases and allergies.]  Antibiotics, silver, hygiene excesses and constipation suggest to me that Dr. Oz has been cruising toward some rude immunological sequelae.

Autoimmunity Results From Antibiotics, Dysbiosis and Compromised Tregs

Autoimmune diseases result when a trifecta of inflammation, compromised Tregs and appropriate antigens occurs.  Normally physical damage, such as abusive shoulder exercise, results in inflammation as the first step in healing.  The inflammation can rev up the immune cells in the local area of tissue damage and some of the proteins, such as lubricin, which lubricates the bursa, may have basic triplet amino acid sequences that lead to presentation to immune system cells.  But no antibodies against self tissues are produced, because the Tregs stop the process.  Healthy gut flora produce healthy Tregs and block autoimmunity.

Dr. Oz abuses his shoulder bursa during surgery, but it can’t heal properly, because he has damaged his gut flora and compromised his Tregs.  The result is the autoimmune bursitis from which he now suffers.  He can reduce the symptoms and inflammation with topical anti-inflammatory natural chemicals, but he needs to repair his gut flora to repair his Tregs and reduce autoimmunity.  In the mean time, he is contaminating his local environment, family and friends with his unhealthy bacteria.  I wonder if Dr. Oz’s friend, Dr. Mike Roizen also suffers from autoimmune diseases?

Prescription to Repair Gut Flora:  Anti-Inflammatory Diet, Soluble Fiber, Fermented Vegetables, Less Hygiene

KEEP YOUR TOOTH BRUSH NEAR THE OPEN TOILET 

Dr. Oz, Pain, Hot/Cold Receptors

The production of endorphins in tissues in response to nerve stimulation relieves inflammation and pain. Dr. Oz and the medical community seem to forget that hot and cold receptors in the skin can be readily triggered by natural products in foods, to stimulate the release of endorphins and treat inflammation in nearby tissues.

Hot and Cold Don't Easily Penetrate the Skin
Athletic trainers commonly apply hot and cold packs to avoid swelling and inflammation from injuries, and they are always discussing the virtues of various hot/cold regimens. They ignore the extraordinary efficiency of the circulatory system in regulating tissue temperatures and avoiding temperature changes. They also ignore the fact that chemical "hot and cold" salves and ointments are effective without actually changing the temperature of the skin. The essential observation is that triggering hot and cold sensing nerves is more important than changing the temperature of the damaged tissues.

Common Food Molecules Activate Hot/Cold Nerve Receptors
Peppers are hot, because they contain capsaicin that binds to protein receptors on nerves in the skin, which results in the brain sensation of heat. Camphor and castor oil bind to the same receptors. Menthol binds to corresponding cold receptors. Vicks Vaporub has both menthol and camphor, and therefore stimulates both hot and cold sensors. Vicks is also an effective treatment for tissue inflammation.

Vicks and Castor Oil are Effective Treatments for Pain and Inflammation
A bee sting or a burn on a finger will produce reddening, swelling and pain, that can be quickly alleviated by applying Vicks to the wrist. The hot and cold sensors of the wrist would be stimulated and the returning nerve signals would be generally detected in the whole hand and produce endorphins that would calm the inflammation and sooth the injured finger. In a similar way, an inflamed joint can be treated by topical menthol and castor oil, and lower abdominal discomfort can be alleviated by castor oil applied to the belly.

Tendonitis can be Treated with Peppermint Soap
I have treated a persistent tendonitis in my shoulder by applying Dr. Bronner's Peppermint Soap liberally to my shoulder and waiting a few minutes before continuing my shower. This gentle, persistent treatment produced relief within a week. This was a cure for this persistent inflammation and pain. It also works on joints.

What Dr. Oz needs to communicate is that there are simple ways to stimulate hot/cold receptors that have nothing to do with changing the temperature of deeper tissues, but these treatments are very effective in stimulating general endorphin production that reduces troublesome inflammation and pain. As an addendum, vagal stimulation, i.e. through yoga postures such as shavasana or the Valsalva maneuver, can produce a reduction in general inflammation.

Baldness Cure: Low Dose Naltrexone?

Naltrexone can be used to block opioids and provide the basis for treatment for drug abuse, but in low doses (LDN) it provides a paradoxical increase in natural endorphins that reverses inflammation and provides an effective treatment for autoimmune diseases, e.g. MS.

Receptors
A recent anonymous post brought the role of cannabinoid and opioid receptors in baldness to my attention. The relationship between these receptors, inflammation and autoimmunity is very complex. The heat and cold sensors, which also bind capsaicin and menthol, appear to be mediated by endorphins. Acupuncture also seems to function by similar mechanisms and is inhibited by high dose Naltrexone.

Low Dose Naltrexone
A side effect of high dose Naltrexone (e.g. 50 mg/d) is hair loss. Low dose Naltrexone (e.g. 1 mg/day, taken at night) appears to stimulate hair production and it may reverse the effects of Finasteride, since LDN improves libido.

Endorphin-Suppressed Inflammation
I would expect hair loss to be prevented/reversed by topical treatments that block inflammation and autoimmune attack on hair follicles. Curcumin, from turmeric, blocks NFkB and appears to help hair loss. Capsaicin can block inflammation via endorphin production and also helps hair loss. I would also expect that topical menthol and castor oil would reduce hair loss.

Anti-Inflammatory Diet
The anti-inflammatory diet that I recommend, may not be sufficient to block hair loss, but it may provide a good foundation for other anti-inflammatory treatments. In fact, other topical treatments may not be effective unless chronic, diet-based inflammation is eliminated. It may also be important to reduce oxidative stress by optimizing glutathione and vitamin C.

I would appreciate comments by others who may have experience with LDN and balding.

Simple Remedies

Simple is usually best. Traditional herbal cures are tried and true. I learn a lot about biology by studying what works in herbal medicine. Some simple plant products, such as Vicks Vaporub, are very potent cures for what typically ails you. Castor oil is an excellent topical pain killer.

Herbs and spices excite our senses and dominate cuisines. Cultures are identified by their food, but the use of particular plant materials to food is not a random act of history, nor is it limited to the regions where the herbs and spices first appeared. Research by Paul Sherman at Cornell, and others has shown that herbs and spices that are used in a culture are also the most effective at inhibiting pathogens and parasites where that food is traditionally served.

I must talk about some related experiences that touch on the same subject, but are simply fun explanations of cultural practices. Milk is used in some interesting cultlural practices, because it has very potent anti-viral, anti-bacterial and anti-fungal components -- milk keep newborns well nurished, but also safe from nasty germs, etc. while the immune system the baby matures. Two astoundingly disparate applications of milk come to mind: pruning fruit trees and walking hot coals. I have observed both. I previously worked with plant pathologists and I watched pruners sanitize their shears in milk between trees. The milk stopped the spread of viruses and bacterial pathogens. I also observed firewalking in the Sri Mariamman temple in Singapore. The firewalkers stepped from the coals into a pool of milk to stop infections of their singed feet. In both examples, milk provided an abundance of anti-microbial molecules that were retasked from protecting babies to protecting trees or adult feet.

Herbs and spices are plant products that are toxic to plant pathogens or herbivores, which are retasked to protect people. Some of these, such as the curcumin in turmeric, are potentially more effective that commercial drugs. I want to point out some of the common plant materials that are very useful in our diets and to remedy common infections, aches and pains.

My current champion cure-all is Vicks Vaporub. This thick ointment has the pleasant scent of its ingredients, menthol, eukalyptol, camphor and terpentine. I associate the smell with childhood treatment for congestion. I also remember that my father used to rub it on his arthritic hands to loosen them up before a day’s work. There is a solid physiological basis for the action of Vicks. Many of the ingredients are powerful antibiotics effective against a variety of bacteria and fungi. Vicks is one of the most effective topical treatments for athlete’s foot and ringworm fungal infections. The menthol is cooling, because it binds to the cold sensing receptors and it is an effective analgesic and anti-inflammatory, because it triggers acupuncture like responses through the vagus nerve. I would also try Vicks on autoimmune conditions of the skin, because of both the anti-inflammatory and anti-bacterial properties. I have even seen Vicks recommended for the same reasons for the treatment of acne. TMJ pain and inflammation apparently responds to the menthol.

Castor oil binds to heat detecting receptors of the skin and works similarly to hot pepper capsaicin. Castor oil can be used to stop many aches and pains in arms and legs by topical applications. Since most of these plant products act through the pain sensors in the skin, they don’t actually penetrate to the joints involved, but rather they trigger release of neurotransmitters from nerves that do penetrate to the sites of interest. I also think that the use of castor oil packs applied to the skin of the abdomen, may have systemwide anti-inflammatory impact.

Garlic is the most anti-bacterial of the herbs, but most of the common herbs added to food probably affect the gut flora and shift it to a more anti-inflammatory composition. Many herbs and spices are used as topical cures for acne, because of their combined antimicrobial and anti-inflammatory qualities. Plant materials are very potent. They contain many compounds that are highly effective at low concentrations in neutralizing plant pathogens and herbivores, and so they are also very potent in their impact on the bacteria of our gut and potential on our own systems. Plants are powerful, but just because they are natural does not mean that they are safe. Plants are also rich sources of poisons. Domesticated plants are safer, because we have selected for variants that have lower levels of the compounds that the plants need to otherwise protect themselves. This also means that the compromised varieties need to be sprayed with antibiotics, e.g. apple trees sprayed with streptomycin, fungicides and herbicides. We have traded one group of plant toxins for manmade toxins. All this aside, plants are necessary for our health, but it is better to browse over many different plants than eat a lot of just one. Grains are a relatively recent addition as large components of the human diet, and should also be limited because of their high starch and inflammatory omega-6 oil content.

Turmeric, red pepper and black pepper are commonly ground together and used to enhance many dishes in a variety of different cuisines. It turns out that the curcumin in turmeric and the capsaicin in red pepper are very potent anti-inflammatory agents, but they are enzymatically modified as they are absorbed through the intestines. The black pepper piperine inactivates the enzymes of the intestines and enhances the effectiveness of the other two chemicals. Thus, there has been a lot of trial and error optimization in the use of spices. It makes a lot of sense to eat the way that locals eat when traveling.