Why Nitric Oxide, (NO), Is Associated With IBDs

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tex
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Why Nitric Oxide, (NO), Is Associated With IBDs

Post by tex »

Hi All,

I've seen a lot of research reports which investigate the phenomenon of elevated nitric oxide levels in the intestines of patients with inflammatory bowel diseases, but I haven't seen any that reach what I would call a "satisfactory" conclusion - they all leave more questions, than answers. Some researchers conclude that NO is harmful, and either causes the inflammation, or makes it worse, and they suggest trying to suppress it, while others speculate that it is a result of the body's efforts to control the disease, (the IBD), and it is being produced in an effort to suppress the disease. This explanation by Stephanie Seneff finally seems to make some sense of it. The problem with most researchers is that they never look beyond the parameters that they are investigating - never realizing that they are looking at symptoms, or intermediate chemical reactions - rather, they almost always view those parameters as either a cause or an effect. Their analysis is almost always too simplistic, for a complex problem.

The following is a quote from a long article about the effects of sulfur on several major health issues. It explains how Crohn's disease, (and presumably, all IBDs), are actually "muscle wasting" diseases, (which can occur even with adequate nutrition). This condition is also known as "low CG syndrome" to represent a situation where the amino acid, cysteine, and the tripeptide, glutathione, become deficient. According to Stephanie Seneff, this syndrome most likely occurs due to a sulfur deficiency, specifically, a cholesterol sulfate deficiency. Note that, as we have found with MC, the fat malabsorption problem becomes self-perpetuating, and leads to additional vulnerabilities.
I will use Crohn's disease as my primary focus for discussion: an inflammation of the intestines, associated with a wide range of symptoms, including reduced appetite, low-grade fever, bowel inflammation, diarrhea, skin rashes, mouth sores, and swollen gums. Several of these symptoms suggest problems with the interface between the body and the external world: i.e., a vulnerability to invasive pathogens. I mentioned before that cholesterol sulfate plays a crucial role in the barrier that keeps pathogens from penetrating the skin. It logically plays a similar role everywhere there is an opportunity for bacteria to invade, and certainly a prime opportunity is available at the endothelial barrier in the intestines. Thus, I hypothesize that the intestinal inflammation and low-grade fever are due to an overactive immune system, necessitated by the fact that pathogens have easier access when the endothelial cells are deficient in cholesterol sulfate. The skin rashes and mouth and gum problems are a manifestation of inflammation elsewhere in the barrier.

Ordinarily, the liver supplies cholesterol sulfate to the gall bladder, where it is mixed into bile acids, and subsequently released into the digestive system to assist in the digestion of fats. If a person consistently eats a low-fat diet, the amount of cholesterol sulfate delivered to the digestive system from the liver will be reduced. This will logically result in a digestive system that is more vulnerable to invasion by pathogens.

The sulfate that's combined with cholesterol in the liver is synthesized from cysteine (one of the two proteins that are deficient in low CG syndome). So insufficient bioavailability of cysteine will lead to a reduced production of cholesterol sulfate by the liver. This will, in turn, make it difficult to digest fats, likely, over time, compelling the person to adhere to a low-fat diet. Whether low-fat diet or sulfur deficiency comes first, the end result is a vulnerability to infective agents in the intestines, with a consequential heightened immune response.

[Dröge1997] further discussses how a reduction in the synthesis of sulfate from cysteine in the liver leads to increased compensatory activity in another biological pathway in the liver that converts glutamate to arginine and urea. Glutamate is highly significant because it is produced mainly by the breakdown of amino acids (proteins in the muscles); i.e., by muscle wasting. The muscle cells are triggered to cannibalize themselves in order to provide adequate glutamate to the liver, mainly, in my view, in order to generate enough arginine to replace the role of sulfate in muscle glucose metabolism (i.e., these activities in the liver and muscles are circular and mutually supportive).

Arginine is the major source of nitric oxide (NO) and NO is the next best thing for muscle glucose metabolism in the absence of cholesterol sulfate. NO is a poor substitue for SO4-2, but it can function in some of the missing roles. As you will recall, I propose that cholesterol SO4-2 accomplishes a number of important things in muscle cells: it delivers oxygen to myoglobin, it supplies cholesterol to the cell membrane, it helps break down glucose, protects the cell's proteins from glycation and oxidation damage, and provides energy to the cell. NO can help in reducing glycation damage, as nitrogen can be reduced from +2 to 0 (whereas sulfur was reduced from +6 to -2). It also provides oxygen, but it is unable to transfer the oxygen directly to myoglobin by binding with the iron molecule, as was the case for sulfate. NO does not supply cholesterol, so cholesterol deficiency remains a problem, leaving the cell's proteins and fats more vulnerable to oxidative damage. Furthermore, NO itself is an oxidizing agent, so myoglobin becomes disabled, due to both oxidation and glycation damage. The muscle cell, therefore, engages in mitochondrial oxidation of glucose at its own peril: better to revert to anaerobic metabolism of glucose to decrease the risk of damage. Anaerobic metabolism of glucose results in a build-up of lactic acid, which, as explained in [Dröge1997] further enhances the need for the liver to metabolize glutamate, thus augmenting the feedback loop.

Furthermore, as you'll recall, if I'm right about cholesterol sulfate seeding lipid rafts, then, with a cholesterol sulfate deficiency, the entry of both glucose and fat into the muscle cell are compromised. This situation leaves the cell with little choice but to exploit its internal proteins as fuel, manifested as muscle wasting.

In summary, a number of different arguments lead to the hypothesis that sulfur deficiency causes the liver to shift from producing cholesterol sulfate to producing arginine (and subsequently nitric oxide). This leaves the intestines and muscle cells vulnerable to oxidation damage, which can explain both the intestinal inflammation and the muscle wasting associated with Crohn's disease.
http://people.csail.mit.edu/seneff/sulf ... sting.html

This explanation may not answer every last question that's involved, but it makes a heck of a lot of sense to me.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Zizzle »

I'm a little lost -- can't comperehend the whole theory, but I 'm trying to understand what the take-home messages are. We should be eating more fatty meat? Low cholesterol is not helpful when you have an IBD. Should statins be contraindicated in MC? Does this explain why statins cause muscle problems? Should we be supplementing with L-Glutamine (as some here already do?)
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Post by tex »

Zizzle wrote:We should be eating more fatty meat?
It's shockingly clear that the dietary recommendations to avoid fatty meats and cholesterol, that the medical community and the government have been promoting for decades, were based on an agenda by a single politician, and bogus science, as I explained in my second post in the thread at the following link, which I have copied below:

http://www.perskyfarms.com/phpBB2/viewtopic.php?t=14528
A century ago, (before politicians became involved), USDA did a much better job. In their first nutritional guideline booklet, (a USDA Farmer’s Bulletin), written by Wilbur Olin Atwater, Ph.D., an agricultural chemist, the importance of a cheap and efficient diet was stressed. One that included more proteins, beans, and vegetables, and limited amounts of fat, sugar and other starchy carbohydrates. Revised guidelines over the years, weren't too bad, either, until the late 1960's, when Senator George McGovern became involved. It appears that we can blame Senator McGovern for drastically changing the course of American health. In an article titled The Soft Science of Dietary Fat, Gary Taubes described the sequence of events:
"It was Senator George McGovern's bipartisan, nonlegislative Select Committee on Nutrition and Human Needs--and, to be precise, a handful of McGovern's staff members--that almost single-handedly changed nutritional policy in this country and initiated the process of turning the dietary fat hypothesis into dogma."

In January 1977, after listening to the testimony of Ancel Keys and other doctors and scientists intent on promoting the unsupported Dietary Fat-Heart hypothesis, the Committee published the "Dietary Goals for the United States" recommending that all Americans reduce their fat, saturated fat and cholesterol consumption, and increase their carbohydrate consumption to 55-60% of daily calories.
Taubes then went on to detail the sad sequence of events that describes how such unscientific data could be promoted as valid information:
Then resident wordsmith Nick Mottern, a former labor reporter for The Providence Journal, was assigned the task of researching and writing the first "Dietary Goals for the United States." Mottern, who had no scientific background and no experience writing about science, nutrition, or health, believed his Dietary Goals would launch a "revolution in diet and agriculture in this country." He avoided the scientific and medical controversy by relying almost exclusively on Harvard School of Public Health nutritionist Mark Hegsted for input on dietary fat. Hegsted had studied fat and cholesterol metabolism in the early 1960s, and he believed unconditionally in the benefits of restricting fat intake.
So in a nutshell, that's how the American public was scammed, by an unmitigated hoax. And presumably, the rest of the world soon followed, on this path to guaranteed health decay. There was nothing scientific about it, and yet it was accepted, and promoted as fact, until now, decades later, most people never think to question it. What a ripoff! I'm beginning to wonder if politicians can be trusted to look out for our best interests. :ROFL:

http://www.healthy-eating-politics.com/ ... ramid.html

Tex


So yes, for normal people, there is nothing harmful about fat and cholesterol in the diet - they're essential to good health and longevity. The red emphasis in the above quote, is mine, of course.
Zizzle wrote:Low cholesterol is not helpful when you have an IBD.
Not only is it not helpful, but it's a symptom of an IBD, (IOW, it's caused by IBDs), and it tends to retard proper healing. Consider what the information in the abstracts at the following links imply, concerning a study of patients with Crohn's disease:
RESULTS:

Decreased levels of all basic lipid metabolism parameters were detected. At the same time, a statistically significant decrease in the levels of lathosterol and camposterol was recorded. The decrease in sitosterol levels was insignificant and the level of squalene was higher than in the controls.

CONCLUSION:

Significant changes in lipid metabolism were demonstrated in the study in patients in active phase of Crohn's disease. Also detected was statistically significant hypocholesterolemia, with altered process of cholesterol synthesis and absorption.
Again, the red emphasis is mine.

http://www.ncbi.nlm.nih.gov/pubmed/18072426

Regarding the risks of hypocholesterolemia, (low cholesterol):
Conclusion

Among older hospitalized adults, low serum cholesterol levels appear to be an independent predictor of short-term mortality.
http://www.amjmed.com/article/S0002-934 ... 1/abstract

Concerning the general advisability of lowering cholesterol levels:
Findings
Mean cholesterol fell significantly with increasing age. Age-adjusted mortality rates were 68·3, 48·9, 41·1, and 43·3 for the first to fourth quartiles of cholesterol concentrations, respectively. Relative risks for mortality were 0·72 (95% CI 0·60—0·87), 0·60 (0·49—0·74), and 0·65 (0·53—0·80), in the second, third, and fourth quartiles, respectively, with quartile 1 as reference. A Cox proportional hazard model assessed changes in cholesterol concentrations between examinations three and four. Only the group with low cholesterol concentration at both examinations had a significant association with mortality (risk ratio 1·64, 95% CI 1·13—2·36).

Interpretation
We have been unable to explain our results. These data cast doubt on the scientific justification for lowering cholesterol to very low concentrations (<4·65 mmol/L) in elderly people.
Note that if we convert those international units to conventional units, (used in the U. S.), 4.65 mmol/L is equivalent to 180 mg/dL. IOW, total cholesterol levels below 180 mg/dL significantly increase mortality risk for older people. We have no information on what it does to the mortality risk of younger people. :shrug: The point is, if a cholesterol level below 180 mg/dL increases mortality risk, then obviously a graduated risk scale exists, so that even at levels above 180 mg/dL, the risk of other adverse effects will likely be increased, and that risk will gradually decrease as the cholesterol level is increased.

The bottom line is that each of us has a "normal" cholesterol level that is established by the body at any particular point in time, and that level is not simply coincidental - it exists because that is the cholesterol level at which the body can establish homeostasis, (normal, stable operation), based on it's overall needs. Elevated cholesterol levels in some individuals may be needed to allow the body to adequately fight inflammation. :shrug:

http://www.thelancet.com/journals/lance ... 2/fulltext

Note that those research conclusions concerning the mortality risks associated with low cholesterol were verified only in older people - not in middle-aged and younger people. Those age brackets remain to be investigated, (though I have a hunch that they should follow suit). Also, note that this article was published in a prestigious peer-reviewed medical journal, over 10 years ago, and yet physicians are still "pushing" the "benefits" of lowering cholesterol levels for seniors, as if those benefits actually exist. Obviously, they do not exist, when all-cause mortality risk is considered.
Zizzle wrote:Should statins be contraindicated in MC?
Well, yes, IMO, but it's difficult to say how significant the effect might be. This issue will be complicated by malabsorption issues, the age bracket of the patient, the amount of cholesterol sulfate in the diet, actual cholesterol levels, etc., for example.
Zizzle wrote:Does this explain why statins cause muscle problems?
Yes, basically it does. There's more detail in the rest of the article, and even better detail in the article at this link:

http://people.csail.mit.edu/seneff/why_ ... _work.html
Zizzle wrote:Should we be supplementing with L-Glutamine (as some here already do?)
It depends. Glutathione is synthesized from the amino acids cysteine, glutamate, and glycine, and all three of those can be produced endogenously, (IOW, in the body), so if the body's digesive chemistry is working correctly, and we're not deficient in any essential ingredients, then we shouldn't need any supplementation. As we all know, though, our digestive system cannot be relied upon to work flawlessly, when we're having a flare. The problem is that arginine is an essential amino acid for young people, but not for adults, and if the body is converting glutamate to arginine, then elevated levels of NO are likely, regardless of supplementation of glutamate. In fact, supplementation with glutamate might possibly make the problem worse, by artificially elevating the NO levels. :shrug: Basically, NO production seems to be a desperate attempt by the body, to try to avoid further damage, but since it's sort of an "emergency" response, it doesn't offer a complete solution - some damage continues to accumulate.

It would seem to me that a better choice would be to supplement with sulfur, to prevent the adverse chemical conversions from occurring in the first place. For anyone who can eat eggs, they are an ideal treatment option, because they are a super source of cholesterol sulphate, (remember the hydrogen sulphide gas that rotten eggs produce? - that's due to the high sulfur content of eggs).

At least that's how I see it.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by sarkin »

Low cholesterol in Crohn's patients has been known for a loooong time - a former coworker with Crohn's had a TC level of 90 at one point (yikes), and was told by his doctor that it was common in Crohn's.

I think statins are counterindicated, period :lol:

I wish I could eat eggs! I wonder whether the huge role eggs played in my diet, before I got my Enterolab results, was helpful in stopping the muscle/weight loss. It's also possible that the month-long "wheat-free vegan" diet I followed right before I got so sick was a bigger contributing factor to my MC 'crash' than I realized, because of the missing sulfur...

Sorry to dive right from research to anecdote - thanks for the excellent food for thought!

L,
S
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Post by sarkin »

Meant to make this point: my co-worker w/Crohn's had his very low cholesterol flagged as an issue more than 20 years ago; my point was that the drumbeat of "lower is better no matter what" regarding total cholesterol has only increased from the medical community.

--S
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