The Environmental Medicine Approach to Neurobehavioral Disord ers. ALBERT F. ROBBINS, D.O.,MSPH Allergycenter.com Fellow, American Academy of Environmental Medicine Board Certified in Occupational/Environmental Medicine & Preventive Medicine. ?. Environmental Medicine. What is it?
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ALBERT F. ROBBINS, D.O.,MSPH
Fellow, American Academy of Environmental Medicine
Board Certified in Occupational/Environmental Medicine
& Preventive Medicine
Environmental factors…what we are exposed to…as causes of conditions and as triggers of symptoms—are investigated as part of a comprehensive medical workup.
Specialized chemical messengers that allow brain cells to “communicate” or talk with one another.
A neurologic disorder is considered an environmental illness if it is “triggered by environmental factors.”
Principles & Practice of Environmental Medicine, Tarcher
If genes load the gun, then the environment pulls the trigger. Sidney Baker, MD
We can change our environmental exposures, our diet and habits. . . and change our health!
Think Outside the Box!
Man with a new idea is a crank until the idea succeeds.
Nothing is more powerful than an idea whose time has come. Victor Hugo
Case Report #1
Tourette syndrome: Thinking outside the box in a search for triggers and successful treatment…Role of allergens
The individual variations in character, course and degree of severity by which TS is manifested cannot be explained by genetic hypotheses alone
Tourette Syndrome Association
The total of the factors contributing to the production of allergic disease and symptoms such as tics, depending on patient susceptibility.
The allergic load staircase to reactions:
James C. Breneman, MD
Stress depletes brain nutrients and affects hormone balance
Chronic exposure to stress hormones can disrupt the production of neuro-transmitters in the brain including serotonin, dopamine, and acetylcholine. David Perlmutter, MD
OCD & PANDAS
Case Report #2
Help for mood swings, OCD, and tics with environmental medicine.
Inhalant and food allergy treatment
Causes of Depression
Hidden allergy: food, mold and more
Chronic stress; Lack of sleep
Hidden infection: fungal, viral, bacterial
All chronic illness involves inflammation at some level that cuts across many medical specialties.
Signs and symptoms of illness in one part of the body can be a clue to a more widespread multisystem generalized disease throughout the body (ex: allergic fatigue).
William Meggs, MD
Inflammation is the common thread linking many of the chronic (allergic) diseases and autoimmune diseases
Uncontrolled inflammation is bad;it causes the immune system to overwork
It is like a car without brakes. . . It can’t be stopped
William Meggs, M.D.
Inflammation is influenced by many environmental factors: what we eat, breathe, drink, use, do, think and feel.
Its effect “ripples” and can be felt throughout the body.
Dr. Meggs reports that brain inflammation is thought to be related to:
Depression Anxiety Allergy
Chemical hypersensitivity Irritability
Tremors Seizures Fatigue
Headaches Brain fog & spaciness
Strokes Autoimmune diseases
This test measures generalized inflammation in the body
Inflammation is a sign your brain neurons are under attack from excessive free radicals
The Silent Epidemic
There’s a silent epidemic out there guys,
it’s a masked illness wearing a disguise.
Nutrients and chemicals compete for receptors at the cellular level
Nutrients are important for chemical detoxification, immune system support and optimal cellular and neurologic function
Example: some drugs, formaldehyde products, pesticides, food additives, cosmetics, VOC’s
Chemicals can have a pharmacologic” effect
We are the first generation on earth to be exposed to toxic chemicals from the womb to the grave. Rachel Carson Silent Spring, 1952
We’ve become the prozac nation seeking chemical gratification. The “Musician/Physician”
Case Report #3
Chemical sensitivity as a major treatable cause of Tourette syndrome
Example: Removal of Plug Ins
and scented candles
Allergy can cause symptoms anywhere!
A hypersensitivity to a specific substance which in a similar quantity doesn’t bother other people.
It’s not just IgE!
World Health Organization
It is conceivable that any food that can cause a hive of the skin could also cause a hive of the brain. Edema in specific areas of the brain could affect the personality, motor function, reflex activity, or almost any central nervous system mechanism.
George Ulett M.D.
Some artificial sweeteners, MSG, food preservatives like sulfites, artificial food colorings and artificial flavorings can overexcite brain neurons. The Feingold Hypothesis
All studies confirmed that some hyperactive children may benefit from an additive free diet. Jonathan Brostoff, MD
Brominated vegetable oil
BHA and BHT
Many variations of chemical sensitivity exist. Multiple Chemical Sensitivity (MCS) may not be one disease. Chemical Exposures, Low Levels and High Stakes, Ashford & Miller
No one knows where we came from, where we are going or what we are supposed to be doing here!
Formaldehyde:wood cabinets, insulation & new clothing, beauty salons, new buildings
Latex:elastic bands, condoms, and gloves
Sulfites:food and wine preservative
Fabric softeners: sheets, towels, clothing
Fragrances & perfumes: cosmetic, personal care
Pesticides:foods, lawns, homes, offices
Phenols: Lysol & tin can linings
Benzenes: aerosol sprays, plug-ins, flea collars
Plastic water bottles
Scented products and tobacco smoke on other people
Dry cleaning fluids
Volatile organic compounds are gases that are released from certain products….This is called outgassing of chemicals. They can be inhaled and go directly to the brain where they can cause damage.
Outgassing of chemicals from:
New building materials, carpet, paints, glues, sealers, formaldehyde wood products, gas heat and exhaust fumes, dry cleaned clothing and new clothing, beauty salons hair and nail products, smoke products, musty environments
Odors go directly to the limbic system of the brain
Odors can have a powerful effect on behavior and neurologic function
The toxic effects of chemical exposure may be heralded by depression, fatigue, and irritability long before more tangible effects appear. Tarcher
Neurologic symptoms are common in the Sick Building Syndrome
National Institutes of Health
Causes of SBS:
Molds release spores, VOC’s and mycotoxins
Solution: Eliminate the moisture and mold can’t grow (CDC)…
Some people must move out of their homes to avoid mold exposure
Associated with movement disorders
Irritability, itching, respiratory problems, and fatigue are common symptoms
Neurologic symptoms are commonly seen in mold sensitive patients
Two children developed a severe tic disorder while living in a mold contaminated home. When their mold allergies were treated and the home was remediated , tic symptoms were significantly reduced.
Pickled & fermented foods
Sweets & maple syrup
Wine and beer
A negative environment can activate bad genes and prevent good genes from being turned on.
Rx: Create a positive environment!
Remove dust collectors
Keep A/C on
Use an Air purifier
No fabric softeners
No scented candles
No stuffed animals or toys
Clean ceiling fan blades
No air fresheners or plug ins
Removal of the allergic patient from the offending environment
A 9 year old girl was highly allergic to tree pollens, very prevalent in her area. When she moved from North Carolina to San Diego and was relieved of all tics; after 2 years she is still doing well
The neutralization technique involves intradermal endpoint titration of progressively weaker dilutions of the food or inhalant allergen to find the first negative wheal or neutralizing dose.
Relief At Last, Joseph Miller, MD
Carlton Lee, MD
(Escalation immunotherapy is not recommended for tic disorders)
Albert Robbins, DO MSPH
Case Report #4
Cross reactivity among foods and other allergens may be through their phenolic content
Phenolic compounds are found in most common foods…We can neutralize (desensitize) to phenol and this decreases both food and chemical sensitivity
The brain requires a steady source of slow burning carbs
Restriction of carbohydrates may trigger hypoglycemia, irritability, cognitive dysfunction and fatigue
Hypoglycemia and fluctuating blood glucose levels can cause concentration and attention problems, irritability and moods swings
If you don’t believe in the mind-body connection, how do you wiggle your toes?
Every thought can be felt and interpreted at the cellular level.
Maxim: Wisdom is avoiding all thoughts that weaken you.
Wayne Dyer, PhD
Corollary: It is wise to avoid all negative environmentalfactors that weaken you.
Albert Robbins, DO
Wisdom is knowing the correct path to take, integrity is taking it.
Some studies suggest that laughter really is the best medicine.
Seek harmony between your mind, body, spirit, emotions and your environment for optimal healing.
Stay on your own path and you will feel balanced and centered and natural healing is promoted! “Zen Guitar” Philip Sudo