• Nutrition for Addiction Part 4: Addiction and Specific Conditions of the Body

    existing-nutritional-conditions-and-disease-that-lead-to-addiction

There are many conditions that lead to addiction and substance abuse.  Many of these conditions are not acknowledged in mainstream medicine as there is not a drug for it.  However, they are fully observed in the realm of alternative medicine and functional nutrition. It has been mentioned that we are biochemically unique, and by identifying underlying issues of addiction we can begin to address the root cause.

Addiction and Specific Conditions of the Body

We know that in alcoholics, for example, higher than normal acetaldehyde levels (due to genetic factors) are believed to be responsible for many of the harmful effects of alcohol consumption and for the addictive process itself.  In the liver, alcohol is broken down to acetaldehyde with the help of enzymes and active niacin as a cofactor. We also know that although reversible, fatty liver is present in all active alcoholics with a degree of severity contingent upon the duration and degree of alcohol abuse. (see appendix 5a for MTFHR factors that can contribute to addiciton)

The following will address some of the other common conditions which may underlie addiction and/or substance abuse (see appendix 1 for a more complete list of consequences associated with alcoholism).  The conditions below are not commonly acknowledged by mainstream allopathic medicine (conventional medicine), but they are well-known in the alternative medicine field as underlying causes to consider for addiction/substance abuse.  Keep in mind, alternative medicine is growing in popularity as many people trust natural remedies over pharmaceuticals. In 2013, alternative medicine was a $30 billion-dollar industry, utilized by almost 50% of Americans.[33]

Adrenal Exhaustion and Addiction (also referred to as adrenal exhaustion)

Your adrenals are two organs the size of walnuts that sit on top of your kidneys.  They manufacture important hormones such as adrenaline, cortisol, DHEA and aldosterone.  Together, with the hippocampus and the pituitary gland, the adrenals form an endocrine triad that influences every tissue and gland in your body.  Their primary function is to mitigate stress, so they have a direct impact on your energy level and sense of well-being.

When exposed to extreme or continual stress, as is the case in addiction/substance abuse, the adrenals work overtime and are susceptible to adrenal fatigue.  Total stress load is a composite of many factors including emotional/relationship, financial/work-related, fears, allergies, chronic infections, sleep deprivation, poor diet, drug/alcohol usage, caffeine, smoking, toxins and too much or not enough exercise.  Cortisol is released in response to stress and low blood-glucose concentration.  It functions to increase blood sugar through gluconeogenesis, to suppress the immune system, and to aid in the metabolism of fat, protein, and carbohydrates.  Studies have demonstrated that chronic alcohol ingestion and its associated effects are connected to adrenal cortical activation in alcoholics.[34]  This puts alcoholics at the risk of being in an almost constant state of stress (‘fight or flight mode’) due to such things as hypoglycemia and withdrawal stress.

Hypoadrenia is a condition in which your adrenals are not working at their optimum level. Typically, this is caused by the adrenal’s overexertion to chronic stress, thus the descriptive term ‘adrenal fatigue/exhaustion’.  The overused adrenals are no longer able to respond effectively and thus an insufficient number of hormones are produced. (see appendix 2 for adrenal fatigue testing, diseases, and the different stages of adrenal fatigue).  Signs and symptoms of adrenal fatigue include:

  • Not wanting to get out of bed in the morning
  • Mild depression- nothing seems fun anymore
  • Fuzzy thinking/Memory loss/Indecisiveness
  • Lack of patience/Irritability/Biting off heads
  • Craving for salt/Compulsive eating/Alcoholism and Drug Abuse
  • Decreased sex drive (stress drives testosterone down, for example, as noted below)

We will discuss the overall paleo diet for recovery in the next article, however, for this condition it is important to also consume foods which specifically support the adrenals, including whole, unprocessed, and unrefined food.   Adrenal exhaustion recovery foods include high quality protein, healthy fat, and a complex carbohydrate with each meal. So as not to put additional stress/strain on the adrenals, it is also important to eat five to six small meals throughout the day. Stress can come in many different forms, including physical, chemical and emotional.  A diet high in refined carbohydrates and trans-fats is chemically stressful to the body. Other items to note to incorporate into diet include the following:

  • Organic Vegetables- eat six to eight servings of colorful, organic vegetables each day
  • Organic Fruit- approximately 1-3 servings per day, depending on your blood sugar balance.  Favor low sugar fruits like berries and peaches over tropical fruits, apples and pears. Avoid eating fruit in the morning to address blood sugar issues.  Limit consumption of bananas, raisins, dates, figs, oranges, and grapefruit as they have a higher glycemic index.
  • Salted Water- people with adrenal fatigue are often dehydrated.  Add ½ teaspoon of Himalayan salt to an 8-ounce glass of water and drink upon rising.  Have another around 2pm to offset the late afternoon blues. The salt helps to replenish electrolytes.
  • Avoid the following which stimulate the adrenals:  caffeine, hydrogenated oils, foods you are allergic to, deep fried foods, processed food, refined grains, sugar and alcohol.
  • Supplements (See Appendix 2A)

Diets high in processed convenience foods are associated with imbalanced blood sugar and are also stressful to the body (see appendix 2B for blood sugar and the adrenals & hypoglycemia section below).

As you will see further into these articles, to stabilize the adrenals, it is also important to remove allergies, inflammation, stabilize blood sugar and look at stress management.  Since we are looking at addiction from a holistic perspective, active stress management is critical to overcoming adrenal issues (ie- yoga, meditation, deep breathing exercises, long walks etc).  Many believe that it is impossible to overcome adrenal issues if one does not look at stress management. Active stress management is an essential component to an adrenal restoration program. One of the main goals is to simply ‘start by stopping’, and find what works for you.

The ‘pregnenolone steal’ refers to favoring stress hormone production (i.e.- cortisol) over sex hormone production (i.e.- testosterone).  For this reason, in men for example, stress caused by addiction diminishes testosterone (sex hormone) production in favor of stress hormones such as cortisol (see appendix 2C for more on the ‘pregnenolone steal’).  Survival is deemed more important than the immune system or sex, hence the cascade toward the ‘fight or flight’ stress hormone cortisol rather than the sex hormone testosterone.[35]  Diminished testosterone in men, and feeling poor as a result, can lead to ‘self-medicating’ and addictive behaviors.

Stress is an underlying contributor to most chronic disease, and adrenal fatigue is a key player in many conditions (see more about stress/addiction under appendix 2D).  In his book Adrenal Fatigue- The 21st Century Stress Syndrome, James Wilson N.D., D.C., Ph.D. states the following:

Adrenal fatigue often precedes a syndrome such as chronic fatigue, fibromyalgia and some cases alcoholism. The immune weakness that results from altered adrenal function sets the stage for easier infection or greater debilitation.  In many alcoholics, adrenal fatigue and the resulting hypoglycemia predispose the person to a compulsive desire for alcohol.  In other cases of alcoholism, the adrenals become fatigued by the continual use of alcohol.  In either case, adrenal fatigue is an intimate component of most alcoholism.  Adrenal support greatly enhances the treatment protocol of alcoholism.[36]

(Author’s Note- Adrenal fatigue falls within the ‘acceptable’ range of conventional medicine testing.  Nonetheless, sustained excess cortisol can lead to bone loss, weight gain, high blood pressure, depression, addiction and degenerative disease over time.)

Hypoglycemia

Sugar is an addiction far stronger than what we see with heroin.  It is the basic addictive substance from which all other addiction flow.  Refined sugar and all refined foods such as polished rice, white flour and the like, are nothing less than legalized poison. – Dr. Abram Hofer[37]

Hypoglycemia (deficiency of glucose in the bloodstream[38] or ‘low blood sugar’) is often the result of alcohol consumption, whereby there is a rapid increase in blood glucose levels followed by a subsequent drop.  In one study from JAMA, ‘the glucose-lowering action of alcohol may induce severe hypoglycemia with irreversible neurological changes.’[39] Blood sugar drops result in cravings for food, particularly foods that quickly elevate blood glucose, such as sugar and more alcohol.  Increased sugar consumption aggravates reactive hypoglycemia, particularly in the presence of alcohol. Hypoglycemia aggravates the mental and emotional problems of the alcoholic, producing such symptoms as sweating, tremor, anxiety, hunger, dizziness, headache, visual disturbance, decreased mental acuity, confusion and depression.  Dr. Hofer was also quoted as saying “I’ve tested over 300 alcoholics, and they’re all hypoglycemic.”[40]

Bill Wilson (co-founder of Alcoholics Anonymous in 1939) understood the link between alcoholism and hypoglycemia.  Later in his life (Bill passed away in 1971), he was helped by Dr. Hoffer using high-dose vitamin therapy and addressing the problems of hypoglycemia.  In 1968, Bill W. wrote a memo to AA physicians stating ‘we alcoholics try to cure these conditions (of hypoglycemia), first by sweets and then by coffee….in exactly the wrong way, we are trying to treat ourselves for hypoglycemia.’[41]  To support recovery from addiction, it is important to keep blood sugar levels balanced in order to prevent these symptoms from occurring and also to prevent sugar cravings which can lead to alcohol and drug cravings. These conditions can be remedied by eating a nutrient-dense diet that contains plenty of organic protein, tons of healthy healing fats, and fiber from leafy greens and vegetables (see section V, recovery diet). (See appendix 3 for more explanation on hypoglycemia, nutritional protocols that are specific for hypoglycemia, and appendix 3A for more about Bill W.’s interest in the biochemical basis of alcoholism and addiction).

Pyroluria

Pyroluria was discussed some above and it was mentioned this condition is present in around 50% of alcoholics (as well as high percentages of people with disorders such as schizophrenia, depression, emotionally disturbed children and those with ADD).[42]  Some research has indicated pyroluria is present in up to 80% of alcoholics.[43]  It is characterized by elevated urine kryptopyrrole levels, which result in relatively severe deficiencies of zinc and vitamin B6. A high kryptopyrrole result is also known as pyroluria, pyrrole disorder, or elevated pyrroles.  Many have not heard of this issue and are not alone. Most doctors do not acknowledge or know much about this condition, much less treat it, as there is not a drug for it. However, this genetic condition has long been recognized in the field of orthomolecular psychiatry and medicine.[44]  A more in depth look at this condition shows that during hemoglobin synthesis, by-products are created, due to a genetic disorder, that bind to zinc and B vitamins and cause deficiency symptoms of these nutrients. Specific testing can be performed to look for nutrient imbalances or deficiencies through blood, urine, or hair analysis.[45]  

People with pyroluria have an inborn error in metabolism that causes them to convert vitamin B6 and the mineral zinc into unusable compounds.  Because B6 and zinc are part of the nutrient team that creates serotonin and other neurotransmitters in the brain, pyrolurics are prone to chronic inner tension as well as intolerance to outer stress, on-going anxiety, poor stress tolerance, digestive issues including difficulty digesting protein, frequent cold and infections, joint pain or stiffness, acne, exzema or psoriasis, mood swings and reactivity, poor short-term memory, a ‘loner’ tendancy and other unique symptoms. [46] (See Appendix 4 for a pyroluria questionnaire and recommended treatment with nutritional protocol).

Zinc and vitamin B6 are critical for the functioning of your entire body and mind–including your digestion, immune system, cognitive functioning and emotions. Over time deficiencies can really take their toll on the way you feel and function and have serious consequences such as abusing substances to cope.  Often people will go for years suffering the effects of pyroluria regardless of what therapies they try or how well they eat. It is important to test for pyroluria when symptoms correspond and addiction is an issue.

Food Sensitivities/Allergies and Addiciton

It has been mentioned numerous times how there is often a connection between mental/emotional health and addiction (anxiety and depression for example).  People seek substances, whether it be food or drugs and alcohol, to ‘self-medicate’ and simply feel better or even normal. One difficulty in the field of nutrition is that many consequences of poor eating take years to manifest.  However, the story changes with mental health as the brain is very sensitive to nutritional status. One of the first signs of nutritional deficiencies and imbalances are altered moods and behavior. If these underlying issues are not addressed it puts one at a greater risk for addiction.  Experiments conducted by Nobel laureate Linus Pauling showed that people’s mental health can even improve simply by taking a multivitamin.[47] Food allergies are a very common underlying problem for mental health disorders and addiction.

Normally, the intestinal lining (which is only one cell thick) is bound very tightly in what is known as “tight junctions.”  This effectively keeps waste and toxins out while selectively allowing nutrients to pass through. However, when these junctions loosen, which can be a result of numerous factors including stress, high sugar diet, and dysbiosis, large food particles enter the blood stream (called ‘leaky gut’) and prompt an immune attack.  This leads to an increase in food and environmental allergies, as well as a host of health conditions such as autoimmunity, IBS and IBD, and diabetes. Because of the toxins, immune complexes are created in the body and become lodged in surrounding tissue, such as the joints and brain, inflaming that specific area. This is a normal and necessary physiological response. However, when it becomes chronic, surrounding tissue can be damaged, resulting in chronic inflammation. It is this chronic inflammation that can be associated with mental health issues, such as depression and anxiety, which puts one at a higher risk for addiction.  Inflammation can also affect serotonin and dopamine levels, in turn affecting moods and appetite.[48] (see appendix 5 for a list of nervous system symptoms as possible signs of food allergies or sensitivities).  Note that food allergic patients and alcoholics have many of the same medical symptoms.  This suggests that alcoholism and food allergy may share common causes, common triggers, and/or common biochemistry and physiology (shared leaky gut; shared abnormal brain chemistry as it relates to depression and   insomnia; and shared liver damage as it related to.[49]

In addiction and substance abuse, food allergies play a significant role in negatively impacting physical and psychological well being.  James Braly, MD, summarizes this in his book Hidden Food Allergies as follows:

….’you are likely to become addicted to those foods that are causing a delayed allergic reaction.  Food allergy-induced food addictions in turn play a key role in predisposition to and perpetuation of alcohol and drug abuse, chronic abstinence symptoms (long-term symptoms that often exist and persist when you’re not drinking or using drugs), and a propensity to relapse into substance abuse over and over again’.[50]

When most alcoholics stop drinking, cravings and other symptoms often lead them to consuming addictive foods to bring the body and brain chemistry back into balance.  This is probably the reason behind many of the addictive foods seen at AA meetings, such as doughnuts, candy and coffee. Those in recovery often binge on allergic-addictive foods to self-medicate.  The consumption of the allergic-addictive foods perpetuates the same abnormal physiology and brain chemistry that the addictive substance achieved. To become sober and remain sober, and reduce the risk of relapse, one must address the problem of allergy-food addiction.[51]   Oftentimes, the food or beverages (including specific ingredients in alcoholic beverages) that people crave the most are to blame and can be a strong hint towards where to start when looking at food sensitivities. Dr. Rudolph Randolph was the very first to propose that many physical/ emotional symptoms and diseases are caused and aggravated by eating certain foods and exposure to environmental chemicals.  At the Fifth World Congress of Psychiatry in Mexico City in 1971, he stated the following:

“(Allergic) foods eaten frequently and regularly are rarely ever suspected as (addictive) offenders.  Persons addicted to common foods simply use them as often as necessary to keep well. In other words, ‘hooked’ persons eat or drink their favorite ‘pick-me-ups’ (food mixtures or primary foods) in order to remain ‘picked-up’ (stimulated) and postpone or treat their ‘hangovers’ (withdrawal effects).  If food addictants are…eaten regularly, obesity, alcoholism, hyperactivity, insomnia, nervousness, and/or anxiety tend to develop; or persons may become self-centered, excited, aggressive, and agitated…These developments, often called the ‘onset’ of the present illness, usually prompt person so affected to seek medical help.”[52]

One should keep in mind that alcohol is essentially liquid sugar, and the grains and sugar are some of the most addictive and allergenic substances on the planet.  An allergen-specific immunoglobulin E (IgE) blood test is one test done to check whether a person is allergic to substances. This method of testing can be pertinent in determining whether food allergies or sensitivities are to blame for the symptoms mentioned above.  One can also do an elimination diet, or more extensive IgG/IgA/IgE blood testing for food sensitivities, to name a few. Epidemiological studies confirm that alcohol consumption has an influence on levels of serum total IgE.[53] However, the paleo diet for recovery, discussed below, addresses many of these concerns by simply eliminating many of the common foods that people develop sensitives to.

Intestinal Flora and the Alcoholic

It was mentioned above that allergens and toxins can negatively impact intestinal flora (bacteria).  In alcoholics, studies show the intestinal microflora is severely damaged.[54] Colonization of the small intestine by bacteria that produce endotoxins (toxins that are present inside a bacterial cell and released when the cell disintegrates) may lead to malabsorption of fats, carbohydrates, protein, folic acid and vitamin B12.  This mechanism is probably the cause of the abnormalities of the small intestine commonly found in alcoholics. Alcohol ingestion also increases intestinal permeability to endotoxins and large particles that can activate the immune system adversely. Some of the measures for restoring the intestinal microbiome are also mentioned in the diet below, as well as simply eating such things as naturally fermented foods with live cultures and/or taking probiotics, which in turn begin to provide some of the inoculation of needed healthy flora.[55] Studies show that short-term oral supplementation of probiotics with Bifidobacterium bifidum and Lactobacillus plantarum 8PA3 is associated with restoration of the bowel flora.  This supplementation also shows improvement in alcohol-induced liver injury more than standard therapy alone (no probiotics etc).[56]

Citations

[33] http://www.smithsonianmag.com/smart-news/alternative-medicine-is-a-34-billion-industry-but-only-one-third-of-the-treatments-have-been-tested-879411/

[34] Jack H. Mendelson, MD, Motoi Ogata, MD and Nancy K. Mello, PhD, Adrenal Function and Alcoholism Psychosomatic Medicine, Vol. 33, No. 2 (March-April 1971)

[35] Robert M. Sapolsky, Why Zebras Don’t Get Ulcers, 2004, 75-78

[36] James L. Wilson, ND, DC, PhD, Adrenal Fatigue, 48-49

[37] Carolyn Dean, Death by Modern Medicine, 2002, 274

[38] OxfordDictionaries.com,  2017 Oxford University Press

[39] The JAMA Network, Ronald A. Arky, MD; Egils Veverbrants, MD; Eugene A. Abramson, MD,  October 14, 1968

Irreversible Hypoglycemia- A Complication of Alcohol and Insulin (http://jamanetwork.com/journals/jama/article-abstract/341306)

[40] Pam Killeen, Addiction- The Hidden Epidemic, 2010, 166

[41] Joseph D. Beasley, MD and Susan Knightly.  Food for Recovery- The Complete Nutritional Companion for Recovering from Alcoholism, Drug Addiction and Eating Disorders, 1994, 53

[42] https://www.integrativepsychiatry.net/pyroluria.html

[43] Woody McGinnis, M.D., Pyroluria: Hidden Cause of Schizophrenia, Bipolar, Depression, and Anxiety Symptoms,

Orlando 21 May 2004 (http://www.hputest.nl/lit108.doc)

[44] Nora T. Gedgaudes, CNS, CNT, Primal Body, Primal Mind, 2011, 324-327

[45] Pam Killeen, Addiction- The Hidden Epidemic, 2010, 343

[46] Julia Ross, M.A.; The Mood Cure; 2002, 304-305

[47] Orthomolecular Psychiatry, Linus Pauling, Source: Science, New Series, Vol. 160, No. 3825 (Apr. 19, 1968), pp. 265-271

Published by: American Association for the Advancement of Science

Stable URL: http://www.jstor.org/stable/1723748

[48] Elizabeth Lipski, Ph.D., CCN, CHN, Digestive Wellenss, 4th edition, 2012, 153-162

[49] Hidden Food Allergies, James Braly, M.D. & Patrick Holford, 2006, 47

[50] Hidden Food Allergies, James Braly, M.D. & Patrick Holford, 2006, 47

[51] Pam Killeen, Addiction- The Hidden Epidemic, 2010, 27

[52] Fifth World Congress of Psychiatry in Mexico City, 1971

[53] A. Linneberg, J. Petersen, N. H. Nielsen, F. Madsen, L. Frølund, A. Dirksen, T. Jørgensen, The relationship of alcohol consumption to total immunoglobulin E and the development of immunoglobulin E sensitization: the Copenhagen Allergy Study, First published: 12 February 2003 (http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2222.2003.01515.x/full)

[54] Irina A. Kirpich, Natalia V. Solovieva, Svetlana N. Leikhter, Natalia A. Shidakova, Oxsana V. Lebedeva, Pavel I. Sidorov, Tatjana A. Bazhukova,4 Andrej G. Soloviev, Shirish S. Barve, Craig J. McClain, and Matt Cave; National Center for Biotechnology Information, U.S. National Library of Medicine; Probiotics Restore Bowel Flora and Improve Liver Enzymes in Human Alcohol-Induced Liver Injury: A Pilot Study, 2009 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2630703/)
55] Elizabeth Lipski, Ph.D., CCN, CHN, Digestive Wellenss, 4th edition, 2012, 14-15, 269

[56] Irina A. Kirpich, Natalia V. Solovieva, Svetlana N. Leikhter, Natalia A. Shidakova, Oxsana V. Lebedeva, Pavel I. Sidorov, Tatjana A. Bazhukova,4 Andrej G. Soloviev, Shirish S. Barve, Craig J. McClain, and Matt Cave; National Center for Biotechnology Information, U.S. National Library of Medicine; Probiotics Restore Bowel Flora and Improve Liver Enzymes in Human Alcohol-Induced Liver Injury: A Pilot Study, 2009 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2630703/)

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