Saturday, July 27, 2013
On Diet and Transverse Myelitis (1)
I recently came across a couple of articles, in magazines to do with Transverse Myelitis, about vitamins and how they may be important for recovery in our damaged nerves. I have become intrigued, and as a psychiatrist who dabbles in ideas about diet (mainly because I am married to a dietitian), I have been wondering more and more about what it might mean to my personal future recovery. Then of course there is the question of what it might mean to you the reader, assuming that you are reading this blog because you have TM.
The first thing to say is that no-one has really said (yet) that problems in our diet may actually cause Transverse Myelitis. However, we have known for many years that there may be a connection between gross and severe dietary problems and neurological function: in fairly extreme cases of things missing from a diet, part of the picture may be a form of peripheral neuropathy. So, the old sailors who discovered America and Australia knew about Scurvy, caused by the chronic absence of Vitamin C (citrus fruits, vegetables) in the diet while at sea. Lethargy, depression, skin problems, bleeding from the gums, and later neuropathy, jaundice, and even death. Key words here are ‘chronic’ and ‘later’ - it takes a long time for the body to run down its resources. Another illness caused by lack of a vitamin is Beriberi, which has several forms. We have all seen the pictures of starving children with big tummies, skinny limbs, and gross malaise. Another form is that caused by chronic alcoholism in which you can get somewhat familiar symptoms of what has been called ‘endemic neuritis’ - tingling and loss of sensation in hands and feet, loss of muscle function and paralysis of the lower limbs, pain and a heap of other things. This is due to the loss of thiamine (vitamin B1). Now I am not saying any of us are 18th century sailors, or chronic alcoholics. But we do have a whole lot of symptoms that could make us think we might have deficiencies. And then you can begin to wonder whether some supplement or the other will begin to help, or even cure us.
I think there are problems in this for all of us. First, when you start to read about these things online, all the articles are full of long biochemical names and even longer scientific explanations, confusing statements that seem to be ‘advice’ but don’t quite seem to apply to you, lots of ‘ifs’ and ‘buts’, or conversely the author has a particular passion for persuading you that this is definitely the answer, and their company has just the right supplement (at a large cost, of course).
We are all different. There is no “one size fits all”. But there are some matters of interest that may make you think hard about your diet, and I would like to try and make some sense of them for you. I cannot do this in one blog. It may take me some weeks or months to make sense of it all, and get the green light from my wife to tell you about it. Whatever I say to you, I would recommend you talk to your physician. Some are knowledgeable, and have had a good training in, or have good knowledge of, how diet can affect us. Others think they know, but may not have been sufficiently trained to know the whole story. Make up your own mind, and then ask to see a dietitian who uses straightforward language to explain things and can give you a good plan.
Let me just say this to begin with. ‘All things in moderation’. You may have some idea of taking a supplement to help your symptoms. It may help you. But if you take too much, that is you take things to extremes, then you may cause yourself more harm than you needed. There is an old rule in medicine, which is: “First do no harm.” You must apply that to yourself....
There is good evidence that a diet low in saturated fats, moderate in intake of carbohydrates and sugars, and high in whole grain cereal foods (breads, rice and pasta), lean meats or poultry and fish, green and orange vegetables, beans and legumes, darker coloured fresh fruits, dairy or soy products, and a variety of nuts, will keep you as healthy as you can be. To this we should add keep the intake of alcohol as low as possible. I said there was good evidence, and I will come back to this in a later blog.
We all have special needs that may come from digestive problems, diabetes, sensitivities or allergies. So you clearly need to take all this into account. There may be things you cannot eat that contain really important nutrients for a complete diet. This is where your doctor or a dietitian may come in.
Frustratingly (but to allow me to do some more detailed research, and have further discussions with the ‘boss’) I will come back to the issue of supplements in later blogs.
The final word is ‘breakouts’ (no, not zits!). I said ‘in moderation’ earlier, but we all need to have a treat once in a while. I have a thing about a biscuit or two with afternoon tea. I also have a thing about ice cream; I manage to get to a tub about once a fortnight or so, and I do make the most of it. I am not sure it does me any good, but it makes me feel good for a short time.
In all of this, if you know something upsets your legs or your balance, then don’t eat it. Trust your body, even though it has sort of let you down.
Any comments or discussion will be welcomed.