Abstract
To ensure that the supplements recommended with the Mind-Body Wellness Program do not add to stress through contraindications, the contraindications are described. For example, alpha-lipoic acid may lower resting blood pressure, contraindicating it for patients with low resting pressure. The recommended supplements and lifestyles form this kernel of a Wellness Program. The weight of scientifically rigorous and statistically significant evidence behind this program is brought to bear in this chapter as it subserves functional medicine as well as clinical medicine. For example, additions to this kernel that help to tailor the program to specific conditions are presented. For example, by adding cannabidiol, the program is customized for pain management (including fibromyalgia) or anxiety. Neurofeedback is also introduced as another means of treating P&S imbalance, as an adjunct to the program.
A series of quality of life questionnaires, specific for autonomic dysfunction conditions (e.g., diabetes, Ehlers-Danlos syndrome, and autonomic neuropathy), are presented to help in the clinic with diagnoses and therapy planning. To further support therapy planning, examples of the program’s application to various therapies and diseases are discussed, including: (1) evidence that supplements and nutraceuticals, augmented by the program, help to improve pharmacology in those patients that respond to the nutraceuticals (i.e., omega-3s help to close the Statin Gap and help to treat atherosclerosis); (2) evidence that various antioxidant treatments, augmented by the program, may treat atrial fibrillation or neurogenic orthostatic hypotension; (3) evidence that the program treats anxiety, depression-anxiety syndromes, PTSD, ADD/ADHD, some forms of migraine headache, chronic fatigue, and persistent fatigue by helping to restore and establish proper brain perfusion and energy production; (4) evidence that reducing stress (both oxidative and psychosocial) as part of the program helps to treat autonomic dysfunction and small fiber neuropathy, as well as cardiovascular diseases and cancer (including breast cancer); (5) forms of hypertension, specifically, hypertension secondary to parasympathetic excess and hypertension secondary to orthostatic dysfunction, are presented with therapy options; (6) mitochondrial dysfunction associated with neurodegenerative disorders is presented with therapy options; and (7) longevity which is addressed through a discussion of telomere length and its maintenance with the program, including fish oils and antioxidants.
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Notes
- 1.
Illustration by Elysian Creative Studio, www.elysiancreativestudio.com, Lizzy Colombo.
- 2.
First consult your physician. Adult RDAs: folic acid (B9) = 400 to 800 μg, thiamin (B1) = 1.1 to 1.6 mg, riboflavin (B2) = 1.1 to 1.6 mg, niacin (B3) = 14 to 18 mg, pantothenic acid (B5) = 5 to 7 mg, vitamin B6 = 1.3 to 2.0 mg, vitamin B12 = 2.4 to 2.8 μg (sublingual preferred), magnesium = 300 to 400 mg, vitamin D = 600 to 800 IU, and calcium = 1000 to 1200 mg.
- 3.
The neural tube is the foundation of the nervous system occurring in utero by the fourth week of pregnancy. As the neural plate folds and forms the neural tube, separating from the epidermis, the central nervous system begins development from the neural tube, and, among other structures, the peripheral nervous system is formed from the epidermis.
- 4.
Ehlers-Danlos is a connective tissue disorder marked by hyper-flexibility and “elastic skin” which bruises easily due to “weak” blood vessels and is well known to involve the P&S nervous systems. It is considered a hereditary disease.
- 5.
BP = blood pressure; HRDB = heart rate response to deep breathing; VR = Valsalva ratio
- 6.
Could be substituted for results of quantitative sudomotor axon reflex test.
- 7.
Phases refer to components of the Valsalva maneuver: IIe and IIl = early and late portions, respectively, of phase II.
- 8.
Extreme or irrational fear of crowded spaces or enclosed public places.
- 9.
Patients with anxiety-like symptoms have conditions that include the same symptoms as anxiety, but they are either not fully relieved by anxiety therapy or have documented additional dysfunction (i.e., P&S dysfunction that causes poor brain perfusion) that may lead to similar or the same symptoms.
- 10.
There is also a possible genetic predisposition to autonomic dysfunction, including PE, which may underlie anxiety.
- 11.
Folate deficiency is associated with problems in cognition, mood, psychosis, and anxiety.
- 12.
Polypharmacy is defined as more than one drug prescribed at the same.
- 13.
As a comprehensive assessment tool endorsed by both the American Psychological Association and the International Society for Neurofeedback and Research, QEEG is used by qualified healthcare professionals to objectively and scientifically evaluate a patient’s brain wave function to determine whether brain wave patterns are abnormal and, if so, where and why these abnormalities occur.
- 14.
Type A fibers are the thickest and fastest conducting. They are myelinated, with diameters of 1.5–20 microns and conduction speeds of 4–120 m/sec. They are the sensory or motor fibers found in the somatic nerves; examples include skeletomotor fibers, fusimotor fibers, and afferent fibers to the skin. They comprise four subgroups, from highest to lowest speed: α, β, γ, and δ. The A fibers found in the ANS are Aδ.
- 15.
Type B fibers are medium in size, i.e., they are smaller than type A fibers but larger than type C fibers. Type B fibers are myelinated, with diameters of 1.0–3.5 microns and conduction speeds of 3–15 m/sec; examples include preganglionic autonomic efferents. In the ANS, they constitute the white communicating branches (preganglionic afferents) of the sympathetic chain.
- 16.
Type C fibers are the smallest and thinnest of the nerve fibers. They are nonmyelinated, with diameters of 0.1–2 microns and conduction speeds 0.5–4 m/sec; examples include postganglionic autonomic efferents and afferent fibers to the skin. In fact, these constitute the majority of the ANS fibers in the body, e.g., the afferent amyelinated fibers of the visceral nerves and the sympathetic postganglionic nerves.
- 17.
Respiratory Frequency area (RFa) is the measured parameter that is the measure of parasympathetic activity.
- 18.
Dynamic autonomic responses are difficult to document, because most medical tests are performed with the patient at rest (sitting or supine). However, most autonomic dysfunctions are dynamic and require dynamic tests to document them.
- 19.
In small amounts, these ROS are beneficial in “burning the trash” (waste products and worn membranes) and helping the immune systems to “burn out” invaders attempting to make one sick.
- 20.
The reason why people who faint fall down is that once horizontal, the brain and the heart are at the same level; therefore, the brain is fully perfused. If while upright all day long the brain is only marginally perfused, the brain is not fully awake. Once supine, ready for sleep, the brain is finally fully perfused and is now fully awake, even though the rest of the body is ready for sleep. If based on subclinical or clinical forms of orthostatic dysfunction, syncope, or PE, falling asleep is a problem, then lying down for 15–20 minutes about 2 hours before bedtime may help to shorten the time it takes to fall asleep, because once fully perfused the brain is able to process the day and prepare for sleep normally.
- 21.
Clinical doses of antidepressants, used for anticholinergic purposes, often induce additional (secondary) symptoms associated with too much anticholinergic. Remember, the P&S systems are like a pendulum; they cannot be altered with force, only gentle nudges.
- 22.
An ejection fraction greater than 45% or 50%.
- 23.
Although very easy elliptical machine workouts, swimming, etc., are also zero impact, they tend to elevate HR and BP too fast and may be perceived as stresses.
- 24.
ALA exists as two enantiomers: r- or s-. (R)ALA is much more active than (s)ALA, and neither requires a prescription. The (r + s)ALA is the less expensive and less effective form.
- 25.
Ragged-red fibers – clumps of diseased mitochondria accumulate in the subsarcolemmal regions’ muscle fibers and appear as “ragged-red fibers” when the muscle is stained with modified Gömöri trichrome stain. It is a symptom of progressive myoclonic epilepsy. In fact, some believe that migraine with spreading depression and epilepsy are two ends of the same spectrum.
- 26.
In the brain, DA affects emotions, movements, and your sensations of pleasure and pain. Too little DA in the brain may cause muscle cramps, spasms, or tremors. Aches and pains and in the extreme Parkinson’s disease. Too much DA in the brain is linked to suspicious personality, paranoia, and withdrawal from social situations. Drugs, such as amphetamines and cocaine, cause buildup of DA, which leads to drug-induced psychosis or schizophrenia.
- 27.
Resveratrol (3,5,4′-trihydroxy-trans-stilbene) is a stilbenoid, a type of natural phenol, and a phytoalexin produced by several plants in response to injury or when the plant is under attack by pathogens such as bacteria or fungi. Sources of resveratrol in food include the skin of grapes, blueberries, raspberries, mulberries.
- 28.
AICARA is an analog of adenosine monophosphate (AMP) that is capable of stimulating AMP-dependent protein kinase (AMPK) activity.
- 29.
Bezafibrate is a fibrate drug that is an agonist of PPARα. It is primarily used as a lipid-lowering agent to treat hyperlipidemia. It helps to lower LDL cholesterol and triglyceride in the blood and increase HDL.
- 30.
Nicotinamide riboside is a pyridine-nucleoside form of vitamin B3 that functions as a precursor to nicotinamide adenine dinucleotide or NAD+.
- 31.
To use the car analogy the person is “riding the brakes” (PE) and must “over-rev the engine” (SE) to get to speed or go anywhere.
- 32.
In general, it takes 2–3 months (depending on physiologic age; the older or sicker, the longer) for the P&S nervous systems to fully adapt to a new condition, including changing or titrating therapy, changing lifestyle, or responding to a new disease or injury (whether physiologic or psychologic).
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DePace, N.L., Colombo, J. (2019). Mind-Body Wellness Program Benefits. In: Clinical Autonomic and Mitochondrial Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-17016-5_9
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