Natural Approach to Mental Health

Dementia and Alzheimer's Disease: a Multifaceted View

    From an early age, I was taught that physical ailments took precedence over any emotional/ mental issues that could be occurring. For example, my parents always took us to our doctor’s appointments whenever we were sick and whenever we needed checkups. If there was a physical symptom present (coughing, runny nose, body aches, etc), it was an immediate onset of questions and concerns. Emotionally, stress was acknowledged and was taken care of by giving space or sustenance to help us cope with it. However, things that couldn’t necessarily be pinpointed were depression, anxiety, ADD/ ADHD, bipolar disorder, etc, which all run prevalently in my family. These were issues that were not in any way degraded: they were simply issues that were presented as “American” beliefs, or things that did not exist when my mom lived in Mexico on her little ranch or when my dad lived in the city a couple of hours away from her. My understanding of the brain was very limited until high school, when I was exposed to several different ideas about how the brain works and how it functions to monitor other parts of the body. The brain was and continues to be a fascinating entity that encompasses all aspects of who we are as people, what biological elements influence our stability, why we think the way we do and how all of these things come together to aid us in staying alive. In an ayurvedic perspective, the brain would be the root that spans into every crack and crevice of the human body. To better comprehend the fullest picture that we possibly can, we have to go past the biological and dive into the social and psychological scopes.

    Brain disorders/diseases in particular are typically categorized in 5 different groups. Neurological disorders, storage disorders, personality/ mood disorders, developmental disorders and prion diseases. The classification of these conditions dates back to Ancient Greece, where it is believed that Hippocrates had the first official ranking for mental illnesses, including melancholia, mania and phobias. Since then, the groupings and types of ailments linked to them have changed, and they continue to be updated periodically as more information and data are collected. Neurological disorders include, but are not limited to, Myasthenia, Gravis, Multiple Sclerosis, ALS, AD, Parkinson’s disease, Huntington’s disease and Dementia. These disorders often affect motor function, the psychological and/ or cognitive mind as well as the emotions. Storage disorders include Tay-Sachs or Gaucher. They are considered to be metabolic disorders that result in degradation of certain lysosomal enzymes meant to digest the larger and more harmful molecules inside cells. Personality/ mood disorders are disorders that include the more common ones we typically hear about, such as schizophrenia, paranoia, obsessive compulsive disorder, depression and bipolar disorder. These are mental disorders that are characteristic of unhealthy patterns of thinking, functioning and behaving. Developmental disorders are disorders like autism, spectrum disorders and Prader-Willi. In psychiatry, this category of disorders is defined as appearing in childhood and is characterized by delay in development of one or more psychological functions (i.e. language). Finally, prion diseases include Creutz-feldt-Jakob, otherwise known as spongiform encephalopathy. These diseases are rare, neurodegenerative disorders that can lead to death. 

    A neurocognitive disorder we will deconstruct is dementia, along with a specific type of it: Alzheimer's disease. Dementia is generally defined as the deterioration of intellectual abilities due to disease. Memory is affected along with judgement and concentration. Dementia also comes with personality changes and emotional instability and can be caused by strokes, diabetes, Huntington’s and Parkinson’s disease, and Korsakoff’s syndrome (severe amnesia). Biologically, there is damage to brain cells in dementia, which interferes with their ability to communicate with one another. As the brain cells get damaged, they become less able to reproduce and multiply to replenish the cells that have already died off. Due to this loss, parts of the brain begin to shrink and more issues begin to arise as a result. The brain as an entity has specific deficits in neurotransmitters like norepinephrine, serotonin, and acetylcholine, that also obstruct its ability to fully function. In psychology, there is a distinction between that scientific aspect, being the brain itself, and the emotional/ cognitive aspect: the mind. The brain is the tangible part, the one that is divided into the forebrain, the midbrain and the hindbrain. The mind is the intangible aspect that has three components to it as well: the conscious, the subconscious and the unconscious. Psychologically, people who have dementia are progressively experiencing changes in function such as memory, language, attention, visual perception, problem solving and concentration. These difficulties affect their sense of identity, how they behave, their mood, their overall well being and alter their social relationships. Once diagnosed, the “people centered” ideal to help individuals with dementia cope with their disorder can either amplify their symptoms or make their condition more manageable. It all depends on their conscious awareness of the disease, how they address their emotional distresses and what support system they have in place to aid them in their stages. The psychological view intertwines with humanism, the social theory that emphasizes common human needs and aims to seek rational ways to solve these human problems. In contrast, the biological view focuses on what can be measured, observed or seen inside the matrix of cells, tissues, organs, etc. Both are needed in order to fully understand the extent of dementia and its components. 

    A type of dementia we mentioned briefly is Alzheimer’s disease. We don’t know what the exact cause is (as is apparent in most brain disorders) but what we do know is that the risk of developing it is linked with genetics. Some patients with AD have a specific genetic problem that can cause an early onset of it as early as 45 years old. Most patients with AD, however, follow other irregular patterns that make it difficult to spot. In neuroimaging, it has been observed that AD patients have plaques (made up of proteins called beta-amyloid) in parts of the brain that show cell loss. The protein that makes up plaques comes from a protein called Amyloid Precursor Protein, or APP, and is needed for neurons to function normally. APP is unfortunately cut up by enzymes into abnormal amounts of beta amyloid. Neurons can get rid of beta amyloid, but only in small amounts. If there is too much, beta amyloid clumps together to form plaques inside of neurons. As a result, the neurons do not function normally and they die off. In addition to that, patients with AD also have “tangles” in neurons. The term is in relation to microtubules, long string-like structures that transport things from the cell body to the end of the axon and dendrites. Those microtubules break apart and collapse into loose nerve endings (axon terminals) and leave a tangled, dysfunctional and dead mess. Externally and simultaneously, the mind is detaching from the person’s body over time. People with AD start to lose their independence and begin to get lost in the memories they have already lived through. They start to digress. One moment, they may be with their spouse or their child and know they are in the car and who they are with, but the next, there may be a shift in their demeanor and they are suddenly confused with their surroundings, where they're going and who it is they were just speaking to. They need to be cared for in a way that helps them live through what goes in their mind. This shift is difficult for those going through these constant shifts and changes, but it is also hard for those that stand by them through it all.   

    There are some medications that have been approved by the US Food and Drug Administration to treat different types of dementia. Those medications include Cognex, Aricept, Reminyl, Exelon and Namenda. All of them actively inhibit acetylcholinesterase, aside from Namenda. Acetylcholine is a neurotransmitter that is released from the presynaptic neuron and then reabsorbed within the body. There is a lot of it in the hippocampus and the cortex. The enzyme acetylcholinesterase breaks down acetylcholine. So in inhibiting the enzyme, the brain is able to retain acetylcholine in the synaptic cleft in order to stimulate receptors on neurons in learning and memory areas. A key factor to consider in these inhibitory medications is that there is some improvement in daily living skills and there is some delay in the progression of the disease. However, it is typically to a small degree and occurs in a small percentage of patients. It can also be very toxic to the liver, which can backfire on life’s overall improvement and can worsen a patient’s mentality about their condition. Namenda, which is the medication we excluded prior, blocks the NMDA receptor for a very short period of time. NMDA receptors are hypothesized to contribute to neuron death in Alzheimer’s disease. There have been small effects in a small number of patients but they have had a dramatic impact on their quality of life.     

    In caring for individuals with dementia or Alzheimer’s disease, it is important to consider the overwhelming costs to treat the disease. According to the multinational biotechnology company Biogen, the direct costs for Alzheimer’s disease and other dementias are estimated at $305 billion for last year alone (Alzheimer’s Association, 2020). Treatment facilities like hospitals, nursing homes, hospice, and home healthcare are also taxed with the burden of having tons of patients but not enough geriatricians, nurse practitioners and other professionals to assist with caring for them. On top of that, an Alzheimer’s Association survey revealed that primary care physicians feel inadequate to manage the rising AD population: 39% of primary care physicians are uncomfortable making a diagnosis for AD, 55% are concerned that there are not enough specialists to meet the demand and 22% had absolutely no dementia training during their residency (after medical school) (AA, 2020). 

    It is impossible to have an ideal situation when dealing with an inevitable disease. However, looking at the biological component of what is going on, the patient’s well being and emotions along with the well being and emotions of those close to them and the primary care physicians involved in treating the patients, helps lessen the gaps in our own misconceptions or ideas. Everything in the body is connected, but the elements that come into play outside of the body are also tied to it.

Sources:

Alzheimer's disease is a serious, growing problem. using biomarkers may alter future care: Identify Alzheimer's disease (ad) - biogen. Alzheimer's Disease Is a Serious, Growing Problem. Using Biomarkers May Alter Future Care | Identify Alzheimer's Disease (AD) - Biogen. (n.d.). https://www.identifyalz.com/en_us/home/addressing-challenges/evolving-alzheimers-disease-care.html.

Psychological dimensions of dementia: Putting the person at the centre of care. www.basw.co.uk. (2018, April 27). https://www.basw.co.uk/resources/psychological-dimensions-dementia-putting-person-centre-care.

Stages of Alzheimer's disease. Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/conditions-and-diseases/alzheimers-disease/stages-of-alzheimer-disease.

U.S. Department of Health and Human Services. (2021, June 9). Brain basics: Know your brain. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Know-Your-Brain.

Ayurveda and the Brain

The human brain is one of the most interesting and impressive developments in all of evolution and biology. The many ways it connects and works with other parts of the body is truly amazing. It is even more amazing to me that despite how much research has been done on the brain, and how much has been learned by scientists, that there is still so much we don’t know about it and how it works. There is still so much research that can be done and how we can utilize that knowledge to help cure or understand certain diseases better. Ayurveda is a huge part of the brain, since not only does the brain control many of the involuntary functions of the body, but it also is how we are able to have conscious thought and cognizance. It is part of both our body and our mind and is the main connection between these two main parts of Ayurveda.

I think Huntington’s disease is a prime example of how the brain is connected, and how certain diseases can affect both the body and the mind through the brain. In Huntington’s disease, a person inherits a dominant defective chromosome 4 from a parent and is affected both neurologically and mentally. Many symptoms include involuntary motor and muscle movements, as well as a change in mood or an increase in irritability or depression and anxiety. An individual with Huntington’s disease can experience some or many of these different physical and mental changes, all because it is a disease that affects the brain. 

Trauma at a young age and the factors that influence it are another way that show how important Ayurveda of the brain is and how it can drastically affect a person. Ayurveda of the brain is a way to illustrate how the body and the mind are connected because the brain is more of the body side of it and the mind is the mind. They are the same thing, and they work together to form the Ayurveda of a person. Therefore, both personality disorders and physical trauma can both come from a traumatic brain injury. It’s interesting that stressors and experience can cause which genes get regulated and which get used, and how that can affect a person both physically and mentally. The gene effects of alleles and environmental factors really gets into the whole nature vs nurture aspect of biology and Ayurveda, and how much each one affects a person is probably very dependent on the person, their genes, and their environment. Environment seems to be especially important for young children and growing adolescents, and a healthy vs non-healthy environment for a child or adolescent can make all the difference when discussing whether a gene for a mental, antisocial, or personality disorder will show or not.

The way that drugs, both for good and for bad, can affect a person’s body and brain functions is one of the most incredible advances in history. It’s unbelievable to me that there are thousands of drugs out on the market that we know exactly what they do and how they work, and even sometimes are used for their side effects. The fact that people in the drug design field can find a molecule and know exactly what it does and use it to help treat a disease or illness is truly amazing to me. Unfortunately, drugs can be both a positive and negative. A major problem in the world of prescription drugs in the United States right now is the opioid crisis. This comes from the fact that a person begins to use prescription opioids, usually because of a real problem with pain management, and they use them too often and/or for too long of a time after they need them, that it tricks their brain into thinking that they are dependent on them to just feel normal. It is a tricky balance between using drugs for an intended purpose and for abusing those same drugs. This, to me, shows again just how delicate the balance of Ayurveda in the brain is, and how that balance can be helped but also so easily thrown off if we are not careful. 

This also includes adolescent and teenage drug use as well. I didn’t know that adolescents and teens had less developed frontal lobes, and that is a reason that they may be more prone to impulsivity. It does make sense that whatever teens spend their time on is what their brain will retain and improve upon, and as drugs increase the dopamine response, it tricks the brain that it is necessary and how addiction begins for many adolescents. It is a dangerous cycle, even for many prescription drugs on the market today including opioids. The laws regarding CII-V drugs try to help reduce or prohibit the excessive use of drugs that have the potential to be addictive, but somehow people still manage to find ways to use them more than they should.

In conclusion, the brain is a very complex and intricate part of the body that can have a tremendous effect on the rest of the body, as well as a person’s Ayurveda. The fact that the brain is essentially the connection between the mind and body makes it that much more important that we do all we can to keep in from being thrown out of its natural balance of Ayurveda. Many diseases, both communicable and inherited, can affect the brain but thanks to modern medicine many of those diseases can be treated or cured through prescription drugs, though excessive drug use is also to be cautioned against in favor of maintaining the body’s natural Ayurveda as well. Outside of drugs and heritable traits, environment can also majorly affect the brain and can have severe consequences for those of younger age that may be in environments that allow certain genes to be used and can affect a person mentally. Though it seems obvious to protect our brains as much as we can, the power it has over us mentally, emotionally, and physically all at once causes it to be of even greater importance than many might initially think. 

Metabolism and Ayurveda

 

I found the topic of Ayurveda to be very interesting because it is all about the connectedness of the mind, body, and spirit which I feel like I have heard about in other contexts throughout my life without using the specific term Ayurveda. For example, I have an aunt that is very involved in homeopathic treatments. From what she has explained to me it is all about energies and the balance of those energies. There are physical or mental stressors that trigger an imbalance of those energies that she treats with extremely diluted substances that are supposed to interact with the person’s energy to recenter them. There is not much scientific evidence backing Ayurveda and homeopathic medical practices, but nevertheless, my aunt swears by it. Even if it is just a placebo effect it still shows that there is a relationship between the mind and body that is important for healing and that they are both important things to consider during medical treatment.

            After researching diabetes, it was interesting to compare that disease and its effects on the body with the ideas of Ayurveda. Diabetes shows that if one thing gets thrown off in the body the whole body starts having other issues since the balance has been thrown off. Since blood sugar levels are unable to be properly regulated by the systems in place, other systems try to pick up that slack which leads to issues in seemingly unrelated systems since they have to do a job they are not designed for. I had previously noticed that people with diabetes often have other medical conditions they need treatment for, but I never would have guessed that those conditions could be connected to diabetes. Diabetes could lead to things like increased inflammation or differences in the microbiome when compared to someone who does not have diabetes. Even things like mental health get affected by this disease. In the article “Chronic Illness and Mental Health: Recognizing and Treating Depression” by the National Institute of Mental Health, it states that diabetes may increase your risk for depression, and if the person does get depression, then the symptoms of both diseases often increase creating an even worse situation for the person. I think that this is especially a good example of Ayurveda and shows the connectedness of mind and body since diseases of the body and mind can make each other’s symptoms worse. I do not fully understand if there is any chemical evidence for the relationship between the severity of symptoms of diabetes and depression or if it just more of an example of Ayurveda and the connectedness of mind and body.

            In some of the microbiome content provided, I learned about the connectedness of the microbiome and the whole body. This is similar to the fact that diabetes often leads to other complications since a change in the microbiome may lead to other diseases or complications as well. I believe this shows just how delicate the balance of the body is and how easy it is to throw off that balance which can lead to some pretty extreme consequences if not addressed quickly. I found this information super interesting because your gut microbiome is linked to your digestive health, which I was aware of, but it is also linked to things like weight or sleep patterns which I was not previously aware of. I think that the gut microbiome would be a super interesting thing to research because if we can take some medication that targets the gut maybe we can help with the high obesity levels in our society or maybe help people with insomnia get some good sleep. In the article, “Cancer and The Gut Microbiota: An Unexpected Link” it describes the relationship between the gut microbiome and disease. Something may throw off the microbiome which leads to disease but then trying to treat that disease by changing something in the microbiome may lead to side effects with the intestinal barrier, so once that balance is skewed it is hard to correct.

            The relationship between the microbiome and cancer was very intriguing to me since I have just taken microbiology and a lot of that information is still fresh in my brain. All of the treatments paired with bacteria sounded very situational and did not seem to have a high or consistent success rate. For example, in some cases, gram-positive bacteria would help with cancer treatments, but then in other cases, the gram-positive bacteria would make treatments less effective. The antibiotic treatments paired with cancer sounded especially shaky since that would get rid of some harmful bacteria, but it would also get rid of other good bacteria which disturbs the balance of the microbiome and may have more negative side effects. Overall, I found it interesting that something as small as bacteria in our gut can have such a big impact on the whole body and things like cancer which can be life-threatening. I was aware the microbiome affected things like IBS but at least that will not kill you like cancer may.

            After doing this research I feel a lot more open-minded and aware of all parts of the body when it comes to disease. I think that it would be beneficial to not simply treat symptoms of a disease but try and see the bigger picture of the illness. Even just making sure the patient is in a good headspace can make a big difference in treatment. I know sometimes when I think too much, I give myself a headache and if I just take a minute to breathe and readjust the headache goes away. There is definitely a strong connection between the mind and the body when it comes to disease and other physical ailments.

Understanding Metabolism through Ayurveda

Ayurveda is an alternative, medicinal system that has stemmed from tradition and dates back to thousands of years. It first began in India and is deeply rooted with the whole person (body, mind and spirit). When it is regarding disease, it means there is an imbalance with the tridoshas (life energies). The three are Vata dosha (space and air); Pitta dosha (fire and water); and Kapha dosha (water and earth). Your Prakriti, which is the prime material energy of which all matter is composed, can help determine what specific diseases or illnesses you are most prone to. People that are composed of Kapha are more susceptible to tonsillitis or congestion in the lungs as a whole. Being made of Pitta would mean you have other vulnerabilities in the stomach or liver as well as be more inclined to have skin disorders. Vata people have a common origin for disease: the large intestine. It is also believed that a disease that exists within the body can present its symptoms in the mind. 

The environmental aspect to this plays a relevant part in the disruption of the tridoshas as well. There are specific emotions that correspond to each one of these and can better help those who practice Ayurveda understand where the problem lies. If there is excess pitta within the body, it will produce anger, hatred and feelings of envy. Pitta is fire and water, so there may be something going on in the stomach, liver or there’s a developing skin disorder not yet perceived. The main idea that is established by ayurveda is connectivity. Everything is made up of matter. Matter is present within us and outside of us. Our bodies are constantly performing functions to help keep us alive and balanced. If there is something wrong with the pancreas, for example, and it does not produce enough insulin to help your body function in normality, you will develop diabetes. In developing this, over time, the body will experience other disruptions. There are multiple pathways, but the idea is the same: there are connections in every part of our body, down to the very cells inside. 

This disorder of the pancreas is most commonly referred to as diabetes. According to the CDC (Centers for Disease Control and Prevention), diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy (2020, para. 1). Most of the food that we ingest breaks down into sugar or glucose and those molecules are then carried through to the rest of our body by our blood. When there is too much sugar for the body to handle, there is a signal that notifies the pancreas to release insulin. Insulin is like the mediator: it helps cells get the energy they need, but also helps regulate the sugar in our system. With diabetes, there may be too much insulin, too little insulin or no insulin at all. There are 2 types: Type 1 and Type 2. Type 1 diabetes mellitus is termed “insulin-dependent” and it is less common than Type 2 diabetes. It is speculated that it can be caused by a hereditary predisposition, endocrine diseases, drugs and chemical toxins, unfavorable environmental factors, damage or removal of the pancreas, autoimmune diseases, viruses and infections or by the autoimmune destruction of beta cells in the pancreas (which are responsible for creating and releasing insulin). As a result of these influences, those that suffer from Type 1 diabetes have an insufficient amount of insulin inside their bodies. As for Type 2 diabetes, this is the most common type for adults. This is also the one that most people have knowledge of. Some causes include a family history of diabetes (genetics), race/ ethnicity, history of gestational diabetes, physical inactivity, high body fat or body weight, high cholesterol, high blood pressure, etc. There is no problem with insulin secretion, but the body becomes insulin resistant over time. Like a lock and key, insulin needs to bind to its receptors in order to allow sugar to go into the cells and provide them energy. Since this isn’t happening, there is an excess amount of sugar in the bloodstream and that leads to hyperglycemia. 

Diabetes does not remain in the pancreas: it affects other parts of the body as well. In an ayurvedic perspective, diabetes is an imbalance of kappa dosha that can cause other issues that stem in different places throughout the body.  In the eyes, it can cause cataracts, glaucoma or retinopathy, each of which can affect the longevity of your eyes and how well you see throughout time. In the kidneys, diabetes can cause high blood pressure, which can damage blood vessels and overwork the organ. The kidney can then become diseased (nephropathy). Being hyperglycemic (having too much sugar in the blood) can damage nerves in the peripheral nervous system, our “rest and digest” system. As a result, there may be pain and numbness in certain parts of the body, including the feet. Wounds may become infected and lead to gangrene and limbs may need to be amputated to prevent the infection from affecting other limbs. 

           Among the 15 leading causes of death in 2013, diabetes mellitus ranked number 7, along with cerebrovascular diseases (strokes) at number 4 and essential hypertension and hypertensive renal disease at number 13. All of these diseases are attributed to lack of exercise and insufficient physical activity. Based on what has been previously written and reported by several sources, diabetes affects more than just blood sugar and insulin. Despite having factors like environment (low income, poor living conditions, low educational attainment, etc), and/or a genetic predisposition to diabetes, it is imperative to find ways to mitigate the onset of it. Accepting the “inevitable” is what furthers the issue. Exercise can help and is proven to lower blood pressure. Eating a healthy and balanced diet also assists in promoting good “gut” bacteria that enables the body to digest more quickly and efficiently. All foods have certain benefits when ingested. Similarly, Ayurvedic treatment for diabetes involves using herbal supplements (using plants that have medicinal properties to promote and enhance insulin sensitivity and balance) as well as exercise and weight management.  

Ayurveda is a practice but also a concept that is meant to enlighten and enhance medicinal approaches. Everything has energy: specific things may have better energy than others. Good habits like eating healthy, for example, would have good energy, as it can boost metabolism and digestion, help the body feel healthy and balanced, etc. Bad habits like drinking alcohol when your blood sugar is low or eating salty and sugary foods at nighttime are “worse” habits, if you will, and open up doors that lead to other problems. It is worth looking into this idea because it can reveal truths we may not have known or understood before. Life is complicated and the human body is complicated too. There are many things we don’t have knowledge about, and many missing pieces. Combining the structural, ever expanding, logic (Western medicine) with the spiritual, connective and natural (Ayurvedic) might help shed light on how to treat new diseases and how to mitigate the onset of others. 

Citations: 

Google. (n.d.). Ayurveda. Google. https://www.google.com/amp/s/www.hopkinsmedicine.org/health/wellness-and-prevention/ayurveda%3famp=true. 

Gordon, A., Buch, Z., Baute, V., & Coeytaux, R. (2019, August 7). Use of Ayurveda in the Treatment of Type 2 Diabetes Mellitus. Global advances in health and medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6686320/. 

Metabolism and Ayurveda

Ayurveda seems to be a very old, traditional form of medicine that uses the body, mind, and spirit to keep the body in its natural, orderly state. From what I have read, its philosophy is that the natural state of things is order, and health is order. In the same way, disease is disorder, and there are many things that affect the order or health of your body. Not just physical things, but relationships, emotions, diet, and things of that nature are all interrelated and play a part in your overall health. This is the main philosophy of Ayurveda as I understand it. Apparently, it has been around for over 5,000 years, mostly passed down by word of mouth, from one person to another, and has been maintained all this time. Many health practices now considered to be homeopathic in the United States have roots in Ayurveda, including oils, yoga, and massage techniques used to help the body and the mind together. Not only is it individual, but according to traditional Ayurveda practice, everything in the universe is connected in this way and the order, or health, can exist between people and populations, and can be either built up or destroyed by practices as have been outlined. The population and individual work together, just as the body and the mind work together. 

Ayurveda also has to do with how the cell processes in the body and how Ayurveda can aid the regeneration of tissues. The balance between the different parts of the cell process and how they work together is very much a part of Ayurveda and is like the way that the body and mind work together in the traditional sense of Ayurveda. While doing some research on diabetes and metabolism, it was cool to see how the different organ systems in the body work together in Ayurveda. Diabetes in particular has the lymphatic, immune, and endocrine systems all working together, and it is one of the reasons that Ayurveda is thrown off with diabetes, because the different systems don’t communicate as much as they should and actually attack each other. 

As I am beginning to research diabetes, one of the first things that struck me as odd was that type 2 diabetes is more concordant in identical twins than type 1 is, which surprised me. I have some family members with diabetes, both type 1 and type 2, and one of my sister-in-law’s has type 1 diabetes. She and my brother have identical twin daughters who aren’t yet quite old enough to know whether or not they will have diabetes as well. It surprises me that they have a higher chance of both having type 2 diabetes than type 1, though that statistic may be different since their mother has type 1 diabetes. It just strikes me as odd, since type 1 diabetes is usually something you are born with and type 2 is something that comes later in life, usually due to lifestyle and eating habits. I also didn’t know that type 1 diabetes is so rare compared to type 2 diabetes. I wonder how rare the other, less well-known types of diabetes are compared to even just type 1. 

I also think it is interesting that diabetes and type 1 in specific are tied to the immune system, since diabetes is usually thought of as more of an issue with blood sugar and glucose by the average person. I think this just goes to show how much must go right for the body to function correctly. Ayurveda is so important for the body in all functions, all the different things that can go wrong if the body and mind are not in harmony. When I think of diabetes, I think of mostly insulin and glucose and their role in regulating the body’s blood sugar level. I am a little ashamed to admit that though my dad has type 2 diabetes, and my sister-in-law has type 1 diabetes, among other relatives with it as well, that I don’t actually know more about the disease itself. I also didn’t know that you could actually get diabetes from a virus or an infection. I was curious about this and looked it up, apparently there are several different viruses that can trigger the onset of type 1 diabetes, with the most common type being enteroviruses. It was even shown in Finland that autoantibody appearance paralleled the enterovirus infection pattern in children (Filippi and Herrath 2008). 

I know such a term as the “diabetes pandemic” has been mentioned before, and while I do think it is probably different due to its incommunicable nature, the graphics of the self-reported obesity among U.S. adults change from 2011 to 2018 is staggering, and makes the pandemic distinction reasonable, with it at least being an epidemic in the United States. I know the graphics are just for obesity, but considering obesity plays such a huge role in many cases of type 2 diabetes, which, as I mentioned before, is by far the most common type of diabetes. I wonder how much obesity plays a factor in type 2 diabetes, if at all. I know it is primarily an issue with the immune system, but it can’t help. Obesity on its own is enough of an issue but dealing with diabetes on top of that can be very difficult for many people, despite it being easy to manage by diet, exercise, and medication. I think diabetes has a bad reputation because people think it is worse than it is, because they only hear about the worst cases, but it is manageable if you know how what to do. That is one reason that diabetes education is so important for people that are new to diabetes. I had a roommate once that was recently diagnosed with diabetes and he wasn’t properly educated about how to take care of himself and how to change his diet, and we had to actually force feed him peanut butter at night because his blood sugar was so low that he was heading into a diabetic coma. 

I’ve always thought it interesting that people with diabetes have issues with their feet and other extremities. On the graphic in the PowerPoint, it says that “feet wounds are likely to heal slowly”, which hits close to home for me, since my dad has type 2 diabetes, and he had an issue with his foot that started about a year ago, I think it was an abscess of some kind. Normally it would heal in a couple of months, but this took much longer, it just barely finally healed completely this month for the first time in a year. I never really thought that it was his diabetes that could be contributing, since he takes such good care of it and has almost stopped taking insulin completely in the last year and a half due to a diet change. Maybe despite that, the narrowing of his blood vessels in his foot over time caused this small issue to be prolonged much longer than it needed to. Even despite how well he takes care of his diabetes, it is still a very scary disease and that a lot can go wrong just due to the nature of the disease. This is what makes it even more scary for those that don’t know how to take care of it, Ayurveda can be thrown off and a lot can go wrong. 

I work in a pharmacy as a pharmacy technician, and one of the most frustrating things about it is how much people must pay for their insulin. Usually, they have to pay really high amounts for the first couple months, before their deductible is met, and then it is a lower cost for a lot of the year. However, this is not true for everyone, and even if it was, it’s still very wrong to me that people with diabetes have to pay so much money for a life-saving drug, one that many of them literally cannot live without. I know it is a hotly debated issue in the United States right now, but insulin prices are too high in my opinion, and they need to be made more affordable. I know it is easier said than done, but there can be improvements made. I like how the slides point out that preventing diabetes is a better strategy to fighting it, and I agree, but those with diabetes shouldn’t be punished for having the disease, they need the medication to live, they shouldn’t have to pay so much for it. Many people that are at risk for diabetes or have diabetes are not able to afford the medication. This makes it even more difficult for those with diabetes that aren’t properly educated to be able to properly treat it if they also can’t afford it. 

In conjunction with my last paragraph, I thought it was interesting that the article focused mainly on the cost of diabetes to the economy, or to the nation, rather than to the individual, which is primarily what I discussed. It is no surprise that such a large portion of the national health care budget is spent on diabetes and other illnesses associated with it. Some of the numbers they brought up are actually really staggering, I had no idea that even almost ten years ago in 2012 that the cost of diagnosed diabetes was $245 billion, $176 billion of which was spent directly on medical costs. I also thought it interesting that a person with diabetes spends about 2.3 times as much on health-related issues than they would without diabetes. This goes back to what I was discussing before about the outrageous cost of insulin and other diabetic supplies and medicine. 

Microbiome: This is a really cool, new topic in science from the last 25 years or so. I took a microbiology class a few years ago and we actually did the feces sample test that it mentions in the first point about the microbiome. I don’t exactly remember what my results were, but I remember that it was cool to see the differences in the gut microbiomes of the different students in the class. The microbiome is such an interesting and unique idea, that all of these microorganisms living inside your body make up a large part of how your body functions, its just fascinating. 

I remember one point that was made in the microbiology class that I took that talked heavily about the microbiome, was the fact that those people that are born vaginally vs those that are born by cesarian section have vastly different microbiomes, and sometimes those that are born via c-section are at more risk for some diseases. I’m not sure how much of a factor it plays, but it makes sense that those children that are not born vaginally may not get the proper microbiome needed from their mother, since much of a female microbiome lives in the vagina, as well as in the gut and gastrointestinal tract. Point number 7 also mentions that children also develop their microbiome through breastfeeding, so those children that are formula fed instead of breastmilk fed may have a disadvantage as well. 

In the eighth point it mentions that use of antibiotics at a young age could actually affect the microbiome to the point that it promotes obesity and autoimmune diseases. I mentioned before that I work at a pharmacy, and I know that a lot of the time, when people are given antibiotics, they will take a probiotic with it to promote healthy bacterial growth, so that the antibiotic only fights against the harmful bacteria and doesn’t collaterally kill the good bacteria in your gut as well. This is something that could possibly combat this issue in young children. I also think it is interesting that they mention how there are E. coli strains in the microbiota, but even when this article was written, and probably even now, they still don’t really know which are the good bacteria and which are the harmful ones. There still needs to be a lot of research done on this topic. 

One thing I never considered is that having pets, and specifically having dogs as a young child, can decrease the risk of allergies, as well as decrease the risk of respiratory diseases. I grew up with dogs in the house, and I have little to no allergies. I usually do not get seasonal allergies, and the only thing that I know of that I am allergic to is horses, which would make sense since I spent little to no time around horses as a young person. Once I got a little bit older, I rode horses very infrequently and it wasn’t until I was about 16 that I realized that I was actually allergic. I think that having dogs in the house possible reduced my risk of allergies. I usually do not get sick very often, and when I do it is pretty mild. This is especially true for respiratory illnesses such as the cold or types of influenza. I even had COVID-19 this last year but it did not severely affect me. Ayurveda is also possibly a factor in the fact that someone that grows up around dogs or near certain animals have some part of their mental psyche that affects their physical body and what they are and aren’t allergic to as adults. I know that some studies have shown that an early introduction to certain foods like peanuts can lower or raise the likelihood of having an allergy to that food. 

There are lots of interesting things about the microbiota I have never thought about before in this article. Both the fact that you can transplant part of the microbiome to another person and that it can help treat disease, and the fact that the transplant could possibly help people with diabetes due to an increase in insulin sensitivity, is pretty crazy. This isn’t something you would think possible in traditional medicine, at least I wouldn’t. I think it is pretty cool that they have figured out how to do this, even if they don’t totally know what the microorganisms are that are helping these improvements specifically. I think that will likely take many more years and lots of research to figure that out. 

I think the logic that said that a higher diversity of gut microbiome is better than a lower diversity makes a lot of sense. The more microbiota you have the higher chance you have of those microbiotas helping your body to fight harmful bacteria. Now, I guess it means that you also have a higher chance of those bacteria being harmful, but generally all of the microorganisms in your gut and microbiome are there for your good. I think overall this article was cool to read to know how much future research and discoveries there will be on this subject, it could be a huge boost to medicine and health research. 

Much of what I discussed earlier is brought up again in the next slides, so I won’t belabor the point and restate things, but I do think it is interesting to think of areas of the body as being “sterile” when we as humans are literally living organisms with many other living organisms inside of us. It is a strange thought, but I suppose some areas are more sterile than others, and others need to be less sterile than others, such as the gut, to perform correctly. I think coevolution is another really interesting point. It is strange to me to think about the fact that not only have humans been evolving for millions of years, but that microorganisms have been living inside of us and as a part of us for just as long, and of almost all animal organisms, and that they have been coevolving along with us the entire time. 

The idea presented in the paper about how the gut microbiota could possibly influence behavior, is such a strange but cool concept to think about. Normally, I would not think of those two areas of the body as communicating beyond simple neural response signals sent back and forth, as is the case with the brain and the rest of the body. However, thinking about the possibility that the gut is partially responsible for mental health and behavioral issues such as anxiety or depression is a pretty crazy thought. I would say mental health is one of the aspects of health that we know very little about comparatively, but this relationship is fascinating. It really takes it all back to the idea of Ayurveda, and the fact that the body and mind are constantly in communication and that they both are capable of influencing each other and are part of the same system. This is where Ayurveda really comes to the forefront of this discussion, to me. 

Cancer: I never quite thought about the microbiome influencing whether or not someone develops cancer or cancerous cells or not, but it certainly makes sense, especially for gastrointestinal cancers. I didn’t really consider the possibility of it affecting the immune systema and other areas of the body in such a way as to either promote cancer, or just not contribute to fighting it. I think genetics probably plays a large role in whether someone’s microbiome helps or hurts their chances of developing cancer, but the research likely also shows that it is largely due to diet and environmental factors as well. Not only this, but it is also very interesting that the microbiome could hypothetically be used.

To conclude, Ayurveda is very important in metabolism as a whole and for diabetes, microbiome, and cancer prevention. diabetes is a flaw in an organ system that involves many different systems in the body, throwing off Ayurveda. The microbiome is Ayurveda on a micro level, with many different microorganisms working together to create a newly discovered organ system that affects all parts of the body in ways that we don’t fully understand yet. It can even help in cancer prevention and if it is thrown off, can be the cause for cancer in some cases. 

The Adapting Body

 

The human body is an amazing machine, and like all machines, they require the correct components for basic function, i.e. glucose for basic cellular respiration. Unlike machines though, the human body tends to find a way to work regardless of the lack of correct components, such as through gluconeogenesis.

                Our bodies have very intricate metabolic pathways that allow us to do extraordinary things. As most people know, glucose is the main fuel source for basic metabolic function but what happens when there is no more glucose to use. Thankfully, the body finds a way to make glucose so that it can continue to thrive and grow. It does this by breaking down glycogen stores first and then it begins to create new sugars that can be used for cellular respiration. This process is known as gluconeogenesis. Gluco being glucose neo being new and genesis being creation. Creating “new” glucose for the purpose of cellular respiration.

                This is just one example of the intricacy that our bodies naturally possess to allow us to grow, reproduce and be evolutionarily successful. This process shows the end product of thousands of years of evolution that have solved the question. What if there is not enough glucose in the environment to consume to sustain life? The body has figured out a way to create new glucose so that in times of famine there is still enough to go around.

                The evolution that is required for these kinds of answers takes time though. I think that because we have so many new problems that arise so quickly then our bodies are not able to adjust and fix the problems itself. If we slowly adapted to eating a highly refined sugar diet then maybe our bodies would have learned to better control the excess sugars and things like diabetes would be less of an abundant issue. However, because we have switched to eating a more refined diet over a generation or two, instead of a millennium or two, we are not able to adequately deal with such a sudden shift. This is not only apparent with glucose-related disease, but look at what is happening with the sudden shift to an over-exposure to artificial light. This has happened even faster than a generation it has happened in as short as 20 to 30 years. We are seeing that an increase in artificial light exposure can lead to things like sleeping disorders, mood disorders, and a whole host of psychological problems.

                 We see these kinds of problems day more and more commonly and one great explanation as to why is an increase in light affects our sleep patterns is Ayurveda. Ayurveda is the traditional Hindu system of medicine, which is based on the idea of balance in bodily systems. This means that when something like light exposure is increased, it not only affects our eyes at the moment of exposure but it will continue to affect other parts of our body that relies on light for signals for biochemical reactions and then on to anything that is affected by those biochemical reactions.

                A great example of these reactions getting out of hand is diabetes. Diabetes is a disease that occurs when there is an incorrect balance of glucose in the bloodstream and not in the cell. When this occurs over long periods of time it's common to see problems like heart disease, stroke, kidney damage, blindness, and nerve damage. I find it fascinating that an imbalance of glucose in the bloodstream can cause you to lose your sight. This shows that Ayurveda is a real concern and that our bodies have very intricate pathways that are all interconnected. It is not that excess blood sugar attacks the eyes resulting in blindness, it’s a far more complicated chain of events that over time affects vision and other aspects of the body that are not directly associated with cellular respiration or blood glucose.

                But we as humans are designed to overcome challenges like this. It is called adaptation and evolution. If we started off slowly “learning” how to handle excess blood sugar then over generations and several thousands of years, it is likely that diabetes would not be a problem, similar to the way that decreased glucose in the bloodstream is not a problem.