Dr. Marrs and I recently had a book published with the title of “Thiamine Deficiency Disease, Dysautonomia and High Calorie Malnutrition”. I was therefore extremely interested to read one of the book reviews published on Amazon books by a patient who had suffered from what has become recognized as metronidazole toxicity encephalopathy (brain disease). Subsequently, she shared her full story with us. It is published here.
A Comparison of Flagyl Induced Encephalopathy and Wernicke’s Encephalopathy
This drug, sold as Flagyl, is prescribed to treat infections caused by anaerobic bacteria and protozoa. Uncommonly, it causes central nervous system toxicity that has the same damage configuration in the brain as Wernicke encephalopathy (WE). WE is the condition that occurs in the brain in people with severe thiamine deficiency. A manuscript in the medical literature was entitled “Metronidazole-Induced and Wernicke Encephalopathy: Two Different Entities Sharing the Same Metabolic Pathway?” There seems to be little or no effort to explain it as a cause and effect relationship rather than seeing the two situations existing with different causes.
Debilitating Symptoms Post Flagyl
The reviewer states that she has, for two years, suffered with what she describes as debilitating symptoms due to a reaction from Flagyl. She states how these symptoms mysteriously wax and wane. On some days she barely notices them, but of extreme importance, she adds that a mild illness or physical exertion will cause the symptoms to reappear, forcing her back to bed for a variable number of days. When she was taking the drug, she lost his ability to walk and speak, but experienced a dozen other symptoms that persisted. These include difficulty in swallowing and breathing, constipation, severe anxiety, insomnia, depression, heart palpitations, chest pressure and several other unspecified problems. She mentions that she has a borderline enlarged heart.
I must point out here that these additional symptoms are surprisingly common in patients attending physicians in America, often classified as psychosomatic. It is the anxiety, insomnia and depression that guides physicians to thinking that the entire list of “inexplicable” symptoms is psychosomatic. Even the use of the word borderline for heart enlargement indicates that the physician could not identify the total symptomology. If thiamine deficiency had been considered as a diagnosis, the “borderline enlargement” would have fit because it is a cardinal sign of this deficiency.
The patient had evidently done some research on her own and had discovered that metronidazole is a thiamine antagonist. She also reported that in the medical literature metronidazole toxicity is constantly being compared with WE. When she came across our book, she had evidently experienced a flare up of symptoms and began to take supplements of thiamine and magnesium. She stated that the flare up calmed down much more rapidly than usual, enabling her to return to work and function in social activities.
She discovered that doctors do not believe in adverse drug reactions and will not treat the condition since they will not acknowledge that it exists. As a result, she has started a support group for people who suffer from this toxicity. Starting with three affected individuals, there are now over 100, all of whom have the same symptoms. Interestingly, they even warn new members how their doctors will react, preparing them for the reality of being dismissed by the medical community.
Thiamine Deficiency and Psychosomatic Disease
As mentioned in our book repeatedly, the multiple symptoms described by this reviewer are common in the offices of American physicians. “Real” diseases, according to the present medical model, are supported “by laboratory confirmation”. Because vitamin deficiency is generally considered to be nonexistent in America, it is only a physician, open to the possibility, who will entertain the laboratory studies required. The cause of many abnormal current laboratory studies performed on behalf of a sick patient is often obscure. None are capable of identifying vitamin deficiency. When positive as a result of the biochemical changes induced in the body by the deficiency, they are ascribed to other conditions that are acceptable to the present medical model. Hence, the diagnosis of psychosomatic disease often rescues the physician from a failure to recognize his own ignorance. It has always seemed to me that blaming the patient for imaginary symptoms without thinking of the brain as an electrochemical machine represents a glaring deficiency in diagnostic perspective. Unfortunately, nutrition has for long been a neglected area of medical teaching and there are extraordinarily few physicians in practice who recognize its vital importance. What is even more important is the recognition that many drugs are capable of precipitating something as bizarre as thiamine deficiency.
Stress and Illness
I mentioned above that it was extraordinarily important for the reviewer to recognize that flare ups of symptoms occur following a mild illness or physical activity. To explain this, I turn to the teachings of Hans Selye, one of the early researchers in the effect of stress as a causative agent in precipitating disease. Stress must be defined as any environmental factor that imposes a necessity for an animal to adapt (resist). Just like a car that climbs a hill, energy requirement must increase to meet the demand. Mental stress is often more energy requiring than physical stress, explaining the breakdown of health that may follow divorce proceedings. Selye had recognized in animal studies that virtually any form of physical or mental stress imposed the requirement of some form of energy in the ability of the animal to adapt. This was pure genius because energy metabolism was largely unknown in Selye’s time. Modern biochemistry has unraveled a lot of its complexities and thiamine stands out as an absolute necessity in the production of energy. Adapting means that the animal being physically stressed in many different ways would be capable of maintaining a state of health. Failure to meet the increased energy demand was marked by many observed performance and biochemical changes commensurate with those seen in sick humans. One of Selye’s students had reproduced in thiamine deficient animals exactly the same manifestations as those caused by physical stressors.
Diseases of Adaptation or Maladaptation?
The conclusion must be obvious. Any form of mental or physical stress induces a complex reaction in the organism that requires a large amount of energy to run the necessary adaptive machinery. In fact, Selye had concluded that illnesses in human beings were what he described as “the diseases of adaptation”. Since it is a failure to furnish the necessary energy, I suggest a refinement by calling them “the diseases of maladaptation”.
A healthy diet is designed to meet the calorie and non calorie nutrients that fully enable the body to synthesize energy. If this capability fails to meet the demand, even under extreme environmental conditions that permit life to continue, disease follows. The weakness may be genetic or nutritional in character or the stress overwhelming. For everyday life, all three factors are in play continuously.
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