People have been asking how the stem cells go past the blood brain barrier to get to the substantia nigra where dopamine is made. Stem cells are not supposed to be able to cross the BBB, which is why early stem cell treatment for Parkinson’s was not broadly successful.But it seems that the Blood Brain Barrier is less a barrier than a regulator which can at times be selective in what it lets through.Now it isn’t clear to me whether the stem cells actually go through the BBB or just signal cells on the other side but it does appear to make a significant difference clinically. I think they do get through based on the research cited below.
There are three primary sorts of barriers of the BBB, the vascular brain barrier, blood-CSF barrier, and the specialty CNS barriers such as the blood-retinal barrier. They transport molecules in by pores, the opening of tight junctions and receptors. (1) One can also bypass the BBB by going through the nose or injecting directly into the cerebral spinal fluid. This even works for larger molecules like peptides and other proteins.(1) Injecting insulin through the nose has been helpful for Alzheimer’s for instance. And they injected stem cells into the middle turbinate of my nose as one form of administration. It was weird but topical lidocaine prevented pain.
However researchers also found that mannose IV infusions open pores in the BBB and increase enzyme passage 10 fold (2). In fact mannose infusion has become a standalone therapy as well as a way of getting drugs to the brain.
StemGenex, the center that performed my stem cell administration, started using mannose infusions long before they started using intranasal injection. It increased the success for neurological conditions. Their mannose solution increases the diameter of pores for 20 minutes, so it is immediately followed by injected and IV stem cell administration.
If you are academically inclined, the following articles give the science behind getting through the BBB. Our understanding of the BBB is growing every day.
So I had the procedure yesterday. In the morning they took blood and did the mini liposection. I was sedated without loss of consciousness. It was laparoscopic with two tiny incisions, filled with saline and epinepherine then fat cells were extracted. They wrapped my abdomen in a stiff binder and took me to the recovery room. After recovery, while the cells were processed, laser and enzyme activated and mixed with Platelet Rich Plasma, they gave me an infusion of mannose to open the blood brain barrier. Apparently they started this practice before having used the intranasal administration and found great improvement in neurological patients.
The cells came back in a mini IV bag of pink liquid and a group of syringes, one for each of the points we had selected and a catheter for the bladder (the only real painful procedure.) I prevailed upon him to stick me at St. 36 for stamina and he was already using Liver 3 for my toe that has been bursting through the cartilage since the Parkinson’s Walk two years ago.
The IV was somewhat curtailed since I have small veins. The nurse decided that I already had a few billion stem cells, so she drew it out of the IV tube into the syringe. I considered self-injection (and ought to have asked for the doctor to inject more into my chronically stiff neck. )
There is more and the staff was interested in how acupuncture can reduce scars and deal with neurological conditions. The medical director said she was told by a Chinese acupuncturist that acupuncture stimulates the activity of stem cells (albeit at a lower concentration.) Silberstein, M. (2009). The cutaneous intrinsic visceral afferent nervous system: A new model for acupuncture analgesia. Journal of Theoretical Biology, 261(4), 637–642. doi:10.1016/j.jtbi.2009.09.008
I found two exciting pieces of research this week that will affect my treatment. If you have been following me you will know that I am fascinated with the gut bacteria and the other tiny creatures that account for 90% of our DNA. The gut/brain interface is more fascinating than you might imagine!
The first study from the University of Helsinki found that the gut bacteria- the microbiome- of people with Parkinson’s is different than that of healthy people. We have more of some bacteria- which increase the worse the symptoms get and others have gone missing, relatively speaking.
The more Enterobacteriaceae we have, the more severe the symptoms. A lack of Prevotellaceae bacteria in Parkinson’s sufferers could mean these bacteria might have a property which protects their healthy hosts from the disease. This seems strange since I generally consider Prevotellaceae to be a sign of inflammation. Or does this discovery merely indicate that intestinal dysfunction is part of the pathology? It might be a result of Parkinson’s disease.
The second piece of research in Blood, the Journal of the American Society of Hematology, shows that people with more gut bacteria do better with stem cell transplants. The more diverse the microbiome, the better the stem cells take. This of course gets me questioning the pre-op antibiotics that StemGenex recommends. Next stop is sending them the research!
Now given that a healthy gut should have some 10,000 species according to Martin Blaser’s book Missing Microbes and a functioning biofilm, taking a probiotic with a maximum of 13 species of lactobacillis and bifidobacteria isn’t going to make it. I do like to take Saccharomyces boulardii which tends to be under-represented and soil based probiotics for the same reason. And to eat Jerusalem artichokes which help them grow. So I am onto my fermented food regimen which allows for unnamed wild species: full fat unsweetened yogurt from different animal milks, olives, miso of various sorts, blue cheese, kombucha, fermented veggies, kimchee, pickles, refrigerated sauerkraut and raw milk products.
I spoke to someone who is in the business of leasing and selling hyperbaric chambers and running hyperbaric clinics who deals with a variety of brands. The single person sit-up chamber is apparently not as durable as the other ones- not something you want for a unit under pressure. (He was personally in a unit that failed and doesn’t recommend it!)
And when I did a web search on hyperbaric chamber safety and read the FDA report I found that not only did the Grand Dive bell chamber fail during its first warranty period but the replacement unit failed within 3 weeks. Those were used as directed but I also found that the soft units that go up to 7 psi use air concentrators designed for waste management and put much to much pressure on seams and zippers. The one I used last week went that high.
The chamber I used was 32″ in diameter and one could not sit even cross-legged like the 40″ chamber shown in the photo. And it was not translucent since it was covered in blue vinyl. Also we need to wear masks to breathe in the oxygen, but that is probably wasn’t sufficiently photogenic.
He did say that in the mild hyperbaric chamber where you breathe 80-90% oxygen through a mask in a compressed air chamber with 25% oxygen is different from a hospital unit with 100% oxygen where you cannot use electronics. And that people can safely use laptops or music sources. Hmm.
But he tells me that there is something like an 80% increased proliferation in stem cells after 40 biweekly sessions. Of course a NYC apartment is no place for a 8′ x 3′ diameter horizontal unit. So the search is still on for a place with a sit up chamber, preferably of the shared type.
Monday I started my pre-implant regimen of hyperbaric oxygen. This is recommended both before and after the stem cell implant. Fat cells, especially the swollen ones in the obese, are often oxygen-starved. The idea of pre-treatment is that the fat cells used to provide the stem cells will be less hypoxic with this treatment and therefore stronger, akin to those of a younger person.
An online friend, the late Dr. Ignacio Fogel, used to sing the praises of hyperbaric oxygen which he used for patients and the Argentine Olympic team alike. At the time the only hyperbaric oxygen I could find was in hospitals, often used for nonhealing sores or scuba diving accidents. Today, with the advent of portable units there are a variety of units in medical practices and spas. I’m a little afraid of claustrophobia, but I have had a hunger for oxygen since my EMT training days.
Hyperbaric oxygen therapy puts oxygen in your fluids in a concentration that differs from say deep breathing exercises, an oxygen bar (which just uses compressed air) or oxygen tanks. The increased oxygen in the blood and body fluids bathes your cells with extra oxygen and has an anti-inflammatory effect on the par with 40 Motrin without the side effects. Apparently President Reagan used it to treat his cancer.
I promised to document both the positives and negatives. I called Downtown PMR which had a lie down chamber that looked like the blue one illustrated. A delightful young lady gave me forms to fill out and agreed to tell the doctor that I had awakened with some vertigo and suffer from mild claustrophobia.
The chamber was an inflatable blue vinyl lie-down chamber with two small portholes near the head. It has the ability to go to 1.5ATA or the equivalent of 7.35 pounds per square inch of pressure. That is about the equivalent of diving 15 feet down, but without the scenery. There are hyperbaric chambers that only go to 3psi, but less oxygen gets into your plasma. And hospital chambers get more pressure and higher oxygen than the 80% used here, but are available only for limited uses. You spend an hour and twenty minutes in the chamber, with one hour at full pressure. Most independent places charge $100-$120 per session.
The way it usually works is that most of the oxygen circulating in your blood is carried by hemoglobin with a small amount in the plasma. Under atmospheric pressure the oxygen gets smaller, more concentrated and significantly permeates the plasma, so you have much more circulating oxygen after a chamber session or “dive”.
The size was about 7 feet long but no more than 36″ in diameter, perfect for a tall skinny person. (They say a child could sit at one end but it would need to be a tiny child and I’m betting the illustration is of a larger chamber than this was.) The oxygen comes in through a face mask but the chamber is inflated and pressurized with air. You are zipped in and a bunch of oversized seatbelts are attached around the chamber. There is an inside zipper for emergency exits but an attendant would need to unlatch the belts.
They suggested chewing gum or airplane earplugs to help clear the ears. (It might be good to have suggested bringing it in advance!) You can read although the light isn’t very good but no electronics or batteries are allowed around the oxygen which meant no music, cell phone or hypnosis mp3s.
The PT promised to stay in the room and told me that she would stay in the room and would check on me. All I needed to do was to bang on the side of the chamber. Given that a woman was unable to get out of a chamber at a spa in Chelsea earlier this year without an illicit (and potentially dangerous) phone call for help I expected they would be vigilant.
The chamber seemed like an oversized sleeping bag but did expand as it inflated. It was pretty dark since the vinyl was blue (there is a white unit on the market that is translucent and more expensive hard sided plexiglass units.) The noise was loud but not intolerable.
My claustrophobia did kick in. I did a lot of yoga breathing, tried going to my favorite hypnosis imagery, read a little from two different books, tried to sleep and made a conscious effort to keep my mind in the present. The PT had stopped checking on me and I could tell she wasn’t in the room since the only chair out of sight was full of my clothing and backpack. To be fair there was nothing much for her to do there and she probably had the door open. But when I started banging on the side so I could find out how much time I had left, she was nowhere to be found. By the time she showed up I only had 5 minutes left but was in no mood to stay. It took several minutes to depressurize.
These are the things that would have made it better: a translucent unit or one with larger portholes. A clock within sight of the unit would have helped me calibrate my energy. Music or video just outside the unit would have distracted me. An attendant with work to do in the room would have helped when I needed assistance. And since the oxygen was drying, I should have had something to drink either before or during the dive. And for me, not wanting to trigger claustrophobia, a seated “diving bell” style unit would have been better, just as I always use a Standup MRI when I need an MRI.
Now I am sorry that my diving certification lapsed because I’d rather scuba dive to compress the oxygen!
However if you know of a sit-up hyperbaric chamber around NYC, let me know.
If I can’t find one I might be back, sedated with skullcap and kava, bearing a clock and an iPad with music to play outside of the window. Or perhaps with a dog to share the chamber with.
Incidentally I have found two new foods that diminish Parkinson’s tremors: watermelon and papaya. I learned about them from a Parkinson’s blogger who calls herself Aunt Bean (after the fava and mucuna beans she grows for PD.) Apparently the late pope used fermented papaya and Aunt Bean has a recipe here. I started out fermenting them. Watermelon was easy: I scooped the pulp into a blender, liquified it and added water kefir grains. It soon turned into a bubbling sour drink. The papaya was harder: I mashed the pulp and fermented it but needed to dry it on fruit leather trays which I don’t have for my dehydrator.
But I also read comments that the unfermented food worked and I noticed that raw watermelon and papaya seemed to reduce tremors. Fermentation does reduce sugar and add probiotics but it doesn’t keep very long. So my dehydrator is going, full of papaya slices (the watermelon is done.)
Now I had no idea why watermelon and papaya work, and they are hardly a cure. But it was tasty and easy to incorporate into a daily diet. I still take the fava beans (note that dopamine medication could interact) but I don’t take them every day any more.
So I went on a search. In Chinese Medicine watermelon is considered a cold medicinal herb, used to drain heat out of the body through the urine and to replenish fluids. Xi gua (watermelon) is known to clear heat, replenishes fluids, regulate urination and expel jaundice- it is used in hepatitis treatment. While the materia medica says that it goes to the Heart, Bladder and Stomach but not the liver, the attributes or meridians named after organs are not identical with those attributed to organs by Western medicine The jaundice and hepatitis indications made me think of the liver and I guessed that glutathione production might be affected. And in fact while I still needed to check scholarly sources, Dr. Oz cites watermelon as a rich source of glutathione. And although short-lived and poorly absorbed from pills, glutathione does reduce tremors.
Watermelon provides 28 milligrams of glutathione per 100 gram portion. A perusal of PubMed shows that watermelon extract can mitigate oxidative damage from X-rays or genotoxicity and neurological balance. To use or make glutathione we need water which is in abundance in watermelon. If we are dehydrated we may not make as much glutathione as we could.
Glutathione, a compound containing three amino acids, glutamate, cysteine and glycine, is the body’s master antioxidant and when its production is damaged a variety of things can go wrong including tremors. IV glutathione is given in a push to stop symptoms of Parkinson’s Disease but the IVs are recommended 3-7 times a week, not covered by insurance. The landmark glutathione Parkinson’s study, “Reduced intravenousglutathione in the treatment of early Parkinson’s disease.‘, was done by the Department of Neurology, University of Sassari, Italy in 1996. In this study all patients improved significantly after glutathione therapy with a 42% decline in disability. Neurologist Dr. Daniel Perlmutter has been giving it to PD patients since 1998.
Now I would not be so reductionist as to say that it is only glutathione that makes watermelon or papaya work. Watermelon hydrates which provides the a matrix for the hydronium ions that carry qi through fluids, It is high in flavanoids Vitamin A, Vitamin C, B vitamins, and potassium, not to mention cirtulline and lycopene, One slice of watermelon (485 g) contains 152 calories, 3 g protein, 34.6 g carbohydrates, 2.4 g fiber, 560 mg potassium, 176 mg vitamin A (RE), 47 mg vitamin C, 8..5 mg choline, 0.1 mg riboflavin, and 0.96 mg niacin.
Papaya contains enzymes that induce glutathione S-transferase. Papaya latex contains at least four cysteine endopeptidases and other constituents including hydrolase inhibitors and lipase. It has rather high levels of potassium and significant levels of calcium and magnesium. Vitamin C, Vitamin A. A small fruit (157 g) contains 67 calories, 0g protein, 17 g carbohydrates, 2.7 g fiber, 286 mg potassium, 1531 IU vitamin A (RE), 86.5 mg vitamin C, 15 mg folate and 0.5 mg niacin. Since the enzymatic effect is important one should avoid irradiated papayas to get the best effect.
There is evidence that a yeast fermented preparation of papaya is more effective than fresh or dried papaya. It reduces oxidative stress and has been found to protect the brain from oxidative damage in hypertensive rats. Pope John Paul ll was prescribed an experimental treatment made from a fermented papaya to ease symptoms of Parkinson’s disease, I suspect that the fermentation makes a difference compared to dried or raw papaya.
So incorporating watermelon and fermented papaya is an easy way to reduce symptoms. Other fruits that also have glutathione and are rich in antioxidants are berries, oranges, pomegranate, apricots, prunes, avocado, grapefruit, strawberries, peaches, cinnamon, asparagus, legumes, nuts, spinach and bell peppers. Or eat cysteine-rich food including dairy products such as cheese,yogurt and chicken breast since cysteine is used in glutathione synthesis. Add a couple of Brazil Nuts for selenium (or tuna, beef, walnuts, eggs, cottage cheese, or turkey) and we are set!
I was diagnosed with Parkinson’s Disease 6 years ago. I am working as an acupuncturist, herbalist and health writer, which all require a steady hand. I have been helping run free clinics since 9-11 and do a lot of public health education on Facebook and my blog Natural Health by Karen and teach as an adjunct professor at NY College for the Health Professions. My private practice specializes in complicated conditions which is rewarding but not lucrative. At best this is a breakeven proposition so my funding for treatment is limited. I have mastered the art of ambidextrous needling and the tremor only happens at rest but the tremor is starting to spread to the other side and it will eventually affect my ability to treat patients.
I have found a promising experimental stem cell trial by StemGenex in La Jolla, California that has a special affinity for Parkinson’s and other neurological diseases. Unlike most stem cell treatment centers they use an intranasal administration to get stem cells to the brain, either traversing or signalling beyond the blood brain barrier.The treatment was pioneered for Alzheimer’s and works for that disease. They do this along with intravenous and direct injections and their internal statistics on Parkinson’s patients are much better than others since getting the stem cells into the brain is difficult. I would like to participate in the trial for this promising procedure.
I have been pre-approved for treatment but insurance will not cover experimental procedures (and trials on procedures are not covered by drug companies!)
The cost of treatment is $15,900 plus air fare of $800 and $1000 for a course of hyperbaric treatment as aftercare.
I will write in detail about the experience, documenting it with video and making medical information available regardless of outcome. This will help others considering stem cell treatment. I will focus on what can be done to enhance the treatment, based on interviews with patients, doctors and my own experiences.
If you know someone with Parkinson’s, would like to advance the medicine, want to help me or just want to do a mitzvah, I would be very grateful. If you know someone else who might help please pass this on.
Thank you for reading this far. I must acknowledge that I am a bit bewildered by this new way of dealing with health care (and hope it doesn’t sound tacky to ask for help,) but I appreciate your interest.
Donations to Paypal at ksvaughan2@aol.com or Go Fund Me
‘In Chinese medicine there are hundreds of traditional formulas that belong to the commons. If you buy Liu wei di huang wan (Rhemannia 6) or Bu zhong yi qi tang (Tonify the Middle and Augment the Qi Decoction) you will find essentially the same formula made by a wide variety of manufacturers under the same name. They may have minor variations but are essentially the same in function and content.Many of the recipes and their names derive from famous doctors like Zhang Zhongjing who wrote the Shan Han Lun or Sun Si Miao. The names of the formulas neither are nor can be trademarked by a single company. The Bensky formulas book contains over 500 traditional formulas.
There exist in Chinese medicine private, patent-protected formulas like the famous Yunnan Bai Yao stop bleeding formula. The difference is that Yunnan Bai Yao is relatively modern, developed by Dr. Qu Huan Zhang in 1902, was always private (but now controlled by the Chinese government) whereas other traditional formulas are and have been public for centuries. So no one can trademark “Liu wei di huang wan”, although one can create other similar formulas for yin deficiency. There certainly are other formulas to stop bleeding and many of them use san qi (notoginseng root) which is believed to be the basis of Yunnan Bai Yao’s secret formula but they cannot use the non-traditional trademarked name.
There are also many modern “hospital formulas” whose exact content remains sketchy in Medscape abstracts and these are being protected for profit. In addition many companies make patent-protected variants of traditional formulas under other names, but the vast majority of herbal formulas are traditional. In Japan these formulas with regulated recipes are part of the the National Health Insurance drug registry.
We have traditional recipes in Western herbal medicine too although far fewer of them. Mithridaticum was a shotgun anti-poison remedy from the first century BCE,. The Romans enlarged and adapted it as “Theriacum”, described in pharmacopoeias for centuries up through the European Renaissance. The Middle Ages brought Thieves’ vinegar, allegedly composed by the midwife mother of one of a gang of 4 thieves who managed to steal from houses where the Black Death had stricken without themselves contracting the plague. During many centuries great herbalists from Hildegard of Bingam to Gerard to Maimonides to Culpepper used formulas, but few were standardized. Most Western herbals classified single herbs both by properties and energetics even if they might be used in combined formula. And assaults against using herbal medicine, from early Christian faith-healing through the witch trials up to the early 20th century Carnegie Commission broke the continuity of traditional herbal formulas in a way that the documented Chinese herbal tradition did not have to contend with.
There were a number of well-known formulas in the 19th and 20th century Samuel Thompson came up with his famous Composition Formula which treated diarrhea and dysentery along with a variety of formulas featuring cayenne and lobelia. Roberts Formula is traditional for ulcers. Neutralizing cordial was developed by the Eclectics for fermenting and irritating conditions of the stomach and intestine. Mother’s cordial was an Eclectic formula promoted by Feltzer and Lloyd to prepare the uterus for labor at the end of pregnancy. Antispasmodic Tincture made from lobelia seed, crushed skullcap, skunk cabbage root, gum myrrh, black cohosh and cayenne was developed by Thompson and refined by both Dr. Christopher and Jethro Kloss for spasms of all kinds and lung conditions. Kloss, D. Schulz, Tommie Bass, Hannah Kroeger, Dr. Shook and Dr. Christopher popularized a variety of formulas for the public good including Blood Stream Formula for clearing “bad blood”, Bone Flesh and Cartilage (BF&C), Anti- Gas Formula and many others. These were freely adapted and many companies produce versions of the formulas. Other herbalists who drew on common formulas include Harry Hoxsey whose named formula drew heavily on the Park Davis Trifolium (red clover) Formula. Black salves and drawing salves for cancer also percolated through the herbal commons, as did versions of Essiac.
There were also trademarked names and patented products. Swedish Bitters is a trademarked version of digestive bitters There are licensed and trademarked Edgar Cayce formulas. Lydia Pinkham tonic is trademarked. Airborne is a modern trademarked and patented product derived from the traditional Yin Qiao San with additional nutrients and echinacea. The difference between a trademark and a patent is that a trademark restricts the name of the formula but not the content while the patent restricts both.
Rosemary Gladstar was one of the early pioneers of the current wave of American herbalists and started teaching in the 1970s. In the tradition of the earlier herbalists she did not trademark her formulas and a wide variety of products have been inspired from her teachings, often using the same names. Fire Cider is a term invented by Rosemary Gladstar over 35 years ago, and has been shared by her freely since then to tens of thousands of people. She has it in her published and copyrighted books and teaching handouts from the 90‘s and pamphlets from the 1970’s. The formula is much older than her – indeed Mrs. Grieve has a similar formula under another name and countless middle European grandmothers have made horseradish and onion-based therapeutic vinegars. Various people have used both the name and basic formula for decades. Monica Rude of Desert Woman Botanicals has sold Fire Cider since the 1990s, for instance and taught the recipe under that name.
We have an herbal incident occasioned by a firm named Shire City who decided to trademark the term “Fire Cider” based on inaccurate information provided to the US Patent and Trademark Office. One of the principals of the firm apparently studied herbalism at the school where Monica Rude was teaching about Fire Cider and experimented with making fire cider at that time. The Shire City Trademark application summarized here claimed that the the first use of the term was 12/4/2010 and that date was its first use in commerce.
Rosemary Gladstar of course has it in her copyrighted books and teaching materials at least since the early 1980s and perhaps earlier. And on Rosemary’s Fire Cider YouTube video.
Rosemary is credited with inventing the term and bringing the basic recipe to the herbal community in her books, The Home Medicine Chest (Storey Publications, 1999) and Rosemary Gladstar’s Family Herbal (Storey Publications, 2001) and has expressed her desire that the term remain in the herbal commons.
We do not know whether the erroneous information in the trademark application is accidental, due to the ineptitude of their attorney (who apparently didn’t do a Google search) or was deliberate, done with the specter of future work defending the trademark, or was done with the cooperation of Shire City. What we do know is that someone from the company or their counsel contacted Etsy and Amazon and that a number of small herbalists were shut down . They insisted on their right to trademark the name, describing its use as unknown before they publicized it. Given the patently untrue assertions, the high regard Rosemary Gladstar is held in and the history of fire ciders, the herbal community erupted with petitions that picked up thousands of signatures in a few hours, calls for boycotts and the Shire City Fire Cider Facebook page was flooded with critical comments.
After requesting a few weeks to consider what to do they doubled down and essentially claimed that the only thing to be done is to sue them, “The only thing that will make the name ‘fire cider’ a generic term is a ruling from the USTPO. Challenging a trademark through the USTPO is a commonplace occurrence with clear rules and requirements, and we welcome anyone who would like to avail themselves of this path. This is legal, fair, and something to be expected as a part of doing business.” Now it isn’t their only option and they may be trading on the idea that the herbal community is unable to mount a legal challenge. The trademark can be withdrawn or abandoned , as was “Soap Loaf” or “Lotion Bar.” It could be transferred to Rosemary Gladstar who would allow free use or it could be amended to exclude “Fire Cider” as “Cider” was also excluded but to protect a name like “Dana’s Fire Cider” or “Shire Fire Cider.
To summarize, Fire Cider has been part of public domain for decades, not a brand name and not even one that was trademarked by its inventor. It is traditional like Bu zhong yi qi tang rather than proprietary like Yunnan Baiyao. Analogously one could legitimately trademark “Shire Fire Cider” which is not a common name. But it was improper to trademark “Fire Cider” because that term was generic in the trade, just as the traditional Chinese herbal formulas like Lu wei di huang wan are.
There is currently a boycott of Shire City’s Fire Cider and it looks like there may have to be a lawsuit. People are asking local health food stores and other venues not to carry the product until the trademark is resolved. So speak to your local health food, food store or co-op and :
Fire Cider is a traditional anti-flu, anti-infection medicine made with lots of garlic, horseradish, onion, ginger and optional herbs like chilies, turmeric, oregano, thyme or the anti-infective herbs of your choice, steeped in apple cider vinegar. For many years I have been making and selling Fire Cider to my patients, after purchasing a bottle from one of Rosemary Gladstar’s students. Like the vinegar of the Seven Thieves this is one of the medicinal herb-infused vinegars that have existed for about as long as there has been vinegar. Rosemary Gladstar first made public her grandmother’s Fire Cider over 35 years ago and here is her grandmother’s recipe (which she probably got from her grandmother.) However a new company, Shire City, has trademarked a term that has been in public domain for decades and claim they have pioneered herbal vinegars.
As a result, February 2 has been designated Fire Cider Making Day to protest the appropriation of a public domain term. If you are set up to do so, sell it through a website or local store.
So here is my recipe, although I make it a bit differently each year depending on the herbs available and diseases in circulation:
Put into a Vitamix or blender (chop well if using a blender):
8 oz chopped ginger
8 oz. garlic cloves
2 red onions
6 oz fresh horseradish root
Three Chimayo or Jalapeno chilies
A bunch of fresh rosemary
A bunch of fresh oregano or bergamot (bee balm) or 1/4 c dried
One organic orange or lemon with the peel
Enough apple cider vinegar to cover the herbs twice
You do not need to use Braggs’ live apple cider vinegar as the anti-infective herbs will kill off the mother. Other additions include fresh or dried turmeric, sage, white sage, thyme, black pepper, elderberries or cinnamon. Process with the blender until the herbs are coarsely grated and transfer into a covered jar. Steep 30 days, then strain, squeezing out the herbs. You may add some local honey to taste- approximately 1/3 of total volume depending on the concentration of the honey. Take a shot (1/2-1 oz.) as needed for colds and flu.
Here are some examples of the term “Fire Cider” being used in commerce or public domain before the trademark:
Fire Cider by UberHerbal
Fire Cider by Domaphile
Here is a video of Rosemary Gladstar demonstrating the making of her Fire Cider (referred to as the “Poor man’s penecillin” . Note that this was recorded before the trademark dispute and she talks about the actual recipe (as opposed to the term) as coming from an unknown source twenty years prior. She also mentions working with her mother and grandmother making it. (I can’t say how I make mine every year or where any given version came from either!)
Constipation refers to bowel movements that either occur less often than expected or with a stool that is hard, dry and difficult to pass. (Types 1-3 on the Bristol Stool Chart, below.) A healthy adult should pass one to two stools a day, although some otherwise healthy adults pass a stool every other day. There are a number of reasons one might not pass feces, including diet, fluid intake, medications, stress, anal pain from hemorrhoids or fissures, lack of probiotic gut bacteria, laxative abuse, specific diseases, such as stroke, diabetes, thyroid disease and Parkinson’s, change in circardian rhythm (due to irregular sleeping while traveling) and a poor posture while eliminating
In Chinese medicine proper digestion has been seen as a paramount hallmark of health and one school of medicine considered poor digestion to be the root of almost all diseases. Chinese medicine looks at whether the constipation is because of a dry hard stool (dryness, usually due to heat) or a normal stool without peristalsis (qi stagnation). Heat can be of external or internal origin and is the major cause of constipation, especially if stools are hard or dry. Qi stagnation involves anything that blocks peristalsis, from emotions (Liver qi stagnation) to physical blockages or lack of exercise.
Laxatives and Laxative Abuse
Western medicine recognizes two types of laxatives: hyperosmolar and stimulant. The hyperosmolar laxatives (MiraLax, GoLytely, and Philips Milk of Magnesium) are agents that draw water into the bowel, making the stool softer and promoting movement of the stool. Hyperosmolar laxatives are over the counter medications, often used in healthcare as they have few risks and tend not to cause abdominal cramping. Stimulant laxatives, on the other hand, stimulate the propelling action of the bowel.. These include the anthraquinone laxatives These medications are associated with cramping and potentially harmful side effects.
In Chinese medicine we use three classes of laxatives. Emergency cathartics are given only in serious circumstances such as constipation accompanied by ascites. Only experienced practitioners should use this category which causes serious cramping and diarrhea. Strong laxatives like Da Chen Qi Tang are often based on stimulants like rhubarb root and hyperosmolar magnesium, which are only taken until the first bowel movement. The second category is comparable to the anthraquinone laxatives (like senna, cascara sagrada, buckthorn, or aloe), Mirelax, phenolphthalein and bisacodyl. Gentle bulk laxatives make up most treatments for constipation. The gentle bulk laxatives include flax and psyllium seed (Metamucil), methylcellulose (Citrucel) and prunes. Stool softeners (emollient laxatives like docusate) are more benign western laxatives which are similarly gentle and allow fluids to penetrate the hard stool. Stool softeners are commonly used when there is a need to soften the stool temporarily and make defecation easier (for example, after surgery, childbirth, or heart attacks). They are also used for individuals with hemorrhoids or anal fissures.They have temporary uses, but over the long run water in the diet should do the trick for most people.
A unique forth class of nourishing laxatives comes from Ayurvedic medicine and is based on the rasayana (longevity tonic) Triphala which consists of three fruits: : Amala (Emblica officinalis) one of the highest natural sources of Vitamin C, Bibhitaki (Terminalia bellirica), and Haritaki (Terminalia chebula). This is the only nourishing laxative I know of and can be used to recover peristalsis after damage from overuse of anthraquinone laxatives. It may be combined with other herbs like guggulu,
Laxative abuse can be a major cause of constipation since people with constipation will often inappropriately choose stimulant laxatives, use them too frequently or use them for purging in a misguided attempt to control weight. This can take over the body’s natural peristalsis and the person will no longer be able to have a normal bowel movement. The anthraquinonne laxatives will cause laxative dependence within two weeks of constant use. Herbalist David Hoffman tells how the British Navy in its wisdom wanted its sailors to be regular, so issued a daily dose of senna, dooming the sailors to lifetime laxative dependence. (Perhaps if they had listened to the Indians they were colonizing, they might have learned to overcome the dependence with triphala!)
Medications and Constipation
There are a number of medications that can cause constipation, notably pain killers and other medicines based on opiods. I once treated a woman on methadone maintenance who had retained so much stool that she appeared 9 months pregnant. She spent a large part of each day trying enemas and other actions to move a little stool. The opiate killed her peristalsis. Codeine based pain killers are known for causing constipation that can be worse than the pain being treated. Examples include Tylenol #3, oxycodone (Percocet), and hydromorphone (Dilaudid.) Ibuprofen (Motrin) often works as well after the first few doses of codeine.
Diuretics like Lasix and calcium channel blocking drugs such as diltiazem (Cardizem) and nifedipine (Procardia) can dry the stool out. Antidepressants such as amitriptyline (Elavil, Endep) and imipramine (Tofranil and anticonvulsants such as phenytoin (Dilantin) and carbamazepine (Tegretol) are constipating although Prozac is not. Parkinson’s disease medications including anticholinergic medications, Artane and Cogentin can constipate, but then so can the disease. Even iron supplements and aluminum-containing antacids such as Amphojel, Maalox, Mylanta, Gelusil and Rollaids can cause constipation. Speak to your doctor about non-constipating alternatives and consider natural alternatives to iron and antacid supplements. For instance dock (Rumex crispus) tincture helps iron assimilation in drop doses. And bitters before meals can reduce the need for antacids (which are usually the wrong remedy for people over 30.)
Diet and Constipation
Diet is perhaps the main cause of constipation and can be the easiest to remedy once laxative dependence is addressed. Dietary influences come from a variety of sources. For example magnesium has decreased by over a third in most foods tested by the USDA since the mid 1970s and magnesium helps attract fluid into the stool. But we also have less fiber and fewer bitter vegetables, both of which would help reduce constipation..
Fluids: If you don’t get enough fluids from food or drink, your constipation won’t go away. You need 6-8 servings of fluid a day, approximately 2 liters. It does not have to be from pure water although water is good. Fluid can come from drinks, fruit like watermelon, vegetables like cucumber, coffee and tea (although a small amount of caffeinated beverages will pass through without hydrating you.) If you sip- half a cup or less at a time- you will hydrate better. If you gulp, you will trigger your urinary reflex. That is a good thing because it flushes out the tissues but you need hydration to stop constipation.
Lots of fluid-rich fruits and vegetables like watermelon, honeydew melon, cucumber and celery.
Allergens or food sensitivities, especially milk can cause chronic constipation by creating inflammation that causes changes in the lining of the gut, specifically the eosinophilia of the rectal mucosa. (see references below.) Sometimes this causes diarrhea or mixed constipation and diarrhiea, but constipation alone can be triggered.
Insufficient fats. Fats lubricate the intestines and allow for smooth passage of the feces. In Chinese medicine we use oily seeds like apricot pits, flaxseed, cannabis seed and olive seed. Coconut or olive oil also work.
Fiber: You need about 25 to 30 grams of fiber every day to soften the stool and encourage proper bowel function. Most American diets contain less than half that amount. Fiber from powdered supplements can impact if you don’t take them with enough fluid. Fruits and vegetables provide fiber in a hydrating package. Bananas, apples, celery, fennel root and cucumber all help.
Mucilage is a specific kind of water-soluble fiber that provides lubrication. Sea vegetables, mucilage from slippery elm bark, hibiscus flowers, marshmallow root, okra, chia seeds or flax seeds will also lubricate the intestines.
Lack of bitters. The bitter taste stimulates the liver to make bile and to stimulate both digestive juices in the stomach and peristalsis. We have significantly reduced this important digestive signal by hybridizing bitter fruits and greens to have a sweeter taste. Bite into a lime peel, then squeeze the sour juice into water and drink it before your meal. Or eat grapefruit, radicchio salad, Karela (bitter melon), drink black coffee or have a little Angostura bitters in water before your main course. Urban Moonshine makes purse-sized bitter sprays that make it easy to get the bitter trigger in the go (tiny amounts work.)
Coffee. This is one of the most common agents to stimulate the bowel and a cup in the morning is often followed by a bowel movement. Coffee is a bitter, is rich in magnesium, chlorogenic acids, cafestol, kahweol, caffeine, theophylline and theobromine.
Fermented foods: are a source of probiotics wrapped up in fluid, frequently fat and often fiber. Aside from buttermilk, yogurt, kefir, sour cream, fermented butter, live blue cheese, gorgonzola, kombucha and live vinegar, which don’t appreciably contain fiber with their organisms, pickles, kim chee, sauerkraut, fermented veggies, olives, miso and fermented fish all help repopulate the gut and move things along. The fermented vegetables are easy to make if not found nearby, and they contain prebiotic foods for the probiotic organisms. Te good bacteria form a living wallpaper in your gut and help the health of the intestinal villi.
Probiotic supplements can be useful to repopulate the gut after antibiotics but very few probiotics have much more than 4-5 Lactobacillus or Bifidobacteria species and we have hundreds to thousands of naturally-occurring gut species. So while there is value in populating the most common probiotic species there is a need to take in probiotic foods. The two probiotics I recommend are Pharmax Sinbiotics Human Lactobacillus Complex which come with very potent sachets and Florastor which uses the less common probiotic yeast Saccharomyces boulardii. In Europe one can find probiotic strains of benign e-coli (the kind thin people have naturally) like Escherichia coli Nissle, but the FDA does not permit their sale in the USA.
Vitamin C is also laxative in large doses. 1000 mg of the vitamin in the morning can help stimulate a bowel movement.
Physical Aspects of Constipation
First, movement is necessary to provide qi to the bowels so peristalsis can occur. A person who never moves is likely to have trouble moving their bowels. Engaging in walking after meals is good for someone who is beginning to move.
Acupuncture can also help move the bowels. Your acupuncturist might us points near your belly button, with additional points on your lower leg to moisten the stool and points below your knee for peristalsis. The acupuncture acts as a reset button for your body to take over normal elimination.
But another, less-appreciated issue in western society is that we eliminate in the wrong position. For most of human history and in most places people have defecated in a squatting position. With the knees above the hips and the pelvic floor engaged, elimination is easier and more complete. I did not appreciate this until going to Beijing and getting intestinal problems. We stayed in a fine hotel that provided both western thrones and eastern squat toilets and surprisingly it was easier to manage with the eastern toilets because you could clear out more easily.
More significant to constipation is the understanding of the role of the puborectalis muscle. The large intestine unloads at the rectum. However the rectum is supported by a loop of muscle, the puborectalis muscle which in a sitting or standing position chokes off the rectum to maintain continence. When one squats, the anorectal angle is increased, the rectum straightens and the stool can be easily evacuated. We pay a high price for retaining the Victorian “throne”. Because the anorectal angle is in a kinked position while sitting one is forced to strain in order to move the bowels, which is the main cause of hemorrhoids. While squatting the angle straightens out allowing the fecal matter to eliminate quickly and easily without straining.
Since most of us will be unable to install a squat toilet in a western home or business, the Squatty Potty was designed as a corrective to the toilet. It consists of an elevated step stool that has a cutout to hug the toilet and allows elimination with a 35 degree anorectal angle. It is better than using a narrow foot stool and certainly better than standing on an unstable toilet seat.
Sitting with elevated feet is not quite as efficient as eliminating in a true squatting position. Weight rests on the buttocks instead of the feet, although one probably could work up to a true squat on the wood versions, as seen in the second video below. Nonetheless it is better than sitting at either a 90 degree angle or balancing on an unstable toilet seat.