WORLD ALZHEIMER’S DAY ; 21St SEPTEMBER

21st September is recognized as “World Alzheimer’s day”. It is wrong to say that this day is celebrated as “World Alzheimer’s day” because celebrations are associated for fun or good memories. In case of Alzheimer’s disease, there are sufferings hidden in the disease process. This article may help to find a ray of hope to all Alzheimer sufferers. Today we are completing 103 years to discover the Alzheimer’s disease but still there are lots of gray areas in the field in terms of understanding the cause, diagnosing it and getting proper treatment to find the solution.
What is Alzheimer’s disease?
Alzheimer’s disease is a type of mental disorder which affects the process of memory related functions of the brain. As on date, it is considered as incurable disease. The progress of Alzheimer’s disease is very slow but affects permanently which wipes out the process of thinking, judgmental skills and finally an affected person becomes incompetent to carry on day-to-day activities for his own survival. Most of the cases are over the age of 60 but the pathology of this disease starts 10-15 years before the symptoms are noticed. At the beginning, the symptoms are taken very casually where the seriousness is hardly known to anybody. Gradually the disease spreads in other parts of the brain which interferes with all the physiological functions of the brain.
Medically, it is recognized as gradual degeneration of the brain tissue. The disease is named based on the observations done by German psychiatrist and neuropathologist Alois Alzheimer in 1906. He was the first to correlate the symptoms of memory loss and the structural changes in the brain of a lady after she died. He found that the brain of the lady had tangles and a plaque made from protein fragments and the entire structure was drastically changed. It is now over 103 years after the disease is known to the medical fraternity but there is no remedy to cure it.
What is the cause?
The short answer to this question is “Not known”. There are some imaginary theories based on epidemiological data as follows:
1) Depressed individuals are more prone to Alzheimer’s disease.
2) Statins (the drugs given for cholesterol lowering) increase the incidence Alzheimer’s disease. Recent research from Prof. Yeon-Kyun Shin, Iowa State University has recently published a report on his exhaustive work on this subject.
3) It is likely that the causes include genetic, environmental, and lifestyle factors. A gene located on chromosome 19 is associated with late onset Alzheimer's disease.
4) Other risk factors for Alzheimer's disease include high blood pressure (hypertension), coronary artery disease, diabetes, and possibly elevated blood cholesterol.
5) Some studies have found that women have more risk for Alzheimer's disease than men.
6) Few studies have proven that Alzheimer’s disease is more prevalent in cases of previous head injuries.
7) It is also studied that Estrogen therapy after menopause triggers Alzheimer’s disease.
But these causes are completely hypothetical. There is no concrete data available to understand the real cause. Hence it is extremely difficult to adopt any precautionary measure to prevent or treat Alzheimer’s disease.
Since medical fraternity has hardly anything to offer for Alzheimer’s disease, caregiver plays a major role in management of such cases. Common suggestions are given to the sufferers like regular exercise, good diet, peace of mind, hygienic surroundings, pleasant atmosphere with cheerful communication etc. Practically all these recommendations are good for any individual for overall health and wellbeing. There is nothing specific attributed to Alzheimer’s disease.
What is the treatment of Alzheimer’s disease?
The shortest answer to this question is “No treatment”. According to modern medicine, when the cause is not clearly understood, how can there be a solution? Most of the diseases of infectious origin, the causative organism is detected and hence it becomes easy to find a recipe to overcome the infection. In the diseases of systemic origin, the pathophsiology is understood properly and the treatment becomes easy. In Alzheimer’s, the picture is different. The disease mechanism is unknown and hence “No treatment”. There is one drug, Donepezil which is used to treat symptoms of Alzheimer's disease in individuals with mild to moderate illness. The drug may cause small improvements in dementia for a short period of time, but donepezil does not stop the progression of Alzheimer's disease. Donepezil helps prevent the breakdown of acetylcholine in the brain, thus temporarily increasing its concentration. In doing so, it improves the thinking process by facilitating nerve impulse transmission within the brain. Diarrhea, nausea, and vomiting occur more often with the 10-mg dose than the 5-mg dosage. Other side effects are abnormal dreams, depression, drowsiness, fainting, loss of appetite, weight loss, frequent urination, arthritis, easy bruising, difficulty in sleeping, dizziness, nausea, muscle cramps, headache, or other pains. Donepezil is not safe as it also has interaction with many other medicines which alter its effects. Since there is no other option left, Donepezil is prescribed for Alzheimer’s. The medical field should have open doors to welcome newer ideas and safe drugs to treat this dreadful condition.
What other alternative?
Considering the patho-physiology of the disease, it is rational to think whether Ayurveda can offer something in Alzheimer’s? It is true that the disease was not mentioned in Ayurveda by this name but there many recipes mentioned to treat various kinds of mental, psychological and emotional disorders. While studying the subject, many hidden things came out which are of immense importance in managing Alzheimer’s disease. Few important references are given below to scientific thinkers.
1) Nasal medication has immediate access to the brain as it bypasses the blood brain barrier. Hence the nasal route would be the best route to treat Alzheimer’s disease. Ayurveda has mentioned very clearly that nose is the gateway to brain and diseases attributed to Central Nervous System can be successfully treated only with nasal medication. American Association of Pharmaceutical Scientists (AAPS) has published a research paper on this concept and the conclusion is “In summary, the advantages of intranasal delivery are considerable. It is both rapid and non-invasive. It bypasses the BBB and targets the CNS, reducing systemic exposure and thus systemic side effects. Even for drugs that can cross the BBB, it can reduce systemic side effects by reducing the need for the drug to enter the systemic circulation. It does not require any modification of the therapeutic agent being delivered and should work for a wide range of drugs. Intranasal delivery may facilitate the treatment and prevention of many different neurologic and psychiatric disorders”.
S Talegaonkar, PR Mishra; Indian J Pharmacol June 2004 Vol 36 Issue 3; 140-147
2) Human brain is made of approximately 70% fat and 30% protein. Therefore it has a natural affinity towards lipids for its normal functioning. Considering references from Ayurvedic texts, cow ghee is the best available lipid and has 3 different actions on the nervous system. Acquisition, storage and recall are the 3 basic functions of the brain and cow ghee possess the properties to enhance these three fold brain functions. It is as simple to understand that water is not easily soluble to oil but another oil or ghee can easily be absorbed. Therefore water-soluble or water based drugs do not penetrate the brain easily. This concept also goes very scientifically with the research on new drug in Europe for Huntington’s disease. Huntington’s disease ("HD") is a genetic neurodegenerative disease characterized by movement disorder, dementia and psychiatric disturbance. Early symptoms might affect cognitive ability or mobility and include depression, mood swings, forgetfulness, clumsiness, involuntary twitching and lack of coordination. Later, concentration and short-tem memory diminish, and involuntary movements of the head, trunk and limbs increase. Eventually, the person is unable to care for himself or herself. Death follows from complications including choking, infection or heart failure. The drug developed for treating this is basically an Omega 3 based fatty acid, given orally and has proved quite effective. The drug is in the process of launching world-wide in a short span of time. Ayurveda has given emphasis on Cow Ghee which is also a fat, easily available and has been an household item of Indian kitchen.
3) A brain wave ‘p300’ is linked to memory and learning. The faster the rate of transmission, the brain functions more efficiently. Researchers took 26 volunteers hooked them with electrodes and checked their p300 rate. Immediately after taking the test, they were given DHA (derivative of Omega-3). Two hours later, their brain waves were measured, and this time the p300 rate was significantly faster in the group. This supports importance of lipids in the neurotransmission as well. What Ayurveda has recommended also goes very much hand in hand with this research. Therefore in Indian tradition, it is customary to put few drops of oil (the purpose is to introduce a fatty substance) during massage given since infancy period.
Myanaga, K., K. Yonemura, and K. Yazawa.
International Conference on Highly Unsaturated Fatty Acids in Nutrition and Disease Prevention. 1996 Barcelona, Spain.
4. The nasal route is studied for the administration of systemically active drugs because delivery is convenient, reliable and rapid. A drug developed was administered through Nasal route and the florescent imaging showed that the absorption is 100 ± 30 % just within 1.5 minutes
Ref: Maria Dahlin and Erik Björk; Department of Pharmacy, Division of Pharmaceutics, Uppsala University, Biomedical Center, SE-751 23 Uppsala, Sweden
5. Another research from VA Medical center, San Francisco, USA which is published in the journal “Future Neurology” in 2008 says that ‘The nose may help the brain; intranasal drug delivery for treating neurological diseases.
There are end number of research papers published which give us a guideline to treat neurological diseases and which could be a breakthrough in treating Alzheimer’s disease. Not only Ayurveda but even modern research also supports the concept of treating the brain diseases through nasal route. Importance of Lipids in neurological diseases is also established by modern medicine which is evident in Ayurvedic classics. Indian traditional way of life supports the theory of using unctuous substances for lubricating the sense organs which are the sensory paths to access the central nervous system. In spite of that why do we still pursue the issue of Alzheimer’s disease?
When should one start Nasal treatment?
The symptoms of Alzheimer’s disease start appearing after 10 to 15 years later after the actual pathology starts in the brain. Therefore it is extremely important to start the treatment at the age of 50.
There are many herbs proven to have phenomenal improvement in the brain at the cellular level. The well known are Brahmi (Bacopa monnieri), Ashwagandha (Withania somnifera), Shankhapushpi (Evolvulus alsinoides), Vacha (Acorus calamus), Saffron (Crocus sativus), Tulsi (Ocimum sanctum) etc. Oral medicines find difficulty in reaching the brain as there is a physiological mechanism called Blood Brain Barrier which prohibits the absorption. Therefore it is practical to use these herbs in the form of nasal medication and also should be processed by special method called “Sneha - Paka - Widhi” described in Ayurveda. This will bypass the Blood Brain Barrier and allow the active herbal constituents to reach the central nervous system and arrest the progress of Alzheimer’s eventually. Besides this, the nasal medication also helps to improve vision, arrest hair fall, prevent graying of hair, improve hearing and many other diseases attributed to ENT and supra-clavicular disorders. Like synthetic drugs have side effects, Ayurvedic drugs have side benefits. Unknowingly these formulations impart some added benefits and contribute to positive health achievements.
As on date, there is no technique available to detect or forecast the Alzheimer’s disease in advance. Therefore it is safe to start such nasal medication at the age of 50 and keep fingers crossed and think positive for gaining élan health in older age. Ayurveda recommends this nasal treatment should be done daily, 4 to 6 drops in both the nostrils, preferably in the morning or evening. It is good to take a sip of warm water after introducing the drops if there is a feeling of the contents coming in the throat. Since the base is ghee, the bottle should be made warm to liquefy the contents in case it is not properly flowing.
Considering the research in modern era and viewing the verses in Ayurveda it becomes evident that Ancient science has enormous hidden potential. It is rather a golden treasury for human beings but needs to be explored and understood properly. Many times it seems that Ayurveda has given short verse with big meaning which is equivalent to one doctorate in that field. It is just like a question asked and the answer given in Ayurveda, modern research helps to find the various steps involved in getting the answer.

Dr. Santosh Jalukar

№ 9969106404

From Fatness to Fitness; Ayurvedic approach

In clinical practice few patients ask treatment for putting on weight and many come for reducing the weight. Very few are happy with their own physical condition. No doubt that very slim or very obese, both conditions are not healthy. Even then if you look health wise, it is good to be slim than being obese. It is very difficult to trim down when you become obese. Not only it looks ugly but also such people are predisposed to number of diseases like High blood pressure, High cholesterol, Type 2 diabetes, Stroke, Gallbladder disease, Osteoarthritis, Heartburn, Snoring, Shortness of breath, some category of cancer, Depression and also infertility. The lifespan of obese is obviously less than slim people. Therefore it is good to be slim than dreaming to put on weight. Overweight makes an individual less active which again tends to increase weight and finally leading to unhealthy situation. The consequences of obesity are well-known to even laymen and hence the obesity clinics have huge number of cases all over the world. It is essential to understand the causes, various treatment modalities, know the effects and side-effects of treatments, diet management, exercise importance and lifestyle modulation for obesity.

Two types of obese personalities: In the society we find people with insatiable appetite and because of over-eating; they tend to put on weight. Another group habitually consumes very less amount of food even then they become obese. Therefore it is essential to understand the constitution before initiating the treatment. Ayurveda has described different approach considering such constitutional variation. The usual anti-obesity herbal formulations have thermogenic effect which naturally tends to stimulate appetite. Adipose tissue (Fats) is like wax which melts on heating and becomes hard when cooled down. The thermogenic (heat generating) herbs are essential while considering obesity regime. In classical textbooks of Ayurveda, out of 29 herbs mentioned for obesity treatment, 20 of them are found in appetite stimulating formulations. It simply proves that anti-obesity formulations may affect appetite in different way. When considering the treatment modality of obesity, it is therefore more logical to consider two factors. The first composition should low down appetite and second to burn the deposited calories in the body. Long-term fasting reduces body weight because the digestive enzymes catabolize the tissues starting with mucous membrane, then muscles and adipose tissue. When such enzymes are stimulated, they will naturally trigger the activity and in turn help to trim down the body weight.

Three way approach: Appetite suppressing herbs are not much known except for Garciania and Hoodia. There are many research papers having controversial views about the efficacy of these herbs. Looking deep into Ayurvedic literature, there are many herbs mentioned for appetite stimulation and “Pitta shaman” group have very activity to reduce the appetite. Various globally acclaimed research journals have also published supportive data to validate the actions of these herbs. The two way approach to overcome obesity problem is therefore very scientific and has also clinically proven benefits. The appetite lowering herbs reduce the enzyme flow, strengthen the mucous membrane of digestive system to tolerate the thermogenic effect of anti-obesity herbs. The appetite lowering herbs also possess the property to lower the serum cholesterol levels in the blood which is an added advantage. The appetite lowering composition works best when consumed within 30 minutes before meals and the calorie burning composition does wonders when consumed within 2 hours after meals. The calorie burning composition otherwise may create some side effects like heart-burn, headache and regurgitation of food but the appetite lowering formula guards the possible unwanted effects. Thus a two way anti-obesity treatment has no side effects but added side benefits while treating obesity.

Why such formulations cause weight gain when the treatment is discontinued? Most of the anti-obesity products possess only thermogenic properties to achieve lipolytic results. As seen earlier, they also stimulate the enzyme secretions. While the treatment is in progress, they inhibit the absorption of fats and effective eliminate it from the body. The effect on the physiological function remains constant. When an individual discontinues the treatment, the accelerated enzyme flow remains constant and thereby the appetite increases. It naturally affects the food intake and weight gain restarts.


How can you tackle obesity?
It is observed that many people advise obese individuals to reduce the food intake and perform physical exercise rather than taking medicines. Here we need to understand 2 aspects:
1. The obese individual possesses more area in the physiological body where oxygen is needed for tissue survival. It is as simple to understand that a bigger joint family requires more grains and grocery. Hence an obese individual can not enjoy a healthy life without adequate intake. Therefore it is near to impossible for the obese individuals to cut down the intake drastically.
2. About physical exercise: Just imagine a healthy man of 40 years whose height is ideal for his body weight is asked to carry 30 kg of weight and walk for 40 minutes on a plain road or climb stairs on 5th floor. It will be extremely tiring and exhausting for him. Same thing happens with an obese individual. Expecting him to walk for 40 minutes daily or climbing is therefore too strenuous for him. Therefore he needs an assistance of medicinal inputs for physiological balancing of caloric intake and caloric expenditure.
3. Another aspect of obesity is hereditary which is linked to genetics. It is true to some extent but it is also important to understand that specific diet habits and lifestyle remains unchanged in families from generations to generations. Therefore blaming genetics only will not solve the problem.

Scientific perspective of CHR’s Slimming Kit
A set of 3 products formulated scientifically for achieving these benefits in short time span and lead quality life.
a) The first one, LIMIN tablets, helps to limit the intake moderately.
b) The second, CALEX tablets, increases caloric expenditure by enhancing the flow of digestive enzymes.
c) Third, GUDLAX powder, which stimulates the intestinal purging and thereby helps proper emptying of the bowel.
Adipose tissue is like wax which melts on heating and solidifies on cooling. Most of the single formulations used for obesity treatment are thermogenic (heat producing). Therefore they help to melt the fat and thereby help to take care for obesity. Ironically, thermogenic ingredients also possess the property of stimulating digestive enzymes and hence simultaneously increase appetite.
The effect of calorie burning and appetite spur work together. Therefore there are following therapeutic actions in the physiological activity:
* Increase the enzymatic flow in the digestive tract
* Burn some extra calories ingested
* Stimulate appetite
* Cause hyperacidity and heart burn
* Increase in appetite may further boost up food intake and in turn again add some calories.
In order to break this vicious sequence, it is judicious to have a better composition to balance the process appropriately. To understand this phenomenon correctly, one should recall the physiology of digestion and then the correlation of therapeutic activity of LIMIN, CALEX and GUDLAX.
The digestive glands that act first are in the mouth; the salivary glands. Saliva produced by these glands contains an enzyme that begins to digest the starch from food into smaller molecules. An enzyme is a substance that speeds up chemical reactions in the body.
The next set of digestive glands is in the stomach lining. They produce stomach acid and an enzyme that digests protein. A thick mucus layer coats the mucosa and helps keep the acidic digestive juice from dissolving the tissue of the stomach itself. In most people, the stomach mucosa is able to resist the juice, although food and other tissues of the body cannot.
After the stomach empties, the food and juice mixture passes to the small intestine, the juices of two other digestive organs mix with the food. One of these organs, the pancreas, produces a juice that contains a wide array of enzymes to break down the carbohydrate, fat, and protein in food. Other enzymes that are active in the process come from glands in the wall of the intestine.
The second organ, the liver, produces yet another digestive juice—bile. Bile is stored between meals in the gallbladder. At mealtime, it is squeezed out of the gallbladder, through the bile ducts, and into the intestine to mix with the fat in food. The bile acids dissolve fat into the watery contents of the intestine, much like detergents that dissolve grease from a frying pan. After fat is dissolved, it is digested by enzymes from the pancreas and the lining of the intestine.
Herbs rich in fiber bind with the cholesterol and thereby help to eliminate the cholesterol from the alimentary tract. The contents of LIMIN act by this way and help not only to minimize the appetite but also regulate the lipid contents in the blood.
Movement of Food through the System
Several factors affect emptying of the stomach, including the kind of food and the degree of muscle action of the emptying stomach and the small intestine. Carbohydrates, for example, spend the least amount of time in the stomach, while protein stays in the stomach longer, and fats stay for the longest. As the food dissolves into the juices from the pancreas, liver, and intestine, the contents of the intestine are mixed and pushed forward to allow further digestion. Since Fats remain in undigested form for longest time, the possibility of re-absorption is higher. Here comes the role of GUDLAX, which helps to eliminate the bowel contents promptly and thereby successfully achieves the 3rd step of weight management.



Importance of diet and lifestyle: It is needles to emphasize the importance of diet and lifestyle while considering successful conquer in obesity. I am purposely avoiding mentioning things like “stay away from sweets, fried food, chocolates etc.” as these are very common and a schooling child would also know about such suggestions. There are small things making exceptional outcome as far as obesity is concerned.
1. Never consume sweets at the end of meals even if it is routine to have desserts at the end. Principally obesity arises due to extra intake and less expenditure of calories. To understand the idea behind this phenomenon, you can perform an exercise. Consume your usual food and then end with a calculated quantity of sweet. Next day, start your meal with same quantity of sweet and then begin your usual food. You will notice that the food intake will be almost half than your normal intake. This is how you can reduce the caloric intake and immediately start feeling lightness of body.
2. Fruits contain good amount of sugar. The peel of the fruit contains astringent properties which balances the sugar. This arrangement is made by Mother Nature to combat the unwanted effects sugar. Hence, as and when possible, it is recommended to consume fruits along with the outer skin for added health benefits. It is easy to have apple, chickoo, mangoes and some grains with the skin. The concept of consuming brown bread (whole wheat bread) is supportive to this statement. The reason of adding saffron or nutmeg to sweets is to compensate the sugar with little amount of bitter or astringent taste which resists the unwanted effect of sugar.
3. Water is essential component for maintaining the electrolyte balance in the body. It also helps for accelerating the digestive process and proper assimilation of food. Cold water obstructs the flow of digestive enzymes and hence leads to digestive disorders leading to obesity. Therefore if you are serious about slimming, avoid consuming cold water intake or even other chilled beverages unless very essential. Some countries in East serve only warm water to household guests or even in restaurants, which is really a good practice for health conscious individuals.
4. Consuming water at the end of meals also leads to more heaviness in the abdomen. It weakens the concentration of digestive enzymes which slows down the digestive process leading to more accumulation of adipose (fat) tissue. If you are serious about slimming, you may drink little amount of water at the beginning of meals.
5. Tea and coffee is offered several times for any walk-in visitor in office or at home. While offering, we also have a tendency to share little amount each time. The sugar intake with such numerous times may lead to high caloric intake unknowingly which may become major health issue in long-term.
6. Avoid sleeping immediately after meals. The calories consumed need mild physical exercise when the stomach is full. Taking rest after meals leads to weight gain.
7. Early to bed and early to rise, that’s the way to be healthy, wealthy and wise. Even if the proverb is pretty old, it is true and good to follow. It is observed that most of the obese people have late sleeping habit and hence they get-up quite late.
8. Milk and other dairy products have substantial amount of proteins, fats and carbohydrates. These nutrients get converted to fats easily if the body has excess of storage. In short, better to be vegan for slimming.
9. Human body is created by the creator of nature for consuming vegetarian food only. After in-depth study of human physiology, it is evident that man is born to be herbivorous. If at all you are fond of Non-vegetarian food, consume it in moderation, once or maximum twice in a week and that too only during lunch.
10. Sedentary lifestyle is yet another cause of obesity. Keep working, be active, avoid laziness in life which will keep you healthy and fit.
11. Sleeping during day time is extremely unhealthy. It is not only bad for obesity but can lead to many other health complications.
12. The sense of fullness of stomach is signaled by the brain and hence the brain gives the instructions to the body to stop taking food. This sensation is passed on by the hypothalamus of the brain after about 10 to 15 minutes of the capacity of the stomach. Therefore it is good to wait for some time after certain quantity of food intake. The brain will then direct the sense of satiety and prohibit you to accept more food.
13. Form a habit of limited intake. This is especially for those who have the habit for eating huge amount of food. If you gradually reduce your intake, your body will get used to it and then without feeling of weakness, you will succeed in achieving the sense of lightness of the body.
14. There are many controversies about number of intakes in a day. It is a sincere attempt to explain you the right way for better health. Do not keep starving more than a time span of 8 hours and avoid repeat food intake within 4 hours after initial intake.
15. Little but regular exercise is most important rather than performing rigorous exercise for body building. It is observed that apparently healthy and muscular people (those who are keen on body building) have low immunity. They have weak bones and even minor accidents can cause fractures very soon in them. Their intellectual excellence is also seldom seen. They suffer from frequent digestive upsets with negligible changes in food habits. The reason is that the nutritional constituents are utilized by the muscular tissue and other systems in the body remain unattended and remain undernourished. Whereas, individuals performing little but regular exercise have better health profile.
Last but not the least, one should understand that medicines contribute only 5% to health but good diet and regular exercise contributes 95%. Hence it is irrational to depend on medication for health concerns, whether synthetic modern medicines, homoeopathic, Ayurvedic or any other branch of medicine in the world. Ayurveda has identified many such formulations and the summary of the studies is mentioned in the original texts of Ayurveda. Modern research is simply trying to find the mode of action of the herbs and then get a satisfaction of a step of achievement. It is rather impossible for the most sophisticated research laboratories in the world to recognize that how Ayurvedic scientists of the then time would have conducted research activities and gathered such a treasury of knowledge for mankind.

Author
Dr. Santosh Jalukar