What is peripheral neuropathy?

An estimated 20 million people in the United States have some form of peripheral neuropathy, a condition that develops as a result of damage to the peripheral nervous system — the vast communications network that transmits information between the central nervous system (the brain and spinal cord) and every other part of the body. (Neuropathy means nerve disease or damage.) Symptoms can range from numbness or tingling, to pricking sensations (paresthesia), or muscle weakness. Areas of the body may become abnormally sensitive leading to an exaggeratedly intense or distorted experience of touch (allodynia). In such cases, pain may occur in response to a stimulus that does not normally provoke pain. Severe symptoms may include burning pain (especially at night), muscle wasting, paralysis, or organ or gland dysfunction. Damage to nerves that supply internal organs may impair digestion, sweating, sexual function, and urination. In the most extreme cases, breathing may become difficult, or organ failure may occur.

Peripheral nerves send sensory information back to the brain and spinal cord, such as a message that the feet are cold. Peripheral nerves also carry signals from the brain and spinal cord to the muscles to generate movement. Damage to the peripheral nervous system interferes with these vital connections. Like static on a telephone line, peripheral neuropathy distorts and sometimes interrupts messages between the brain and spinal cord and the rest of the body.

Peripheral neuropathies can present in a variety of forms and follow different patterns. Symptoms may be experienced over a period of days, weeks, or years. They can be acute or chronic. In acute neuropathies such as Guillain-Barré syndrome (in which the body’s immune system attacks part of the peripheral nervous system and impairs sending and receiving nerve signals), symptoms appear suddenly, progress rapidly, and resolve slowly as damaged nerves heal. In chronic forms, symptoms begin subtly and progress slowly. Some people may have periods of relief followed by relapse. Others may reach a plateau stage where symptoms stay the same for many months or years. Many chronic neuropathies worsen over time. Although neuropathy may be painful and potentially debilitating, very few forms are fatal.

In diabetic neuropathy, one of the most common forms of peripheral neuropathy, nerve damage occurs in an ascending pattern. The first nerve fibers to malfunction are the ones that travel the furthest from the brain and the spinal cord. Pain and numbness often are felt symmetrically in both feet followed by a gradual progression up both legs. Later, the fingers, hands, and arms may become affected.

How are the peripheral neuropathies classified?

More than 100 types of peripheral neuropathy have been identified, each with its own symptoms and prognosis. In general, peripheral neuropathies are classified according to the type of damage to the nerves. Some forms of neuropathy involve damage to only one nerve and are called mononeuropathies. More frequently however, multiple nerves are affected, called polyneuropathy.

Some peripheral neuropathies are due to damage to the axons (the long, threadlike portion of the nerve cell), while others are due to damage to the myelin sheath, the fatty protein that coats and insulates the axon. Peripheral neuropathies may also be caused by a combination of both axonal damage and demyelination. Electrodiagnostic studies can help healthcare providers determine the type of damage involved.

What are the symptoms of peripheral nerve damage?

Symptoms vary depending on whether motor, sensory, or autonomic nerves are damaged. Motor nerves control voluntary movement of muscles such as those used for walking, grasping things, or talking. Sensory nerves transmit information such as the feeling of a light touch or the pain from a cut. Autonomic nerves control organ activities that are regulated automatically such as breathing, digesting food, and heart and gland functions. Some neuropathies may affect all three types of nerves; others primarily affect one or two types. Doctors may use terms such as predominantly motor neuropathy, predominantly sensory neuropathy, sensory-motor neuropathy, or autonomic neuropathy to describe the types of nerves involved in an individual’s condition.

Motor nerve damage is most commonly associated with muscle weakness. Other symptoms may include painful cramps and fasciculations (uncontrolled muscle twitching visible under the skin), muscle atrophy (severe shrinkage of muscle size), and decreased reflexes.

Sensory nerve damage causes a variety of symptoms because sensory nerves have a broad range of functions. Larger sensory fibers enclosed in myelin register vibration, light touch, and position sense. Damage to large sensory fibers impairs touch, resulting in a general decrease in sensation. Since this is felt most in the hands and feet, people may feel as if they are wearing gloves and stockings even when they are not. This damage to larger sensory fibers may contribute to the loss of reflexes. Loss of position sense often makes people unable to coordinate complex movements like walking or fastening buttons, or to maintain their balance when their eyes are shut.

Smaller sensory fibers without myelin sheaths transmit pain and temperature sensations. Damage to these fibers can interfere with the ability to feel pain or changes in temperature. People may fail to sense that they have been injured from a cut or that a wound is becoming infected. Others may not detect pain that warns of impending heart attack or other acute conditions. Loss of pain sensation is a particularly serious problem for people with diabetes, contributing to the high rate of lower limb amputations among this population.

Neuropathic pain is a common, often difficult to control symptom of sensory nerve damage and can seriously affect emotional well-being and overall quality of life. Often worse at night, neuropathic pain seriously disrupts sleep and adds to the emotional burden of sensory nerve damage. Neuropathic pain can often be associated with an oversensitization of pain receptors in the skin, so that people feel severe pain (allodynia) from stimuli that are normally painless. For example, some may experience pain from bed sheets draped lightly over the body. Over many years, sensory neuropathy may lead to changes in the skin, hair, as well as to joint and bone damage. Unrecognized injuries due to poor sensation contribute to these changes, so it is important for people with neuropathy to inspect numb areas for injury or damage.

Autonomic nerve damage symptoms are diverse since the parasympathetic and sympathetic nerves of the peripheral nervous system control nearly every organ in the body. Common symptoms of autonomic nerve damage include an inability to sweat normally, which may lead to heat intolerance; a loss of bladder control; and an inability to control muscles that expand or contract blood vessels to regulate blood pressure. A drop in blood pressure when a person moves suddenly from a seated to a standing position (a condition known as postural or orthostatic hypotension) may result in dizziness, lightheadedness, or fainting. Irregular heartbeats may also occur.

Gastrointestinal symptoms may accompany autonomic neuropathy. Malfunction of nerves controlling intestinal muscle contractions can lead to diarrhea, constipation, or incontinence. Many people also have problems eating or swallowing if autonomic nerves controlling these functions are affected.

What causes peripheral neuropathy?

Peripheral neuropathy may be either inherited or acquired through disease processes or trauma. In many cases, however, a specific cause cannot be identified. Doctors usually refer to neuropathies with no known cause as idiopathic.

Causes of acquired peripheral neuropathy include:

Physical injury (trauma) is the most common cause of acquired nerve injury.

• Injury or sudden trauma, such as from automobile accidents, falls, sports-related activities, and surgical procedures can cause nerves to be partially or completely severed, crushed, compressed, or stretched, sometimes so forcefully that they are partially or completely detached from the spinal cord. Less severe traumas also can cause serious nerve damage. Broken or dislocated bones can exert damaging pressure on neighboring nerves.

• Repetitive stress frequently leads to entrapment neuropathies, a form of compression injury. Cumulative damage can result from repetitive, awkward, and/or forceful activities that require movement of any group of joints for prolonged periods. The resulting irritation may cause ligaments, tendons, and muscles to become inflamed and swollen, constricting the narrow passageways through which some nerves pass. Ulnar neuropathy and carpal tunnel syndrome are examples of the most common types of neuropathy from trapped or compressed nerves at the elbow or wrist.

Diseases or disorders and their related processes (such as inflammation) can be associated with peripheral neuropathy.

• Metabolic and endocrine disorders impair the body’s ability to transform nutrients into energy and process waste products, and this can lead to nerve damage. Diabetes mellitus, characterized by chronically high blood glucose levels, is a leading cause of peripheral neuropathy in the United States. About 60 percent to 70 percent of people with diabetes have mild to severe forms of nervous system damage that can affect sensory, motor, and autonomic nerves and present with varied symptoms. Some metabolic liver diseases also lead to neuropathies as a result of chemical imbalances. Endocrine disorders that lead to hormonal imbalances can disturb normal metabolic processes and cause neuropathies. For example, an underproduction of thyroid hormones slows metabolism, leading to fluid retention and swollen tissues that can exert pressure on peripheral nerves. Overproduction of growth hormone can lead to acromegaly, a condition characterized by the abnormal enlargement of many parts of the skeleton, including the joints. Nerves running through these affected joints often become entrapped, causing pain.

• Small vessel disease can decrease oxygen supply to the peripheral nerves and lead to serious nerve tissue damage. Diabetes frequently leads to impaired blood flow to nerves. Various forms of vasculitis (blood vessel inflammation) frequently cause vessel walls to harden, thicken, and develop scar tissue, decreasing their diameter and impeding blood flow. Vasculitis is an example of nerve damage called mononeuritis multiplex or multifocal mononeuropathy, in which isolated nerves in two or more areas are damaged.

• Autoimmune diseases, in which the immune system attacks the body’s own tissues, can lead to nerve damage. Sjogren’s syndrome, lupus, and rheumatoid arthritis are among the autoimmune diseases that can be associated with peripheral neuropathy. When the tissue surrounding nerves becomes inflamed, the inflammation can spread directly into nerve fibers. Over time, these chronic autoimmune conditions can destroy joints, organs, and connective tissues, making nerve fibers more vulnerable to compression injuries and entrapment. Chronic conditions may alternate between remission and relapse. Acute inflammatory demyelinating neuropathy, better known as Guillain- Barré syndrome, can damage motor, sensory, and autonomic nerve fibers. Most people recover from this autoimmune syndrome although severe cases can be life threatening. Chronic inflammatory demyelinating polyneuropathy (CIDP) usually damages sensory and motor nerves, leaving autonomic nerves intact. Multifocal motor neuropathy is a form of inflammatory neuropathy that affects motor nerves exclusively. It may be chronic or acute.

• Kidney disorders may cause neuropathies. Kidney dysfunction can lead to abnormally high amounts of toxic substances in the blood that can damage nerve tissue. A majority of indviduals who require dialysis because of kidney failure develop polyneuropathy.

• Cancers can infiltrate nerve fibers or exert damaging compression forces on nerve fibers. Tumors also can arise directly from nerve tissue cells. Paraneoplastic syndromes, a group of rare degenerative disorders that are triggered by a person’s immune system response to a cancerous tumor, also can indirectly cause widespread nerve damage. Toxicity from the chemotherapeutic agents and radiation used to treat cancer also can cause peripheral neuropathy. An estimated 30 to 40 percent of people who undergo chemotherapy develop peripheral neuropathy and it is a leading reason why people with cancer stop chemotherapy early. The severity of chemotherapyinduced peripheral neuropathy (CIPN) varies from person to person. In some cases people may be able to ease their symptoms by lowering their chemotherapy dose or by stopping it temporarily. In others, CIPN may persist long after stopping chemotherapy.

• Neuromas are benign tumors that are caused by an overgrowth of nerve tissue that develops after a penetrating injury that severs nerve fibers. Neuromas are often associated with intense pain and sometimes they engulf neighboring nerves, leading to further damage and even greater pain. Neuroma formation can be one element of a more widespread neuropathic pain condition called complex regional pain syndrome or reflex sympathetic dystrophy syndrome, which can be caused by traumatic injuries or surgical trauma. Widespread polyneuropathy is often associated with neurofibromatosis, a genetic disorder in which multiple benign tumors grow on nerve tissue.

• Infections can cause peripheral neuropathy. Viruses and bacteria that can attack nerve tissues include herpes varicellazoster (shingles), Epstein-Barr virus, West Nile virus, cytomegalovirus, and herpes simplex members of the large family of human herpes viruses. These viruses can severely damage sensory nerves, causing attacks of sharp, lightning-like pain. Postherpetic neuralgia is long-lasting, particularly intense pain that often occurs after an attack of shingles. Lyme disease, diphtheria, and leprosy are bacterial diseases characterized by extensive peripheral nerve damage. Diphtheria and leprosy are rare in the United States, but the incidence of Lyme disease is on the rise. 

 
The tick-borne infection can involve a wide range of neuropathic disorders, including a rapidly developing, painful polyneuropathy, often within a few weeks of being infected. West Nile virus is spread by mosquitoes and is associated with a severe motor neuropathy. The inflammation triggered by infection sometimes results in various forms of inflammatory neuropathies that develop quickly or slowly.

The human immunodeficiency virus (HIV) that causes AIDS is associated with several different forms of neuropathy, depending on the nerves affected and the specific stage of active immunodeficiency disease. A rapidly progressive, painful polyneuropathy affecting the feet and hands can be the first clinically apparent symptom of HIV infection. An estimated 30 percent of people who are HIV positive develop peripheral neuropathy; 20 percent develop distal neuropathic pain.

Exposure to toxins may damage nerves and cause peripheral neuropathy.

• Medication toxicity can be caused by many agents in addition to those for fighting cancer. Other agents that commonly cause peripheral neuropathy as a side effect include those used to fight infection such as antiretroviral agents for treating HIV. In addition, anticonvulsant agents and some heart and blood pressure medications can commonly cause peripheral neuropathy. In most cases, the neuropathy resolves when these medications are discontinued or dosages are adjusted.

• Environmental or industrial toxins such as lead, mercury, and arsenic can cause peripheral neuropathy. In addition, certain insecticides and solvents have also been known to cause neuropathies.
• Heavy alcohol consumption is a common cause of peripheral neuropathy. Damage to the nerves associated with long-term alcohol abuse may not be reversible when a person stops drinking alcohol, however, doing so may provide some symptom relief and prevent further damage. Chronic alcohol abuse also frequently leads to nutritional deficiencies (including B12, thiamine, and folate) that contribute to the development of peripheral neuropathy.

Genetic mutations can either be inherited or arise de novo, meaning they are completely new mutations to an individual and are not passed along by either parent. Some genetic mutations lead to mild neuropathies with symptoms that begin in early adulthood and result in little, if any, significant impairment. More severe hereditary neuropathies often appear in infancy or childhood.

Advances in genetic testing in the last decade have led to significant strides in the ability to identify the genetic causes underlying peripheral neuropathies. For example, several genes have been found to play a role in different types of Charcot-Marie-Tooth, a group of disorders that are among the most common forms of inherited peripheral neuropathies. These neuropathies result from mutations in genes responsible for maintaining the health of the myelin sheath as well as the axons themselves. Key characteristics of Charcot- Marie-Tooth disorders include extreme weakening and wasting of muscles in the lower legs and feet, gait abnormalities, loss of tendon reflexes, and numbness in the lower limbs.

How is peripheral neuropathy diagnosed?

The symptoms of peripheral neuropathy are highly variable. A thorough neurological examination is required to sort out the cause of the symptoms and involves taking an extensive medical history (covering symptoms, work environment, social habits, exposure to toxins, alcohol use, risk of HIV or other infectious diseases, and family history of neurological diseases). In addition, tests are usually performed to identify the cause of the neuropathy as well as the extent and type of nerve damage.

A physical examination and various tests may reveal the presence of a systemic disease causing the nerve damage. Tests of muscle strength, as well as evidence of cramps or fasciculations, indicate motor fiber involvement. Evaluation of the person’s ability to sense vibration, light touch, body position, temperature, and pain reveals any sensory nerve damage and may indicate whether small or large sensory nerve fibers are affected.

Blood tests can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, other metabolic disorders, and signs of abnormal immune system activity. An examination of cerebrospinal fluid that surrounds the brain and spinal cord can reveal abnormal antibodies associated with some immune-mediated neuropathies. More specialized tests may reveal other blood or cardiovascular diseases, connective tissue disorders, or malignancies. Genetic tests are becoming available for a number of the inherited neuropathies.

Based on the results of the neurological exam, physical exam, patient history, and any previous screening or testing, the following additional tests may be ordered to help determine the nature and extent of the neuropathy:

• Nerve conduction velocity (NCV) tests can measure the degree of damage in large nerve fibers, revealing whether symptoms are caused by degeneration of the myelin sheath or the axon. The myelin covering is responsible for the very fast speed of nerve conduction. During this test, a probe electrically stimulates a nerve fiber, which responds by generating its own electrical impulse. An electrode placed further along the nerve’s pathway measures the speed of impulse transmission along the axon. Slow transmission rates and impulse blockage tend to indicate damage to the myelin sheath, while a reduction in the strength of impulses at normal speeds is a sign of axonal degeneration.
• Electromyography (EMG) involves inserting a fine needle into a muscle to record electrical activity when muscles are at rest and when they contract. EMG tests detect abnormal electrical activity in motor neuropathy and can help differentiate between muscle and nerve disorders.

• Magnetic resonance imaging (MRI) can show muscle quality and size, detect fatty replacement of muscle tissue, and can help rule out tumors, herniated discs, or other abnormalities that may be causing the neuropathy.

• Nerve biopsy involves removing and examining a sample of nerve tissue, most often from the lower leg. Although this test can provide valuable information about the degree of nerve damage, it is an invasive procedure that is difficult to perform and may itself cause neuropathic side effects.

• Skin biopsy is a test in which doctors remove a thin skin sample and examine nerve fiber endings. This test offers some unique advantages over NCV tests and nerve biopsy. Unlike NCV, it can reveal damage present in smaller fibers; in contrast to conventional nerve biopsy, skin biopsy is less invasive, has fewer side effects, and is easier to perform.

What treatments are available?

Address underlying conditions

The first step in treating peripheral neuropathy is to address any contributing causes such as infection, toxin exposure, medication-related toxicity, vitamin deficiencies, hormonal deficiencies, autoimmune disorders, or compression that can lead to neuropathy. Peripheral nerves have the ability to regenerate axons, as long as the nerve cell itself has not died, which may lead to functional recovery over time. Correcting an underlying condition often can result in the neuropathy resolving on its own as the nerves recover or regenerate.

The adoption of healthy lifestyle habits such as maintaining optimal weight, avoiding exposure to toxins, exercising, eating a balanced diet, correcting vitamin deficiencies, and limiting or avoiding alcohol consumption can reduce the effects of peripheral neuropathy. Exercise can reduce cramps, improve muscle strength, and prevent muscle wasting. Various dietary strategies can improve gastrointestinal symptoms. Timely treatment of injuries can help prevent permanent damage. Smoking cessation is particularly important because smoking constricts the blood vessels that supply nutrients to the peripheral nerves and can worsen neuropathic symptoms. Self-care skills such as meticulous foot care and careful wound treatment in people with diabetes and others who have an impaired ability to feel pain can alleviate symptoms and improve quality of life. Such changes often create conditions that encourage nerve regeneration.

Systemic diseases frequently require more complex treatments. Strict control of blood glucose levels has been shown to reduce neuropathic symptoms and help people with diabetic neuropathy avoid further nerve damage.

Inflammatory and autoimmune conditions leading to neuropathy can be controlled in several ways. Immunosuppressive drugs such as prednisone, cyclosporine, or azathioprine may be beneficial. Plasmapheresis — a procedure in which blood is removed, cleansed of immune system cells and antibodies, and then returned to the body — can help reduce inflammation or suppress immune system activity. Large intravenously administered doses of immunoglobulins (antibodies that alter the immune system, and agents such as rituximab that target specific inflammatory cells) also can suppress abnormal immune system activity.

Symptom Management

Neuropathic pain, or pain caused by the injury to a nerve or nerves, is often difficult to control. Mild pain may sometimes be alleviated by over-the-counter analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). More chronic and discomforting pain may need to be addressed through the care of a physician. Medications that are used for chronic neuropathic pain fall under several classes of drugs: antidepressants, anticonvulsant medications, antiarrythmic medications, and narcotic agents. The antidepressant and anticonvulsant medications modulate pain through their mechanism of action on the peripheral nerves, spinal cord, or brain and tend to be the most effective types of medications to control neuropathic pain. Antidepressant medications include tricyclic antidepressants such as amitriptyline or newer serotonin-norepinephrine reuptake inhibitors such as duloxetine hydrochloride or venlafaxine. Anticonvulsant medications that are frequently used include gabapentin, pregabalin, topiramate, and carbamazepine, although other medications used for treating epilepsy may also be useful. Mexiletine is an anti-arrythmic medication that may be used for treatment of chronic painful neuropathies.

For pain that does not respond to the previously described medications, the addition of narcotic agents may be considered. Because the use of prescription obtained pain relievers that contain opioids can lead to dependence and addiction, their use is recommended only after other means of controlling the pain have failed. One of the newest narcotic medications approved for the treatment of diabetic neuropathy is tapentadol, a drug with both opioid activity and norepinephrine-reuptake inhibition activity of an antidepressant.

Topically administered medications are another option for neuropathic pain. Two agents are topical lidocaine, an anesthetic agent, and capsaicin, a substance found in hot peppers that modifies peripheral pain receptors. Topical agents are generally most appropriate for localized chronic pain such as herpes zoster neuralgia (shingles) pain. Their usefulness for treating diffuse chronic diabetic neuropathy is more limited.

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive intervention used for pain relief in a range of conditions, and a number of studies have described its use for neuropathic pain. The therapy involves attaching electrodes to the skin at the site of pain or near associated nerves and then administering a gentle electrical current. Although data from controlled clinical trials are not available to broadly establish its efficacy for peripheral neuropathies, TENS has been shown in some studies to improve peripheral neuropathy symptoms associated with diabetes.

Other complementary approaches may provide additional support and pain relief. For example, mechanical aids such as hand or foot braces can help reduce pain and physical disability by compensating for muscle weakness or alleviating nerve compression. Orthopedic shoes can improve gait disturbances and help prevent foot injuries in people with a loss of pain sensation. Acupuncture, massage, and herbal medications also are considered in the treatment of neuropathic pain.

Surgical intervention can be considered for some types of neuropathies. Injuries to a single nerve caused by focal compression such as at the carpal tunnel of the wrist, or other entrapment neuropathies, may respond well to surgery that releases the nerve from the tissues compressing it. Some surgical procedures reduce pain by destroying the nerve; this approach is appropriate only for pain caused by a single nerve and when other forms of treatment have failed to provide relief. Peripheral neuropathies that involve more diffuse nerve damage, such as diabetic neuropathy, are not amenable to surgical intervention.

What research is being done?

The mission of the National Institute of Neurological Disorders and Stroke (NINDS) is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health (NIH), the leading supporter of biomedical research in the world.

NINDS-funded research on neuropathy ranges from clinical studies of the genetics and natural history of hereditary neuropathies to basic science investigations of the biological mechanisms responsible for chronic neuropathic pain. Other efforts are focused on understanding how immune system dysfunction contributes to peripheral nerve damage. Together, these diverse research areas will advance the development of new therapeutic and preventive strategies for peripheral neuropathies.

Specific genetic mutations have been identified for some of the known hereditary neuropathies. NINDS therefore supports studies to identify other genetic defects that may play roles in causing or modifying the course of disease. The Inherited Neuropathies Consortium, focused on Charcot-Marie-Tooth neuropathies, seeks to better characterize the natural history of several different forms and to identify genes that modify clinical features in these disorders. Better knowledge of genetic causes may help identify people who are at high risk for developing peripheral neuropathy before symptoms appear. Understanding the role of genetic mutations may also lead to the development of gene therapies that prevent or reduce cumulative nerve damage. In addition, advances from genetics research inform studies to understand disease mechanisms. For example, scientists are using animal models to study how inflammation and nerve damage result from mutations in the Autoimmune Regulator (AIRE) gene, the cause of chronic inflammatory demyelinating polyneuropathy (CIDP) in some people.

Several NINDS-funded studies aim to determine why nerve axons degenerate in different types of peripheral neuropathies. Rapid communication between the peripheral nervous system and the central nervous system depends on myelination, a process through which special cells called Schwann cells create an insulating sheath around axons. Research has shown that Schwann cells play a critical role in the regeneration of nerve cell axons in the peripheral nervous system. By better understanding myelination and Schwann cell function, researchers hope to find targets for new therapies to treat or prevent nerve damage associated with neuropathy.
One promising area of research focuses on a class of molecules called neurotrophic factors. These substances, produced naturally by the body, protect neurons from injury and enhance their survival. Neurotrophic factors also help maintain normal function in mature nerve cells, and some stimulate axon regeneration. Several NINDS-supported studies seek to learn more about the effects of these powerful chemicals on the peripheral nervous system.

Another area of research aims to better understand inflammatory peripheral neuropathies, such as Guillain-Barre syndrome (GBS), in which the body’s immune system attacks peripheral nerves, damaging myelin and impairing signal conduction along affected nerves. NINDS-funded researchers are investigating the mechanisms by which the body’s immune system stops recognizing peripheral nerves as “self” and starts attacking them. GBS is usually preceded by a microbial infection, some as common as food poisoning or the flu, and researchers hypothesize that antibodies generated by the immune system to fight bacteria also attack nervous system proteins. Studies to test this hypothesis may lead to treatments that prevent these antibodies from damaging nerves. As a different strategy, researchers are studying the blood-nerve barrier in inflammatory nervous system disorders and developing ways to reduce the movement of immune cells from the bloodstream into nerve tissue, which may reduce inflammation, demyelination and nerve injury.

Transcranial magnetic stimulation (TMS), which uses a coil either held above or placed on the scalp that delivers electromagnetic pulses to activate electrical currents in general or specific parts of the brain, has shown some analgesic effect in treating various pain conditions. Current studies are examining the effectiveness of TMS in treating peripheral and chronic neuropathies.

In addition to efforts to treat or prevent underlying nerve damage, other NINDSsupported studies are informing new strategies for relieving neuropathic pain. Researchers are investigating the pathways that carry pain signals to the brain and are working to identify substances that will block this signaling.
 

Autoimmune Disease

Can the lemon water help autoimmune diseases, such as lupus or vasculitis?

Lupus is an autoimmune disease in which the immune system attacks its tissues, causing inflammation, swelling, pain, and damage. Lupus symptoms vary, and early lupus symptoms include fatigue, joint pain, fever, and a lupus rash, especially after being in the sun. Many experts believe endometriosis is caused by an autoimmune disorder.

 9 out of 10 people who have lupus are women. This tells me that there is a definite connection between the causes of endometriosis and the causes of lupus, especially in regard to the environmental factors that affect women, such as the use of cosmetics and other personal care products.

According to Lupus.org, “Vasculitis is an inflammation of the blood vessels. Inflammation is a condition in which tissue is damaged by blood cells entering the tissues. In inflammatory diseases, these cells are mostly white blood cells. White blood cells circulate and serve as our major defense against infection. Ordinarily, white blood cells destroy bacteria and viruses. However, they can also damage normal tissue if they invade it.”

I encourage you to read further down the page on that Lupus site, where you will see an explanation on how lupus might be caused by an immune or "allergic" reaction in the vessel walls. The substances which cause allergic reaction are called antigens. The antigens stimulate the production of antibodies which bind to the allergens to get rid of them.  Commit to re-hydrating your body, first and foremost.

The process of rehydration can literally take months or even a few years of drinking enough water consistently every day to stop the drought management in the body.

The type and quality of water you drink can also make a big difference.

Dehydration and Autoimmune Diseases

Every autoimmune disease is highly complex and I don’t mean to oversimplify the causes and treatments. However, I believe that the most essential root cause of just about every autoimmune disorder is caused by chronic dehydration.

Dehydration is closely linked to the production of antigens and the inflammatory process in the body. In addition, dehydration significantly affects digestion and elimination.

Health scientists have revealed that nearly 80 percent of our immune system function originates in our gastrointestinal tract.

That says a lot about how important proper digestion and elimination really is.

How Lemon Water Can Assist with Autoimmune Disease

Lemon water significantly aids digestion and elimination, helping to prevent toxic build-up in the gut, leaky gut syndrome, and various other conditions which contribute to the production of allergens in the body, which cause inflammation and disrupt immune system function.

After laying the foundation with hydration and lemon water, a comprehensive program of managing stress, proper diet and nutrition supplementation, body cleansing, and regular moderate exercise is usually necessary to help restore balance.

The body’s innate intelligence is beyond our comprehension. I know that if we give the body what it needs (specifically water, oxygen, and real food) and reduce the stuff it does not need (tobacco, alcohol, processed food, chemicals and numerous other toxins from air, water, food), it is possible to not only manage the symptoms of autoimmune disorders, but to potentially reverse these conditions.

Health Benefits of Drinking Water
The Healthy Cell Concept

Common sense tells us that if we have healthy cells, we will have a healthy body. So, what constitutes a healthy cell?

I could write a whole book on this topic. It is fascinating and inspiring to delve into the workings of the highly intelligent and complex functioning of the human body, especially at the cellular level.

However, to summarize, I believe the simplest answer to cellular health is this:

A healthy cell is one in which the nutrients can easily get into the cell and the toxins can efficiently get out.

Cell Water Turnover

This process is referred to as “cell water turnover” and I believe the efficiency of this process is the essence of physical health.

Adequate hydration is obviously essential to cell water turnover.
Our cells need nutrients to survive. Not only is water the transport fluid for nutrients to get into the cells, water itself is a nutrient.

In fact, oxygen and water are the most important nutrients for the human body. Thus, water plays an important metabolic role in all functions in the body.

Eliminating waste is another one of the essential health benefits of drinking water and efficient cell water turnover. This is the factor that I think people overlook the most.

According to Dr. William J. Yarwood, who practiced natural healing and nutritional therapy with thousands of patients over 30 years:

“All diseases are nothing more than different expressions of toxicity."

He says it works like this: “Genetically, each of us has stronger and weaker areas in our bodies. As you accumulate toxins during your lifetime, your toxins congregate in the weakest areas of your body because that is where they get the least resistance.

“When enough toxins have accumulated in a part of your body, they will manifest themselves in the form of a disease that is indigenous to that part of the body.”

With rare exceptions, I believe optimal health ultimately comes down to the quality of the environment within the body. And that environment is primarily composed of water.

Living in a Fish Bowl

Over the years I have heard a number of health practitioners make the analogy of human health to living in a fish bowl. I like fish and, for some reason, the analogy always makes me smile, so I will share it here in case you haven’t heard it.

Think of the environment inside your body as a fish bowl and your cells are like the fish. If you’ve ever had an aquarium or fish bowl, you know that if you don’t change or filter the water regularly, the fish will die. Why is this?

Because fish eat and eliminate waste (as in cell water turnover). If the wastes in the water are not removed, they build up and can eventually choke the fish (our cells) to death.

When water is deficient, wastes build up in the fluid that surrounds the cells, preventing nutrients from getting into the cell.

When toxins accumulate, they can deprive the cells of oxygen and even cause cell mutation, a primary cause of cancer. Likewise, when water is lacking in your body, one of the first functions that is affected is detoxification.

All of the detoxification functions in the body—including breathing, sweating, urinating and defecating—require water. 
However, the body is ingenious at adapting. When dehydrated, it will safely store toxins in various places in the body, such as in fatty tissue, in arterial deposits or in the joints.

In other words, it will store the toxins in safe places—away from the major organs. So our life is preserved in the short term, but the long-term health consequences are significant. Because those stored toxins are only "safe" for a while.

All Bodily Functions Are Affected by Water

As important as it is, efficient cell water turnover is only one of the numerous health benefits of drinking water daily. In addition to water, healthy foods nourish life and fuel energy.

Since most adult bodies are about 70 percent water, it is easy to comprehend how important water is.

You might be interested to know that babies are approximately 80 to 90 percent water and many elderly people are only 50 to 60 percent. This information, in itself, gives us a clue into the health benefits of drinking water for slowing the aging process.

Water regulates ALL the functions in the human body. Just a few of the most important functions include the following:

• The flow of blood and lymph through the body
• The functioning of our brains
• The cushioning and regulation of organs
• The transfer and absorption of nutrients into cells and tissues
• The removal of waste out of the cells
• The movement of nerve impulses through the nervous system
• The balance of hormones
• The regulation of body temperature
• The lubrication and cushioning of joints

Specific Health Benefits of Drinking Water

As far as I am concerned, EVERY health condition, illness and disease is affected by water, as explained above.
Drinking enough pure water has been shown to help the body heal itself from many sicknesses, including:

• General pain and inflammation in muscles and joints
• Tension headaches and migraines
• Tension headaches and migraines
• Weight loss
• Water retention
• Skin problems, including acne, eczema and psoriasis
• Gastrointestinal issues
• Spinal problems
• Hearing and sight problems
• Dysfunction of the kidney or liver
• Hormonal problems
• Diabetes
• Gall and kidney stones
• Circulation issues
• Cancers
• Heart disease and strokes
• Mental disorders and addictions
• Impaired memory and brain function
• Autoimmune disorders, such as Lupus and fibromyalgia

This is not to say that water alone will cure every disease. However, I do believe proper hydration is often the missing link and should be an essential part of every health program.

Importance of Drinking Water
Functions and Recycling of Water in the Body

The importance of drinking water daily is often overlooked, even though every function in the human body is dependent on water. In short, without water, nothing lives.



Consider this: the adult human body is about two-thirds water, and most of the key organs and fluids in the body consist primarily of water.

The following percentages are estimates and vary slightly from expert to expert and from person to person:

• Brain 85%
• Heart 79%
• Blood 85%
• Intestines 75%
• Lungs 79%
• Liver 90%
• Kidneys 83%
• Muscle 76%

Functions of Water in the Body

In addition to the high water content in the body, basic physiology reveals the importance of drinking water in how the body functions.
Water is essential for EVERY function in the human body. Other pages on this site will explain these functions in more detail.

Just a few of the most vital functions include the following:

• Brain functioning
• Organ regulation and cushioning
• Blood and lymph flow
• Nutrient transfer and absorption at the cellular level
• Nerve impulse movement throughout the nervous system
• Hormone balancing
• Temperature regulating
• Joint lubrication and cushioning
• Waste removal

The Body's Water Recycling System

Thus, we know water is critical to the survival and maintenance of the human body. But what is the importance of drinking water daily?

It has to do with the body’s water recycling system. The body recycles hundreds of gallons of water a day just to maintain normal biological functions.

During the recycling process the body comes up short of at least six to ten glasses of water per day.

This daily water shortage varies greatly depending on individual diet, lifestyle and environmental factors.

Read more on drinking enough water facts. . .

No Water Storage System in the Body

In addition to the daily water shortage issue, our bodies have no water storage system to supply water in times of drought—thus, the importance of drinking water regularly and throughout the day.


Contrary to popular belief, most of the water we need does not come from the foods we eat.

At best, if we are eating primarily whole, fresh foods, we may get as much as 20 percent of our daily water needs.

However, most people are eating a high percentage of processed foods, which have little if any water content.

In addition, many of the beverages we drink—such as alcohol, sodas, coffee and tea—are actually dehydrating to the body.
They act as diuretics and cause the body to lose even more fluids.

Drought Management in the Body

What happens to our bodies when we don’t drink enough? We start to experience mild dehydration symptoms, such as fatigue, headaches, feeling irritable or anxious, constipation and other digestive disorders, and not sleeping well.

When dehydration continues, the body learns to adapt with a drought management program.

However, sooner or later the ill effects will begin to appear in the body in the form of pain and inflammation. The location of the pain and inflammation often depends on where acid wastes have built up most in the body.

According to Dr. F. Batmanghelidj in Water for Health, for Healing, for Life,there are six conditions that denote chronic dehydration and drought management in the body. These conditions include:

• Asthma
• Allergies
• Constipation
• High blood pressure
• Type II diabetes
• Autoimmune disorders

Importance of Drinking Water for Healing

The importance of drinking water is understated in this article. My intent here is to simply provide a glimpse into the amazing properties of water in relation to the maintenance of the human body.

Water also plays a key role in the body's ability to heal itself. 
For example, medical research tells us that drinking enough water daily (at least half our body weight in ounces of water) can decrease the risk of bladder cancer by 50 percent and decrease the risk of colon cancer by 45 percent.

As you read other pages on this blogsite, you will find more in depth information and guidelines about how drinking water can aid in disease prevention and healing of many illnesses, disorders, ailments and diseases.

Drinking water daily is quite simply the easiest and most effective way to provide a solid foundation for optimal health, fitness and longevity.
 

The history of lupus can be divided into three periods: classical, neoclassical, and modern. This article concentrates on developments in the present century which have greatly expanded our knowledge about the pathophysiology, clinical-laboratory features, and treatment of this disorder.

Lupus in the classical period (1230-1856)

The history of lupus during the classical period was reviewed by Smith and Cyr in 1988. Of note are the derivation of the term lupus and the clinical descriptions of the cutaneous lesions of lupus vulgaris, lupus profundus, discoid lupus, and the photosensitive nature of the malar or butterfly rash.

The word ‘lupus’ (Latin for ‘wolf’) is attributed to the thirteenth century physician Rogerius who used it to describe erosive facial lesions that were reminiscent of a wolf's bite. Classical descriptions of the various dermatologic features of lupus were made by Thomas Bateman, a student of the British dermatologist Robert William, in the early nineteenth century; Cazenave, a student of the French dermatologist Laurent Biett, in the mid-nineteenth century; and Moriz Kaposi (born Moriz Kohn), student and son-in-law of the Austrian dermatologist Ferdinand von Hebra, in the late nineteenth century.

The lesions now referred to as discoid lupus were described in 1833 by Cazenave under the term “erythema centrifugum,” while the butterfly distribution of the facial rash was noted by von Hebra in 1846. The first published illustrations of lupus erythematosus were included in von Hebra's text, Atlas of Skin Diseases, published in 1856.

Lupus in the neoclassical period (1872- 1948)

1872;Systemic lupus identified as distinct from cutaneous lupus.

 

The Neoclassical era of the history of lupus began in 1872 when Kaposi first described the systemic nature of the disorder: “...experience has shown that lupus erythematosus ... may be attended by altogether more severe pathological changes, and even dangerous constitutional symptoms may be intimately associated with the process in question, and that death may result from conditions which must be considered to arise from the local malady.”
Kaposi proposed that there were two types of lupus erythematosus; the discoid form and a disseminated (systemic) form. Furthermore, he enumerated various signs and symptoms which characterized the systemic form, including: 

• subcutaneous nodules
• arthritis with synovial hypertrophy of both small and large joints
• lymphadenopathy
• fever
• weight loss
• anemia
• central nervous system involvement

The existence of a systemic form of lupus was firmly established in 1904 by the work of Osler in Baltimore and Jadassohn in Vienna. Over the next thirty years, pathologic studies documented the existence of nonbacterial verrucous endocarditis (Libman-Sacks disease) and wire-loop lesions in individuals with glomerulonephritis; such observations at the autopsy table led to the construct of collagen disease proposed by Kemperer and colleagues in 1941. This terminology, ‘collagen vascular disease,’ persists in usage more than seventy years after its introduction.

Lupus in the modern era (1948-present)

The sentinel event which heralded the modern era was the discovery of the LE cell by Hargraves and colleagues in 1948. The investigators observed these cells in the bone marrow of individuals with acute disseminated lupus erythematosus and postulated that the cell “...is the result of...phagocytosis of free nuclear material with a resulting round vacuole containing this partially digested and lysed nuclear material...”.
 

1948;The Lupus Erythematosus cell is discovered.

 

This discovery ushered in the present era of the application of immunology to the study of lupus erythematosus; it also allowed the diagnosis of individuals with much milder forms of the disease. This possibility, coupled with the discovery of cortisone as a treatment, changed the natural history of lupus as it was known prior to that time.

Two other immunologic markers were recognized in the 1950s as being associated with lupus: the biologic false-positive test for syphilis and the immunofluorescent test for antinuclear antibodies. Moore, working in Baltimore, demonstrated that systemic lupus developed in 7 percent of 148 individuals with chronic false-positive tests for syphilis and that a further 30 percent had symptoms consistent with collagen disease.

Friou applied the technique of indirect immunofluorescence to demonstrate the presence of antinuclear antibodies in the blood of individuals with systemic lupus. Subsequently, there was the recognition of antibodies to deoxyribonucleic acid (DNA) and the description of antibodies to extractable nuclear antigens (nuclear ribonucleoprotein [nRNP], Sm, Ro, La), and anticardiolipin antibodies; these autoantibodies are useful in describing clinical subsets and understanding the etiopathogenesis of lupus.

First animal model developed

Two other major advances in the modern era have been the development of animal models of lupus and the recognition of the role of genetic predisposition to the development of lupus. The first animal model of systemic lupus was the F1 hybrid New Zealand Black/New Zealand White mouse. 

This murine (mouse) model has provided many insights into the immunopathogenesis of autoantibody formation, mechanisms of immunologic tolerance, the development of glomerulonephritis, the role of sex hormones in modulating the course of disease, and evaluation of treatments including recently developed biologic agents such as anti-CD4, among others.

Other animal models that have been used to study systemic lupus include the BXSB and MRL/lpr mice, and the naturally occurring syndrome of lupus in dogs.   

Genetic component recognized  

The familial occurrence of systemic lupus was first noted by Leonhardt in 1954 and later studies by Arnett and Shulman at Johns Hopkins. Subsequently, familial aggregation of lupus, the concordance of lupus in monozygotic twin pairs, and the association of genetic markers with lupus have been described over the past twenty years. 
 

1954;It is discovered that there is a genetic component to lupus.

Molecular biology techniques have been applied to the study of human lymphocyte antigen (HLA) Class II genes to determine specific amino acid sequences in these cell surface molecules that are involved in antigen presentation to T-helper cells in individuals with lupus. These studies have resulted in the identification of genetic-serologic subsets of systemic lupus that complement the clinico-serologic subsets noted earlier. 

It is hoped by investigators working in this field that these studies will lead to the identification of etiologic factors (e.g., viral antigens/proteins) in lupus.

Over the last decade or so, we have witnessed significant advances in the understanding of the genetic basis of lupus, and of the immunological derangements which lead to the clinical manifestations of the disease.

Advances have been made in the assessment of the impact of the disease in general, and in minority population groups, in particular and efforts are being made towards defining lupus biomarkers which may help both to predict disease outcome and to guide treatments.

Lupus therapies then and now 

Finally, no discussion of the history of lupus is complete without a review of the development of therapy. Payne, in 1894, first reported the usefulness of quinine in the treatment of lupus. Four years later, the use of salicylates in conjunction with quinine was also noted to be of benefit. 
 

1950;Nobel Prize awarded to scientists who discover the effects of corticosteroids.

 

Cortisone/corticosteroids were introduced for the treatment of lupus in the middle part of the 20th century by Hench. Presently, corticosteroids are the primary therapy for almost all individuals with lupus.
Antimalarials, used in the past principally for lupus skin and joint involvement, are now recognized to prevent the occurrence of flares, the accumulation of damage, and the occurrence of early mortality. 

Cytotoxic/immunosuppressive drugs are used for glomerulonephritis, systemic vasculitis, and other severe life-threatening manifestations of lupus. Newer biologic agents are now used, either off-label or after approval by regulatory agencies in the U.S., Europe, and other countries. 

Other potential drug products are being investigated as new disease pathways are being discovered.

Looking forward

The history of lupus, although dating back at least to the Middle Ages, has experienced an explosion in this century, especially during the modern era over the past 60 years. It is hoped that this growth of new knowledge will allow a better understanding of immunopathogenesis of the disease and the development of more effective treatments.

Use Water Cure Protocol Formula (Click for Results)

 

ABC of Asthma, Allergies and Lupus

ABC of Asthma, Allergies and Lupus 
by  F. Batmanghelidj, MD

For over twenty years Dr. Fereydoon Batmanghelidj (pronounced Batman-ge-lij) has been researching the effects of water and dehydration on the human body. Dr. Batmanghelidj explained the many effects of dehydration in his first book Your Body's Many Cries for Water. Water, which makes up 75% of the body and 85% of the brain, is more than a solvent. Just as water is needed for seeds to grow into plants, our bodies need it to perform metabolic chemical reactions, to create energy, and to remove waste and acid from tissues. Every day we lose at least two quarts (eight 8-oz-glasses) of water and some salt (which is necessary for maintaining acid/ alkali balance) via urine, respiration, and perspiration. Instead of replacing lost water by drinking more water, many people drink caffeinated beverages. Caffeine found in soda pop and in coffee acts as a diuretic that forces more water from the body than is contained in the caffeinated beverage itself.

Dr. Batmanghelidj's research indicates that dehydration causes fatigue, depression, anxiety, localized chronic pain and, eventually, a number of chronic dysfunctions. In his newest book, Dr. Batmanghelidj explains the correlation between dehydration and asthma, allergies, and autoimmune disease, specifically lupus. He begins ABC of Asthma, Allergies and Lupus by describing the huge increase in the numbers of people suffering from asthma. From 1980 to 1994, the number of children with asthma, ages 0-4 years, rose from 2,000 to 6,000 per 100,000 population. The rate of asthma among 5-14 year olds rose from 3,500 to over 7,000. Older age groups have also shown an increase. Conventional medical treatment includes the use of antihistamine drugs. Dr. Batmanghelidj asserts that this suppression of histamine ignores physiology and the effects of dehydration.

During dehydration, the body produces more histamine. Histamine is a neurotransmitter involved in water rationing. It also regulates the thirst mechanism. The spasms that histamine incites in the bronchiole tubes are actually an attempt to conserve water, needed by the air sacs. (alveoli) in order to maintain their shape. Asthma tends to affect children more severely because their bronchial tubes are smaller and less rigid than adults', allowing greater constriction. Children also produce more histamine in their bodies because, in addition to being a water regulator, histamine is a growth factor. The demands for water created by a growing body and a lack of water reservoirs make children especially susceptible to dehydration.

Dehydration can also account for the runny nose and watery eyes that accompany allergies. During dehydration the immune system becomes suppressed. In order to cope with pollens and other antigens, histamine and its subordinate chemicals direct water to the nose and eyes in an attempt to remove pollens through tears and nasal secretions. Dr. Batmanghelidj notes that while a well-hydrated body is able to produce more antibodies to neutralize organic antigens, this same mechanism cannot protect the body from toxic chemicals and gases. Instead, the body tries to prevent entry by constricting breathing. In susceptible, dehydrated people, exposure to the smell of some chemicals can lead to shortness of breath, an irritating cough, and even an asthma attack.

As stated before, conventional medicine treats asthma and allergies with antihistamine medications. Instead of using drugs to block histamine, Dr. Batmanghelidj uses water and a bit of salt (about 1/2 tsp. per 10 cups of water) to reduce the body's histamine production. He says that "[a] rough rule of thumb of how much water a person needs a day is half one's body weight in ounces of water....Some children might need three-fourths of their body weight in ounces of water." People with heart or kidney problems are warned to increase their water intake slowly, preferably under the supervision of a doctor. As people drink more water, urine production should also increase. Thus, more minerals and water-soluble vitamins may be excreted, so Dr. Batmanghelidj recommends taking supplements. He also gives information on beneficial foods, exercise, and sunlight's role in converting cholesterol into vitamin D. ABC of Asthma, Allergies and Lupus contains letters from several people - including doctors - who have been able to greatly reduce or eventually discontinue their own asthma medication, or that of their children's, by adhering to the water and salt program.

Dr. Batmanghelidj chose to examine lupus after encountering the Townsend Letter's special issue on lupus and autoimmune disease (August/September 1999). In ABC of Asthma, Allergies and Lupus, he describes the symptoms of systemic lupus erythematosis (i.e., fatigue, persistent headaches, malar flush, LE cells, muscle and joint pain, Raynaud's Phenomenon) and how the symptoms relate to water deficiency. One of the hormones produced by the brain when it is stressed and dehydrated is vasopressin, an antidiuretic. Vasopressin is also a strong cortisone release factor (CRF). CRF stimulates the secretion of interleukin-1 (IL-1) and inhibits interleukin-2 and interferon. Histamine also inhibits the production and release of interleukin-2 and interferon. Without the presence of interleukin-2 and interferon to neutralize it, interleukin-1 levels rise and the body produces more CRF. Eventually, the body begins secreting other chemicals that break down tissue in an attempt to "recycle some primary raw materials [including cellular water] that the brain/body needs." Dr. Batmanghelidj explains, "In this type of process, the CRF and IL-1 that should only temporarily become engaged in releasing some primary materials from the body's own tissues, get stuck on the job and 'remain commissioned' - their production is not stopped by their feedback mechanism because of dehydration. The outcome of one form of this type of crisis management of a stressed/dehydrated body that has to resort to cannibalism of its own tissues is called autoimmune disease. One form of autoimmune disease is lupus." Research by F. Tjernstrom and associates (Journal of Lupus #8, 1999, pp 103-108), found that "[people] with constant IL-1 activity in their bodies are 700 percent more likely to suffer from lupus than those without IL-1 activity."

The skeptical mind finds it hard to believe that something as simple as water and a bit of salt can have any effect on conditions as serious as asthma and lupus. When one looks at the cascade of biochemical reactions that occur when cells become dehydrated, however, one begins to understand how vital this one substance is for maintaining health. The body produces histamine and other chemicals for a reason. Doesn't it make sense to try to understand that reason instead of simply trying to block their activity with drugs? Dr. Batmanghelidj has done that, and he has provided ABC of Asthma, Allergies and Lupus to help more people understand the power of water.

Global Health Solutions, Inc., P.O. Box 3189, Falls Church, Virginia 22043 USA

Phone 703-848-2333 or 800-759-3999; fax 703-848-2334; www.watercure.com


Softbound, ISBN 0-9629942-6-X, 2000, 237 pp., $17.00.

The Water Cure Recipe:

Drink 1/2 your body weight of water in ounces, daily.

Example: 180 lb = 90 oz. of water daily.

Use 1/4 tsp. of sea salt for every quart (946.35 mL)of water you drink. Use a good sea salt without additives.
-----------------------------------------------
Books by Dr. F. Batmanghelidj:

1.Your Body’s Many Cries for Water (1992),

2.How to Deal with Back Pain & Rheumatoid Joint Pain (1991),

3.Water: Rx for A Healthier, Pain-free Life (1997),

4.ABC of Asthma, Allergies and Lupus: Eradicate Asthma – Now!,

5.Water For Health, For Healing, For Life (2003),

6.Water Cures: Drugs Kill: How Water Cured Incurable Diseases, (2003)


7.Obesity Cancer Depression; Their Common Cause & Natural Cure, (2005)

CAFFEINE and the BODY

CAFFEINE and the BODY

Heath Effects, Reproductive Issues, and Short-Term Memory
Bennett Alan Weinberg, Esq. and Bonnie K. Bealer.
Mr. Weinberg is a medical and science writer.
Ms. Bealer is a researcher, writer and editor.

Opinion

Editor's Note: The following is excerpted from the book The World of Caffeine: The Science and Culture of the World's Most Popular Drug.by Bennett Alan Weinberg and Bonnie K. Bealer (Routledge, 2001).

What is it in man's devious make-up that makes him round on the seemingly more wholesome and pleasurable aspects of his environment and suspect them of being causes of his misfortunes? Whatever it is, stimulants of all kinds (and especially coffee and caffeine) maintain a position high on the list of suspicion, despite a continuing lack of real evidence of any hazard to health.
-Editorial, British Medical Journal, 1976, I:1031       

Coffee and caffeine have long been suspected of causing illnesses ranging from myocardial infarction, arrhythmias, hypertension, hyperlipidemia, gout, and anxiety, to fibrocystic breast disease, various cancers and birth defects, and osteoporosis. No other agent in the human environment has been as frequently associated with such a variety of chronic-degenerative, even malignant diseases.        

-Siegfried Heyden, "Coffee and Cardiovascular Disease," 1993       

Caffeine and, before caffeine was identified, coffee, tea, and chocolate, have been said to cause, exacerbate, palliate, or cure an enormous variety of diseases and have also been said to confer marvelous benefits, including increases in both intellectual and physical capacities. If, like the great majority of people in the world, you use caffeine regularly, you are faced with a complex, confusing, and often apparently contradictory cacophony of traditional and contemporary claims about its effects on human health. ... In the last half of the 20th century, an explosion of general medical knowledge and a large number of controlled experiments have shed scientific light on many of caffeine's effects. It has been often and truly said that caffeine is the most studied drug in history. Yet, because of its nearly universal use, the variety of its modes of consumption, its presence in and effects on nearly all bodily systems, and its occurrence in chemically complex foods and beverages, together with the complexity of the social and psychological factors that shape its use, caffeine may also be one of the least adequately understood. Despite tremendous scientific scrutiny, many central health questions about caffeine remain unanswered or even unaddressed.

Caffeine is like the air. You don't see it and usually hardly notice it, but it's there all the same, and it becomes part of you in a critical metabolic exchange that involves every cell in your body. Considering that the sensorium and biomass of the human race is virtually awash in caffeine, and has been besotted so for hundreds of years, and that an overwhelming majority of people in almost every nation, including young and old, healthy and infirm, rich and poor, has made the regular use of this psychoactive stimulant more popular than the habitual use of any other drug, what do we really know of caffeine? What do we know of what it is doing for us, doing to us, even doing to our unborn children? The answer, as should become clear after reviewing the very impressive record of studies presented in the following chapters and the appendices, and evaluating both the findings and limitations of this research, is, "not nearly as much as we need to know."

The great majority of babies begin life with detectable levels of caffeine in their blood. The lack of adequate information about caffeine's health effects is evident in the disagreements that exist among experts. For example, the FDA, as recently as the late 1980s, reaffirmed its earlier position that medical evidence demonstrated no adverse health consequences from caffeine in soft drinks, and the National Academy of Sciences' National Research Council and the U.S. Surgeon General's office agreed that no risk to health had been shown for moderate caffeine intake. In contrast, many researchers, adducing the complexity of caffeine's effects on the human body and the many aspects of these effects that have received limited research attention, argue that such a "clean bill of health" is not fully justified. ...       

Caffeine and Birth Defects       

The nature of caffeine's effects on birth abnormalities and fertility is probably the most urgent unresolved question that remains to be addressed by future researchers...

The consensus of the medical and scientific community is that, to avoid risk to the fetus, women ought to curtail caffeine use during pregnancy, although authorities differ about the nature or extent of the dangers of failing to do so. But the worrisome fact is that, despite this admonition, most women using caffeine continue throughout pregnancy, with an average intake among users of more than 200 mg a day. As a result, the great majority of babies begin life with detectable levels of the drug in their blood. Because fetal exposure to caffeine is so pervasive, any unfavorable effect on the health of the newborn, even one with a very low incidence, could mean tens of thousands of defective births a year in the United States alone. It is therefore critical to investigate the effect of caffeine exposure on the outcomes of pregnancy as exhaustively as possible.       

Two facts about caffeine metabolism increase concern over the harm that could be posed by maternal caffeine use.        

    First, caffeine metabolism dramatically slows during gestation. The metabolic rate drops progressively, falling to one-half normal during the second trimester, and to one-third normal during the third trimester, before returning to normal within the week following delivery. This means that caffeine that is ingested by the woman in the last few months of pregnancy will remain in her system three times longer than usual and, consequently, that the exposure of her unborn child to caffeine will last three times longer.        

Second, the livers of the fetus and newborn are unable to metabolize caffeine. Because of the incapacity of their hepatic enzyme systems, their livers cannot transform caffeine into its metabolites, so the drug lingers in their systems much longer than in either children or adults, until it is finally excreted, virtually unchanged, in the urine. One researcher found the mean elimination time in infants being treated for apnea with caffeine was one hundred hours, 15 times the adult average, and other scientists report a range up to about 350 hours in premature infants. These dramatic metabolic decrements, however, are short-lived. The infant's capacity to metabolize caffeine progressively increases in the first months of life until it reaches the adult level of three to seven hours by the eighth month, though full maturity of the metabolic pathways of caffeine may not be achieved until the end of the first year.    

Caffeine and Memory       

    In recent years, in addition to continuing studies of caffeine's effects on complex mental activities such as reasoning and learning, researchers have paid increasing attention to its effects on short-term memory. Overall, the results show that caffeine improves performance on tasks that require remembering small amounts of information and impairs or leaves unaffected performance on tasks requiring remembering a great deal. An example of a more demanding sort of memory task is a test in which subjects listen to or read long lists of words and are then asked to remember as many as possible. The experimenters note either no effect from caffeine or perhaps even a small impairment. Another way of conceptualizing these effects is provided by the Humphreys-Revelle model, according to which tasks that are primarily dependent on information processing, such as vigilance, simple arithmetic, or reaction time, are improved, because they make relatively small demands on short-term memory, while tasks with a high short-term memory component may be unaffected or adversely affected. Unfortunately, there is much ambiguity in the data that do exist about these effects. When weighing the conclusions of existing research, we would do well to remember a well-designed 1974 memory experiment by researcher V. E. Mitchell and his colleagues, the cautionary results of which were reminiscent of the title of Luigi Pirandello's play Right You Are, If You Think You Are, because they seem to demonstrate that performance was improved by caffeine when and only when the participants were told that they had ingested the drug.       

Caffeine may help you to stay awake, but it won't necessarily improve your intellectual skills. Nevertheless, millions of students use caffeine to fuel "all-nighters." Based on the available scientific evidence, how does this use of caffeine affect studying and test taking? Caffeine helps people to feel less drowsy and less fatigued, be better able to perform some manual or perfunctory tasks, such as typing or calculating, and, under certain circumstances, to be more capable of sustaining rapid thought and to remember more. However, some studies have found that caffeine does not significantly alter numerical reasoning, short-term memory of complex data, or verbal fluency. In other words, caffeine may help you to stay awake, but it won't necessarily improve your intellectual skills.       

Students depending on caffeine to extend their study time should also be aware of its possible adverse effects when taken in large quantities and be prepared for the crash after its stimulating powers subside. As Socrates suggested, the best guide for students is to know themselves: From a couple of Vivarin tablets, the sensitive may experience restlessness, anxiety, nausea, headache, tense muscles, and sleep disturbances, or a subsequent letdown, while others, from a much higher dose, might feel fine.

Excerpt from 'ABC's of Asthma, Allergies and Lupus'
by Dr. F. Batmanghelidj

Naturally, the quality of drinking water is most important to health. Water should be water and not just any drink. Asthmatics should observe this instruction to the letter.

Water should be free of chemicals, particularly caffeine and alcohol.

Please bear in mind that caffeine and alcohol are toxic chemicals – addictive drugs – as far as the cells of the human body are concerned. It is true that the manufacturers of these agents have unrestricted permission to contaminate good drinking water with these toxic chemicals and to sell them to the public, but, sooner or later, their detrimental impact on society will also become the focus of attention like the tobacco industry presently is.

It is my sincere belief that many of our society’s problems of ill health can be blamed on the marketing tactics and unceasing pushes of the beverage industry. They tend to cultivate the palates of younger people toward the selection and use of their products in preference to the water that young bodies need to develop naturally and normally. Once teenagers - the target of the industry – became addicted to caffeine, the industry has converted them to cash machines for the rest of their shortened lives! The unfortunate outcome of addiction to caffeine is the “upgrade” effect that forces some children to experiment with harder drugs.

Caffeine is a natural diuretic. It forces more water out of the body than is contained in the caffeinated beverage. Caffeine also acts directly on the brain cells and forces them to use some of their critical energy reserves on trivial actions and whims. It lowers the threshold for triggering an action from cells that would otherwise remain quiet until a more serious engagement is deemed necessary. The effect of caffeine on the brain is energy depletion. Caffeine, if taken repeatedly, eventually exhausts the brain. When the brain needs energy reserves to cope with a crisis, it will be far less effective because it is energy-depleted and depressed. The energy-reserve-depleting effect of caffeine on the brain is one of the primary causes of Attention Deficit Disorder (ADD).

Caffeine has another detrimental effect on the brain that should be considered as the second main impact that pushes the brain in the direction of reaching an ADD status. The brain maintains its energy reserves to use for new confrontations, experiences, dangers, and exciting, fresh ideas. This is how it learns selectively and from new experiences. Caffeine not only depletes the stored energy pools in the brain, it also inhibits the enzyme system initiated by PD (phospho-diesterase). PD activity is a vital step in “memory making” by the brain cells.

All seeds that are designed to create the next generation of a plant contain in their covering shell one or other chemical to deter food scavengers, such as ants and beetles, from eating the protein-rich seeds before they sprout. If this were not so, these plants would become extinct. Legumes such as lentils, peas and green beans possess a chemical called CCK (chol-e-cysto-kinin), a digestive enzyme inhibitor that causes a form of indigestion in the systems of critters that eat the seeds. It causes gas formation in humans who eat lentils without soaking them well and discarding the skin, or boiling them briefly first, washing them well, and then boiling them a second time until cooked. This is the way to “de-gas” legumes that would normally produce indigestion. Get rid of the CCK.

Caffeine is naturally designed to produce stupefaction of the brain.  Caffeine is used by a number of plants as a nerve warfare chemical against their predators. The coffee plant produces caffeine in its seeds to defend itself. Caffeine inhibits the nervous system and the memory mechanisms in its “food-chain” predators in such a way that they lose their “wit” and their art of camouflage. They become less alert and less reactive, and thus less able to protect themselves. They become much easier prey for their predators.

This is why the coffee plant is plagued by fewer bugs than most other plants during its growth period. Bugs know better than to eat it. But we humans take the caffeine-containing coffee beans, brew them to our desired concentration, and consume the plants chemical poison as a pleasure-inducing beverage. High soda consumption, in my opinion, is the reason so many kids in American school have reading and learning problems. Despite all the money that is spent on their education, their average standard is far below children in less- privileged societies, whose access to caffeine-containing beverages is much more limited.

The beverage industry grows and thrives on the addictive properties of caffeine. A report published in the magazine, The Nation, April 27, 1998, states: “The most conservative estimates have children and teens guzzling more than sixty-four gallons of soda a year – an amount that has tripled for teens since 1998, doubled for the 6-11 set and increased by a quarter for under-5 tots (from a 1994 survey by the Agriculture Department).” This finding confirms what I published several years ago in my book, Your Body’s Many Cries for Water, on pages 104-113. It is also interesting to note that the increased consumption of sodas by infants under five years is most probably why the rate of asthma occurrence in that age group tripled in the years between 1980 and 1994.

The beverage industry’s recent name selection of new brands – Surge, Zapped, Full Speed, Outburst, Josta, laced with caffeine and the pick-me-up herb guarana, that hypes “raw primal power” – is designed to attract children and teenagers to consume more and more sodas. The 12-oz cans of soda that contains high amounts of caffeine include Jolt with 72 mg., XTC with 70 mg., and Pepsi-Cola’s Surge with 51 mg. And you get near double dose when you buy the 20-oz bottles.

At schools, the kids often take sodas in place of milk and the schools profit from the sale of these addictive beverages. They serve the regular 12-oz cans of soda, with Mountain Dew containing 55 mg. Of caffeine per can, Coke containing 45 mg., Sunkist with 40 mg., and Pepsi with 37 mg.

Grown-ups consume so much coffee that coffee bars are growing like mushrooms. It is said that a regular 12-oz cup of regular Starbucks coffee contains 190 mg. of caffeine.


In my professional opinion that caffeine by itself has all the detrimental effects on the brain cells to produce the type of brain physiology that dislocates the brain from stimuli received from outside. In addition, the dehydration caused by extensive caffeine intake produces different health problems, devastatingly and early. Among the symptoms are asthma and allergies. Thus, my protocol for the treatment of asthma excludes any form of caffeine-containing beverage until the body has recovered from caffeine’s unhealthy side effects, particularly on the brain and its nervous system. After that, wisdom will have to take over.