Nutritional Treatment for Detoxification and Recovery from Alcoholism--The Functional-Molecular Medicine Approach.pdf

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Nutritional Treatment for Detoxification andRecovery from Alcoholism:

The Functional/ Molecular Medicine Approachby David A. Arnes on, NMD, and Angela Pinkhasova, MD (Russia), NMD (Candidate)

IntroductionC o n v e n t i o n a l t r e a t m e n t for

alcohol ism, or drug dependency, has

been f oc us ed on m ono- t he rapeu t i capproaches. The literature is inundatedwith treatmen t regimes that are based on

medical, counseling, or spirituaily-basedapproaches, Unfortunately, rarely are

these protocols used simultaneously andrarely is treatment successful when the

holistic approach is ignored. At best, mosttreatment programs, even those claimingholistic treatment, are bimodal in theirapproach. Andwhen they are uti l ized

together, n utrition isoften overlooked asa necessary component of detoxificationand recovery. Certainly, one can f indample information, on the Internet and

elsewhere, on the nutritional aspects of

treatment ofalcoho lism. However, rarelydo these n utritional protocols ad dress thedeeper issues. Fortunately, there are

l eade rs in the f ie ld of i n t eg ra t i v e /functional medicine who are changing theway we look at treating chronic disease- nu t r i t ion a l ly . A lco ho l ism is now

recognized as a chronic disease. Whentreatment programs ut i l ize body-mind-sp i r i t approaches w i th we l l -des ignednutritional protocols, thesuccesses are

dy nam ic . In t h is monograph we wil lat tempt to in t roduce the concepts of

funct ional /molecular medic ine for the

treatment of alcoholism and suggest whystudying the deeper issues of nutritionaltherapy is an absolute necessi ty for

successful detoxification and subse quentsuccessful recovery.

Functional/Molecular Medicine

Functional medicine is a practice of

m ed ic ine t ha t f oc us es on ho l is t ictreatment of the individual rather than thetreatment of thedisease sym ptom. Theprimary focus is prevention of diseasestates but it is highly efficient in returningind iv idua ls to hea l th even when the

disease is created by lifestyle choices.Functional medicine requires that the

practitioner understand how things are

designed to work, and for what purpose,at the molecu lar leve l and how th isdesign/purpose affects the function of theo rgan i s m as a w h o l e . T h e r e is

recognition, by the physician, that thereare numerous complex ac t ions and

interactions that m ust occur at the cellularlevels to keep the patient at optimumhealth. This complexity is compoundedwhen we accept that each individual is

"an island unto himself." The individualnature of each pat ien t mus t be

r ec ogn iz ed as we l l as how h is / he rd i s eas e m an i f es t s i t s e l f t h roughenvironmental inf luences. Funct ionalmedicine is not about ignoring science. It

is intimately involved with science, yet

unde rs t ands t ha t m ov em en t t oward

science-based health on the physicallevel must coexist with emotional and

spiritual health.*'

Mo lecu lar med ic ine , and how the

environment inf luences molecular and

cel lu lar events, is an integral part of

functional medicine. Molecular medicineaddresses cel lu lar funct ion and how

t hese func t ions change th rough the

chan ging internal and external influencesof the i nd i v i dua l env i r onm en t .Un f o r t una t e l y , m o lec u la r m ed ic inewithout the necessary focused nutritionalcomponents along with pharmaceutical

d rug c om ponen t s is c o m m o n in thet r e a t m e n t of a l c o h o l and d rugdependency. Many t imes, rather thanas s i s t the pa t i en t to recovery , the

pharmaceutical treatment adds to the

chemical burden, resulting in abnormalmetabolism at the cellular level. It may

be that chemical therapy at this level is

sometimes necessary, especially if the

patient is a danger to self orothe rs. Yetin our clinical experience, we find this is

ra re ly the c as e when the p rog rame n c o m p a s s e s f u n c t i o n a l / m o l e c u l a rmedicine with nutritional components.

O ne of the pr imary advocates of

molecular medicine with the nutritionalcomponent is Majid Ali, MD.'"'"^ Dr. All

states that molecular medicine refers to

a p rac t i c e of m ed ic ine bas ed on

molecular events that occur before cellsand t issues are in ju red by d is eas e .Rather than treat the diseas e, we shoulddesign treatment protocols, based on

knowledge of cel lu lar s t ructure and

f unc t i on , wh ic h s a t i s f y the c e l l u l a rrequirements of the individual.'*^ There is

l i t t le doubt tha t the t r e a t m e n t ofa l c o h o l i s m , and d rug dependenc y ,benefits from this approach.

Functional medicine has been in the

process of conceptualisation for the pastdec ade t h rough the p rac t i c e of

naturopathy, with physicians trained in

science and nutrit ion, and holisticaltyeducated medical doctors and healthprofessionals. Since the early 9O's, its

lead ing proponent has been Jef feryB land, P hD. * ' In th is ar t ic le we use

funct ional medic ine as meaning bothf unc t i ona l / m o lec u la r m ed ic ine w i t h

nec es s a ry nu t r i t i ona l / env i r onm en t a lcomponents. In both concepts one thingis abundantly clear - nutritional therapyis not so much about what we eat or drink.Rather, it is about how what we eat or

drink - in combination w ith environmentalfactors - affects genetic functions and

molecular events in the body and mind.Jeffery Bland states, "We are not reallywhat we eat but what weabsorb fromwhat weeat."^^ Hegoes on to point out

that gastrointestinal dysfunction (commonin alcoholics), causes poor abso rption ofnutrients.

Nutritional Background

Adequate and balanced nutrit ion is

commonly overlooked in well-meaning

detoxif icat ion and recovery programs.

This is especially true in programs {lowor non-funded) that t reat the lower

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Alcoholism

p rog ram s enc ou rage rec ov e r ingalcoholics to eat and take basic vitam insand supplements, what is lacking is ac lear unders tand ing by most mono-therapeutic treatment programs of thedepths of physiological changes caused

by a l c oho l i s m . Fu r t he rm ore , m os tprograms have l it t le abil i ty to assesswhether the pat ien t can adequate lyabsorb nutrients taken orally.

Time is needed to bring the alcoholicback to an acceptable state of health sothat body functions (both physical andmental) can be assessed at baselineconditions. Furtherm ore, what is missingin many program s is the ability to providequality nutrients in sufficient quantities (orprovide accessibility to these nutrients)to assist the client's recovery through thehea l ing o f t i ssue damage and

neurotransmitter dysfunction.The meansto deliver these nu trients, espec ially in thedetoxification stages or early in recovery,need to be considered. Furthermore,many alcoholics and drug addicts, havingsuf fe red th rough years o fmalnour ishment , suf fer profound andpos s ib l y i r r ev e rs ib le phy s io log i c a lchanges which intensify discomfort inrecovery and, for many, lead to relapse.E m bed ded In t he m u l t i - d is c ip l i na r yapproach is an in tense focus onnutritional deficits and the profound long-term effects of chronic malnutrition and

alcohol intoxication.

Proper intake of oral nut r i t ion -including water, proteins, carbohydrates,fats, vitamins, and minerals - is theabsolute basis of our health and mentalwell-being. All t reatment interventionsmust s tar t w i th an assessment o fnut r i t iona l s ta tus o f the ind iv idua l .Treatment will be less effective if thepatient has impaired cognitive functiondue to nutritional deficiencies from thelong-term effects of alcohol and/or drugabuse. P roper hydration may be the most

important factor since every biochemicalprocess in the human bod y operates in af lu id mat r ix . F lu id is essent ia l int ranspor t ing nut r ien ts and remov ingwaste products in and out of cells. It isnecessary for all digestive, absorption,circulatory, and excretory events, as wellas the absorp t ion o f water -so lub levitamins. Proteins supply energy as wellas needed building blocks for hormones,neurotransmitters, antibodies, enzymes,and help maintain the proper acid-alkali

balance of the body. Carbohydratessupply necessary energy along with fiberwhich keeps gast rointest inal funct ionno rm a l i z ed . Fa t s a re es s en t i a l i nproviding energy and support cellularf unc t i on . I n add i t i on , p ro t e ins ,carbohyd rates, and fats are also integralpar ts o f ce l lu la r membranes andmembrane function. It is also well knownthat alcohol interferes w ith the absorption

of nutrients, especially vitamins. Vitamins,which are essential for l i fe and goodquality health, are cofactors (also know nas coenzymes) for enzymatic processesin the body. Additionally, two vitamins,v i tamins A and D, are cons ideredhormo nes. The major macro-mine rals -s od ium , po t as s ium , c a l c i um , andm agnes ium - f unc t i on i n ene rgymetabolism, membrane transport, andthe main tenance o f the membranepotential. Also necessary for life, and ofspec ia l impor tance, a re the m ic ro-m inera ls - chromium, copper , i ron ,

selenium, and zinc. Common nutrientdeficiencies in alcoholics are thiamine,fo l ic ac id (most common def ic iency) .Vitamin B-12, niacin, riboflavin. VitaminB-6, zinc. Vitamin C. and Magn esium. Anyprocess that interferes with the abovenumerous ora l nu t r ien ts can causedisease states. But most of the time thesed isease s ta tes remain subc l in ica l -especially in alcoholism.

The fact that nutrition has often beenoverlooked in the past in the areas ofpha rm ac o logy , s t anda rd m ed ic a l

practices, and treatment of addiction isnot surprising. More than two-thirds of themedical schools in the United States stilldo not have a specific nutrition course intheir curriculum.^ This ongoing failure toteach nutrit ion and pract ice nutrit ionalmedicine is embedd ed in the idea that weget our recommended daily allowance(RDA) of nutrients if we eat within certaindef ined parameters. There is a c learunderstanding now that even RDAs ofthese nutrients, established by the Foodand Nutr i t ion Board of the Nat ionalAcademy of Sciences (NAS) in 19 4 1 , may

k eep s ubc l i n i c a l d i s eas e s t a t essubc l in ica l . Because the RDAs forvitamins are minimum amounts that willonly prevent the signs and symptoms ofdef ic iency diseases, the dai ly intakeshou ld o f ten be h igher thanrecom men ded. This is especially true fortreatment of alcoholism. Furthermore,however well RDAs wo rk as a guideline,for any given person, they may be anunderest imate or overest imate of theamo unts actually needed for any specific

health problem. The fact that alcoholichave impaired ut i l izat ion of the basinutrients is unquestioned, but the leveof deficiency is unique to e ach alcoholicIn fact, these subclinical states may exisbefore active alcoholism because of poonutrition. Furthermore, de /acfo nutritiondeficits must exist in a subclinical statbefore they becom e clinica lly apparent.̂ "

All chronic a lcoholics suffer from som

level of nutritional deficiencies.^^'" Thalcoholic obtains most, if not all. his/hedaily energy requirements from ethanowhich although not a nutrient, containapproximately 7 calories per gram anrepresents about 3% to 5% of the daienergy intake of the adul t Amer icapopulation. As the most widely abusedrug of our society, ethanol contributedramat ica l ly to the deve lopment odisease states of several organ systemsespecially the liver'̂ and gastrointestinatract.'3 For many, the result is diminisheut i l izat ion of oral nut r ients that ar

necessary for normal health which leadto the subsequent s ta te omalnutr i t ion." '^

Treating alcoholic malnutrit ion anend organ injury is a complex problemDamage to vital organ function via thtoxic effects of alcohol is just one of thmany issues that need to be addressedAbsorpt ion, assimilat ion, and eliminatioa re a l l im pa i r ed t o s om e deg reeUnfortunately, the efficacy of intestinabsorption in a given patient cannot bpredicted adequately.^" Inadequate die

digestion, and malabsorption contributto secondary malnutr i t ion. '^ '^ Alcohcauses change s in protein digest ion anmetabol ism,^ ' absorpt ion, m etabol ismand u t i l i z a t i on o f v i t am ins , " ^ ^ andeficiencies of minerals.^*

Lack of quality oral nutrition, impaireu t i l i za t ion o f these nut r ien ts , anexcessive loss and reduced storage othese nutrients, all impede a return tmen tal and physical health and recoverIn fact, the central paradox in treatinchronic alcohol ism is get t ing enougnutrients into the alcoho lic for organ repa

so that the organ itself can utilize thnutrients in the most eff icient mannepossible. This is one reason that somtreatment programs have begun to suppvital nutrients in muoh higher quantitieto recovering alcoholics than one wousupply a person in reasonably goohealth.̂ ^ Nutritional supplem entation anthe correction of subclinical deficiencieare not only vital for improvement ogenera l phys io log ica l hea l th dur indetoxification and treatment,'^ but als

S4 TOWNSEND LETTER for DOCTORS & PATIENTS - JANUARY



abs o lu t e l y nec es s a ry for r e laps eprevention. Imp roving nutritional status is

not only paramount in the detoxificationstages andearly treatment, it has alsobeen shown, at least inthe long-term, to

decrease the over-all relapse rate . '^^

Not only do nutrit ional def icienciesincrease alcohol crav ings, they alsopromote comp lications in alcoholics suchas heart disease, liver disease, high b lood

pressure, diabetes, osteoporosis, andincreased ca ncer risk.^' Additionally, the

chronic use of alcohol hasbeen shownto promote the d e v e l o p m e n t of

depression, '^^'^*' Nutrit ional therapieshave been shown to not only reducehepa t o t ox i c i t y , r educ e w i t hd rawa ls y nd rom es and crav ings , they a lsoalleviate depression and anxiety.^^

Well-intentioned "nutritionally" basedhospital diets have bee n shown to be lesseffective in treating alcoholism than w holefood diets, tnone such trial, coffee, junkfood, dairy products, andpeanut butterwere replaced by a special diet whichincluded fruit and a whole foods protocol.At the six-month review, fewer than 38 %of those on the hospital diet had rema inedsober, compared to 8 1 % of those eatingthe special diet.^ Other trials have shownthat restricting sugar, increasing complexcarbohydrates, and eliminating caffeinereduc ed a l c oho l c rav ings . ^ " Whenalcoholics are placed on d iets high in rawfoods, many spontaneously avoid alcohol(and tobacco); those placed o n nutrient-loaded diets along with mult iv i taminsupplem ents did far better at follow-up in

abstaining f rom alcohol than did thecontrols .^ ' Unfor tunately , research is

limited involving nutritional treatment of

alcoholism or drug addiction. However,in the well-planned nutrit ionally basedprograms that have been implemented,negative results are rare.

J oan La rs on , d i r ec t o r of Hea l t hRecovery Center and author of SevenWeeks to Sobriety, has compiledastonishing statistics after designing a

program that ut i l ized nutrit ion as the

foundation of alcoholic recovery. One

hundred alcohol ic c l ients, chosen atrandom , were followed up 3.5 years aftercomp leting the program. At discharge (7-weeks), 85% were free of anxiety, 94%claimed no sleep problems, 98 % claimedno s hak ines s , 96% were f ree f romdizz iness, and95% were subject ivelydepression-free. Furthermore, at the 6-

month interview 92 % were abstinent fromalcohol, 85% of whom had remainedcont inual ly abst inent s ince t reatment .Som e three years later, 95 of the original

100 subjects were interviewed and 74%had remained abstinent.'^

It has been known forsome time that

cer ta in sys temic prob lems, such as

hypoglycemia, can cause an increase in

the desire touse alco ho l." In fact, it ha sbeen noted that almost all alcohol icssuffer from some level of dysfunctionalblood sugar regulation.^ This conditionin itself increases alcohol cravings plus

the desire to increase sugar intake.Control of blood sugar is paramount in

recovery and has to be included in all

levels of the treatment regime.In the c om m on t y pe of 2 8 - d a y

t rea tment program where nutr i t ional

Alcoholism

s uppo r t is not the f o u n d a t i o n of

w i t h d r a w a l and recovery , res idua lsymptoms such as ongo ing anx ie ty ,i ns om n ia , t r em ors and s h a k i n e s s ,d izz iness , depress ion , and impa i redcognitive function are not uncommon for

up to4-8 weeks after discharge."^^ It is

for this reason that we feel the currentunders tand ing of the mechan isms of

withdrawal and detoxification, especiallyin treating alcoho lism, must be redefined.Withdrawal encompasses more than just

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Alcoholism

c l in ica l phases where the a lcoho ldisappears from the human system. Fore xa mp le , i t h a s b e e n re co g n ize d ,especially in opiate dependency, that thewithdrawal syndrome does not end in 5-7 days. Subt le signs and symptoms

exist ing past the current ly acceptedwithdrawal phase , termed the "protractedwithdrawal syndrome,"^' may last up tosix months. This is one of the reasonsthat maintenance programs such asmethadone treatment, along with otherpsychotropics such as benzodiazepines,are utilized for extended periods of theopiate withdrawal.^^^ In comparison toalcohol, opiates by themselves may beone of the least toxic drugs on humanphysiologic functions and tissues whilethe long-term effects of alcohol on liverfunct ion, gastrointestinal function, and

brain neurochemistry have been welldocumented.'^^^"^''^^ It is our positionthat the long-term effects of alcohol onorgan system function contribute greatlyto the h igh re lapse ra tes amongrecovering alcoholics. Repair of affectedorgans requires a st rong nutr i t ionalfoundation during treatment and ongoingrecovery . Th is p r imary focus on a"nutritional foundation" is lacking in almostall alcoholic treatment protocols at thist ime.

Every b iochemical process at the

mind-body level is controlled by g enetics.We receive one set of genes from ourmother and one set from our father atconception. We are the combination ofgenetics from these two people and alsoa l l o f ou r past re la t ives. Cer ta inexpressions of gene function cannot bechanged (our genotype), such as our eyecolor. However, we stil l carry enoughgenetic differences that we all function atthe molecular level somewhat differentlyOur pheno type , o r how genes a ree xp re sse d t h ro u g h e n v i ro n me n ta lin f luences, is the most impor tan t

consideration in the treatment of anychronic disease including alcoholism,Mutations of genes can cause variantsof gene produ cts. However, in one study,h igh vi tamin therapy at least part lyrestored enzymatic function in 50 geneticd iseases. "^ There fo re , i t is c r i t ica l ,especially in the nutritional treatment ofalcoholism, that the clinician understandssome basic concepts about genetics andbiochemistry (i.e., functional/molecularme d ic in e ) . Ad d i t i o n a l l y , n u t r i t i o n a l

treatment of any disease requires somekn o w le d g e o f n u t r ie n t a b so rp t io n ,distribution, metabolism and elimination.

Al l metabo l ic react ions (energy-requiring events) in biological systemsrequire enzymes. Enzymes are proteins(the products of gene expression) thatserve as catalyst to increase the rates ofreactions without being destroyed in theprocess. As ment ioned above, these

metabolic events are changeable throughenvironmental factors. The environmentalfactors that control the rate and extent ofenzymatic reactions are: 1) The amountof substrate the enzyme has to act on.The bas ic subst ra tes o f b io log ica lsystems are proteins, carbohydrates, andfats - the food we eat. At this ievel onemust also consider the concentration ofenzymes ava i lab le to act on thesubstrate. Our genes largely determinethe concentration of enzymes availablefor metabolic reactions but only if theamount of protein substrates is available

for the production of enzymes . E nzymescan also break down products of enzym icreact ions (ca tabo l ic react ions) . Anexampie of this function involves thenormaiiy occurring enzyme monomineoxidase, which breaks down excessiveserotonin or dopamine at the brain level.Mo n o min e o x id a se in h ib i t o rs a recommonly used by psychiatrists to treatdepression. In fact, at least half of themost commonly prescribed drugs in theUn i ted Sta tes act as inh ib i to rs o fenzymes;" 2) Enzyme reactions vary inefficacy in relationship to tempe rature at

wh ich they a re exposed . H ighertemperatures typically increase whilelower temperatures decrease velocity ofthese reactions; 3) E nzyme reactions areaffected by the pH (acidity or alkalinity)of the environment. The pH opt imumchanges with d i f ferent enzymes. Fore xa mp le , e n zyme re a c t io n s in t h estomach exist in a low pH (highly acidic)environment; 4) Cofactors, or coenzymes(v i tamins, minera ls , and some non-vitamins), are nee ded for m ost, if not all.metabolic enzyme activity. Furthermore,enzym es contain an active site that binds

preferentially to the substrate w ith whichit is to act upon. Once the product isgenerated, the enzyme disassociates andthe product is available to provide itsdesigned fu nction. However, it's importantto note that rare ly is the prod uctgenerated the final product. Therefore,the s tudy o f b iochemis t ry requ i resfo l low ing bas ic nu t r ien ts , and the i rco n ve rs io n t o p ro d u c t s , t h ro u g hmetabolic pathways. The product of one

enzyme/substrate reaction is more oftthe substrate for the next reaction.

An example is the conversion of thp ro te in t ryp tophan to the b ran e u ro t ra n smi t t e r se ro to n in . L osero ton in , as well as changes in tneurotransmitters dopamine and GABAhas been implicated in alcoholism adepression."*^ Supplementing tryptophis a commonly suggested t reatme

adjunct. Tryptophan. an essential amiacid (which cannot be synthesized in tbody), is taken into the system throuoral nutrition. Although tryptophan can taken as a singular am ino acid, it normaenters the body as part of a larger protecompiex (po lypep t ides) wh ich goth rough enzymat ic c leavage a t tstomach, and later the small intestine,yield the singular amino acid. It is thabsorbed from the gastrointestinal traand delivered to the liver for subsequeprocessing. These necessary events acommonly impaired in alcoholism.^'

least two products are generated and twe n zyme - re la te d e ve n t s a re n e e dbefore serotonin is formed at the bralevel . Furthermore, the serotonin nu t i l ized as a neuro t ransmi t te r eventual ly ut i l ized as a substrate generate melatonin (necessary for goquality sleep amo ng other activities). Thco n ve rs io n re q u i re s se ve ra i moenzyme related- events. The essential cenzymes needed for these reactions avitamin B-6, niacin, and magnesium."'Genetic variants, substrate and cofactoconcentration, or environmental facto

can affect the quantity, or quality, of amolecule in any metabolic pathway.

As a side note, the clinician must warned abou t supp lement ing h ighdoses of L-tryptoph an, Tryptophan can utilized in several metabolic pathwaysthe l ive r . Too much supp lem entt r yp to p h a n ca n y ie ld u n d e s i ra bmetabo l ic p roducts and a t h ico n ce n t ra t io n s l i ve r d a ma g e moccur."^« 5-Hydroxytryptophan (5-HTPwhich bypasses l ive r p rocess ing , sometimes util ized in the place of

tryptophan to avoid this potential probleHowever, at least theoretically, it must noted that any nutrient supplementatiin exces s may have the potential to harthe client.

Nutritional therapy is a complex issuClinicians, who wish to pursue this levo f t rea tment fo r the i r c l ien t , muunderstand extensive in format ion metabolism a nd genetic function. Withounderstanding the intricacy of molecufunctions, and how they are activated a

TOWNSEND LETTER lor DO CTORS ft PATIENTS - JANUARY



manipulated through nutritionaltreatment, the clinician is more likely tocreate more harm then good. Even ifharm is not caused to the client, treatmentoften fails to produce the desired result.Just taking one particular vitamin, oramino acid, toaddress health issues indetoxification and recovery is akin tosupplying the client with just Prozac to"cure" their depression, Majid Aii, says it

best: Wo molecule exists in biology alone,functionally orstructurally. This is self-evident. And yet we physicians insist indiagnosing "anutrient deficiency" tounderstand "a disease" which we canthen treat with "a nutrient therapy" Thecentral issue here is: Mononutrienttherapy has no place in the clinicalpractice of molecular medicine *°

Nutrient therapies become complexbecause all nutrients that enter thehuman body have multiple functions. Asan example, magnesium is involved in

over 300 metabolic processes. It isessential for the production of ATP (amolecule which delivers energy forcellular processes) and for the synthesisof nucleic acids and proteins. In fact,magnesium is necessary for every majorbiological process.^^ Magnesiumdeficiencies arecommon in alcoholismdue to decreased intake, vomiting,diarrhea, and increased loss throughurinary excretion.^ Another example ofmultiple coenzyme functions involvesvitamin B-6. Vitamin B-6 is a coenzymefor over 100 enzyme-related events in thehuman body and is essential for theproduction of most majorneurotransmitters including serotonin,dopamine, norepinephrine, and GABA.Vitamin B-6 is also necessary forproduction of nucleic acids, haemoglobin,and proper nerve function.^^ It is a matterof fact that the absorption of all B-vttaminsis affected by alcohol abuse. The level ofdeficiency varies, as was mentionedpreviously, from person to person.

Assessing nutrient deficiencies isdifficult. Many times lab tests may shownormal results even if specific levels are

within defined parameters. As anexample, only 1 % of the magnesium inthe human body is free in the blood andthe rest is found in the cell or bone." Inone lab study, involving alcoholic patientswith low hemocrit, multiple nutrientdeficiencies were noted. The researchersfound that normal laboratory parameters,used for non-alcoholic patients, wereinadequate when applied to alcoholicpatients. This makes sense sincenutrients have multiple andcomplex

interactions at thecellular level and allalcoholics have varying degrees ofdeficiencies,^ Since all chronic alcoholicssuffer from some level of nutrientdeficiencies, then the best treatmentprotocols appear to Involve designingbalanced nutritional protocols, especiallyuti l izing intravenous vitamins andminerals, which will assist the patient inrecovery and detoxification. The goal withcomprehensive IV nutritional therapy isto provide necessary nutritional supportat the cellular level in the individual

Alcoholism

alcoholic whose gastrointestinal tract iscompromised. Ultimately, this therapy willassist the individual back to a state ofhealth so that o ral nutrition w ill suffice intheir ongoing health. Initial physicalmeasurements such as body weight,

height, and percent body fat would allowthe clinician a point from which tomeasure therapeutic efficacy of the

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Alcoholism

treatment. A measurement of

psychological parameters during

treatment, whether subjective or

objective, can also be used to measure

therapeutic efficacy of the treatment

protocol.

Conclusion

The s uc c es s f u l t r ea t m en t of the

disease of alcoholism requires knowledge

of cel lu lar and b ioc hem ic a l ev en t s .Funct ional medic ine recognizes that

nutrition is the necessary co rnerstone for

all good health, which includes adequate

detoxification and continued recovery in

alcohol ism. Through the uti l izat ion of

nutrit ional therapy, the patient can be

brought back to health quickly so that hisbody and m ind funct ions can be utilized

at the fu l lest extent . It has bec om eapparent that mono-therapies, of any

nature, have low success ratios in the

t reatment of alcohol ism. It is t ime for

health professionals of all disciplines to

come together, with open minds, toutilizeholistic treatment regimes that improve

the success of t reatment . In the few

p rog ram s whe re t h i s has o c c u r r e dsuccess rat ios for continued recovery

have risen dramatically.

Correspondence:

Dr. David Arneso n. NMD

550 W. Indian School R oad. Suite 122Phoenix, Arizona 85013 USA602-234-1158

Fax 602-234-9691

thesourcenmc @ msn.com

References1. J Chick: Alcohol, health, and the hea rt: Implications

for clinicians. Alcohol and Alcoholism 1998, 33:576-91 .

2 C Lo: Integrating nulrilion as a ttiome throughoutthe m edical school curriculum. American Journalof Clinical Nu trition 2 0 0 0 , 72:8825.8898,

3. LMMjelde-Mossey: Nutrition and recovery fromalcoholism. In- Treatment Choices for Alcoholismand Substance Abuse Edited by Milkman, pp. 74-

B6 : Macmillin, New York: 1990 : 74-86 .4. JD Biachley, JP Knochel: Ethanol andminerals.

Phatmacologyand Therapeutics 1987.33:435-48.5. PR Ryle, ADThomson: Nutrition and Vitamins in

Alcoholism. In: In Clinical Biochemistry ofAlcoholism Edited by SBHosaiki: Harper & Row.New York; 1984,

6 . B Wood: Alcohol and nutrition, Australian Alcohol/OrugRevlew^984. 3(2) :107-10,

7. PJ Fahey, JM Boltr i. JS Monk: Key issues innutrition. Postgrad Medicine 1987, 81 :123,

8 . EB Feldman, E Kaufman: Malnutr it ion in theAlcoholic and Related Nutritional Oeficiancies. In:Encyclopedic Handbook ot Alchoholism Edited byEM Pattison, E Kaulman. pp, 25S-62: New York:Gardner Press; 1 982: 255-62 .

9. SShaw, CS Lieber. HA Schneider, CE Ande rson.DB Courson: Alcoholism. In: Nutritional Support lorMedical Practice, 2 nd ed . New York: Harper & Row;1983.

10 . JR Graves: Role of Nutrition in theTreatment ofAlcoholism. In: Progress in Alcohol Rssearch. vol,1. pp 24 7-63, Utrecht: VNU Science Press; 1985:247-63.

11 CM Leevy, 0 Frank. CB Leevy. H Baker: Nutritionalfactors in liver disease of the alcoholic. Acta MsdicaScandir^avica 1985, 703:67-69.

12 . TM Brody. J Larner, KP Minneman: Nutritionalaspects of pharmacology. In: Human Pharmacolgy-

Molecular to Clinical Edited by M Brown, pp. 843-8 6 0 . St, Louis: Mosby; 1 998: 843-860 .

13. MJ Wor ld, PR Ryle. A.D.Thomson: Alcoholicmalnutrrtion and the small intestine. Alcohol andAlcoholism. 1985. 20 :89-12 4,

14 . CSLe ibe r: /Vu(rf l©v1988. 46:241 .

15. S Shaw. CS Lieber: In: Modern Nu trition in Healthan d Disease E dited by RS Goodhart, ME Shils. pp.1229. Philadelphia- Lea & Febiger; 1980: 1229.

16 . CSLeiber: Alcohol and the liver: Metabolism olethanol. metabolic effects and pathogenesis otinjury. Acta Medica Scandinavica 1985. 703:11 -55.

17 . JM Larson: Correcting chemistry. In: Seven WeeksTo Sobriety, pp, 117 - 118 . NewYork: BallantineWellspring; 1997:11 7-11 8.

18 . CS Leiber: Alcohol nutrition interaction. Joum a/o /Dentistry for Children ^96A. 51:137-40,

19 . I Diamond: Alcohol ic myopathy andcardiomyopathy, NEnglJMed 1989. 320:458 -59.

2 0 . PSWissel: Drug and Nutrient Interactions: 1987.2 1 . L Glor ia . M Cravo . ME Camilo: Nutr i t ional

Deficiencies in Chronic Alcoholics: Relation toDietary Intake and Alcohol Consumption. TheAmerican Journal of Gastrosnterotogy 1997.92:485-89.

2 2 . NA Aliyev, ZN Aliyev. AR Altguliyev: Amino acidneurolransinitters in alcohol w ithdrawal. Alcoholan d Alcoholism 1994. 29:643-47.

2 3. CA Al lan . I Smi th , M Mell in : Changes inpsychological symptoms dur ing ambulantdetoxif ication. Alcohol and Alcoholism 2 0 0 2 .37:241-4.

2 4. M Driessen. S Meier. A Hill. T Wetterling. W Lange.K Junghanns: The course ot anxiety, depressionand dr inking behaviours af ter completeddetoxi f icat ion In alcoholics with and withoutcomorbJd anx iety anddepressive disordefs. Alcoholan d Alcoholism 2 0 0 1 , 36:249-55,

2 5. JP MacMurray, DG Nessman. MG Haviland. DLAnderson. JSrud>*fcohoA 1987. 46:277-80.

2 6 . AT McLeilan. GE Woody. CP O'Brien: Developmentof psychiatric illnesses indrug abusers. N EngI JMed1979. 301:1310-1314.

2 7. RVerhaul. Wvd Brink. PGM-A, A Ihree-pathwaypeychobiological model of craving for alcohol.AkMhol and Alcoholism. 1999. 34:197-22 2

2 8 . PPVescovi. V Coiro: Persistence of defectiveserotonergic and GABAergic controls of growthhormone secret ion in long- term abst inentalcoholics. Alcohol and Alcoholism. 1997, 32:85-90 .

2 9. RM Guenther: Role of nutr it ional therapy inalcoholism treatment. IntJBiosoc Res 1993, 4:5-18.

30 . MR Werbach: Alcohol craving, Int j AltemComplementary Me d ^^3. Ju\^.^2.

31 . UDRegister: Influence of nutrients on the Intakeof akx>hol. J Am Diet Assoc 1972, 61:159-62,32 . J Chick. CK E rickson: Conference summary:

Consensus Conference onAlcohol Dependenceand the Rote of Pharmacotherapy in its Treatment.Alcohol Clin Exp Res 1996, 20:391-402 .

33. CKE rikson: Voice of the Victims, Alcohol Clin ExpRes 1996. 20:403,

34 . K Forander: Q J Stud Alcohol ^95a. 19:379.35. DE Smith. RB Seymour: Nutritional counseling and

other concerns in supporting recovery. In: CliniciarTSGuide to substance abuse, pp, 319-326 New Yiork:Magraw-Hill; 2 0 0 1 : 319-326

36 . D Mossberg: Clinical conditions in alcoholics duringlong term abstinence. Alcoholism. Clinical andExperimental Research 1984. 8 :250.

37. WR Martin, D Jasinki: Psychological parametof morphine in man: tolerance, early abstinenprotracted abstinence JPsychiatry Res 1969.17 ,

38 . AT McLeilan, CP O'Brien. D Melzger. Al AUermJ Cornish. H Urscel: Howeffective Is substaabuse treatment-compared towhat? In: AddicStates Edited by CP O'Brien. J JaHe, pp. 231-2NewYorK: Raven Press; 1992: 231-2 52.

39. CPO'Brien: Treatment of alcoholism as a chrodisorder. In: Toward a Molecular Basis of AlcUs e and Abuse. Edited by B Jasson. HJornvpp. 349-359, Basel, Switzerland: BirkhausorVer1994: 349-359.

40 . Majid All. M.D.: Intravenous Nutrient ProtocolsMolecular Medicine. In: Nutritional MediciPrinciples and Practice {unpublished manuscrInstitute of Preventive Medicine, 95 East MStreet. Denville. New Jersey 0 784 3. pp 1-7.

41 . Jeffery Bland Ph,D: Functional M edicine: NutritioInfo Revolution. In: Holistic Health Care.Goldman, ed. April 15. 20 02 ; vol. 3, No. 1 ;p p 17,

42 . JE Pizzorno. MT Murray, and JS Bland: Functiomedicine in natural medicine. In TextbookNatural Medicine, 2nd ed. Churchhill-LivingstoNew York. 1999-Vol 1:pp3-15.

43 . P Champe and R. Harvey: Lippincott's IllustraReviews: Biochemistry, 2nd ed, J,B, LippinCompany. Philadelphia. 1994

44. J Growden-. Neurotransmitters in Ihe diet.Nutrition an d the Brain. R Wurtman. et al. New

NY: Raven Press. 1979: Vol 3:ppi 17-16745 . Metabolic Pathways Chart. SIGMA Chemi

Company. P.O, Box 14508 . St. Louis, Misso63178.

46 . BNAmes, I Elson-Schwab. and EA Silver: Hidose vitamin therapy stimulates van ant enzymwilh decreased coenzyme binding af i in(increased Km): relevance togenetic disease apolymorphisms, American Journal ol ClinNutritionVo\. 75. No. 4. 616 -658. Apr i l 20 02 .

47 . MLCohen and TM Brody: 5-HydroKylryptam(Serotonin) and therapeulic agents that modulserotonergic neurotransmission. In: HumPharmacology:Molecular lo Clinical, 3rd ed . Eby M. Brown. Mosby Year-Book. Inc. St. Louis.1998, pp 157- 166 .

48 JR Cooper. FE Bloom, and RH Rolh: SerotoninHydroxytryptamine) and Histamine. In: TBiochemical Basis ol Neuropharmacology, 7tOxford University Press. NewYork. NY 19pp.352-391.

49 . M Ali. MD : The Butterfly and Ufa Span NutriI s l ed . 1992. pp. IV

50 . PDeW itte:The role of neurotransmitters in alcodependence: animal research. Alcohol AlcohMarch 1996; 31 Supp11: 13-6.

51 . L Feinman: Absorption and utilization of nutriein alcoholism. Alcohol Health and Research W13(3) :207-210. 1989.

52 . CS Leiber: The cntluence of alcohol onnutritioslatus. Nutrition Reviews 46(7):241-254, 1988

53. CS Leiber: Alcohol and nutr it ion: An overviAlcohol Health & Rgsearch World 13(3):197-21989,

54 . L Marsano and Cj Mcclain: Effects of alcohole lect ro lytes and minerals. Alcohol HealthResearch WorW13(3):255-260. 1989.

55. PD R forNutntional Supplements. S HendlerD Rorvik. eds. 2003.56 . EB Flink: Magnesium deficiency in alcoholis

Alcoholism: Clinical and Expenmental Resea10(6) : 590-592. 1986

57. MJRosenthal and JSGoodwin: Cognitive effeof nutritional deficiency. Advances in NutriResearch7: 71- 100 . 1985

56 , D Savage and J Lindenbaum : Anemia in AlcohoMedicine (Ballimore) 65(5): 322-38. 1986.

59. J Bland and SH Benum: How your dcommunicates with your genes. In: GenNutritioneering, Keats /NTC/Con temporPublishing Group. Inc, 1999. pp 51 ,

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