Posted by Dr. Bob on October 27, 2003, at 22:12:22
In reply to IMPORTANT OCD LINK - INCLUDES NATURAL THERAPY, posted by freedom2001 on October 27, 2003, at 3:34:20
> http://bonniegr.com/Interview%20with%20Bonnie.htm
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> Questions for Bonnie Grimaldi
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> 1. Can you discuss the genesis of ts-PLUS TM products? What led you to develop ts-PLUS TM products?
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> A. I started my research into Tourette’s syndrome in 1995 in order to help a loved one then 13-years-old. He had diagnoses of Tourette’s syndrome, Obsessive Compulsive Disorder, and Attention Deficit Disorder. He had tried different medications for these disorders with no success and some with intolerable side effects.
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> He was failing in the 7th grade, even though he had done well in earlier years, and was being removed several times a day for disruptive tics. He would hear a noise in the classroom such as a hand or book touching a desk, or a cough and would need to make a certain noise accompanied by a certain movement. His impulsivity caused him to pull the microphone plug on guest speakers. His inattention caused him to not complete or turn in his homework. He had a compulsion that caused him not to be able to complete reading a book. He would read the same line over and over again, getting himself stuck and not be able to move past that point. He wasn’t comfortable sitting across from other kids at tables and had to sit by himself off to the side in the back of the classroom.
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> At home he couldn’t eat or ride in the car with his family without triggering a series of complicated vocal tics and movements because the chewing noises, voices, and gestures of his father and brother would set his tics off. He couldn’t go to movie theaters, restaurants or church without his tics being set off by people’s coughs and throat clearings. Dogs barking in the neighborhood caused his tics to be set off also. His compulsions at home included turning a certain way as he went through doorways and was very time consuming.
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> As I researched the literature on PubMed, a popular internet search engine for scientific literature, and the medical libraries, I found that there was not much written describing non med approaches in the treatment of TS. My background in biochemistry came in handy, however, in piecing together clues I came across, such as increased serum kynurenine found in all TS subjects in studies funded by the TSA and reported by Handley, combined with increased norepinephrine levels in TS subjects reported by Chappell and Leckman, and low blood serotonin levels in TS subjects reported by Comings.
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> I found that a common link that could tie these and many more reported findings together is magnesium deficiency since magnesium is required for the breakdown of kynurenine, which when increased inhibits the production of serotonin leading to low serotonin. Furthermore, magnesium deficiency inhibits the formation of active vitamin B6 in which there is an increased turnover of norepinephrine.
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> Complicating factors from magnesium deficiency, such as vitamin B6 deficiency, increased Substance P, glutamate NMDA receptor activation, and increased kynurenine, may play roles in the development and severity of symptoms according to reports in the scientific literature. For instance: Rage behavior, depression, anxiety, and self-injurious behavior can be associated with Substance P overactivity. Compulsive behavior, abnormal head movements, hyperirritability, and inattention can be associated with low vitamin B6 activity. Anxiety and motor tics can be associated with increased kynurenine. Rage behavior, motor and vocal tics, and increased anxiety can be associated with NMDA receptor activation. NMDA receptor activation leads to increased release of dopamine in the striatum and modulates dopaminergic transmission in the striatum involving the D2 dopamine receptors implicated in TS. In a study by McGrath, a mouse model of comorbid TS and OCD was produced by increasing brain glutamatergic activity.
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> Certain drugs and conditions that can cause magnesium imbalance and that have been reported to potentially cause or worsen tics are stimulant meds, corticosteroids, and stress.
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> The distinguished OMIM (Online Mendelian Inheritance in Man) website tentatively designates 11q23 as the site for Tourette’s syndrome and is also the site for magnesium wasting.
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> There are many reports of conditions associated with magnesium deficiency that are also reported to be associated with TS such as restless leg syndrome, migraine, bruxism, seizure, heart arrhythmia, asthma/allergy, attention deficit hyperactivity disorder and hyperarousal (heightened sensitivity to sensory stimuli).
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> 2. How did you develop the formula? Walk us through the development process.
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> A. Based on my readings I developed a daily nutritional routine that included magnesium, taurine, niacin, vitamin B6, inositol (a B vitamin), zinc, vitamin E, vitamin C, glutathione, selenium, calcium, grape seed extract, lecithin, EPA and DHA, with a special emphasis on magnesium, vitamin B6 and niacin. I knew that magnesium alone would not help.
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> Initially my loved one started the supplements listed above without grape seed extract and EPA/DHA. Within 2 days, his teachers noticed a dramatic improvement in his behavior at school. He was never again removed from class for disruptive behavior. His attention span was much better and he could sit anywhere in the classroom comfortably, but still had trouble with homework. It took a little longer for his home-life to improve, but in a few months he had a full family life again. He wasn’t triggered by barking dogs, coughs, hands or books touching desks, his father’s or brother’s voices, etc. His compulsion to turn a certain way through doorways went away.
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> The next year I added EPA and DHA (essential fatty acids found in fish oil) to his regimen because of the studies showing that magnesium deficiency causes essential fatty acid deficiencies and another study showing that dopamine was inhibited from binding to D2 receptors by fish oil. Grape seed extract was needed as an additional antioxidant to help heal oxidative damage from a possible magnesium deficiency, combat allergy, and to prevent auto-oxidization of DHA and EPA in the gut. An interesting thing occurred, he immediately started completing and handing in his homework on time. His grades improved greatly and he no longer needed his allergy shots.
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> His problem with his reading compulsion was still there, however. I started giving him extra inositol based on the studies by Fux and Benjamin that show that high dose inositol is effective for OCD, especially for those who don’t respond to SSRI’s such as Prozac. He slowly began to be able to read for longer periods of time until he was able to complete an entire book on his own for the first time. His grades improved and he consistently was on the honor roll.
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> Soon I found myself sharing the protocol with friends who just wanted to try it. Then, by word of mouth, people on internet TS message boards began requesting it. In order to offer the info to as many as possible I started a web site: http://bonniegr.com
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> After 6 years of suggesting they order separate supplements from the local natural food store or by mail order from Cas at The Natural Food Store, I had the nutrients formulated by Douglas Laboratories in order to simplify the process and to provide consistency and quality for families.
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> I know that this will not be the answer for everyone, but the positive responses we have received indicate there is a clear benefit for some people. We will continue to request both positive and negative anecdotal reports from those who try any of the products.
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> 3. ts-PLUS CONTROL TM is a system, composed of a number of different elements that the user must take on a daily basis. Can you discuss the synergy created by these various components?
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> A. Long term magnesium therapy should be combined with its synergistic components in my opinion. Taurine helps the uptake of magnesium into the cells and magnesium taurate has been found to provide long lasting protection from magnesium deficient conditions. Zinc is needed to be taken with magnesium so that a deficiency in zinc didn’t occur. Also zinc is needed to activate vitamin B6. Selenium is needed with glutathione for its activation. Calcium needs to be taken with magnesium in a 1:1 or 2:1 ratio to keep the parathyroid hormone from drawing on bone stores to keep this balance. I use a high dose of no flush niacin to inhibit the tryptophan to niacin pathway and reduce breakdown of tryptophan to its intermediary product, kynurenine. This allows more tryptophan to be available for serotonin synthesis. The B vitamins must be taken in a B complex to prevent a deficiency in one from occurring. For instance, too much vitamin B6 will cause a vitamin B1 deficiency. Magnesium deficiency causes other nutrients to become deficient such as vitamin C, vitamin B6, inositol, lecithin, glutathione, vitamin E and I believe that these are beneficial when supplementing with magnesium to correct a long term magnesium deficient condition, which may be present in TS according to my hypothesis.
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> 4. Medical science is now making progress by leaps and bounds. What do you see in the future for TS research and drugs?
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> A. The future of TS research and drugs (as with most conditions) will ultimately lie in cracking the genetic code for TS/ and or the individual symptoms associated with TS. Nutritional deficiencies can directly or indirectly affect the phenotypic expression of the genetic code. Markers for TS will become known, possibly through nutritional research. For example, serum ionized magnesium levels are just now being recognized experimentally as a marker for migraine headaches, which can be associated with TS, and magnesium therapy has been successful in both prophylactic and acute treatments. I would also like to see TS research in Substance P inhibitors.
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> 5. Are there any biotech or pharmaceutical companies that you know of who are developing any drugs specifically for TS? Or who are conducting interesting TS research? If so, please discuss.
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> In 2002 my hypothesis, “The central role of magnesium deficiency in Tourette’s syndrome: causal relationships between magnesium deficiency, altered biochemical pathways and symptoms relating to Tourette’s syndrome and several reported comorbid conditions.”, was published in Medical Hypotheses. Universities and other facilities around the world interested in testing my hypothesis have contacted me for information. I am working with Robert DiSilvestro, PhD at The Ohio State University on a nutritional study in TSA volunteer subjects that can improve our understanding of nutritional status in TS. Eventually we would like to determine which TS profiles can most benefit from this comprehensive nutritional approach.
> 6. On your website, you call yourself a “medical technologist”. What does that mean?
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> I am a medical technologist [MT (ASCP)], which means that I have a bachelor’s of science degree in medical technology and am certified by the American Society of Clinical Pathologists to analyze and verify clinical laboratory results. I have worked in and supervised most areas of the clinical laboratory (including Chemistry, Hematology, Coagulation, Microbiology, Serology, and Blood Bank). Currently I am in Cytogenetics where I analyze chromosomes of cancer patients in order to identify the specific chemotherapy tailored for their diagnosis.
> In addition to being a medical technologist, I am a graduate student and a master’s candidate in Human Nutrition at The Ohio State University.
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> 7. Are there any foods that people with TS should try to avoid?
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> A. I suggest that allergens/sensitivities by removed as much as possible from the environment. This includes food and airborne allergens as well. A single elimination diet is the best way in my opinion to identify food sensitivities. In general, foods and food additives to be avoided in TS if found to be increasing symptoms are: azo dyes (such as red dye# 40), aspartame, caffeine, and tyramine (such as chocolate in large quantities, aged cheese, soy sauce, red wine, raisins, canned fish (canned tuna or salmon are fine and don't contain tyramine), pickled herring, chicken livers, cured meats, and most alcoholic beverages). Of course, the common food allergens such as milk (casein), wheat (gluten), corn, and citrus could be major culprits in food sensitivities.
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> 8. Can you discuss the role of magnesium, tyramine, and phenylalanine in TS?
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> A. I have discussed the hypothetical role of magnesium in TS as I interpreted it above.
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> The hypothetical role of tyramine in TS is another one of my interpretations: If there is excess tyramine in TS by ingesting tyramine containing foods and from inhibited monoamine oxidase activity (through the actions of certain drugs or nutritional deficiencies), stores of norepinephrine, which have been found to be already increased in TS in studies, can be released in the body possibly leading to increased symptoms. Tyramine containing foods should never be taken with MAOI (monoamine oxidase inhibitor) drugs because a serious hypertensive crisis could develop.
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> High phenylalanine in the diet can block other "Large Neutral Amino Acids", such as valine, leucine, isoleucine, tryptophan, tyrosine, histidine, and methionine from entering the brain. Notice that tryptophan is on this list, which is the precursor for serotonin, a neurotransmitter necessary for the feeling of calm. Phenylalanine is also a precursor for dopamine and may cause problems in TS where certain dopamine receptors may be supersensitive.
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> 9. There are some interesting statistics on your website, but the sample size is small. Any plans on conducting a larger study in the future?
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> A. I am currently conducting surveys on my website on a quarterly basis on the New Survey page.
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> 10. Do you have any advice for parents of kids with TS? And for kids and adults who have TS?
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> A. The most important thing after getting an accurate diagnosis of TS from a qualified TS specialist that a family member (especially parent) can do is to demonstrate unconditional love and acceptance of the loved one with TS. TS does not define the person and is just one aspect of their life. Earplugs are great tools during times of loud vocal tics both for the parent and child who is triggered by noises to be able to ignore and cope at home.
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> Medication isn’t for everyone and should not be used indiscriminately, in my opinion. In cases where the person with TS wants to try pills to alleviate symptoms, I would try ts-PLUS TM products as a nutritional supplement before medications after a check-up with the physician and with the physician’s knowledge. A good conventional physician with an open mind toward nutriceutical use is the best physician for TS in my opinion. While the evidence for symptom improvement is anecdotal at this time, it is plentiful. ts-PLUS TM products are at the very least safe according to physicians and pharmacists consulted. I strongly recommend that the ts-PLUS Diet be followed on my website for optimal results with ts-PLUS TM products.
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> Send mail to BonnieGr@aol.com with questions or comments about this web site.
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> Copyright © 2001 Bontech Supplements, Ltd.
> Last modified: 10/04/03
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poster:Dr. Bob
thread:274102
URL: http://www.dr-bob.org/babble/alter/20031023/msgs/274102.html