CLINIC: CASE STUDIES
Hypertension, weight gain, gout and restless legs
SB was 43 when he presented with a history of hypertension. His doctor indicated that if his blood pressure was not controlled then he would need to have it managed pharmaceutically. SB was keen to avoid medications, as he was already taking drugs for gout, as well as benzodiazepines and painkillers for a back injury. SB was concerned the he was overweight and that his liver enzymes were elevated. He was having trouble sleeping at night due to Restless Legs Syndrome (RLS) and was experiencing joint pains associated with gout. Despite going on long fast walks during the week and following an intermittent fasting diet (restricting his calorie intake to 600Kcal for 2-3 days a week) he was unable to lose weight. His diet was generally good, although it was high in alcohol and simple carbohydrates. SB was working long hours and was experiencing high levels of work-related stress.
- Central adiposity
- Pain between the shoulder blades
- Itchy skin, rashes, allergies
- Periodontal disease
- Shoulder, back and joint pain
Initial Lab Results:
- Blood pressure: 164/113
- Weight: 114.2kg
- ALT: Above range
- Uric acid: Very high above range
- Ferritin: Above range
- Low bile
- Fatty liver
- Insulin resistance
- Intestinal permeability
- Neurotransmitter insufficiency
- Oxidative stress and inflammation
- Multiple mercury amalgams
INITIAL HEALTH OPTIMISATION PLAN
In this case, hypertension and weight gain, the chief presenting complaints, don’t require direct intervention. Rather, an investigation of root causes led to the identification of oxidative stress and poor detoxification as the likely causes of subtle nutrient deficiencies that contribute to high blood pressure and weight gain.
Gout and RLS are associated with high oxidative stress and chronic inflammation, which can lead to increased weight and hypertension. Gout develops when high concentrations of uric acid deposit as crystals in the joints. Under normal physiological conditions, the liver produces uric acid which acts as an antioxidant and provides over 50% of the antioxidant capacity of blood plasma. However when antioxidant capacity is low, uric acid rises, representing an attempted protective response in the body. At high concentrations uric acid can function as a pro-oxidant, correlating and predicting the development of obesity, hypertension and cardiovascular disease.
RLS is associated with the oxidation of dopamine in the brain which leads to impaired neurotransmission for generating movement. RLS increases the risk for cardiovascular disease and hypertension.
Antioxidant depletion may be caused by a number of factors including: a high alcohol intake, heavy metals such mercury in fillings, toxic elements in vaccinations, infections, pharmaceutical drugs, a low intake of vitamins, minerals and phytonutrients, and stress.
The protocol focused on increasing the antioxidant status of the body, however for antioxidant supplementation to be effective, an optimum level of digestion and assimilation is required. Given suspected hypochlorhydria, bile and intestinal permeability issues, these were dealt with first, in Phase I of the protocol. Increasing antioxidants will increase detoxification and production of oxidants in the liver, hence elimination and excretion pathways must also be addressed. In particular, gastrointestinal permeability can lead to an increased level of toxins entering enterohepatic recirculation, causing more stress to the liver. Additionally, dietary changes are recommended to support the protocol.
The protocol aimed to:
- optimise the gastrointestinal tract (GIT) function for digestion, assimilation and excretion;
- optimise liver function for biotransformation and elimination;
- increase the antioxidant status of the body;
- resolve inflammation.
2 WEEK FOLLOW UP – PHASE 1
SB made excellent progress in 2 weeks. He adhered closely to his new nutritional plan, in which he was well supported by his wife who took all the recommendations on board when planning meals.
SB’s weight reduced by 2kg and his blood pressure lowered from 163/113 to 133/93. He was not having any sugar cravings or feeling hungry. His RLS and gout symptoms decreased significantly so he slept much better. His shoulder and back pain reduced from 8/10 to 5/10 and so he reduced his intake of painkillers and benzodiazepines. His mind was clearer and his mood was much improved.
SB now progressed to Phase II of the protocol, addressing anti-oxidant status and support for detoxification and nutritional deficiencies.
4 WEEK FOLLOW-UP – PHASE II
Four weeks after starting the protocol SB lost 4kg in weight and his blood pressure further reduced to 120/87. His blood work showed normal uric acid production, normal liver enzymes, normal cholesterol and ferritin levels. SB’s doctor was happy for him to stop all his medications and reported that his stroke risk had reduced from 19 to 9.6.
SB reported that his evergy levels were high, and despite being very busy at work and home, he was coping very well. He was having several days in a row without any pain at all, and when there was shoulder or back pain, it was very much reduced. RLS and gout symptoms had completed resolved.
Identifying and treating the underlying cause of imbalances, which in this case were oxidative stress and poor detoxification, resulted in improvements in blood pressure and weight.