Thursday, September 3, 2009

My Regimen

Before reading on, please be aware that I am not a doctor or a scientist. If you see something below that interests you, I encourage you to do your own research and to consult your doctor.

I have organized my regimen conceptually in accordance with the intent of each intervention. Some of my interventions belong in more than one category.

1. General health and anti-cancer protocol (the interventions I would do even if I didn't have Barrett's esophagus)
Low-carbohydrate, with most fats from dairy, omega 3 eggs, grass-fed beef, and coconut oil and
most carbohydrates from starch (potatoes and rice) or fruits and vegetables. Lots of fruits and vegetables, to drink only water or unsweetened, freshly brewed green tea, served warm (not hot), mostly organic, limited grains, sugar, and vegetable oils (except coconut and some olive), low AGEs (advanced glycation end products), meaning (for now) limited charred meats, many spices in cooking, and limited fructose/lactose.
Supplements. (in low doses, except D3).
Vitamin D3 (3600 IUs per day), vitamin A, folic acid, B-12, zinc, B-6, selenium, magnesium, EGCG, curcumin, fish oil (high EPA), pomegranate/blackcurrant extract, probiotics
Cardio on weekends and strength training during the week (avoiding intense strain that could worsen my hiatal hernia).

2. Healing the esophagus
a. Avoiding additional injury.
(i) Acid suppression. 40mg of Nexium 30 minutes before breakfast.
(ii) Reflux at night. Avoid food & beverage for 3 hours before bedtime. Elevate head of bed by 6 inches.
(iii) Thermal injury. Avoid hot food & beverage. (Ice cubes in tea before drinking.)
b. Mucosal Defense.
(i) Healing time. I avoid my inflammation inhibitors (see below) periodically for short intervals (24-48 hours), especially after experiencing significant reflux. On these occasions, I instead take 6 mg of melatonin 45 minutes before bed (and usually take an additional 1 mg sublingually upon waking during night). I am still investigating melatonin's effect on PGE2 and oxidation.
(ii) Better saliva. I occasionally chew B-Fresh gum (xylitol and calcium) to stimulate saliva and raise its ph. I am currently investigating licorice extract to stimulate PGE2 and mucus (for use on melatonin days).
(iii) Closing the lower esophageal sphincter. I avoid major LES relaxation triggers, which for me seem to include chocolate, hot peppers, peppermint oil, and too much liquid food (e.g., big soups). At night I also avoid minor triggers, which for me seem to include caffeine, alcohol, tomatoes, citrus, garlic, onions, leeks, and asparagus. High fat meals do not increase reflux for me; in fact, after a few days on a high-fat diet, my reflux gets much better. I drink decaf green tea at night to help close the LES. I am currently also investigating various pharmaceuticals/supplements that may help close the LES, including cisapride (pulled from market), ashwaganda, and baclofen/L glutamate.
c. Enhance Bile Composition of Reflux. I attempt to reduce the concentration of deoxycholic bile acid (which might be carcinogenic) with curcumin, fish oil, and probiotics. I am currently investigating ursodeoxycholic acid treatment. Also, I am currently investigating the effect of a high fat diet on bile acid composition.

3. Preventing oxidative injury
a. Exogenous antioxidants
Anthocyanins (wild blueberries, blackcurrant extract), curcumin, EGCG, carotenes (from vegetables), vitamin E (30IU supplement per day), selenium, zinc, and vitamin C (from fruit). I am currently investigating (both for BE and general health) reseveratrol, quercetin, Pycnogenol, and others. In the meantime, I am experimenting with them periodically.
b. Endogenous antioxidants. (The idea is to upregulate the body's natural antioxidants)
Sulforaphane, selenium/vitamin E, whey.
Exercise, short cold/heat shock (hormesis in the shower?).
Curcumin and green tea.
I am currently investigating glisodin, sodzyme, & Extramel and NAC (not sure it does more than whey does more safely).

4. Disrupt chronic inflammation.
Inflammation inhibitors: (i) enteric aspirin (300mg) (ii) curcumin and/or ginger, (iii) 5-Loxin (boswellia), and (iv) Pycnogenol.
I try to get under 2% of my calories from omega 6 fat and to get at least 1-2% of my calories from omega 3 fat (especially EPA).
Vitamin D3.
Green tea.
No gluten.

5. Anti-proliferative/pro-apoptopic/misellaneous anti-cancer
Some acid reflux may actually be anti-proliferative. I think I take care of that at night... :(
Low leptin/IGF levels by eating a low-carb diet.
IP-6/inositol (1.5 grams every other day) on empty stomach.

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