Ehlers-Danlos – The Key to Collagen Disorders?
This is a letter I wrote to colleagues and friends on 5-6-06 after doing a little reading about this sad but fascinating condition. I have been wanting to write something on this topic for months, relating skeletal abnormalities to food intolerance in a more specific way. I hope you get something vital from it.
Dogtor J
Ehlers Danlos Syndrome- The Key to Collagen Disorders?
Hi Everyone,
Yes, I am still reading and thinking….and writing. Sorry. LOL But its sort of like the comedian Louie Anderson said about sweating during his performances. “Sorry I sweat so much but, if I don’t, I’ll explode.”
Have you guys wondered why dogs generally rupture cruciate ligaments during a certain time of their lives, about the same time that other dogs are blowing discs, developing heart murmurs, and suffering from immune mediated diseases and that first big wave of cancer? Haven’t you seen patterns that beg answers, like the same old breeds having this happen and even the same time of year? Yes, I had three cruciate ligament injuries come in the same week last month. Hmmm…”Coincidence”? I don’t think so. Why do they rupture those in one leg and then six months or a year, sometimes to the day, they blow the other? That’s the pattern we see in almost all immune-mediated diseases of tissue, whether it be the eyes, neurological system, and even the kidneys. (Ever wonder why one kidney of the cat with immune glomerulonephritis is almost always smaller than the other?) And what breeds of dogs are involved? It’s the dogs that are the most food allergic, isn’t it? (Labs, Cockers, Poodles, Rotties, Labs again, English bulldogs, Bichons, Cavaliers…the usual suspects). How about the ones that do it the earliest in their lives? I have had English bulldogs and Labs do it before two years. And, how did we create the chondrodysplastic breeds of dogs, anyway? Anybody seeing the newest anomaly..the Munchkin cat?
The answer lies in the study of collagen. Now, I’m not gonna bore you with a big, long lecture on how collagen forms. here is the Wikipedia link if you need a quick review (http://en.wikipedia.org/wiki/Collagen ). Then all you need to do is read a little about one of my new found friends, Ehlers-Danlos Syndrome (EDS). ( http://en.wikipedia.org/wiki/Ehlers-Danlos_Syndrome ). An internet search is very useful here. Some things appear to be here on earth to help us understand how things work…and go wrong (like peanut allergy). When we look at EDS, we see some interesting things like the extremes of what goes wrong when collagen gets screwed up. And why does it happen? “Genetics” and mutated “genes” hold the key and that is right if we have accepted the tenet that our DNA holds contains more viral information than it does genes. I can easily believe that viruses mutate…that’s what they do. I have a harder time grasping how and why our basic genes mutate without the presence of these guys wedging themselves in there somewhere.
Again, the patterns we see as veterinarians should tell us so much. We ought to be working with epidemiologists to solve the world’s health woes. We can help sort out the cause-and-effect relationships that we so often get completely wrong, with our tendency being to latch onto the first thing that surfaces and makes sense to us. Years later, we dig a little deeper and see that our original assumption is wrong because we didn’t dig enough. Sound familiar? We are seeing this all of time right now as this paradigm shift in medicine is taking place in such a huge way. Drugs are coming off the shelf and true causes are being found. And ideas like sunlight “causes” cancer just don’t hold up. Even my least medically inclined client has said “Hey, we’d all be dead if that was the case.” Yup. Just like they quickly see how foolhardy it is to take an aspirin for a fever caused by a virus….after it is pointed out to them. That is the key, though. Hmmm…. Why have we been we so shortsighted?
So, you have the obviously chondrodysplastic dogs like Dachshunds, Shih Tzu, Bassets, and Pekingese. Then you have the intermediate guys like Cockers, Schnauzers, Cavaliers, Bichons, and Poodles. And then you have the “normal” breeds like Labs, German Shepherds, Golden retrievers, and Irish setters (Well, we used to have Irish setters, before we added all of the wheat to their diets. Darn that gluten intolerance …that we all forgot about from our school days.) Which of these groups have the worst cruciate ligament ruptures, back problems, and heart valve problems? Which develop gastric volvulus (“Hey, how did that one get in there?”), which results from the combination of gastric motility disorders and weakened supportive ligaments? Which one dies of acute mitral valve prolapse just about the same time the discs are blowing in other breeds? Anyone having AIHA, ITP, glomerulonephritis, pancreatitis or diabetes developing about this time?
The interesting thing to see is that it is not just the fact that a breed is chondrodysplastic that sets them up for weakened ligaments in their knees, back, or abdomen. All of the three groups above are affected by one or more of these collagen-related disorders. Some are just affected more than others. Part of the problem IS that their collagen never formed properly. We’ll talk about that in a second. But, the timing of these things is one of the keys, as are the unilateral nature and even the seasonal aspects that I have observed.
As most of you are already expecting, I will tell you what I believe is the common denominator. The breeds that have the worst problems are the most food allergic. And, the food allergy is simply the warning sign that food intolerance is taking place in the gut. Again, the IgE is formed at the time the damage to the villi is taking place and the main culprits are the “big 4”- gluten (wheat, barley, rye), casein (dairy products), soy, and corn- the top 4 human, dog and cat allergens and the primary allergens. We know that most other food allergies are secondary to this damage, a condition known as the “leaky gut syndrome” in people. This fascinating process develops when the intestine releases a hormone called “zonulin”, which increases the flow of nutrients through the compromised bowel wall. Unfortunately, food proteins (and other things) pass though the wall in an abnormal fashion, setting the individual up for secondary food allergies to otherwise healthy foods (eggs, rice, chicken, tree nuts, tropical fruits, etc.).
Celiacs are notorious for developing multiple secondary food allergies. This villous damage and atrophy then leads to the malabsorption of calcium, iron, iodine, B complex, C, and multiple trace minerals, nutrients essential in the formation and maintenance of our entire body, including the enzyme systems that are so vital to its function.
So, why doesn’t the collagen form properly? Kinda falls into the “duh” category now, doesn’t it? Why do the Lab, Rottie and G. shepherd have the worst juvenile bone diseases? They will be proven to be among the most food intolerant…when enough interest is generated in this topic. Hey, Hill’s Science Diet now has potato-based diets and they cite “food intolerance” and food allergy as the indications. Halleluiah! I wonder if any pathologists are dusting off their microslides of celiac disease in the Irish setter and re-familiarizing themselves with that lesion? Hey, human pathologists have overlooked this lesion for years and years. We didn’t go from “a rare disorder occurring in less that 1:5000 people” to 1:100 overnight because of contrails overhead. The lesion has always been there. They just missed it for a number of reasons.
And those with food intolerances such as celiac disease have staggering rates of immune-mediated disorders. Whopping amounts of Hashimoto’s and Graves disease, rheumatoid arthritis, type one diabetes, lupus, and other immune-mediated diseases. Why is that? Well, all we really have to understand is the concept of lectins and we’re off and running. Suddenly, we’re even eating by our blood type. Researchers do know so much. Why don’t we hear about these things in the field (things like the known viruses that cause epilepsy and osteosarcoma)?
Could it be that collagen is just another tissue type that the immune system decides to attack at some point, just as it does blood cells, kidneys, eyes, the pancreas, and the peripheral nerves? Why not, eh? Could some of these spontaneous (and even some of the not-so-spontaneous) cruciate ruptures be immune-mediated? Hey, the timing is right. Where do lectins go when they enter the body? The same place that paramyxoviruses go…everywhere ! Have you ever thought of an immune-mediated disease as “house-cleaning”, with the immune assaults wiping out the lectins and the viruses they “broke out of jail” by changing the cell wall’s physiology and causing those viruses…embedded in the cells cytoplasm and those in our very DNA- to adapt to the challenge? I wonder why some viral information makes it to the DNA and that from other viruses remains in the cytoplasm. We ought to look into that.
What happens when we become sensitized to these lectins? When does that take place in an individual’s life? Are there degrees of sensitivity? Are we sensitive to one, two, or all four of the “big 4”? Is there such thing as a mild case of gluten intolerance? Are some people eating much worse diets than others? Are there good things in nature that help block the effects of the bad lectins? Do pollution, lifestyle, lack of sleep, and other bad habits play big roles in who is most afflicted? I think most of you know the answers these very important questions. They help establish the spectrum of illness we see among individuals.
Ehlers-Danlos is an interesting condition. When you read about it, you see everything from being “double jointed” to mitral valve prolapse, excessive bleeding, and aortic aneurysms. It’s a “who’s who” of connective tissue diseases and another good example of a spectrum disorder. But if you put “acquired Ehlers-Danlos” in the search, you get some really interesting stuff. As a friend and mentor used to say to me, “You might wanna look that one up.”
Hope this is as interesting to you as it is to me.
John
John B. Symes, D.V.M. (“Dogtor J“)
