MISSION, PURPOSE, FOCUS

SOF HEALTH INITIATIVES PROGRAMPrepared and presented by Geoffrey P Dardia

CFC # 49942

OUTLINESOF HEALTH INITIATIVES

SOF Health Initiatives Program Introduction

SOF Related Exposures

Functional Medicine Initiative (FMI) – Metabolic Analysis

Mt Sinai - KXRF Bone Lead Research Initiative

Mild Traumatic Brain Injury (MTBI) - Overview

Neuroendocrine Dysfunction (NED)- Overview

Discussion – Questions and answers

SOF HEALTH INITIATIVES PROGRAM

The SOF Health Initiatives Program is a Mind, Body, Spirit and Purpose driven program focused on finding the root causes of illness and treating them with Functional Medicine.

The SOF Health Initiatives Program offers a full systems, patient-centric approach to medicine and creates an environment conducive to healing and recovery.

The SOF Health Initiatives Program also offers a platform to educate and empower health care providers, service members and their families how to repair and maintain themselves.

Self Advocacy is the home front equivalent of Self Aid in combat.

http://www.taskforcedagger.org/#!sof-health-initiatives/vkt7d

SOF HEALTH INITIATIVESSOF Related Exposures

Complex environmental exposures from a variety of sources can affect a person’s health and cause disease. Traditionally, we think of exposures as occurring outside of the body, including chemicals, radiation, infectious agents, and lifestyle factors such as diet and exercise. However, chemicals can also be produced endogenously and might interact with exogenous “environmental” exposures and, therefore, must be considered. These include products of metabolism, hormones, and the microbiome, which is all of the microorganisms naturally in and on the body. Measuring the totality of the exposures that a person experiences from conception to death along with the associated biological response is referred to as the exposome, a concept that has become increasingly important for discovering the environmental causes of disease.

A better understanding of the complex nature of how a person’s environment contributes to his/her health requires sustained development of technology to measure exposures, such as better biomarkers, new sensors and monitors, and remote detection of exposures. Scientists are developing ways to screen compounds for toxicity, creating advanced computer models that can be used to predict toxicity and working on more sensitive ways to analyze how the body responds to exposures. Large amounts of exposure data can now be measured, which means that new computational tools are needed to manage and analyze this important data.

http://www.niehs.nih.gov/research/supported/dert/programs/exposure/

SOF HEALTH INITIATIVESCommon Exposures

SOF HEALTH INITIATIVES PROGRAM (SHIP)

WORK ENVIRONMENT – MILITARY LIFE

Constantly operating in a high stress environment (chronic stress) programs your nervous system to remain in a state of sympathetic over - activation (Fight or Flight). HYPERVIGILANCE

By remaining in sympathetic activation (chronic stress) you cannot fully activate the parasympathetic nervous system (feed, breed, rest, digest, repair) and your homeostatic (sleep), detoxification, immune, digestion, reproductive systems all suffer.

Being “Stressed” has a catabolic effect on the body. WEAR AND TEAR/DISREPAIR.

Chronic stress suppresses the IMMUNE SYSTEM and disables the body’s ability to clean, repair and maintain itself. Stress leads the body to become vulnerable to external environmental threats (TOXINS), and prone to CANCER.

Environmental exposures can damage DNA and cause mitochondrial dysfunction and inflammation. If you do not repair DNA and your mitochondria (life force) does not function properly, they can destroy the body from within (CANCER).

The body has to go into deep sleep to properly repair and maintain your MIND and BODY. Prolonged stress and irregular sleep schedules disrupt deep sleep (REM) and your natural CIRCADIAN RHYTHM.

FUNCTIONAL MEDICINE INITIATIVE (FMI)

Functional Medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership. It is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, Functional Medicine addresses the whole person, not just an isolated set of symptoms. Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, Functional Medicine supports the unique expression of health and vitality for each individual. - See more at:

https://www.functionalmedicine.org/What_is_Functional_Medicine/AboutFM/#sthash.yVsGIa2F.dpuf

FUNCTIONAL MEDICINE INITIATIVECleveland Clinic - Center for Functional

Medicine

http://my.clevelandclinic.org/services/center-for-functional-medicine

PRECISION MEDICINE INITIATIVE (PMI)POTUS DIRECTIVE

About the Precision Medicine Initiative Cohort Program

Far too many diseases do not have a proven means of prevention or effective treatments. We must gain better insights into the biological, environmental, and behavioral influences on these diseases to make a difference for the millions of Americans who suffer from them. Precision medicine is an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person. While some advances in precision medicine have been made, the practice is not currently in use for most diseases.That’s why on January 20, 2015, President Obama announced the Precision Medicine Initiative® (PMI)(link is external) in his State of the Union address. Through advances in research, technology and policies that empower patients, the PMI will enable a new era of medicine in which researchers, providers and patients work together to develop individualized care.

https://www.nih.gov/precision-medicine-initiative-cohort-program

FUNCTIONAL MEDICINE INITIATIVE (FMI)

METABOLISM: DEFINITION

Metabolism is a term that is used to describe all chemical reactions involved in maintaining the living state of the cells and the organism. Metabolism can be conveniently divided into two categories:

Catabolism - the breakdown of molecules to obtain energy

Anabolism - the synthesis of all compounds needed by the cells

Metabolism is closely linked to nutrition and the availability of nutrients. Bioenergetics is a term which describes the biochemical or metabolic pathways by which the cell ultimately obtains energy. Energy formation is one of the vital components of metabolism.

FUNCTIONAL MEDICINE INITIATIVE (FMI)

Nutrition, metabolism and energy:

Nutrition is the key to metabolism. The pathways of metabolism rely upon nutrients that they breakdown in order to produce energy. This energy in turn is required by the body to synthesize new proteins, nucleic acids (DNA, RNA) etc.

http://www.news-medical.net/life-sciences/What-is-Metabolism.aspx

FUNCTIONAL MEDICINE INITIATIVE

http://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/basics/definition/con-20027243

(Deployments, training, work, relationships)

(Heavy metals)

(Sugar/Trans fats)

FUNCTIONAL MEDICINE INITIATIVE (FMI)

FUNCTIONAL MEDICINE INITIATIVE

FUNCTIONAL MEDICINE INITIATIVE (FMI)

met·a·bol·ic syn·drome

Noun MEDICINE

A cluster of biochemical and physiological abnormalities associated with the development of cardiovascular disease and type 2 diabetes."the new research may suggest treatments to combat metabolic syndrome, such as anti-inflammatory drugs"

FUNCTIONAL MEDICINE INITIATIVE (FMI)

Metabolic Risk Factors

The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.

A large waistline. This also is called abdominal obesity or "having an apple shape." Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.

A high triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.

A low HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). HDL sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease.

FUNCTIONAL MEDICINE INITIATIVE (FMI)

High blood pressure (or you're on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.

High fasting blood sugar (or you're on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

Metabolic Syndrome

#1 Cause of death in the US600,000 annual deaths

Top selling prescription drugs in the militaryBlood pressure, cholesterol and diabetes medications

FUNCTIONAL MEDICINE INITIATIVE

FUNCTIONAL MEDICINE INITIATIVE

FUNCTIONAL MEDICINE INITIATIVE

FUNCTIONAL MEDICINE INITIATIVE

FUNCTIONAL MEDICINE INITIATIVE

CHRONIC STRESS = INFLAMMATION

Metabolic Stress/Metabolic SyndromeCHRONIC INFLAMMATION

B

The Costs of Metabolic Stress/Metabolic SyndromeDOD Costs

B

Cholesterol

Asthma

Blood Clotting

Acid Reflux

Allergies/AsthmaInflammation

Cholesterol

Acid Reflux

Acid Reflux

Diabetes

InflammationDepression

Osteoporosis

Sleep disorders

Allergies

The Costs of Metabolic Stress/Metabolic SyndromeCivilian Costs

What is Humira?Humira (adalimumab) reduces the effects of a substance in the body that can cause inflammation.

The Costs of Metabolic Syndrome

https://www.dmdc.osd.mil/appj/dwp/dwp_reports.jsp

ANNUAL ACTIVE DUTY MILITARY PRESCRIPTION DRUG COSTS 2014$2,558,743,973

Mt Sinai Research Hospital KXRF Bone Lead/Research Initiative

Profile

The Bone Lead X-Ray Fluorescence testing facility (in the Department of Preventive Medicine at The Mount Sinai Medical Center in New York City) is one of the country's leading centers for a novel, relatively new technique for measuring long-term lead exposure.

Primarily a research group, in vivo human bone lead levels are measured non-invasively with a technique called X-Ray Fluorescence that is both developed and used here.

Volunteer subjects are measured for federally funded research studies. Also measured are people who are referred to us by physicians because they have symptoms of lead toxicity or are concerned about lead exposure they may have suffered in the past. The information obtained from bone lead measurements can provide evidence of historical lead exposure, in the absence of documented exposure.

Contact Information

If you are interested in our work, to collaborate or to enquire about current job opportunities, you may contact us via:TelephoneUSA+212-824-7053FAXUSA+212-996-0407Postal addressBox 1057, One Gustave L. Levy Place, New York, NY 10029Electronic mailGeneral Information: andrew.todd@mssm.edu Dr Andrew ToddWebmaster: andrew.todd@mssm.edu

Mt Sinai Research Hospital KXRF Initiative

• Lead exposure occurs when lead dust or fumes are inhaled, or when lead is ingested via contaminated hands, food, water, cigarettes or clothing. Lead entering the respiratory and digestive systems is released to the blood and distributed throughout the body. More than 90% of the total body burden of lead is accumulated in the bones, where it is stored. Lead in bones may be released into the blood, re-exposing organ systems long after the original exposure.

• Source - http://www.health.ny.gov/publications/2584/

• LEAD IS NEUROTOXIC

LEAD TOXICITY SYMPTOMS

• decreased libido*• depression/mood changes, headache*• diminished cognitive performance*• diminished hand dexterity*• diminished reaction time*• diminished visual motor performance*• dizziness*• fatigue*• forgetfulness*• impaired concentration*• impotence*• increased nervousness*• irritability*• lethargy*• malaise*• paresthesia* - numbness, tingling and burning on limbs• reduced IQ scores*• weakness*

There is also some evidence that lead exposure may affect adults' postural balance and peripheral nerve function. (ATSDR 1997a, b; Arnvig et al. 1980; Haenninen et al. 1978; Hogstedt et al. 1983; Mantere et al. 1982; Valciukas et al.1978 as cited in ATSDR 1999)

• Symptoms that are the same or overlap TBI

• Source -http://www.atsdr.cdc.gov/csem/csem.asp?csem=7&po=10

Lead Toxicity – Mechanism of action

Toxic mechanisms

The direct neurotoxic actions of lead include apoptosis, excitotoxicity, influences on neurotransmitter storage and release processes, mitochondria, second messengers, cerebrovascular endothelial cells, and both astroglia and oligodendroglia. Although all of lead’s toxic effects cannot be tied together by a single unifying mechanism, lead’s ability to substitute for calcium [and perhaps zinc (Bressler and Goldstein, 1991)] is a factor common to many of its toxic actions. For example, lead’s ability to pass through the blood–brain barrier (BBB) is due in large part to its ability to substitute for calcium ions (Ca 2+). Experiments with metabolic inhibitors suggest that back‐transport of lead via the Ca‐ATPase pump plays an important role in this process (Bradbury and Deane, 1993). More direct evidence for the role of the Ca‐ATPase pump in the transport of lead into the brain has been provided by in vitro studies of brain capillary endothelial cells, the primary constituent of the BBB (Kerper and Hinkle, 1997a, b).Lead’s uptake by excitable cells is also due in large part to its interactions with cellular mechanisms that, under ordinary conditions, perform calcium‐mediated functions. Uptake of lead by pituitary GH3, glial C6 and HEK293 cells is increased by depletion of stored calcium (Kerper and Hinkle, 1997b). Lead enters astroglia and neurons via voltage‐sensitive calcium channels (Kerper and Hinkle, 1997b; Legare et al., 1998), the predominant channel subtype depending on the specific type of cell (Audesirk and Audesirk, 1993).

Lead and neuronal deathApoptosis (programmed cell death) can be induced by a variety of stimuli. Apoptosis occurs when a cell activates an internally encoded suicide programme as a response to either intrinsic or extrinsic signals. One of the better characterized apoptotic cascade pathways has mitochondrial dysfunction as its initiator. Mitochondrial dysfunction initiated by the opening of the mitochondrial transition pore leads to mitochondrial depolarization, release of cytochrome C, activation of a variety of caspases and cleavage of downstream death effector proteins, and ultimately results in apoptotic cell death. While a variety of stimuli can trigger opening of the mitochondrial transition pore and cause apoptosis, a sustained intracellular increase in Ca 2+ is one of the better‐known triggers; accumulation of lead is another. Lead disrupts calcium homeostasis, causing a marked accumulation of calcium in lead‐exposed cells (Bressler and Goldstein, 1991; Bressler et al., 1999). Lead, in nanomolar concentrations, also induces mitochondrial release of calcium (Silbergeld, 1992), thus initiating apoptosis.

http://brain.oxfordjournals.org/content/126/1/5

TBI – Mechanism of action

General pathophysiology of traumatic brain injury

The first stages of cerebral injury after TBI are characterized by direct tissue damage and impaired regulation of CBF and metabolism. This ‘ischaemia-like’ pattern leads to accumulation of lactic acid due to anaerobic glycolysis, increased membrane permeability, and consecutive oedema formation. Since the anaerobic metabolism is inadequate to maintain cellular energy states, the ATP-stores deplete and failure of energy-dependent membrane ion pumps occurs. The second stage of the pathophysiological cascade is characterized by terminal membrane depolarization along with excessive release of excitatory neurotransmitters (i.e. glutamate, aspartate), activation of N-methyl-D-aspartate, α-amino-3-hydroxy-5-methyl-4-isoxazolpropionate, and voltage-dependent Ca2+- and Na+-channels. The consecutive Ca2+- and Na+-influx leads to self-digesting (catabolic) intracellular processes. Ca2+activates lipid peroxidases, proteases, and phospholipases which in turn increase the intracellular concentration of free fatty acids and free radicals. Additionally, activation of caspases (ICE-like proteins), translocases, and endonucleases initiates progressive structural changes of biological membranes and the nucleosomal DNA (DNA fragmentation and inhibition of DNA repair). Together, these events lead to membrane degradation of vascular and cellular structures and ultimately necrotic or programmed cell death (apoptosis).

http://bja.oxfordjournals.org/content/99/1/4.full

MTBI SYMPTOMS CONT

http://www.warriorsupportteam.com/downloads/Worldwide-TBI-2000-2014Q1.pdf

MTBI SYMPTOMS CONT

MTBI SYMPTOMS CONTActive Duty SOF Member’s SPECT Scan confirming TBI and Toxic

Encephalopathy(Concussions, Blast overpressure and Heavy Metal Exposure) dark

colors = low perfusion

MTBI SYMPTOMS CONT

TBI – Neuroendocrine Dysfunction

The term “neuroendocrine dysfunction” refers to a variety of conditions caused by imbalances in the body's hormone production directly related to the brain.

There are two areas of the brain responsible for regulating the production of hormones, the hypothalamus and the pituitary gland.

Damage to the hypothalamus or pituitary gland caused by TBI (including vascular damage, rupture, brain swelling, vasospasm, pituitary swelling or inflammation), may impact the production of pituitary hormones and other neuroendocrine functions of the brain.

NED following TBI is the result of direct trauma (e.g., coupcontrecoup injury), or biochemical response to a blast exposure, that interferes with the normal production and regulation of hormones produced by the pituitary gland and the hypothalamus.

http://dvbic.dcoe.mil/files/resources/DCoE_TBI_NED_Training_Slides.pdf

TBI – Neuroendocrine Dysfunction

TBI – Neuroendocrine Dysfunction

TBI – Neuroendocrine Dysfunction

TBI – Neuroendocrine Dysfunction

TBI – Neuroendocrine Dysfunction

BLAST OVERPRESSURE

QUESTIONS?