Alcoholism, Part 1 Metabolic Chaos By David Gersten, M.D.

. Alcoholism is a problem of such magnitude that the task of organizing the information in a useful way for the reader is daunting. Alcoholism affects 10 to 20 percent of men and 3 to 10 percent of women. Nearly 14 million people in the United States abuse alcohol or are alcoholic. This disease contributes to over 50 percent of car and industrial fatalities, drownings, and child or domestic abuse. Half of us have a close family member who is alcoholic. In 2002, 2.6 million binge drinkers were between the ages of 12 and 17. In each of the last three years there have been 17,000 alcohol-related traffic fatalities. In addition to traffic accidents, alcohol abuse causes: 1,400 deaths, 500,000 injuries, 600,000 assaults, and 70,000 sexual assaults. Life expectancy is decreased by about 15 years. Men who consume more than two alcoholic drinks per day are at increased risk for cancer, cardiovascular disease, accidents, and violence. Twenty-one years ago, alcoholism was recognized and defined as an illness by mainstream medicine. Rehab centers abound and everyone knows the name Alcoholics Anonymous, the famous 12-step program for recovering from alcohol and other addictions. Alcohol treatment is a hot topic. In fact, established modes of treating alcoholism are essentially hallowed ground, not easily challenged. Alcoholism is a chronic disease in which a person drinks alcohol to excess in spite of alcohol's severe deleterious effects, which include: mental and physical illness, job impairment or loss of work, and impaired relationships (work, social, and family). If one's alcohol use negatively impacts any of the above areas of life, one is alcoholic. This is a 2-part article, with part I focusing on a description of alcoholism and the profound metabolic problems caused by drinking. Next month, we will look at a wide variety of treatment options, which must include repair of damaged body chemistry from head to toe. Signs and Symptoms The biggest problem in treating alcoholism is admitting that one has a problem with drinking. Breaking through denial allows the individual to find the motivation for help. The signs and symptoms are vast and affect every organ system, causing literally hundreds of different symptoms, including: 1. Craving for alcohol, inability to control or stop drinking, withdrawal symptoms (nausea, sweating, shakiness, and anxiety), when alcohol use is stopped after a period of heavy drinking. 2. Tolerance (the need for increasing amounts of alcohol in order to feel its effects) 3. Malnutrition 4. Cardiovascular symptoms 5. Repeated infections 6. Dehydration 7. Weakened immune system 8. Central nervous system disordersunsteady gait, depression, anxiety, tremor, cognitive impairment (poor memory and concentration), blackouts, coma, psychosis, and sleep disorders. We will go into a great deal of detail about the problem with impaired neurotransmitter functioning in alcoholics.

9. Womenmiscarriage 10. Interruption of normal menstrual periods 11. Pancreas inflammation and pancreatitis. This is an excruciatingly painful illness and can be fatal. 12. Liver toxicity and hepatitis 13. Slow wound healing 14. Hypoglycemia 15. The endocrine system is severely strained and drained by heavy drinking. Every endocrine gland can be adversely affected. Hormones are distant communicators, messengers sent, for example, from the thyroid, to regulate the metabolic rate of every cell. Loss of correct thyroid function means that each cell is on its own, slowly deteriorating and losing the unifying, central mechanisms that keep the human body working as a whole. Some people can drink to excess and not have a problem. Others, who know they are abusing alcohol can simply quit and be done with it. Those who are most at risk are: genetically predisposed, have a preexisting psychiatric disorder, began drinking during teenage years, and have an impaired capacity for coping with stress as well as strong emotion. These are the predisposing factors. Absence of all of these factors does not make one immune from becoming alcoholic. Metabolic Imbalance Alcohol, or ethanol, does its damage by disturbing metabolism in every organ and in countless, important metabolic pathways. Alcohol is a toxin as is acetaldehyde, the primary metabolic product of alcohol. Acetaldehyde toxicity is most prevalent in the liver, brain, gastrointestinal tract (GI), (adrenal glands and pancreas. These toxins are powerful generators of free radicals, causing metabolic chaos through oxidative stress. Once a person stops drinking, his or her body does not suddenly return to normal. If a person has been drinking heavily for five years or longer, there is often permanent brain damage, although it may be quite subtle. Alcoholics have very poor blood-sugar management. They are getting half of all their calories from alcohol and their body has gotten used to using sugar and simple carbohydrates for energy. Unfortunately, sugar does not turn into protein. Alcoholics are always malnourished and have protein deficiencies with massive amino-acid abnormalities. Because protein is required for all the structures in our body, for cell structure and function, for neurotransmitters, enzymes and hormones, one can quickly see that the protein deficiency alone is devastating to the body of an alcoholic. The malnutrition of the alcoholic depletes all vital nutrients vitamins, minerals, essential fatty acids, healthy carbohydrates, and amino acids. For this reason, a treatment program must address the complex metabolic and nutritional issues. No matter how well one works his 12-steps, no matter how committed he is to recovery, his body will not spontaneously recover. Toxins will need to be slowly removed. Body tissues and organs will need to be rebuilt. Neurotransmitters will take time to return to normal, but the process is incredibly slow without providing the brain the nutrients it requires to make neurotransmitters. Oxidative Stress Toxins and free radicals, produced during the breakdown of alcohol, kill cells in every organ of the body. A free radical is any molecule that is missing an electron. Wherever a free radical goes, it steals an electron from healthy tissue, slowly eating away at normal body chemistry. Organs that suffer the most initial cell

damage are the brain, liver, pancreas, adrenals, stomach and GI tract. Alcohol irritates the lining of the gastrointestinal tract, eventually leading to leaky-gut syndrome. The liver is one of the main targets of alcohol and acetaldehyde toxicity, depleting the liver of glutathione (GSH). GSH is our body's number one detoxifier, one of our five essential anti-oxidants, and is critical to energy chemistry. A body depleted of GSH cannot defend itself against the constant onslaught of free radicals and toxins. While this article cannot elaborate on how to repair every metabolic pathway and every damaged organ, suffice it to say that GSH can be restored to healthy levels through nutritional supplementation, especially with the amino acid, N-acetyl cysteine. Neurotransmitters The most significant metabolic problems caused by alcoholism may be: 1) depleted neurotransmitters, 2) impaired sugar metabolism (with resulting hypoglycemia), 3) a damaged gastrointestinal tract, and 4) damaged detoxification function. Various sources cite serotonin and endorphins as the key neurotransmitters that are depleted by alcohol abuse. That is not the case. Let's take a quick look at the major neurotransmitters that are depleted in alcoholism: Dopamine, the feel-good neurotransmitter. The amino acid L-Tyrosine makes dopamine. Serotonin is a feel-good, mood enhancing, and sleep-promoting neurotransmitter. L-Tryptophan and 5-HTP (5-hydroxy-tryptophan) are the amino acids that make serotonin. Norepinephrine deficiency leads to a huge array of cognitive problems, including poor memory and concentration, anger, outbursts, fatigue, depression, emotional instability, tremors, and insomnia. LTyrosine is the amino acid that makes norepinephrine. Endorphins are our body's powerful, self-manufactured painkillers. Alcohol causes a temporary increase in serotonin and endorphin levels, which is why alcohol makes so many people feel good. But, over time, serotonin and endorphin receptor sites are strained to the max. Acetaldehyde binds with endorphins, shutting down the body's own production of endorphins and serotonin. This toxic process diminishes the brain's ability to produce its own feel-good neurotransmitters, serotonin and endorphins, which then produces depression and other mental disorders. The brain is producing less and less of these neurotransmitters, so the individual drinks more and more in order to create more serotonin and endorphins to fill their up-regulated receptor sites. Acetylcholine deficiency impairs memory, general nerve health, and neurotransmitter transmission. Acetylcholine also carries impulses from neurons to muscle cells, where it generates muscle contractions. Impaired acetylcholine chemistry leads to muscle problems, weakness, and muscle atrophy. Researchers at Scripps Institute and articles in the journal, Science , point to the neurotransmitter GABA (gamma amino butyric acid) as one of the keys to understanding the alcoholic brain. if not THE key. GABA is an inhibiting neurotransmitter that makes us feel relaxed. The GABA receptor site is where minor tranquilizers like Xanax and Valium work. In the short-term, alcohol increases GABA transmission in the amygdala, which is a major pleasure center, but it is also involved in fear. When a person overdrinks, GABA becomes depleted. Alcohol is believed to mimic the effects of GABA, binding to GABA receptor sites. The GABA-starved brain craves anything to regain balance. We feel miserable when GABA is depleted. And so the alcoholic drinks more and more, partly to compensate for the loss of GABA. Unlike norepinephrine and serotonin that can be boosted relatively easily by supplementation with their respective nutritional precursors, namely L-Tyrosine and L-Tryptophan, increasing brain GABA levels is difficult. You will be able to find GABA in any health food store, but there is a big problem. Very little GABA crosses the blood-brain barrier and gets into your brain. Some GABA is made from the amino acid

L-Glutamine and some is a product of sugar metabolism. Because alcohol acts like sugar, one of its functions is to create more GABA temporarily. One cannot ingest huge enough amounts of L-Glutamine to raise GABA levels. Eighty percent of the LGlutamine we ingest is taken up and used by the GI tract. The 20% that is absorbed is used by muscle, the immune system, and the brain. In the brain, L-Glutamine turns into the inhibitory neurotransmitter, GABA, as well as the excitatory neurotransmitter, Glutamate. We don't want a large excess of glutamate. Now here is the good news in this sad story. Meditation will increase GABA and will balance the stress hormones that contribute to neurotransmitter chaos and depletion. Secondly, while very little ingested GABA makes it into the brain, it does make it into the blood. Every cell in our body is covered with GABA receptor sites, and those cells outside the brain will be in a healthier state when circulating GABA levels are increased. Butsome orally ingested GABA does make it into the brain, although this varies from person to person. For a minority of people, GABA will produce some relaxation. But don't think that, more is better. While 2,000 to 4,000 mg a day may help some of you to relax, doses from 6,000 to 8,000 mg will produce severe anxiety and panic. Gastrointestinal Tract If you could open up the GI tract and lay it out, it would be the size of two tennis courts. Its main functions are to: absorb nutrients, keep toxins out of the body, and act as our first line of immune defense. Alcohol damages the lining of the GI tract as well as other critical parts of digestion, including the liver and pancreas. The assault on the GI tract causes three major problems for the alcoholic: 1. Malabsorption Due to damage of the cells of the GI tract, the alcoholic does not absorb all the food he eats. To add to the problem, as mentioned before, an alcoholic is often getting half of his calories from alcohol. The result of malabsorption and poor diet is malnutrition and massive protein deficiency. 2. Leaky-gut syndrome Undigested food particles slip directly into the blood stream from the GI tract. White blood cells see a small piece of food, identify it as foreign and make an antibody to it. The antibody gloms onto the food particle, resulting in a food-antibody complex. These complexes deposit in the tissues of your body, creating irritation and inflammation wherever they deposit. Leaky gut and food-antibody complexes are closely related to allergy. Alcoholics have a much higher incidence of allergic reactions than do nonalcoholics. 3. Candida Alcohol is made through fermentation of yeast with grains, fruits, and sometimes sugar. These happen to be the ideal foods for yeast or candida. I have devoted two entire articles in The Light Connection to candida. In-and-of-itself, it is a huge topic. If one only has to treat candida, one has a big job. All of us have a balance of yeast (candida albicans) and healthy bacteria in our GI tracts. An imbalance can occur, in which healthy bacteria become depleted, yeast is being fed, with the result that yeast explodes, proliferating throughout the GI tract. Intestinal candidiasis (yeast) can cause nearly every GI symptom. In addition, candida often becomes systemic, moving from the GI tract into the blood and into the tissues of the body. Systemic candida causes fatigue, depression, muscle wasting, hypoglycemia, allergy, rashes, poor memory

and concentration, asthma and much more. And this is just one component of alcoholic metabolism. The average alcoholic who gets motivated for treatment will be referred to AA and may be put on some medications, such as anti-depressants. Or he may be put on Antabuse, which works by making the individual incredibly sick when he drinks. This is aversive therapy. The idea is that, once an alcoholic on Antabuse has experimented, taken the gamble, and lost, he won't drink again. Sometimes that strategy works. Sometimes, the alcoholic just stops taking the Antabuse. Immune System The components of the immune system are made up primarily of amino acids (protein) and essential fatty acids. Acetaldehyde, the toxic byproduct of alcohol, alters proteins. These abnormal proteins can result in the immune system mounting unwarranted immune responses, including allergy. In addition, there is a dramatic decrease in white blood cells, a major component of our immune system. Due to a weakened immune system, the alcoholic gets frequent infections, gets unusual infections, and has a hard time shaking them off. All of the metabolic damage you've just read about has its most pronounced effects on sugar metabolism and brain chemistry. The alcoholic is prone to hypoglycemia, and is consuming mainly sugar and simple carbohydrates. In addition, he probably has systemic candida, which further worsens blood-sugar problems. The entire fuel system is thrown far off balance. Because of poor fuel, blood-sugar problems, candida, free radicals, and malnutrition, the alcoholic brain cannot make a normal amount of neurotransmitters. When the brain is way out of balance, life becomes a living hell. This article, Alcoholism Part I, is intended to show you the extraordinary complexity of alcoholism, what alcoholism is, and how excessive drinking slowly poisons every organbut especially how the alcoholic brain limps along, no longer able to generate its own neurotransmitters. Alcohol serves both as surrogate fuel and surrogate neurotransmitters. The alcoholic drinks more and more because his brain is calling out for serotonin, dopamine, norepinephrine, beta endorphin, and GABAand alcohol provides a temporary relief from suffering, temporarily mimicking some of these neurotransmitters. Information is power. This information is not intended to demoralize those of you with drinking problems but rather to help you see exactly what is going on, why you are addicted, how your body is trying to compensate, and why the compensation fails. Complexity does not mean that you are hopeless. Rather it means that treatment has to be deep, wide, and covering as many bases as possible. Having read what alcohol is doing to your body, or that of a loved one, please avoid a typical alcoholic response of shame and self-blame. You could say to yourself, Oh, I am so ashamed. I had no idea I was destroying my body in the way this article describes. If shame arises, simply note it, observe it, and realize that a shame response is also just part of the illness, part of the complete picture that we address in helping you not just to become abstinent, but to become happy and whole. Alcoholism is not a life sentence or a death sentence. In the next issue, we will look at a wide variety of treatment options. While I recommend that my alcoholic patients go to AA, I must address the nutritional deficiencies, the brain abnormalities, the emotional issues not yet faced, the spiritual issues not yet faced, and the alienation from God or a Higher Power that is much higher in alcoholics than in the rest of the population. Look for solutions next month. We will look at the use of vitamins, minerals, amino acids, essential fatty acids, herbs, homeopathy, acupuncture, Alcoholics Anonymous, cranial electrical stimulation, mental imagery, meditation, and more. Alcoholism, Part 2 -- Fixing the Brain 1

By David Gersten, M.D. Alcoholism is an illness of metabolism, or biochemistry, and it is vastly complicated. While there are enormous psychological issues related to alcoholism, these are primarily caused by alcoholism. They are not the cause of alcoholism. I am assuming that you are alcoholic or someone close to you is. This statement is true for 50 percent of you. All the depression, anxiety, shame, guilt, low self-esteem, panic, and fear are caused by disorders of brain chemistry, or neurotransmitter disorders. Alcoholics did not become heavy drinkers because they were depressed. They are depressed because they have the illness of alcoholism. This point is critical to understand so that: 1) you don't blame your illness on your psychological weaknesses or poor will power, and 2) you realize that by healing brain chemistry and much more, you can be cured of most of your mental/emotional problemsor all of them. I do not mean to imply that stress and unresolved conflict have nothing to do with alcoholism. Emotional imbalance can be a contributing cause of any and all illness, but is not specific to alcoholism. No one likes to throw around the word cure when talking about alcoholism, but that is because few people have dealt with the illness itself, examined the metabolic roots, and treated the root causes. For those of you in doubt, after reading this article, read Seven Weeks to Sobriety: the Proven Program to Fight Alcoholism Through Nutrition, by Dr. Joan Larson. This is a well-researched book, which has grown out of a very successful treatment model. Here are the key problems we have to treat: 1. Brain Neurotransmitters 2. Essential Fatty Acid Chemistry 3. Hypoglycemia 4. Candida Overgrowth 5. Adrenal Exhaustion 6. Gastro-Intestinal Dysfunction 7. Nutrient Depletion 8. Allergy and Immune System 9. Oxidative Stress and Detoxification We need to fix neurotransmitters first. Problems with brain chemistry are why you drink, why you have problems with mood, sleep, cognitive functioning, and why you became addicted to alcohol. All the other key problems (2 9) contribute to bad brain chemistry. Due to the complexity of the metabolic chaos in alcoholism, it is important that we start by helping you deal with the single most important problem, which is healing the central nervous system. In the next article, you will read about how to balance and cure all of the other 9 nutritional and metabolic causes of alcoholism. Before diving into your brain, a quick look at non-brain issues is in order. Nutrient depletion is an important cause of poor brain function. It is essential that an alcoholic begins to ingest minimal amounts of essential nutrients as well as curative amounts of nutrients to heal serious problems. The alcoholic gets half of his calories from sugar and alcohol, both of which have zero nutritional value. Not only is his nutrition poor, alcohol destroys many key vitamins and minerals.

Most alcoholics suffer from hypoglycemia, which produces quite an emotional roller coaster ride. Hypoglycemia and a host of other factors, lead to adrenal exhaustion, which makes it impossible to deal with mental or physical stressand which makes hypoglycemia worse. Hypoglycemia deprives the brain of its only nutrient, namely glucose, or blood sugar. Candida, a systemic yeast infection that is quite common in alcoholics, causes problems from head to toe, creating symptoms that include: exhaustion and fatigue, brain fog, depression, poor concentration, poor memory, hypoglycemia, adrenal exhaustion, intestinal gas and bloating, and muscle weakness. Each of the core causes of alcoholism interacts with each other. For the purposes of understanding the illness and how to treat it, we need to compartmentalize. At the same time, understand that so many of these causes interact with each other to form one whole metabolic mess. Ultimately, all the primary causes end up creating deficiencies in all important neurotransmitters. The brain is the target organ of alcohol. If you are an alcoholic who is just starting to get sober, or you have just gotten sober, you are facing these kinds of thoughts, Fourteen years of my life are gone. I have screwed up everything. What am I going to do? I am about to return to the real world, return to work, and I am scared to death? Who will help me? Maybe I should kill myself? This last item, suicidal thoughts, is very important. They are common in alcoholism, as are suicide attempts. You are looking at the stage of Fear and I won't try to talk you out of your fears. It is scary facing the real world after years during which you were lost in a bottle. What you need to know is that you were or are alcoholic because of complicated metabolic problems. Once you understand these problems, and the best way to do so is to seek professional help and have appropriate nutritional testing, you will see the light at the end of the tunnel. Unless drinking has caused severe liver damage, we can repair your chemistry. What that means is,'We can cure the biochemistry that made you crave alcohol, which made you tolerant and addicted. So, please keep this in mind as you face the reality of recovery. Without treating the underlying metabolic problems, the alcoholic will have the same metabolic problems in five years. He will still crave sugar. He will still lack normal neurotransmitters. Curing alcoholism is not simply an issue of discontinuing the use of alcohol. It is much more. Brain Neurotransmitters The alcoholic's brain suffers due to the actions of three toxins: alcohol, acetaldehyde (a primary breakdown product of alcohol), and tetrahydroisoquinolines (THIQs). Acetaldehyde combines with neurotransmitters to make THIQs, which are addictive, morphine-like compounds. These three toxins affect every important neurotransmitter, and do so in a variety of ways. The main way they cause problems is by acting as pseudoneurotransmitters and by binding to neurotransmitter receptor sites. As we will shortly see, it appears that the most important neurotransmitter system involved in alcoholism is GABA (gamma-amino butyric acid). These toxins also wreak havoc with serotonin, norepinephrine, and endorphins, causing depletion in these critical neurotransmitters. Alcohol and its two evil twin toxins fool your brain into thinking it is getting the right nutrients to make neurotransmitters. So, alcohol will temporarily increase endorphins, norepinephrine, serotonin, and GABA. When the alcoholic stops drinking, the action of these neurotransmitters disappears. He goes into withdrawal and begins to drink again, because his brain is crying out for a substitute for these neurotransmitters. Of course, neurotransmitters are only manufactured by a diet rich in the precursors to neurotransmitters. The alcoholic diet is largely devoid of nutrition. It is really enough for you to know just this much, but I will provide a bit more detail. As the endorphins and serotonin dissipate, and the symptoms of the upregulated brain receptors surpass the person's ability to tolerate them, the upregulated system will again seek their complimenting neurotransmitters, causing the person to seek out and indulge in drinking. THIQs mimic good neurotransmitters (endorphins and serotonin), responsible for the natural sense of peace, joy and happiness, which most of us are capable of, by binding to their respective receptor sites. The brain is'upregulated and the pseudo-neurotransmitters create a euphoric experience. This is the genesis of

dependency, as the person begins to need the external substance to feel okay. Scientists at The Scripps Research Institute have described the mechanisms underlying the brain's response to alcohol and published their findings in the journal Science. Alcohol produces many of its intoxicating actions through facilitation of GABA receptor site activity. Preclinical studies of alcohol dependence have shown that GABA activity decreases during alcohol withdrawal and protracted abstinence. GABA changes are probably a major cause of relapse. GABA is the major inhibitory neurotransmitter in the brain, and GABA-like drugs are used to suppress spasms. Alcohol is believed to mimic GABA's effect in the brain, binding to GABA receptors and inhibiting neuronal signaling. Drugs like Xanax, Valium, and Ativan work at the GABA receptor site. That should give many of you an idea what GABA feels like. So, the alcoholic has greatly diminished amounts of GABA in his brain. Alcohol and THIQs make him feel as if he has enough GABA, but he does not, so when he stops drinking, he goes into severe withdrawal mainly GABA withdrawal. GABA is one of the most difficult neurotransmitters to restore, but here are the nutrients you can use to help restore GABA. Amino acids will be the key to restoring GABA. With any amino acids, make sure you purchase nutraceutical grade, which you cannot find in healthfood stores. For some people, GABA, from 1 gram to 3 grams a day will bring peace and serenity and will dramatically alleviate anxiety. The problem is that GABA is erratic in terms of its ability to cross the bloodbrain barrier and get into your central nervous system. For some people there is no problem and for others, there is problem. Two words of caution. 1) With GABA, more is not better. Don't play with this. At doses greater than 7 grams per day, GABA does the opposite of what you want, producing severe anxiety and panic. 2) Metabolism of all amino acids requires a healthy liver. If you have seriously compromised liver function due to alcohol toxicity, you should not use amino acids, or should do so only while being closely monitored by a doctor with expertise in this area. It is very interesting to note that every cell in your body, not just in your brain, is loaded with GABAreceptor sites. This is according to a personal conversation I had with Dr. Candace Pert, who discovered the endorphin receptor site. What is odd about her finding is that there is generally very little GABA in the blood. So, why is the body loaded with GABA receptors? I suspect that spiritual adepts, yogis, rishis, and the like have attained states of consciousness associated with very high brain levels of GABA, levels so high that it spills over into the blood, essentially leaving each cell in a state of cellular bliss and perfect cellular health. For the non-rishis among us, my theory is that, when we ingest GABA, even if it does not all get into the brain, it is binding to GABA receptor sites all over the body, which would produce a calming effect on every cell. Now, back to getting more GABA into your brain. The amino acid L-glutamine easily enters the brain, where it is converted into GABA and L-glutamic acid (an excitatory neurotransmitter). Glutamic acid converts into glutamate and GABA. You DO NOT want excessive amounts of glutamate in your brain. It can be highly toxic. However, as a backup plan to ingesting L-glutamine, you can take L-glutamic acid, but you must take a healthy amount of a B-Complex as well as P-5-P, which is the active form of Vitamin B-6. If you are affected by alcoholism, imprint the letters G-A-B-A into your brain and do your own Internet research. Keep your eyes and ears open over the coming years to see what is happening regarding GABA, because it may be the single most important key to understanding alcohol addiction. What else can you do to increase your GABA levels? Practice some form of meditation on a regular basis. By so doing, you will assist your brain in making GABA, but don't forget to feed your brain what it requires to make GABA. Starting to Eat Right

While you will understand the Alcohol Recovery Diet much better after reading part III and IV in this series, let's get you started today with a diet that will help heal your brain, your blood sugar, your candida, and more. 1. Eliminate simple sugar. 2. Increase complex carbohydrates. 3.Consume adequate amounts of healthy, unprocessed protein. 4.Increase essential fatty acids in your diet. There are a number of good products on the market, but I like UDO's blend of essential fatty acids that you can get at any local health store. Udo Erasmus is the nation's authority on fatty acids, so I trust his blend. Take 1 tablespoon twice a day. Put it on your salads or steamed vegetables if you like. 5. Decrease saturated fats and fried foods. 6. Increase your intake of water. It will help begin the detoxification process. If you are not a water drinker, try VitaminWater, which comes in multiple flavors. Your local health food store carries it. It tastes great and is not sweet or syrupy. In other words, it will not worsen your hypoglycemia. I love it, and have no ties to any products I have listed here. 7. Avoid wheat and dairy. There is an allergic component to alcoholism, which relates to these two food groups. 8. Avoid caffeine. This may be a tall order. Start where you can start. Here is a short list of nutritional supplements you can start using that addresses neurotransmitter activity, as well as some biochemistry related to total body health, and that will begin your journey to a cure. Start these supplements this month. In the next article, the supplementation recommendations will address many more issues. These will get you started. Nutritional Supplementation 1. B Complex. 2. GABA 1,000 mg 2 to 3 times a day. 3. Multivitamin. 4. Multimineral. 5. L-Glutamine 1,000 mg 3 times a day. 6. Pyridoxal-5-Phosphate (active form of Vitamin B-6) 40 mg twice a day. 7. L-Tyrosine 500 mg 3 times a day to increase norepinephrine brain levels. (Make sure you have had blood tests for thyroid function before starting). 8. 5-HTP (5-hydroxy-tryptophan). 50 mg 3 times a day. You still need a prescription for L-tryptophan, but 5-HTP will help increase serotonin levels and is non-prescription.

9. Blend of Essential Fatty Acids. Try UDO's Perfect Blend. Take 1 tablespoon twice a day. Drink it out of the spoon or put it on your veggies. 10. GLA (gamma-linolenic acid) 250 mg 3 times a day. 11. VitaminWateror just lots of water. By understanding the principles I've outlined and beginning to follow some of the suggestions for restoring normal neurotransmitter function, you WILL begin to feel better. You will begin to restore, not only GABA, but also norepinephrine and serotonin, two vital neurotransmitters. You will need to understand the totality of alcoholism's metabolic chaos to see the complete picture. For now, remember that alcohol is mainly a disease of brain chemistry. In this article, we have focused on one important neurotransmitter, GABA. In the next issue, we will take an in-depth look at serotonin and norepinephrine. You can now stop blaming yourself, your parents, or anyone else. Understand that alcohol, acetaldehyde and THIQs destroy neurotransmitters, trick neurotransmitter sites, and create a huge craving for alcohol because alcohol mimics the neurotransmitters that it destroys and displaces from receptor sites. When you begin to rebuild and restore neurotransmitters in a healthy way, much will change in your life for the better. Alcoholism, Part 3 -- Fixing the Brain 2 By David Gersten, M.D. Last month we looked at the devastating impact that alcohol has on the brain. Every important neurotransmitter system is impaired by alcohol. Alcoholism brings with it three major toxins, namely: Alcohol (ethanol), acetaldehyde (a primary bre akdown product of alcohol), and tetra-hydroisoquinolines (THIQs). Acetaldehyde combines with neurotransmitters to make THIQs, which are addictive, morphinelike compounds. These three toxins act as pseudo-neurotransmitters by binding to neurotransmitter receptor sites. When the alcoholic is drinking, his brain thinks there is enough serotonin, norepinephrine, dopamine, endorphins, acetylcholine, and GABA. But the brain has been tricked by alcohol and its two related toxins. As soon as the alcoholic stops drinking, his brain truly experiences serious deprivation of all major neurotransmitters. He resumes drinking because alcohol makes the brain believe, once again, that it has plenty of GABA, serotonin, and the other major neurotransmitters. In the last article, we went into detail about the process by which the brain is damaged, and reviewed the theory that disorders of GABA (gamma-amino-butyric-acid) may be the single most important factor in alcoholism. In this article, the focus will be on specific neuro-cognitive problems caused by alcoholism, and how we can treat those problems in a natural way. Before exploring these symptoms and problems, let me clear up a very important and controversial issue surrounding alcoholism. In order to move toward an understanding of how to cure alcoholism, let's start by addressing two important issues that are frequently misunderstood. First, let's talk about the alcoholic personality, the type of makeup that predisposes one to become alcoholic. Understanding this makeup will make it easier for you to know which kind of psychotherapy or support system will best suit you. Here is the answer. In 1984 a study of 650 young men showed that there was no evidence whatsoever that there is an alcoholic personality. So, folks you can throw out the notion that your mother, father, your abuse, neglect, or stress caused your problem with drinking. Alcoholism is not a psychiatric disorder and does not belong in the DSM-IV, the psychiatric bible of diagnosis. Secondly, you need to understand that support systems, including Alcoholics Anonymous (AA), according to a great deal of research, do not have better than a 5 percent cure rate. Mind you, I refer my alcoholic

patients to AA. AA was never intended as a treatment modality. It is support and is profoundly helpful. But alcoholism is a physical disease. You cannot cure diabetes or cancer through support groups or psychotherapy, nor can you cure alcoholism through such support. I also don't buy into the nearly universal belief that alcoholism is an incurable disease. The point of this tongue-in-cheek discussion of the Alcoholic Personality is to help you finally set aside such a notion. There is not a Diabetic Personality or an Arthritic Personality. Similarly, alcoholism is a disorder of severely disturbed biochemistry. There is metabolic chaos from head to toe. In this article, we continue to examine and repair the metabolic chaos within the brain and nervous system that we began to heal in the last article. Treating Specific Neuro-Cognitive Problems Every neuro-cognitive, psychological, or mental-emotional problem is associated with specific neurotransmitter problems. Here is how you can address each of these major symptoms associated with alcoholism. Anxiety and Insomnia 44% of alcoholics suffer from anxiety. Anxiety and sleep disorders are closely related. Take GABA for anxiety. Serotonin is the main neurotransmitter that induces sleep. The amino acid L-tryptophan is the precursor to serotonin, so supplementation with L-tryptophan or 5-HTP (5-hydroxy-tryptophan) will help with sleep and anxiety. If you ever blacked out due to drinking, you have a tryptophan deficiency. Inositol, a B vitamin helps regulate serotonin and treats anxiety and panic disorder. You will also want to take P-5-P (pyridoxal-5-phosphate, the active form of Vitamin B-6), for L-tryptophan requires P-5-P to get converted into serotonin. Vitamin B-3 (niacin or niacinamide) helps with serotonin chemistry. Niacin can cause a brief but uncomfortable skin flush, but niacinamide (another form of B-3) won't do that. Bill Wilson, the founder of Alcoholics Anonymous, became quite interested in nutritional approaches to treating alcoholism. In one study of 30 patients treated with Vitamin B-3, 20 were cured of all their symptoms in approximately two months. Bill Wilson was at the forefront of Orthomolecular Medicine. While his first huge contribution, AA, became widely accepted, the medical establishment did not support his claims about niacin, and so he continued his orthomolecular research outside of the mainstream. Tremors The amino acid, taurine, stabilizes nerve tissue, decreasing tremors as well as the risk of seizures. In addition, take calcium, magnesium, and B Complex. The amino acids, L-glycine and taurine, both enhance alpha brain waves, which are calming. So consider these two for tremors as well as anxiety. Depression At least 40% of alcoholics are affected by depression. People often blame their depression on what alcohol has done to their performance at work, social life, and marriage, not understanding that they have profound neurotransmitter problems. The two most important neurotransmitters involved in mood are serotonin and norepinephrine. We've already talked about the use of L-tryptophan to increase serotonin levels. This is what the SSRI anti-depressants do (drugs like Paxil and Zoloft). They increase serotonin levels. At least half of depressed people suffer from a norepinephrine depletion and not serotonin depletion, although many alcoholics have both of these anti-depressant neurotransmitters depleted. The amino acid L-tyrosine is the precursor to norepinephrine. Like L-tryptophan, L-tyrosine must be taken with P-5-P in order to get converted into its end product, namely norepinephrine. Both L-tyrosine and Ltryptophan should be taken away from meals and from other amino acids in order to get into the brain more

readily. Omega-6 Essential Fatty Acid Defect Amino acids are not the only nutrients involved in brain chemistry. In alcoholics, there is a genetic defect in handling the omega-6 fatty acid gamma-linolenic acid (GLA), which converts into prostaglandin 1 (PGE1) in the brain. Orientals lack this genetic defect and, as a result, have an incredibly low incidence of alcoholism. Due to the genetic defect, the ability to produce PGE1 drops in the alcoholic brain. PGE1 is very much involved in mood. Alcohol helps the brain produce PGE1, by taking whatever meager supply of GLA that is present and converting it into PGE1. Over time, GLA and PGE1 drop. Because alcohol can mimic PGE1, the alcoholic drinks because his brain is asking for more PGE1, and so he succumbs to what his brain is demanding. By supplementing your diet with GLA, you can treat the depression caused by GLA and PGE1 deficiency. If this happens to be your problem, GLA is a wonder nutrient. Gastro-Intestinal (GI) Tract and Brain While this is a complex subject, which must wait until next month for deeper analysis, for now I want to mention that alcohol damages the lining of the GI tract. Without a healthy GI tract, it is impossible to get an adequate, balanced supply of the vitamins, minerals, fats, and amino acids required to produce neurotransmitters and to maintain good overall brain health. The L-glutamine you will take to increase GABA levels in your brain is also extremely helpful in restoring intestinal health. Consider this: If you were to open up the GI tract, it would take up the space of two tennis courts. It is a huge organ with five major functions, namely: 1) absorbing nutrients, 2) keeping toxins out of the body, 3) manufacturing neurotransmitters, 4) acting as the first line of defense of the immune system, and 5) removing waste. The first four GI functions are impaired in alcoholism, and these four affect the brain for better or for worse. Few people know that the GI tract is like a second brain in that it produces huge amounts of neurotransmitters. It is also the largest part of our immune system. Ultimately the alcoholic will fully recover when his brain and GI tract have fully recovered. The liver, part of the digestive process, is often damaged in alcoholism. All nutrients absorbed through the GI tract pass through the liver. An impaired liver gives rise to poorly assimilated nutrients. Start taking the herb Sylamarin to begin liver repair. Vitamins and Minerals B vitamins, all of them, are important for healthy neurotransmitter function. Alcohol destroys B vitamins, so start supplementing with a good multiple B vitamin right away. B vitamins cannot be stored in the body, so they must be ingested and absorbed on a daily basis. Alcohol inhibits fat absorption, impairing absorption of the fat-soluble vitamins: A, D, E, and K, all of which are involved in wound healing. Calcium and magnesium help to calm the nervous system, decrease anxiety, improve sleep, and reduce withdrawal symptoms. These minerals stabilize the cell membrane of neurons, or nerve cells. The mineral, manganese, is needed for proper functioning of the B vitamins and also helps stabilize blood sugar.

Amino Acids While each section of this article has discussed amino acids, as they relate to a particular symptom, it is important to now look at them as a whole. Amino acids are called the building blocks of life. The main purpose of DNA is to take amino acids and use them to build protein, neurotransmitters, hormones, enzymes and other tissue structures. Each gene in our DNA codes for one particular protein. There are 9 Essential amino acids, which means that we must ingest these from food: Arginine, Histidine, Methionine, Threonine, Valine, Isoleucine, Lysine, Phenylalanine, Tryptophan, and Leucine. The remaining 11 major amino acids are either Non-Essential, meaning our body can make these from other amino acids, and Conditionally Essential. Conditionally essential amino acids are those that our bodies ordinarily can make but due to a variety of stresses and illnesses, our bodies stop making these amino acidsat which point they become Essential and we must either ingest foods with those amino acids or take nutritional supplements. This group of amino acids includes: Alanine, Asparagine, Aspartic Acid, Cysteine, Glutamine, Glutamic Acid, Glycine, Proline, Serine, Taurine, and Tyrosine. The fact is that both Non-Essential and Conditionally-Essential amino acids can become Essential when we are stressed or sick. In other words, our bodies stop making these. Amino acids participate in every chemical reaction in the body, but let's focus on how they are involved with brain chemistry. Ordinarily, the letter L precedes the name of an amino acid, but I will skip that formality here. The only regularly used amino acid with a different form is DL-phenylalanine, which is used to alleviate pain. Tyrosine is the precursor to the neurotransmitters dopamine and norepinephrine. If you are deficient in norepinephrine, you may feel depressed, anxious, sleep poorly, and have poor concentration, poor memory, and a host of other cognitive problems. In general, supplementation with tyrosine will bring norepinephrine levels back to normal and will alleviate some or all of these symptoms. Before taking tyrosine, or going on an amino acid program, lab work should be done for amino acids, and thyroid function should be checked, since one of tyrosine's functions is to produce thyroid hormone, or thyroxin. In my opinion, the best laboratories for analyzing amino acids are Great Smokies Diagnostic Labs, MetaMetrix, and Doctor's Data. The best amino acid tests have 41 sub-tests, which provides an enormous amount of useful information. Dopamine, also made from tyrosine, is a feel-good neurotransmitter. The dopamine receptor site is where cocaine and amphetamines work. Dopamine mediates the feel-good of sexual orgasm. If you have too little dopamine, you are not likely to feel cheerful. If you have too much, you are likely to experience anxiety, fear, or paranoia. So, dopamine needs to be kept in careful balance. More is not necessarily better. Tryptophan is the precursor to serotonin. Low serotonin levels will lead to depression, insomnia, and some cognitive impairment. Taurine is an amino acid that is a direct neurotransmitter, stabilizing nerve cells (neurons) as well as heart cells. In alcoholism, it is useful in stabilizing an agitated brain, and in helping to prevent tremors and seizures. Glutamine is the precursor to another amino acid, GABA. GABA is another feel-good neurotransmitter and is the most calming of all neurotransmitters. Alcohol toxins dramatically impair GABA and GABAreceptor sites. As mentioned previously, GABA may be the key to understanding alcoholism.

Like GABA, glycine is an inhibitory neurotransmitter, producing a calming effect. Other amino acids play a role in brain chemistry, but the ones you've just read about are the most important. Amino acid chemistry is very complicated. It took me ten years of study and amino-acid testing before I began to get a handle on it. Don't just play around with amino acids. Look carefully at the recommendations in this article and in the last one, and remember that, while taking tyrosine (which will usually lift depression and brain fog), don't forget to focus on healing problems with digestion. If you have a healthy GI tract, you will be able to absorb most of the amino acids you need from a healthy diet. A final word about amino acid therapy. A multi-amino acid is going to help alcoholics. These contain all the essential amino acids in relatively high doses, as well as the non-essential amino acids. Some multiamino acids are formulated to assist with problems of muscle weakness. Others are formulated to help people with blood sugar problems. Whatever you do, do not buy amino acids from health food stores. These aminos are usually made in India and China, can be contaminated with impurities such as arsenic, may not have the amino acids in the capsule as promised, and may have nutrients in the capsule that are not supposed to be there. Buy nutraceutical grade amino acids. The Internet is the best and easiest place to find nutra-ceutical grade amino acids. Nutraceutical brands include Montiff, Pure Encapsulation, Thorne, and Allergy Research, to name a few. This article and the last one have given you a strong dose of knowledge about alcoholism and brain chemistry. In the next issue, we will look at non-brain problems of alcoholism, including: hypoglycemia, candidiasis, allergy, and adrenal exhaustion. Alcoholism, Part 4 -- Healing the Body By David Gersten, M.D. Over the course of the last three issues of The Light Connection, this column has been exploring the causes, symptoms, and cures for alcoholism. While we must first heal brain chemistry, all organ systems need to be supported and healed, and three major metabolic imbalances need to be targeted in the alcoholic. 1. Hypoglycemia 2. Candidiasis 3. Adrenal Exhaustion Hypoglycemia 90-95% of alcoholics are hypoglycemic, including alcoholics who have not had a drink in years. Hypoglycemia can cause depression, digestive disorders, muscle pain, numbness, lack of sex drive, allergies, poor concentration and memory, muscle twitching, nightmares, anxiety, fear, shortness of breath, fatigue, and dizziness. Let's look at basic sugar chemistry. Each time you consume any form of sugar, whether processed white sugar, fruit, or alcohol, your pancreas releases insulin in response to a rise in blood sugar (glucose). Insulin temporarily binds to glucose and transports it across cell membranes into our cells. Glucose is our body's main fuel and our brain's only fuel. After insulin drives glucose into the cells, blood sugar drops. Let's say that your baseline blood glucose before breakfast is 80. Thirty to sixty minutes after breakfast (or the consumption of sugar), your blood sugar might rise to 150. After insulin transports glucose into our cells, glucose in the blood drops. In the healthy individual, glucose slowly and steadily declines over a five-hour period until it is back at your baseline (80, for example). In the healthy individual, glucose will not drop below your baseline. Things are

quite different for the hypoglycemic. One to two hours after eating, glucose will drop from its high point (150, for example), and will plunge below baseline. Let's say that your glucose drops to 60. It will take several hours for your glucose to slowly climb back to baseline (80). During those hours of hypoglycemia your brain will be deprived of glucose and you may feel depressed, anxious, shaky, confused, and tired. People with fatigue and depression 2 to 4 hours after eating are dealing with hypoglycemia. The alcoholic cures his hypoglycemia by drinking, for alcohol is loaded with sugar. Each sip of alcohol temporarily increases your glucose. Briefly, you will feel better and may even function better. However, alcohol is the worst source of glucose you can find. If you are hypoglycemic, you may feel as if you are on a mental and physical roller coaster, and probably don't know why. Over time, your pancreas has a more difficult time creating insulin in response to the sugar you ingest, and so insulin-glucose chemistry becomes impaired. The stress of hypoglycemia causes your adrenals to work overtime, releasing the hormones epinephrine and cortisol. Epinephrine causes your liver to break down glycogen into glucose. We'll talk more about the adrenal glands in a minute. For now, it is important to understand that blood sugar problems steadily pound away at the adrenals. Treating Hypoglycemia To begin to manage low blood sugar, you will need to change your diet by restricting sugar and low quality carbohydrates. Fruits, vegetables, and some grains are high quality carbohydrates. Junk foods and pasta are low quality carbs, and they break down quickly into sugar. By eliminating sugar, you can finally give your pancreas a rest. Here are nutritional supplements that will help with sugar metabolism and will decrease sugar cravings: L-Glutamine, an amino acid that decreases sugar cravings. L-Alanine (amino acid), Vitamin C, Magnesium, Pantothenic acid, and Niacin (Vitamin B3). Chromium picolinate stabilizes blood glucose. Alcohol and refined sugar cause a loss of chromium. One study showed low chromium levels in 91% of alcoholics. Candida Generalized candidiasis (also called candida) is a huge problem for many alcoholics. Candida, a systemic yeast infection, causes problems from head to toe, creating symptoms that include: exhaustion and fatigue, brain fog, depression, poor concentration, poor memory, adrenal exhaustion, intestinal gas and bloating, muscle weakness . . . and hypoglycemia. By looking at this last item, hypoglycemia, you can begin to see the tangled web of metabolic chaos caused by alcoholism. Candida remains voodoo medicine for much of mainstream medicine. Most conventional doctors do not believe you can have a yeast problem throughout your body unless you have AIDS, terminal cancer, or are suffering from the side effects of

cancer chemotherapy. Here is how candida begins. We all have some yeast in our gastrointestinal (GI) tract. It is part of the normal balance or ecology of the GI tract. A variety of things can cause yeast, or candida, to overgrow. Antibiotics are a main offender. You may be prescribed an antibiotic for a bladder infection, but antibiotics do not have intelligence, so they kill bacteria everywhere, including friendly bacteria in our GI tracts, like acidophilus and bifidus. When healthy bacteria are killed off, candida rapidly multiplies, so that your GI tract is filled with excessive amounts of candida. This intestinal overgrowth can lead to gas, bloating, abdominal pain, constipation, diarrhea, and heartburn. Candida has two statesa bud state and a hyphae state. Hyphae are like fingers that dig into the lining of our GI tract, causing irritation, malabsorption, and possibly leaky-gut syndrome. Candida does its damage is several ways: 1) It causes irritation and inflammation wherever it is present. In the GI tract it causes chronic irritation and inflammation of the lining of the GI tract, 2) Candida eats some of the food you are ingesting. Instead of feeding your body, you are feeding your candida, 3) Candida produces up to 100 neurotoxins which are made up of short chains of amino acids, called peptides. Candida, all by itself, can make your brain quite sick. It will not permanently poison your brain, for the toxins it releases are subtle in their action and are not deadly. After years of intestinal overgrowth, candida easily finds its way into the blood stream, infiltrating nearly every organ and anchoring into body tissues with their hyphae. Systemic candida can be innocuous or it can cause more than 50 symptoms, as described above. In terms of alcoholism, candida causes hypoglycemia, digestive problems, fatigue, mood swings, insomnia, poor memory and concentration, allergies, and sugar cravings. Nothing feeds candida better than alcohol, for the two foods that feed yeast are sugar and yeast. Alcohol is made by a fermentation process involving fruits, grains, and sometimes yeast. Consumption of alcohol makes candida worse and worse. A 1991 study of 213 alcoholic patients showed 55% of alcoholic women and 35% of men had candida overgrowth. There are a number of ways of diagnosing systemic candida. The history is extremely important, for one can have normal lab data, but still have candida overgrowth. If a woman has frequent vaginal yeast infections, oral thrush (white coated tongue), fungus growing between her toes and in her fingernails, I know she has systemic candida, regardless of what the results of lab work are. But lab work is important and includes: 1) Stool analysis for yeast, 2) Anti-candida antibody blood test. I order the blood test through ImmunoScience Labs in Beverly Hills , California . This test indicates if one has intestinal candida overgrowth, systemic overgrowth . . . or both. It also provides a numerical value for the amount of candida, which lets me know how bad the candida problem is. When I re-test after 3 months of treatment, the anticandida antibody test lets me know how much improvement there has been. Treating Candida 1. Anti-fungal drugs and herbs. Medications like Nizoral and Diflucan are, by far, the most powerful agents for killing candida wherever it is. However, these medications can be hard on the liver, and so I never prescribe them without first ordering blood work to test the liver. I repeat liver tests every month. The medication Nystatin is weaker than Nizoral or Diflucan, but does not adversely affect the liver. Herbs, like Caprylic Acid, Olive Leaf Extract, and oil of oregano are useful in controlling overgrowth of intestinal candida, but are not terribly effective in treating systemic candida. 2. The amino acid, L-Glutamine, helps heal the lining of the GI tract, which is damaged by candida. 3. Probiotics, supplements containing billions of friendly bacteria (acidophilus, bifidus, and other friendly

bacteria) are a must. 4. The mineral Molybdenum prevents candida from going back and forth from the bud state to the hyphae state, keeping candida in its bud state. 5. Candida diet. Avoid all forms of sugar, yeast, bread, and anything fermented or aged. With the exception of mushrooms, all vegetables are fine, whether raw or cooked, as are beef, poultry, and fish. You can find yeast-free bread. You cannot be reductionistic in treating a chronic health problem, looking for the one and only cause. From this series of articles on alcoholism, you have seen how complex the causes of alcoholism are, and how comprehensive treatment must be. After reading about hypoglycemia and candida, you can see that there is overlap between these two problems, with candida worsening hypoglycemia. Together they gang up to cause chronic stress on the adrenal glands. Adrenal Exhaustion Chronic physical and mental/emotional stress hammer away at the adrenal glands. The stress of candida and hypoglycemia cause the adrenal glands to produce epinephrine and cortisol in response to each signal of stress. The adrenal glands are part of our fight-or-flight system. The pituitary gland is the master gland of the endocrine (hormone) system, and is part of a feedback loop with the adrenals. Cortisol and epinephrine mediate all the physiological reactions of the fight-or-flight response. The fightor-flight response evolved as an emergency survival mechanism. When the caveman was confronting a cave bear, the fight-or-flight chemistry kicked in, preparing him to either run for his life, or fight for survival. Our mind/body complex cannot tell the difference between the real threat to life of the cave bear, and the threat of an angry boss. Our bodies respond to all stress as if it were life threatening. The physiology of the fight-or-flight response includes: Glycogen breaks down into glucose so there is an instant release of ready energy. The heart pumps faster. All bodily functions not required for immediate survival shut down. Digestion stops. Blood vessels in your skin shut down, so that if you are injured in combat, bleeding will be minimized. However, blood pressure goes way up. The immune system temporarily weakens, as it is not needed to fight the cave bear. Sexual function also shuts down. Cortisol is the main stress hormone. It functions by: Increasing blood coagulation. Reducing inflammation and the immune response. Stimulating the brain and reducing sleep. Reducing insulin secretion by the pancreas. Increasing glucose production in the liver by breaking down glycogen.

Increasing blood sugar levels. To review: You have already read that increased blood sugar levels cause your pancreas to produce more and more insulin. Chronic blood sugar problems, namely hypoglycemia, cause the adrenal glands to work overtime to stabilize blood sugar. Many of us live in a state of frequent or constant stress. With the alcoholic, much of the adrenal stress is caused by physical factors. In the early phases of stress, the adrenals are pumped up, producing high levels of cortisol and epinephrine. Over the years, the adrenals cannot keep up with the stress and so the release of cortisol becomes erratic, with the adrenals releasing too much cortisol at certain times of the day, and too little at other times. You WILL BE exhausted when your adrenals are not producing enough cortisol. After many years of unrelenting stress (mental or physical), the adrenals give out, producing abnormally low levels of cortisol throughout the day. At this point, you become overwhelmed by stress, light, sound, emotion, and other stimuli. Social interactions that were once easy for you become challenging. We require cortisol to handle the normal stress of everyday challenges. This is healthy stress. Not all stress is bad. However, when cortisol levels drop to permanently low levels, once simple tasks become difficult. Focusing and concentrating on once simple tasks can become overwhelming. At this point, you are in adrenal exhaustion and you feel fatigued most of the time. Treating Adrenal Exhaustion Healing adrenal exhaustion is not easy, but here are some initial steps: 1. Practice meditation or relaxation techniques to decrease stress. 2. Take a multiple B Vitamin 2 to 3 times a day. Stress depletes B Vitamins. 3. Take the necessary steps to treat hypoglycemia and candida. By so doing, you will take an enormous stress off the adrenals. 4. Take the B Vitamin Pantothenic Acid to support adrenal function. 5. See your doctor and ask for an Adrenal-cortico stress test. This is a saliva test. 6. Your doctor may suggest that you take pregnenolone, the mother hormone for the adrenal gland, from which adrenal hormones are made. Pregnenolone is a safe hormone. 7. Your doctor may suggest taking DHEA in the range of 25 mg a day, to support the adrenal glands while they are resting and healing. 8. If you have normal blood pressure, you can take licorice root, which supports the adrenals as well as the lining of the GI tract. 9. Adrenal glandular extracts. 10. If you suffer crippling adrenal exhaustion, your doctor may recommend hydrocortisone (trade name: Cortef). Cortef should not be taken in doses greater than 15 mg a day, which is the amount your adrenals should be making. If you take too much Cortef, you will interfere with the adrenal-pituitary axis, and it will be difficult for your adrenals to recover.

Diagnosis and treatment of adrenal stress and exhaustion is complex. You want to look at all of the above recommendations as temporary solutions that give your adrenals a rest as well as the nutrients they need to recover. If you don't address issues of stress, both mental and physical, you won't give your adrenal glands a chance to recover. Adrenal exhaustion and candida have a great deal to do with intestinal health. And blood sugar chemistry (hypoglycemia) has a lot to do with adrenal exhaustion and candida. Full recovery from alcoholism requires a change in thinking. There are multiple causes of alcoholism. There are tremendous problems with brain chemistry that can be repaired. There are huge problems from head to toe that I call metabolic chaos. Hypoglycemia, candidiasis, adrenal exhaustion, and digestive problems are the major causes of metabolic chaos. All of these problems can be tested for, diagnosed, and treated. What is required for full recovery is a powerful commitment to change your life, your diet, and how you handle stress. You can also re-define what is really a stress for you. You can move out of the mind-set that alcoholism is an untreatable disease. You will need a good doctor, determination, understanding, and the willingness to go the distance until you achieve your level of optimal health. Do not let anyone determine or define what your highest level of functioning can be. Such labeling is usually destructive. It's your life. Go for broke, and realize that there is no false hope. To quote Bernie Siegel, There is only false no-hope. When you are ready, begin your climb out of a lifetime of metabolic problems to discover that a wealth of energy, peace of mind, physical strength and well-being is probably a reasonable dream to strive for. In the next issue, we will conclude this five-part series on alcoholism by examining psychological and spiritual issues. Alcoholism, Part 5 -- Reconnecting to Spirit By David Gersten, M.D. Over the past four issues, you have read, in detail about the metabolic chaos caused by alcoholism, and you have learned how it is possible to cure the alcoholic's defective brain chemistry as well as system-wide problems like hypoglycemia, candida, and adrenal exhaustion. You have clearly seen why alcoholism is a disease. We continue this series by looking at the essential need of the alcoholic to get spiritually re-connected. This article will focus on the long-term issues of recovery, but first we will briefly look at the obstacles to even beginning sobriety. The alcoholic's denial is a huge obstacle. He does not believe he has a problem. He is also an incredibly good liar, finding endless ways of proving to his family, friends, and himself that he does not have a drinking problem. He suffers from terminal uniqueness, the belief that, unlike all other drinkers, he can handle itor that the situation of his life is so unique, so different from anyone else's, that alcohol is a necessary part of his life. Those married to an alcoholic know that he is having an affair, an affair with a bottle. The spouse of an alcoholic knows that she comes second to alcohol. Alcohol is truly the object of love of the alcoholic, and he merges with his lover. Alcohol is woven into the fabric of the alcoholic's life, personality, and relationships. Given the comfort that alcohol provides, the alcoholic is a reluctant participant in his own recovery, and he is usually dragged kicking and screaming to get detoxed and begin on the path to recovery. I want to remind the reader about the biology of alcoholism. While there are powerful psychological issues that perpetuate the illness, the brain chemistry of the alcoholic drives him back to the bottle over and over

again, because alcohol mimics the effects of all major neurotransmitters. Alcohol and THIQs (created by alcohol) bind with receptor sites for the neurotransmitters GABA, serotonin, norepinephrine, endorphins, and more. When the alcoholic drinks, his brain thinks it is receiving GABA or serotonin, and so the craving to drink is very strong, as alcohol causes the brain to temporarily feel as if it has all the right neurotransmitters. The alcoholic is dealing with very powerful problems of biochemistry. The linchpin of alcoholic brain chemistry involves the neurotransmitter GABA (gamma amino butyric acid). Let's say, for example, that a man began drinking when he was 17 and stopped drinking when he was 37 years old. He is like a prisoner who has spent decades in jail. He has no clue how to live. However, the prisoner just released from prison has an advantage over the alcoholic, for he has had to learn, day-by-day, what coping skills will work best to keep him the happiest, safest, and most sane. He has had time to use his brain/mind to negotiate the difficult challenges of everyday life. The alcoholic has not developed any of the normal coping skills to deal with life's everyday stresses, and so he is emotionally raw and terrified in the face of dealing with anything. He has no tools at all. He has lived in a dream world for 20 years, amongst a fiction of lies he has told himself. When he begins to wake up, he asks himself, Who am I without alcohol? and he has no answer, for his entire identity has been entangled with alcohol. He asks himself, What is my purpose? Why am I here? and he has no answer, for he did not evolve a purpose the way others do. He is like a terrified child who is lost and abandoned, and he has lost his one source of love and consolation, namely the bottle. He has not developed inner mechanisms for healing old wounds. In essence he is facing a terrifying new world, and it does not look as good as the old world. And the promise of a better life without alcohol does not seem real and feels more like a cruel lieat least, especially when he is trying to give up alcohol, or even right after he has given it up. Alcoholism requires a profound re-connecting of the spirit, a discovery of one's relationship to God, and finding the serenity of one's own Self or Soul. It is not surprising that the incidence of atheism in adolescence is much higher among alcoholics than it is for non-alcoholics. For some reason, that has not yet been identified, large numbers of future alcoholics lose faith during adolescence. They lose faith in themselves, their ability to cope, and in the existence of a soul, God, or a Higher Power. After going through the trials and tribulations that finally lead to sobriety, he is face to face with his spiritual void. If he does not succeed in his spiritual quest, the risk of severe depression is quite high as is the risk of successful suicide. Alcoholics Anonymous (AA), the well-known 12-step program, is the best-developed program to help the alcoholic begin to reconnect at all levels. The whole purpose of AA is to put people in touch with God. However, the Big Book, as it is called, is often misused in alcohol treatment programs. I worked at Scripps MacDonald Center 's Drug and Alcohol Treatment program for many years and also worked at Mesa Vista Hospital 's drug and alcohol program. As with anything else, it is important to clarify that those who propagate a message or technique are not always as pure as the source. The Bible is a good example! All too often I saw drug/alcohol rehab counselors treating AA more like a dogmatic religion than what is actually contained and recommended in the Big Book. I was kicked off the staff at Scripps MacDonald Center by the medical director, for using mental imagery techniques. I decided to come on staff after interviewing with the medical director and letting him know what I do, so I was a bit shocked to be told to leave, after having made it clear how I practice. I had developed a series of mental imagery techniques that supported each of the 12 steps. Subsequently, the medical director was fired for reasons I will not go into here! (Notice my small grin here). Recently I spoke with a priest, who is a recovered alcoholic, who has worked in drug and alcohol rehab facilities, and who runs workshops with a Native American shaman. I gained greater clarity of the essence of the 12-steps, along with pitfalls on the road to recovery. Some of what follows comes out of my

discussion with him. The 12 Steps Step 1. We admitted we were powerless over alcoholthat our lives had become unmanageable. The short version: I can't. Step 2. Came to believe that a Power greater than ourselves could restore us to sanity. The short version: God can. Step 3. Made a decision to turn our will and our lives over to the care of God, as we understood Him. Short version: I will let God. The shorthand way of understanding the first three steps is: I can't. God can. I will let him. Steps 4 9 have to do with the causes that brought on and perpetuates alcoholism, and in making amends. Making amends involves more than saying, I am sorry. It involves taking action to correct wrongs done to others. For example, if you owe someone money, you make amends by setting up a payment plan to pay off the debt. The 12 steps intend to help the individual move from the small, ego-self, to an identification with one's inner essence, soul, atma, or spirit. The steps help people to get involved in helping others, to express gratitude, and to move out of the small mind, the selfish mind. Sobriety is different from being undrunk, and involves a metamorphosis, a spiritual transformation. The alcoholic who is truly on a healing journey moves from getting and forgetting to giving and forgiving. Every day he prays that his actions will not be driven by fear, greed, envy, or anger, but will be motivated by love, service, and gratitude. Each day the conscious, recovering alcoholic prays, Thy will, not my will. The alcoholic has been in a deep sleep for a very long time. Waking up is not easy, but a spiritual awakening is essential, for the body has been drugged, the mind poisoned, and the soul left to languish. Through the 12 steps, an individual begins to get in touch with God or a Higher Power and, over time, strives to deepen that connection. He also re-connects with family and friends at the level of love, rather than from the level of fear, addiction, lying, and manipulation. And he strives to quiet his mind to reconnect with Self. The Priest and the Shaman What role does the shaman play in the healing modality I am reviewing here? He is most concerned with helping the alcoholic re-connect with Mother Earth. The shaman teaches that the Earth does not belong to us, but we belong to the Earth. The shaman teaches that every breath is the breath of God, and that by simply becoming aware, present, and expressing gratitude to the elements of Mother Earth, one can become more fully re-connected. If we don't realize that our connection to the Earth is essential and that in alcoholism we have become disconnected from everything, total healing will not occur. The alcoholic, as well as the rest of us in the West, have lost our grounding and our ability to live in the Now and simply being present with what is. All of us in the West, as part of our disconnect from Mother Earth, have become disconnected from natural, deep breathing. If you consider that the word inspire means to breathe as well as to be spiritually elevated, you can appreciate the importance of our disconnection from Mother Earth and natural breathing that is part of a solid connection to Her. No matter how you look at it, alcoholic recovery requires that one become free of the mind. There are endless techniques to help one become free of the mind, to quiet the mind, to find an inner stillness. It is not the point of this article to elaborate on techniques, but to underscore what is required for recovery.

The spiritual quest does not end after 5, 10, or 20 years of sobriety. It is a life-long process, which reaches fruition when life becomes a prayer. And, as outlined in past issues, alcoholic biochemistry does not selfcorrect. After ten years of sobriety, the underlying biochemical problems that gave rise to alcoholism and that became ingrained through years of drinking must be healed through comprehensive nutritional supplementation. When this task is accomplished, one no longer has alcoholic biochemistry. Being sound in body and mind makes spiritual work much easier. The alcoholic learns, through AA, to live one day at a time. That is all any of us can do. We will evolve more quickly if we live one moment at a time, learning to surrender to and accept what IS in each and every moment. When we bring conscious awareness to what is going on in our body, mind, and spiritin this moment, profound shifts in consciousness occur. Spiritual re-connection occurs at levels we never dreamt possible. Living life through a bottle is a life of limitation. Living a sober life, in which we fully experience each moment, is a life of peace, joy, and truly limitless possibilities. Spiritual re-connection is its own goal. While sobriety is the result of this re-connection to God, Self, and Nature, spiritual reconnection in-an-of-itself is the ultimate goal. Alcoholism, Part 6-- Surrender By David Gersten, M.D. During my years working in hospital-based alcohol rehabilitation centers, I was frequently struck by the profound misunderstanding of the t erm surrender as it is spoken of in the 3 rd of the 12 steps, in which one surrenders to a higher power. I would grow a bit queasy when a patient in treatment would tell me they had surrendered to their higher power today. Surrender is not something you accomplish in one day and are then done with it. It is a process that goes on throughout one's life. In AA, surrender means that we allow God or a Higher Power to begin to run our lives, and that we try to align ourselves with God's will, rather than the will of our ego-mind. This is a useful way of looking at surrender for a novice, but is shortsighted. Surrendering to the moment, means, becoming fully aware of one's inner and outer worldand accepting everything exactly as it is. It means that everything in this moment is perfect. It does not mean that we can become passive and Let God do everything. Surrender is not un-like The Tao, which means the way . . . and more. The Tao implies that everything in this moment is perfect and that striving is not required. Acceptance of what ISis what is requiredbut even to use the word required misses the point a bit. The Tao, the way of non-striving, the sense that everything in this very moment is okay and perfect, requires nothing. Surrender also means, Seeing and accepting truth. But in the Western World, we are conditioned to think that surrender means giving up. So, many people will have trouble with the idea of surrender, feeling that they are losing a battle. It is important to point out a major difference between Western and Eastern spirituality. In all three major Western religions, there is a God or Higher Power to surrender to. That is the highest truth in the West. Eastern spirituality teaches that man and God are made of the same stuff, that God is the ocean and each of our individual souls is a river, which will eventually merge back into that ocean. Another way to say it is that each of us is a small spark of the divine, and the divine is an infinite flame. Ramana Maharshi was/is one of the best teachers regarding the discovery of our true nature. If, for example, someone asked Ramana Maharshi how to deal with a child with severe illness (or any problem at all), Maharshi would answer, Who wants to know? Who is asking the question? Your body is not asking the question. Your mind is not asking the question. Who is the I' that is asking the question? Maharshi's goal was to help bring the student or spiritual seeker to the conclusion that the I asking the question was the source, the core, the soul of the individual . . . and that when one realizes that one IS the soul, all questions are answered. By the way, this is a tough path to enlightenment!

In Eastern spirituality, the idea of separateness is considered to be an illusion. Anyone who has had a mystical experience knows that separateness is an illusion, and that unity is reality. According to a recent Gallup poll, 43 percent of Americans have had an unusual spiritual experience and 15 percent of us have had a near-death experience. Both of these are experiences in which one experiences the unity of all things, and feels one's Self merge with God or Nature. In these experiences we do not feel different than, or separate from God. This philosophy and way of living definitely ruffles some Western theological feathers. You can easily imagine a fundamentalist of any Western religion saying, How dare you say that you are God, that your nature is God, that you are the same as God. Whether one is attempting to surrender in a Western way or an Eastern way, one is trying to answer the question, Who am I? and the answers are slightly different between East and West. However, the overall notion that we are spiritual beings does not need interpretation. East and West agree on the need to connect with and identify ourselves with Source. In a sense, the difference in perspective between East and West is academic. The spiritual aspirant of the East, especially Hinduism, begins by identifying a God or Higher Power, and then does his best to surrender to that Higher Power. His goal is ultimately to become one with God . . . but that is no small task and may take a lifetime of spiritual work to attain. So, in a more down-toearth way of looking at things, East and West are not so far apart. All of us are (hopefully) trying to surrender to something greater than ourselves (our small ego-self). Perhaps the Native Americans can serve as a meeting place between East and West. The Lakota phrase, Mitakuye O'Yasin, which literally means all my kin really means that all beings are part of an interconnected web of life. Each of us is part of that web, connected to all other beings and to Mother Earth. When one embraces Mitakuye O'Yasin on a daily basis, one's recovery is ongoing. One's spiritual progress is ongoing. Eventually, one sees that there is nowhere to run, and nowhere to hideand surrender really means accepting the reality of our interconnectedness. Alcoholism and Mysticism One might assume after what you have read that a serious commitment to spiritual growth and transformation will be an enormous aid in recovering from alcoholism. And you might think that the drunk alcoholic is lacking in spiritual experience. As with everything in life, the issue is not quite so cut and dried. Many alcoholics drink in order to quiet their mind, and when their mind is quiet, they may have experiences of Self and God. This is not a popular thing to say, but it is what many alcoholics report. It is not a false God they are finding in a bottle. Rather, they are able to experience God and even have genuine mystical experiences while drunk because their mind has been set aside and the soul is allowed to emerge. The goal of recovery is obviously to help the alcoholic have an experience of his Source and God without the aid of alcohol, experiencing the joy and bliss without the destruction of life that alcohol causes. The alcoholic needs to learn that what he has found in a bottle is something that has always resided deep within, and that by re-connecting to his soul, he will become whole and will require no external drug or stimuli to feel connected. I have run across another interesting connection between alcoholism, mystical experience, and psychic abilities. Some people who have psychic gifts or healing abilities are frightened of them and bury them with alcohol. For such people, recovery and sobriety can lead to an unexpected eruption of powerful spiritual and paranormal experience. The best example I know is a nurse, whom I'll call Tina, who works in one of the local hospitals. In her sobriety she was deluged with paranormal phenomena. It was something she had to get used to. Here is one example of her psychic abilities. Nurses give report at the change of shift. One nurse talks and another takes notes. Lisa would be taking report, taking notes, while the other nurse gave report. At times, Tina would keep writing after the reporting nurse had briefly stopped talking. The other nurse would look at her and ask what she was doing and what she was writing. What Tina was writing were the next words the other nurse was about to say, and Tina usually heard those words in advance of their being spoken. She heard the words as clearly as those spoken through ordinary means, and

was not able to tell the difference between words she heard from the lips and those that came straight from the other nurse's mind. Tina did verify with the reporting nurse that what she heard and wrote were, in fact, the exact words the other nurse was about to say. Her level of empathy reached extraordinary proportions. She might be in an elevator and suddenly experience crushing pain in her left leg. She would slowly look around the elevator and notice a man with a cast on his left leg. She experienced the pain of people from across the streeteven the pain of trees being cut down. She also developed, rather suddenly, the ability to heal with her hands. I remember on one occasion, showing some nurses at Mesa Vista Hospital , a piece of hematite I carried around. Hematite is a shiny, silver-colored stone that is dense and heavy. The stone I carried with me was egg-shaped and less than an inch long. Several of the nurses held the stone and then passed it to Lisa. When Lisa handed it back to me, it was about 30 degrees hotter than it had been. I asked, Lisa, what did you do to this stone? It is so hot I can hardly hold it. She just laughed and said, Oh, I transferred some energy into it. She went on to explain that earlier in the day she had cured another nurse with a lesion on her face. Lisa simply placed a finger on the lesion and a minute later, the lesion had disappeared. Lisa is unusual, but it is important to be aware of the unusual. Her story shows how alcohol can suppress latent psychic and healing abilities, and how those can erupt very quickly once alcohol is out of the system. Like other alcoholics, Lisa had to learn normal coping skills. She also had to quickly learn how to deal with an explosion in her consciousness that was giving rise to paranormal abilities and mystical experiences. Alcoholism: Medical Disease or Spiritual Disease? The first four parts of this series dealt with alcoholism as a physical disease. Now you read about alcoholism as a spiritual dilemma. The answer is not either-or. Alcoholism involves problems at the level of the body, mind, and spirit. You will lose the essence of what I have been writing if you think strictly in a linear way. You may ask, Well, which is more importantthe physical disease or the spiritual disconnection? Western medicine only works in this linear, analytical fashion. I suggest trying to hold all of these elements in your mind at the same time, and, rather than looking for a simple answer to complex problems, look for what is practical. What is practical is to address body, mind, and spiritand don't let theories get in the way of what works. Now, here are some ways of looking at the relationships between body/mind and spirit. As a rule, consciousness precedes manifestation in the physical world. In the beginning there was nothing except for pure consciousness, formless God. From pure consciousness, physical form, the physical Universe, emerged. A similar principle is involved within each of our lives. We may work hard at spiritual growth for years and not see any positive, tangible thing happening in the external world. What is happening is that your spiritual work is transforming and elevating your consciousness. When consciousness has hit critical mass, or a critical level, those changes in consciousness will manifest in the physical world. Let's look at the implications this idea has for the alcoholic. Using the AA model, recovery is essentially a plan to re-connect spiritually and raise consciousness. On a mental and physical level, the non-drinking alcoholic may feel miserable for a long time and may crave alcohol for a very long time. Unknown to him is the fact that the gradual shift in consciousness will transform his life. Ultimately the elevation in consciousness will manifest on the physical plane as love, peace of mind, focus, purpose, and a healthier mind and body. Now, let's look at these relationships from the other direction. While spiritual re-connection is essential, it will not, in-and-of-itself, correct brain chemistry, hypoglycemia, adrenal exhaustion, and systemic candida. By repairing the metabolic chaos, you will eventually cease to have alcoholic chemistry, which, in some ways means that you are no longer alcoholic. I know that last statement can be interpreted as heresybut I do believe in the word cure. By curing your alcoholic biochemistry, you will feel better. Your body will be stronger and more vital.

Your mind will have greater focus, concentration, and memory capacity and your moods will stabilize. This will occur by repairing brain chemistry and total body metabolism. When you feel healthy, spiritual work becomes much easier. When you have a brain capable of concentrating for long periods, meditation, contemplation, and prayer become much easier. It is terribly difficult to remember and practice what you should be doing spiritually when you feel miserable. You don't feel miserable just because you are spiritually disconnected. You also feel miserable because of the metabolic chaos. A brief example. I have treated a great number of people with CFS/ME. I struggled with a near-fatal case of CFS/ME for nearly ten years, starting in 1984. Do you know what kind of spiritual work you can do in that state? Very little. I recall that all I could do was hang onto God for dear life. That is all I had to hang onto. I certainly could not meditate, do yoga, or any of 50 spiritual disciplines I practice. If you can imagine God with feet, all I could do was imagine that I was hanging on to those feet, and just going for the ride. It was a terrible and terrifying ride, but without a brain that worked, there wasn't anything else I could do. For the alcoholic, and for all of you, try to remember that surrender means, accepting what IS. It means, trying to live with faith and trust even during the dark night of the soul, even when it looks like nothing is working and that there is no help. And how do you get to faith. You get to faith through a leap of faith. Most of all remember that there are no hopeless situations, and remember to be very kind to yourself on your healing journey. I can tell you to re-connect spiritually, learn to surrender, trust, and have faith, and you might be thinking, Go to hell, Dr. Gersten. You don't know how this feels. But that's where you're wrong. I do know how it feels, and I know that only you can carve out your healing path. No one else can take the steps for you. And if God really is running the show, then your recovery is going to take as long as it takes in God's time, which is never our time. God certainly does not agree to my time requirements ever! Try to accept the current moment, knowing that healing occurs moment by moment, and that, if you allow yourself to fully experience this moment, you will discover that This Moment is okay. Then you can move on to the next moment. By becoming more and more present, you will re-connect on all levelsbut it will not occur at any timetable determined by me, AA, or anyone else. This one is between you and God. Best of luck on your life journey of spiritual re-connection.