Dr. Peter D'Adamo: Personalized Healing

Science is fact-based, but scientists can sometimes be charmingly naïve. One of the most common ways they display this naiveté is the coining of politically correct euphemisms. So, instead of the negatively charged term “race” you sometimes see the phrase “mutually inbred ancestral groups” which, at least to me, sounds even worse.

Despite the gloss, we at least now have a framework to allow us to collect and categorize those genes and polymorphisms that show different frequencies between races.

Called “Ancestry-Informative Markers” (AIM) this category of genes includes blood groups, markers of pigmentation and other SNPs that distinguish between races but don’t always result in some visually detectable difference. A collection of AIMs that distinguish African and European populations contains over 3000 highly differentiated SNPs. An example of an AIM gene is called “Duffy” and it codes for the Duffy blood group. A variant codes for a Duffy blood group type (Duffy Null allele) that is found 100% of Sub-Saharan Africans, but occurs very infrequently in other races. Interestingly, like some of the hemoglobins, this variant has been known to provide some resistance to malaria infection.

Looks like it’s time for another one of my semi-autobiographical digressions.

By the mid 1970’s I had completed the required college level classes to allow my application to a college of naturopathic medicine, since by then I had determined to follow in the footsteps of my father and enter this (at the time) obscure and curious profession. This was a time of great difficulties for this tiny healing art; more naturopaths were retiring and dying than entering the schools, and the future of the profession indeed looked rather bleak. There were tiny glimpses of hope however at least in the one remaining school, where the “Old Guard”--most often gentlemen who had learned their trade in the 1920’s and 30’s—- were giving way to “Young Turks”; aging hippies and other political rejects from the 1960’s. Unfortunately this was not at all harmonious, and at the time I was to apply we heard that the school was in uproar, as one faction or another had locked it opposite out, changed the locks, kidnapped the files –you name it.

So instead, we looked across the Atlantic, to The British College of Naturopathy and Osteopathy, and upon acceptance, I duly relocated to the “Post-Swinging London” of the late 1970’s, which as it turned out was in a rather downtrodden phase, with escalating energy prices, joblessness and at times civil unrest. This was the era of the “Urban Punk” and “Anarchy in the UK”. One only had to look around to see heart-wrenching tableaus of its more hypocritical aspects: Homeless folks sleeping against under banners proclaiming the Queen’s Silver Jubilee.

Jobs were scarce, and as a foreign student, it would have been virtually impossible to get the few that were available. I had a small stipend, and made a “few quid” doing some odd jobs. Nonetheless the dire economic circumstances forced a series of relocations, each typically one level further down the social level than the one prior. Yet these were happy times, with great friendships and new experiences, more so when I landed at the charming London neighborhood of East Finchley, a quiet suburban backwater about five miles from London City Center.

Again, as long before, a pleasant and affluent suburb, East Finchley in 1977 was the infrastructure and architectural equivalent of a visit to an eccentric, wealthy, emphysemic great-aunt. While sipping tea and hearing of the “old days” you might gaze upon the fine wood details of the hand made furniture or the anonymous faces in the dulled and dusty photographs on the wall, often in the poses of stern solidity or in an exuberant moment of victory. It would seem that only the passage of time could dull the greatness of all that past glory.

If Great Britain was at its mercantile and military zenith by the beginning of the 20th century, even more so was its pre-eminence in the rapidly growing fields of genetics, statistics and evolutionary biology. In 1890, at the pinnacle of the gilded greatness that was Victorian England, doughty old East Finchley witnessed the birth of one the greatest of her sons, a man who in the words of a one historian was a “genius who almost single-handedly created the foundations for modern statistical science.” His name was Ronald Aylmer Fisher.

The son of a successful businessman, Fisher was had a precocious intellect, and because of his poor eyesight learned mathematics without the use of paper and pen; leading to a marvelous ability to visualize problems in geometrical terms, and to forever frustrating both teachers and students by being able to produce mathematical results without setting down the intermediate steps.

Fisher published an important paper in 1918 in which he used powerful statistical tools to reconcile what had been apparent inconsistencies between Charles Darwin's ideas of natural selection and the recently rediscovered experiments of the Gregor Mendel. Among many and varied later accomplishments, it was this singular achievement that gave birth to modern evolutionary science. This was completed with the publication of The Genetical Theory of Natural Selection in 1930.

In 1943 Fisher accepted the Chair of Genetics at Cambridge University. Photographs invariably show a bearded, white haired, bespectacled man, with very thick glasses owing to his extreme myopia. More often that not, a billowing pipe accompanies the picture. He was addicted to the crossword puzzles of the London Times, which in characteristic fashion he filled in only those letters where the words crossed each other. His eccentricities, termed by his student “Fisherania,” though sometimes embarrassing, where more often the source of great entertainment to his friends.

Johann Wolfgang von Goethe wrote that “Certain flaws are necessary for the whole. It would seem strange if old friends lacked certain quirks.” Certainly Fisher had his flaws. He was an early and enthusiastic proponent of Eugenics, a social theory advocating the improvement of human hereditary traits through various forms of intervention, including sterilization, prenatal testing and screening, genetic counseling, birth control. Fisher was also opposed to the developing argument that smoking caused lung cancer, partially due to his dislike and mistrust of Puritanism and perhaps also due to the solace he had always found in his pipe.

Although he would rapidly wash his hands of the more dunderheaded students, Fisher was a inspirational mentor to his acolytes, many of who would go on to stellar careers of their own in the field of genetics, statistics and anthropology. These ranks included the previously mentioned A.E Mourant, who did work with Fisher on the epidemiology of Rh blood group genetics; Robert Race and Ruth Sanger (who my friend Gerhard Uhlenbruck once described as 'Being married-- but to other people.') themselves later on co-authored an acclaimed textbook on blood groups; A.W.F. Edwards and Luca Cavalli-Sforza, who studied the “relatedness” among various population groups.

Although just about everyone knows something about DNA, I’d like to take a few moments to introduce you to RNA, the real power behind the throne.

Protein represents what biologists call phenotype – the living, breathing, metabolizing part of life. DNA is information. Other than acting as a blueprint and occasionally remembering to replicate itself, it doesn’t have a single real world obligation. It is RNA that acts as the bridge between DNA and protein, translating the message of DNA into the reality of proteins. All the basic functions of the cell require RNA. Copies of the desired DNA gene message are first copied onto one type of RNA, which is then read by a machine composed in part by some more RNA to create proteins by linking amino acids which are delivered by another type of RNA.

Let’s start the second part of our story with the sweet, if short life of Messenger RNA, or mRNA.

At a certain point in its life, the cell may get an urge to make some sort of protein or enzyme. Let’s say that you have developed an untidy habit, like smoking cigars. As anyone who has ever tried one can tell you, the first experience with nicotine is usually far from pleasant, with dizziness and nausea the usual end result. This reaction occurs because the new smoker has yet to habituate himself to the poisons in the cigar and has not yet developed a way to detoxify and break them down. Over time the continued smoking of cigars sends an environmental message to cells of the liver telling them that they need to make higher levels of the enzymes used to detoxify tobacco toxins. This message (“hey, he’s trying to kill us out there!”) travels to the cell nucleus, where special machinery locates the section along the DNA that contains the gene to produce these detoxifying enzymes, snips it open and unravels that part of the DNA to expose the blueprint.

At that point an enzyme called RNA polymerase comes along, reads the DNA code and makes an RNA copy by linking together similar building blocks (a stretch of RNA is similar to DNA except that RNA is almost always single-stranded and uses the nucleotide Uracil instead of Thymine). This is called “transcription” and just like a court stenographer transcribes the court proceedings, so RNA transcripts the proceeding necessary to make a protein. The RNA strand, called Messenger RNA, (mRNA) is then extensively primped and tweaked to clean it up and get it just right. From here it is about to embark on the ride of its life.

Once everything is set to go, the mRNA is shot through the one of the many pores which act as gates between the cell body and the nucleus. Once out into the cell proper it is carried to the real workhorses of protein synthesis, the ribosomes. Using a railroad analogy, you can think of a ribosome as a dispatcher in the rail yard, whose job it is to assemble an entire freight train. Each time the phone rings the dispatcher gets his next order:

“Fetch the Baltimore and Ohio flatbed with the Honda Hybrids on it. Attach it to the Union Pacific 3985 locomotive.”

“Next, locate and attach the milk tanker from Happy Cow Farms.”

And on and on, until you have one of those interminably long freight trains that take twenty minutes to pass by the railroad crossing as you desperately try to get to the airport.

Just like our rail dispatcher, ribosomes get the information from messenger RNA, by zipping along the code like an old fashioned ticker-tape, reading the code called 'codon triplets' to determine which amino acid to fetch, then linking that amino acid to the prior one, and fetching the next instruction, etc. until it gets a stop message.

In this job the ribosome is assisted by a different type of RNA called Transfer RNA which acts like a crusty old rail yard worker, bringing the appropriate amino acid to the ribosome. At some point the protein is finished up and released, and the messenger RNA decomposes back to the basic building blocks of DNA and RNA, called nucleotides, and ready to do it all over again.

From there the sky is the limit. Proteins are interesting in a lot of ways but perhaps most interesting in their folding tendencies, a molecular origami if you will. Depending on the amino acid sequence and length proteins will fold into a myriad number of complex three dimensional shapes, and it is these shapes that give them their unique powers over the environment.

For example a protein of a certain shape may function as an enzyme, taking sugar molecules and attaching them together, turning single sugars onto cellulose, an important dietary fiber. The protein that results from our string of amino acids might be an insulin molecule, helping to control the owner’s blood sugar, or even a protein that helps DNA do its job, perhaps even part of another ribosome!

As I said, the sky is the limit.

The RNA Queen is so basic to life that many scientists think that perhaps life originated with it, and not with DNA: That DNA came along later as a way to 'memorialize' the work of RNA.

This is the time of our lives. The past may have been better or worse on one level of another, but hey, the past is past. 'Create each day anew' wrote Morihei Ueshiba, the founder of Aikido, in the Art of Peace.

Is today going to be a success or failure? Only I can decide. However, if I carry the trials and tribulations of yesterday with me, what possible outcome can I expect? Many people have written me over the years, depressed and angry because they seem to fail again and again at following the diet.

Well, I need go no further than look at my own failures to know what at least works for me.

The trick to surviving failure is to refuse to be disillusioned by it. It is this gradual effect of disillusionment ('retreat after defeat') that saps the will and prevents us from enduring to the end in order to triumph over our challenges.

The first step in mastering this process is the least obvious. Don't make the mistake of degrading your failures by stripping them of their spiritual value. The ability to learn from mistakes and shortcomings is the most powerful stimulant to success that I know of.

It is also why most successful people are actually experts in failure.

Failures are always so much more interesting than successes from an analytical viewpoint, and it is a shame that our society encourages us to run away from them, feel embarrassed by them, or sweep them under the rug.

If you look at the origin of the word 'Aikido' it derives from the phrase 'the way of Aiki.'

Aiki is a blending and harmonizing energy, the perfect example of which is the so-called 'Tenkan Step', which is an entrance into your attacker that involves a step to the outside of his body and 180 degree turn and stepping back once again. What this does is place you shoulder-to-shoulder alongside your attacker so, for that instant in time, you both look out at the world from the same perspective and viewpoint.

Try giving a 'failure' the Tenkan step. Interesting things may happen.

The last few weeks in the clinic have continued to keep the old spark going. How much better I enjoy practicing by myself! No rush, no big administration hassles, no egos to stroke. Just patients and health problems. In prior times it seemed I'd almost forgotten why I went into this profession! In future blogs I'll spend some time detailing a few of the more interesting case histories since I do seem to be seeing quite a few interesting cases these days.

I've been joined by my friend, Dr. Ginger Nash, who has really brought a nice energy into the practice. We've decided to rename the clinic The NE Center for Personalized Medicine (from the prior 'D'Adamo Clinic') to hopefully get the message out there that this concept is bigger than any one person.

I meet this afternoon with the administration and faculty of the naturopathic college at the University of Bridgeport to lay the the groundwork for my Personalized Medicine shift in the UB Naturopathic Clinic. I'm very excited about this as I love teaching and as the UB clinic serves a somewhat underprivileged section of society, I'm psyched to put resources like SWAMI GenoType into the hands of people who really need the help.

If you are interested in becoming a patient of the Personalized Medicine Clinic Shift, contact the Health Sciences Center at UB for more information. This may be an especially good option for folks who are on a limited income as the total fees for the visit are very reasonable ($45 base charge plus $125 surcharge for all testing and materials). Of course it is a teaching environment, so you'll have students in the room, but as clients of my own clinic soon learn, much more information floats through the air when I've got to explain each and every aspect of my thoughts and plans.

I recently did an interview with the Association of Accredited Naturopathic Medical Colleges for their newsletter and website. Although they did excise some of my more pithy remarks, I think it is still a pretty good reflection af where my head is nowadays about health and natural medicine.

The last few weeks have been devoted to finishing up the SWAMI GenoType and SWAMI Xpress programs, working on my 1971 VW Westfalia restoration, and trying to fins time to get out and sail a bit, though the weather this spring and summer has been 'wet' to say the least.

It is a constant source of amazement that this website continues to be graced by the generous efforts of others. To all of you who have given so freely of your time, creativity and energy over these last ten years, I thank you.

Had a rather relaxing week in Jamaica. Beautiful weather and friendly people. It was nice to just sit around a pool and read something besides computer or medical textbooks. I confined my reading to mostly ancient history.

Since being back I've be messing around with Facebook, the social networking website that everybody seems to be on nowadays. I think it is much better than MySpace, since it does not allow you to alter the appearance of your pages all that much. I always found MySpace rather unsettling, what with all the blaring colors, poor quality videos and music on people's sites: most of which I prefer not to see nor hear.

When Facebook does allow you alter stuff, it is mostly in the form of applications ('Facebook Aps') which run inside of Facebook. Programming these applications can be perplexing, since Facebook uses may proprietary pseudo-languages and interfaces -and the documentation can be spare at times.

If anyone has been to my Facebook page recently, they'll already know this, but for those who have not, my first application called 'Is it right for your blood type?' is now up and running.

Here is the link

Of course, you'll have to be on Facebook to use it, but they make it very easy to join and it is a rather safe place overall.

The app is based on the TypeBase Program on this website, but also allowing you to search by foods (soy, celery, beef, etc.). You can add the app to your profile sidebar which then allows others to join and use it as well.

Like golf, learning new computer languages is occasioned by a rather irksome awkward stage, but I think I'm finally heading out of it. if you do use the app and find a bug please drop me a line and let me know.

In addition to the Facebook work this morning was spent doing a half-hour interview for Singapore radio with a charming young host. While on the radio I opened some recent mail and was pleased to receive three spanking new copies of the 'Allergies' book, which has just been translated into Arabic. It is wonderful to marvel at just how global this eating philosophy has become.

As is typical of this time of year, it’s been a very active time for your humble physician-author-blogger.

January started off with a whirlwind visit out to Arizona for a daylong presentation to the Arizona Naturopathic Medical Association. This was followed by a two week intensive period of website redesign, overhauling the website of The D’Adamo Clinic in addition to the navigation system for North American Pharmacal. The Clinic website is a simple white design that I like very much and it conveys what being inside the Clinic feels like to me. I’m not normally a fan of all-white walls, but in the Clinic it works.

The NAP redesign was much more challenging. Here the issue was to present a myriad of different links and categories in a way that did not alienate or confuse visitors. I had long admired the witty way that Apple uses to showcase their Mac computers, but was unaware of anyone other than Apple who used this widget. I suspected that the bright folks over there had conjured this up themselves. Googling around the Internet, I found a lot of threads speculating on how they did it, but no one seemed to have done it. My chance came when someone mentioned that Apple appeared to have built the showcase around a package of free JavaScript libraries called ‘Scriptilicious.’ After downloading and studying these scripts it became evident just how they did it. I’ll spare you the gory details, but it turns out that Apple did make a small coding mistake on their site, which, if you notice, prohibits them from using bulleted text on pages that use the product showcase. Maybe I’ll email them and alert them to this.

One problem you come across again and again when you program for the Internet is cross-browser support. I’ve learned the hard way that a web page that works and looks good in Firefox for the Mac may not necessarily look or work the same way in Internet Explorer for Windows. Many, many times it’s been a last minute check on an outdated browser running Windows 95 that kiboshed a terrific idea.

Putting the final touches on the SWAMI software. I’ve decided to port it to two platforms. One will be the traditional SWAMI GenoType for professionals, the other will be a SWAMI Xpress that will be available online. Introduction of the SWAMIGenoType will be linked to the IfHI 2009 Conference, where Tom Greenfield, Natalie Colicci and I will have the time to take the attendees through the interface, filters and matrices. If you are a physician or IFHI certified educator planning to use SWAMI GenoType in your practice, you’ll need to attend IfHI 2009 to get the full training.

SWAMI Xpress will contain all the base programs of his more muscular brother, but is being designed for general-purpose use. SWAMI GenoType has advanced filters and controls that allow a physician to exert complete control over the client diet and is geared to practitioners who want to have a more micrometric control over things. Introduction of SWAMI Xpress will be as part of NAP’s “Do It For A Month” program.

On the lecture horizon, I’ve got a webinar with the Massachusetts College of Pharmacy on March 31 and an upcoming Grand Rounds presentation at the University of Bridgeport College of Naturopathic Medicine on February 11. After that things calm down until the IfHI 2009 Conference June 5. IfHI should be challenging. I’ve scheduled myself for something like 9 hours of lecture time, and if you could believe it I’m stressing out about not having enough time to do justice to the material. Figured out how to control my slide show from an iPhone, which is very cool. I should be able to pace around the room and use the iPhone to cue the next slide.

After completing a few movies/animations I’ll be pretty much done preparing material for the conference, leaving plenty of time to perfect the software and get the 1971 VW Camper ready.

Got lucky yesterday. Found a site that had the entire LP of the 1974 classic The Portsmouth Sinfonia Plays The Popular Classics available as a download. I certainly don’t support intellectual property theft but this album has never made it to CD and I think the original record label is now extinct. The Portsmouth Sinfonia is the ultimate ode to amateurism: Take a bunch of English art school students --who either cannot play a musical instrument or are willing to play one they are unfamiliar with-- and put them into an orchestra. The only rules being that you had to come to rehearsal and you could not purposely play the wrong notes.

What resulted were renditions of the popular classics (Peer Gynt Suite, The Blue Danube Waltz, The William Tell Overture, etc) in which the inexperience and lack of talent produces a series of acoustic near-misses that collect into this cloud-like approximation of what the proper pitch and notes should sound like. Popular classics were selected on purpose since everyone in the orchestra would know the music and could at least aspire to what the piece should resemble--or at the very minimum whether they should be sounding higher or lower pitched notes.

Here is their rendition of Blue Danube Waltz, Op. 314 (Johann Strauss)

Beethoven was supposedly fond of listening to amateur productions of his work, and I’ve often thought that this would be among the most perfect of medical education paradigms.