How to get rid of rosacea

How to get rid of rosacea

Rosacea is a common skin disorder that manifests as a red spotty rash typically found on the face, including the forehead, chin, nose and cheeks, but can also affect other regions of the body such as the eyes, chest and back. Sometimes referred to as the “adult acne”, rosacea is more common during middle age and is three times more likely to affect women. Although a specific cause has not yet been elucidated, rosacea has been linked to a variety of factors including chronic infection, poor digestion, improper diet, medication side-effects, and lifestyle factors. Chronic cases of rosacea often manifest as small bumps and pustules along with a generalized increase in local redness, often accompanied by red eyes, as well as burning or stinging sensations. If left untreated, chronic rosacea can lead to telangiectasia (dilation of superficial blood vessels on the face) as well as rhinophyma, in which the nose gradually becomes bulbous and red from chronic inflammation. There is also evidence that rosacea can lead to the development of basal cell carcinoma.

Over the last 20 years of practice, I have treated rosacea many times, but earlier in my career, I found myself struggling to get results. In Ayurveda, rosacea has all the characteristics and qualities of a pitta disorder, which is more or less synonymous with a state of chronic inflammation. Over the years, however, I found that the typical pitta-reducing treatments didn’t always have a positive effect. Similar to the typical recommendations, I had patients avoid spicy foods and potential irritants like coffee and alcohol, as well as hot weather, excess sunlight, and temperature extremes, in conjunction with an antiinflammatory diet and herbs. In some cases this approach was sufficient, but there were still patients that weren’t completely better. Unsatisfied with these results, I continued to look for better ways to address the condition. Although I don’t have a magic wand to make rosacea disappear, through experimentation and practice, I have been able to come up with some very useful measures that can be used to resolve rosacea permanently.


The human microbiome

If it isn’t perfectly clear by now, we humans are not autonomous organisms separate from nature. We exist as part of the ecology, and likewise, each of us maintains our own microbiome: a collection of micro-organisms that we originally acquired at birth that has grown and evolved to become a highly intimate part of our body. Our skin in particular contains an enormous diversity of microbes, with about 1000 different species of bacteria including the Propionibacteria that play a role in teenage acne, Corynebacteria that can cause diptheria, Staphylococci that are frequent causes of skin infections, and Lactobacillus, which is commonly used as a probiotic supplement. Not just bacteria, however, our skin plays host to a diversity of other organisms including fungi such as Candida that cause yeast infections, and Trichophyton species that cause athlete’s foot and jock itch. Understanding the complexity of the human microbiome is key in the treatment of many diseases, and no less so in rosacea, particularly considering the research which suggests that disturbances or alterations in the human microbiome can result in inflammatory skin disorders. For example, Helicobacter pylori is a bacterial pathogen commonly implicated in peptic ulcer disease, but some research is showing that this pathogen may also play a role in rosacea (1). This is an interesting finding, because it supports an age-old assertion in traditional medicine that what is happening in the skin can be a reflection of what’s happening in the gut. In a similar fashion, researchers have linked a condition called Small Intestine Bacterial Overgrowth (SIBO) to rosacea, demonstrating that when the antibiotic rifaximin is used to eliminate the bacterial pathogens from the small intestine, a significant proportion of patients with rosacea note an improvement in their condition (2).

Demodex mites in situ; isolated Demodex folliculorum specimen

Demodex: arthropods in your skin

Apart from the issue of gut health, it has been suspected for a number of years that rosacea could be the result of an infection with a tiny parasitic mite called Demodex (D. folliculorum, D. brevis). Although a normal part of the human microbiome, when the right factors are present, the population of Demodex can increase, resulting in an inflammatory reaction in the skin from both bites as well as the feces produced by the mites (3). Demodex in particular, thrives on the waxy sebum secreted by our skin, and when temperatures increase in the spring and summer, we produce more sebum, facilitating the growth of Demodex. This explains why rosacea seems to get worse with sun exposure or an increase in temperature. However, this association doesn’t explain why oily-skinned teenagers tend not to get rosacea, why rosacea seems to increase in prevalence with age, and why it is often associated with dry skin. One suggestion is that as we age, the skin becomes more dry, fragile and brittle, providing more opportunity and surface area for the Demodex mite to thrive (4). Certainly we see this same dynamic in other skin infections, such as toenail fungus, which grows into the cracks and fissures of aging, dehydrated skin. Likewise, it has been suggested that altered fat metabolism as we age results in the production of sebum and other factors that encourage the growth of Demodex. Thus, ensuring that the skin is properly hydrated is a key element in the treatment of rosacea, as is ensuring a proper balance of essential fatty acids in the diet, as well as promoting proper fat digestion. The key to getting rid of Demodex, however, is to take measures to restore digestion and the gut ecology, and using topical remedies that can kill the mites.

The role of altered immunity

Another feature to consider in rosacea is the issue of altered immunity. Rather than being a distinctly separate feature of rosacea, alterations in immune function that promote the inflammation of rosacea seem to be generally linked to gut health. Although the connection may seem obtuse, over 60% of immune cells are located in the gut wall, and thus when the gut ecology goes sideways, the impact is an upregulation of inflammation by the body’s immune cells. The idea that rosacea could be in part an immune disorder was given credence recently when researchers discovered that rosacea sufferers have greatly elevated levels of stratum corneum tryptic enzymes (SCTE), in conjunction with elevated levels and altered function of the antimicrobial peptide called cathelicidin.(5). When these two components are elevated, SCTE enzymes act on cathelicidin to give rise to peptides that directly promote skin inflammation. The trigger for the increased production of SCTE enzymes and cathelicidin appears to be a bacteria called Bacillus oleronius that has been isolated from the Demodex mite (6). The presence of this bacteria alters the function of toll-like receptors (TLRs) which are part of the body’s defense against microbes. Patients with rosacea have been shown to express an elevation in TLR activity, which in turn leads to increased cathelicidin synthesis. Interestingly, TLRs also play a role in vitamin D3 metabolism, enhancing the the enzymatic conversion of the precursor 25(OH)D3 to 1,25(OH)2D3, the active form of vitamin D3 in the body. This is important because 1,25(OH)2D3 also regulates cathelicidin production, and research has demonstrated that rosacea sufferers may have high serum vitamin D levels compared to controls (7), providing a direct link between sun exposure and the worsening of rosacea symptoms. Although it isn’t clear what factors alter TLR activity, some research suggests that glucocorticoid creams used to reduce skin inflammation enhances TLR activity, and thus may contribute to rosacea (8).

Putting it all together

While there clearly isn’t just one cause when it comes to rosacea, the research in combination with my own clinical experience suggests that rosacea is at its root an immunological disorder that is precipitated by a variety of factors, including diet, gut health, and lifestyle factors including skin care and sun exposure. Taking all this into consideration, this is a breakdown of how I approach a patient with rosacea.

1. Restoring a healthy microbiome.

In consideration of the role that our microbiome plays in immune health, it is vitally important to restore the gut ecology in rosacea. To achieve this, I typically recommend the consumption of lactic acid bacterial (LAB) ferments, such as sauerkraut, kimchi and pickled foods on a regular basis, about one cup daily eaten with food. I do not, however, recommend other kinds of ferments including SCOBYs like kombucha, as they inoculate the gut with unhelpful organisms such as yeast. In this regard, it is vitally important to make sure that the diet is low in sugar and refined carbohydrates when treating rosacea, as this will tend to promote inflammatory changes in the gut microbiome that are in turn reflected in the skin. If there are issues with SIBO, a diet low in fermentable fibers is helpful to limit bacterial growth, but more active measures may need to be undertaken to inhibit the pathogens involved, using antibacterial herbs such as neem leaf, garlic bulb, turmeric root, wormwood leaf, and Oregon grape root. Likewise, if you regularly take drugs that impair gut function, including antibiotics, NSAIDs, proton pump inhibitors, antacids and opiates, these can also play a big factor in SIBO, and hence contribute to rosacea. In addition to the consumption of live culture foods, I also have patients apply the pickle brine directly to the skin a few times a day, to inoculate the skin with lactic acid bacteria. These bacteria compete with pathogenic bacteria for nutrients, as well as produce inhibitory substances such as bacteriocins and organic acids that can kill or limit the growth of bacterial pathogens (9). Applying pickle juice to your rosacea seems like a rather unsophisticated and simplistic remedy, but I have found it very helpful in my practice to restore the health of the skin. Just remember that if you’re going to use the pickle juice topically as a probiotic, that you apply it to the skin AFTER you have applied treatments to kill Demodex, so as not to kill the probiotic organisms.

Azadirachta_indicaNeem (Azadirachta indica)

2. Dealing with Demodex

While not all cases of rosacea will involve the Demodex mite, the evidence that Demodex is an active player in many cases of rosacea is undeniable, although as I have stated, the bacteria that colonize Demodex may also play a role. Regardless, the goal here is to get rid of this infestation and prevent its recurrence. Remember, however, that Demodex is a normal component of our microbiome, so the measures we’re undertaking are meant to limit Demodex populations, not wipe them out completely. In part we can achieve this by using live culture pickle juice as I mentioned, and while this does encourage healthy skin, it isn’t directly lethal to the Demodex mite. For this purpose, we have a number of options, including herbs with miticidal (mite-killing) activities, including neem and wormwood, avoiding those which might otherwise be effective if they didn’t cause skin irritation (e.g. garlic) or temporarily stain the skin an unpleasant color (e.g. turmeric). As part of my protocol for dealing with Demodex, I have patients prepare a facial scrub and mask. For example:

  • coarsely ground green mung beans – 50 g
  • neem leaf, finely sieved powder – 50 g
  • white sandalwood, finely sieved powder – 50 g

Mix all the above ingredients together, and use a small handful with a little bit of water to make a paste. The paste can then be used as a facial scrub, gently rubbing the mixture over the affected area to exfoliate and remove the mites. If the area is too sensitive or irritated to use as a scrub, I have patients use the paste to make a mask, which is then applied over the affected area. When the mask dries, and starts to fall off about 15-20 minutes later, it can be gently removed with water. Both neem and sandalwood have miticidal properties and are anti-inflammatory, and in particular, the sandalwood has long been used in India as a skin care agent. Following this, I have the patient apply a tincture of miticidal herbs, such as neem, wormwood, black walnut hull, quassia and pau d’arco to the face with a cotton ball. Not only do the herbs kill the mites, but the alcohol from the tincture also has an inhibitory activity. Another excellent miticide is tea tree oil, which can be applied undiluted to the skin to inhibit Demodex, used by itself or in combination with neem oil.

Santalum_album_leaves_and_flowers_04Sandalwood (Santalum album), leaves and flowers

3. Restoring the skin

In traditional herbal medicine, the state of the skin reflects the health of the blood, which itself is a refinement of the foods we eat in our diet. Thus anytime we see skin issues, we need to direct our attention to the nature of our diet and the health of the gut. Overall, I tend to recommend a low-carbohydrate diet in rosacea, that is rich in nourishing fats, with plenty of leafy greens and bitter foods to upregulate the liver, and correct the altered fatty acid synthesis that plays a role in abnormal sebum production in rosacea. In this regard, avoiding oils and foods rich in omega 6 fatty acids is generally a good idea, as is taking a herbal remedy to upregulate liver function, including bile stimulants (cholagogues) such as Oregon grape root, dandelion, and bupleurum root. Likewise, because of the strong immunological role for rosacea, potentially antigenic foods including wheat (i.e. gluten) and dairy should be removed from diet. Sugar in particular is bad news for the skin, as most people can observe that when they eat sweets, they typically will have some kind of skin eruption. To help heal and moisturize the skin, I recommend avoiding conventional soaps and shampoos, which are extremely drying and irritating, and completely destroy the delicate bacterial ecology of the skin. We need to remember that a healthy bacterial ecology serves as a component of the immune system, so if we weaken our bacterial ecology, we essentially weaken our immune system. Instead of soap, I recommend the daily application of oil to the body, a practice in Ayurveda called abhyanga. When oil is applied to the skin it has a cleansing activity, saturating the surface and penetrating deep below the epidermis to rehydrate, dissolve grime, and exert a mild antimicrobial activity. Choosing the right oil, however, is an important consideration, as some oils such as coconut are comedogenic, and could cause pimples in some people. I don’t have any issue using coconut oil when the skin looks very dry and fragile, but otherwise, I tend to suggest non-comedogenic oils such as almond, apricot, sesame or castor oil. These oils can be rubbed on the face after treatment to rehydrate, and can be a carrier oil for essential oils such as lavender, which not only smells nice, but also has a mild miticidal effect. Another measure that is effective for restoring the skin is the regular application of mid-stream morning urine. This can be collected in a clean glass and applied fresh to the affected area with a compress or cotton ball. Although many will balk at the idea of putting urine on their face, it’s important to note that many skin cosmetics contain urea to take advantage of its unparalleled ability to moisturize the skin. Dry, flaky skin typically occurs due to a reduction in its urea content, and thus rosacea sufferers that exhibit these symptoms in particular will definitely benefit from this measure. Not only does urea and urine moisturize and hydrate the skin, it also helps to promote wound-healing, accelerating the process of cellular renewal, and also has some anaesthetic properties, reducing the irritation and burning sensations that often accompany rosacea. As a purely symptomatic measure, fresh aloe gel scraped from the leaf rind and applied as a fresh poultice to alleviate burning sensations and overcome dryness.

These are only some of the major recommendations I employ in the treatment of rosacea. One thing I haven’t spent much time talking about is the sun and vitamin D3, but it’s worth discussing further. As I previously stated, rosacea sufferers often experience a worsening of symptoms with sun exposure, and likewise, some rosacea sufferers may have elevated levels of circulating 1,25(OH)2D3. Although the research seems to imply that sun avoidance and limiting vitamin D3 is a good idea, it’s important to note that a significant proportion of rosacea sufferers in one study (i.e. 38%), had lower than normal levels of vitamin D3 (10). My suggestion here is to get your vitamin D3 level checked, and if it’s high, reduce your sun exposure and vitamin D3 supplementation accordingly. Otherwise, if you have rosacea, supplement with vitamin D3 to achieve optimal levels, and make sure to limit your sun exposure, wearing protective clothing and wide-brimmed hats in sunny weather. And in keeping with the recommendations of Ayurveda I discussed at the outset, try to follow a regimen that generally helps to reduce heat and inflammation (pitta), avoiding stimulants like caffeine, chocolate and alcohol, nightshades (e.g. potato, tomato, eggplant), pungent-tasting foods (e.g. chili, garlic, ginger), and sour-tasting foods such as yogurt, vinegar, and citrus. As you improve, however, these foods should cease to be an ongoing issue.

DSC_0005“Arthropods? On me?”

As a last note, I want to mention that pet owners may acquire Demodex mites from their pets, particularly if their immune system is weak. Although cats and dogs have their own species-specific mites such as D. canis and D. cati that aren’t supposed to jump to humans, I have seen several patients, including myself, acquire mite infections from their pets, even if the dog or cat is otherwise healthy. Remember, Demodex is a normal part of our shared microbiome, so just because a dog or a cat has mites doesn’t mean that they have mange or are unhealthy. But if you love to rub faces with your pet(s), let them sleep in your bed, or on your clothes, you are running the risk of infection. Thus, if you are a pet owner with rosacea, it might be time to change your lifestyle arrangement. Once the dog or cat is removed from your personal area, it’s also a good idea to thoroughly wash your sheets and clothes in hot water with borax and soap, and maybe buy new pillows. For the extra paranoid, you can apply diatomaceous earth to your mattress and areas surrounding your bed, but please make sure to wear a proper ventilator, because regardless of what the “authorities” say, inhaling DE or any super fine dust is really hard on your lungs.

Do you have rosacea?
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My take on E3 Live during pregnancy

My take on E3 Live during pregnancy

Several months ago a patient in her first trimester of pregnancy asked me about a new product called E3Live® BrainON®, and was wondering if this product was safe her to take. Many of her friends were taking it, and she was wondering about a convincing testimonial from an Evita Ramparte on the E3Live® website.

I went through my entire pregnancy drinking E3Live® Enhanced with BrainON, which kept my mind alert, awake and positive. I gave birth to [a] very healthy baby boy. I am breastfeeding, and I believe it is thanks to E3Live® that I have plenty of milk and no post-partum depression. We’re in good spirits and good health. Besides, I have already lost all the weight I gained in pregnancy! As a wellness journalist, I am often asked whether E3 is safe for pregnant and nursing moms. On the bottle, it’s written: ‘Consult your physician.’ Unfortunately, few physicians know about this beautiful gift of Nature. Naturally, they are afraid to recommend something they have not studied.

That’s quite an endorsement, which might allay the concern of any pregnant mom, but it’s also pre-emptive shot-across-the bow against any rational critique of this product. It’s like Ms. Ramparte is telling us that E3Live® BrainON® is something so unique and so different, that science truly cannot understand it’s virtue and benefits, that it lies beyond any kind of logical explanation. But taking a look at the ingredients, I don’t see anything heretofore unknown to science. In fact, I see something rather concerning – especially for my pregnant patient.

According to the website, E3Live® BrainON® is stated on the website to contain “Organic, liquid fresh-frozen AFA algae (Aphanizomenon flos aquae) with BrainON®, an organic AFA extract of Phenylethylamine (PEA).” Let’s examine these two ingredients in detail:

Aphanizomenon flos aquae

The first ingredient, Aphanizomenon flos aquae (AFA), is a blue-green algae or cyanobacteria, that used to be sold under the trade name “Super Blue-Green Algae®” in the early 1990s when I was training as a herbalist. I recall that it was popular among some of the students, and lots of people were talking about it: not surprising given that it was sold as part of an MLM scheme. But I felt wary of this product, just like I did with grapefruit seed extract, which was also becoming popular at the time. Among its most vociferous adherents in my class was a young woman who claimed to have stacks of research papers on SBGA® – unfortunately, she only lasted a few months before having to bow out due to sickness. It was a short time later that we learned of major problems with AFA, as detailed by John M. McPartland (DO) in the Townsend Letter for Doctors:

“A. flos-aquae also produces hepatotoxins and neurotoxins. Some of these are carcinogenic.(6b) Others are acutely lethal. The LD50 of one hepatotoxin, microcystin-LR is a mere 50 µg/kg, compared to cyanide’s LD50 of 10,000 µg/kg.(7) Neurotoxins produced by A. flos-aquae include neosaxitoxin and anatoxin.(8) Anatoxin is a chemical cousin to cocaine. Anatoxins may be the reason why people eating blue-green algae sometimes feel energized. Some people also describe being addicted to blue-green algae. Animals are known to develop a fatal attraction to mats of blue-green algae washed up on shorelines.(9) Anatoxins are neurotoxins and eventually destroy brain cells.(10) And contrary to claims by Cell Tech, toxins have been found in A. flos-aquae coming from Klamath Lake.(6,11,12) Cell Tech reportedly tests their algae for these toxins. But in 1984 batches of blue green algae distributed by Cell Tech were found to be toxic and seized by the FDA.”

While Super Blue-Green Algae® is no longer available, it has been reinvented in products such as E3Live® BrainON®, which uses the same species of cyanobacteria that Dr. McPartland refers to in his article. And while the company that makes it, Klamath Algae Products Inc., claims that it is safe, and has many testimonials to back it up, they don’t publish the actual level of these hepatotoxins and neurotoxins in their product. I contacted the company in April of 2013, and asked them for these details, because I was concerned for my pregnant patient. When I first called, the customer service representative hadn’t any clue what I was asking for, but reassured me that E3Live® BrainON® was a great product. Later, I received an email from an E3Live® rep, who forwarded me first a simple monograph, but when pressed for actual data, sent me a “certificate of analysis”:

This “certificate of analysis” isn’t helpful of course, because it is just an example. Again, I wrote E3Live® again for the actual data, but as of yet I have not heard back from the E3Live® rep. As you can see in the analysis they provided, E3Live® states that they test for microcystin, a toxic peptide that is highly toxic to the liver. The regulatory limit for microcystin established by the Oregon Health Division and the Oregon Department of Agriculture is 0.1 micrograms per gram. Microcystin levels above this limit thus represent a risk to the consumer, and the higher the levels, the greater the risk.

Most retail products containing Aphanizomenon flos aquae are sourced from Klamath Lake, in Oregon. Locals to the area are well aware of frequent public health notices, warning recreational users about the danger of algal blooms in Oregon, which is well established to cause a variety of health issues including diarrhea, cramping, vomiting, fainting, numbness, dizziness, tingling and paralysis. Under the current regulations, however, AFA has received an exemption from the Oregon Health Authority:

Aphanizomenon flos-aquae (AFA) is a species of cyanobacteria commonly found in Oregon’s fresh waters. Although some studies have shown this species to produce toxins in other parts of the world, subsequent evaluations of that work show that the species either was or likely was misidentified. For the purpose of issuing public health advisories, AFA is excluded from calculation of combined cell counts of toxigenic species.

While this seems to provide some reassurance, and perhaps reflects the influence of a powerful stakeholder, other research continues to identify problems with products containing AFA. In 2008, the Universität Konstanz in southern Germany found microcystin levels that exceeded the safety level of 1 microgram microcystin per gram in 10 out of 16 samples of AFA sourced from Klamath Lake. In a more recent study in Italy, an analysis of 17 different brands of AFA-containing products were found to be “contaminated by highly variable levels of microcystins (MC-LR and MC-LA congeners), up to 5.2 μg MC-LR equivalents per gram product”. In the WHO’s Guidelines For Drinking-water Quality (3rd ed.) (p. 280), naturally-occuring toxins in Aphanizomenon species include not just peptides like microcystins, but alkaloids such as anatoxin-A, the saxitoxins, and cylindrospermopsin, none of which are listed in the “certificate of analysis” from E3Live®. But it starts to get even worse. Although E3Live® BrainON® is supposedly safe for pregnancy, another study has showed that AFA contains high levels of retinoic acid, a well-established reproductive toxin (teratogen) that promotes birth defects of the nervous system, skeleton, heart, thymus, and urogenital system, in all types of vertebrates, including humans. And even after you remove all these toxins, in study of 259 people using a detoxified extract of Aphanizomenon flos aquae, AFA still caused an allergic reaction in 12% of the population. If you are offering advice to a pregnant woman, does any of this sound safe to you?


The product information for E3Live® BrainON® also states that it contains phenylethylamine (PEA), a monoamine alkaloid that naturally occurs in the brain, acting both as a neuromodulator and neurotransmitter. Similar to amphetamine in action, PEA is synthesized in the brain from the amino acid phenylalanine, and stimulates the release of norepinephrine and dopamine, just like cocaine and methamphetamine. In this way, PEA is a “feel-good” substance when secreted in the brain. In their marketing, the manufacturer claims that E3Live® BrainON® contains a natural-sourced PEA, and on the surface, I didn’t find this too surprising. PEA is found in a variety of plants such as cacao bean, and at one time, was a proposed as a mechanism for the mood-enhancing effects of chocolate. While I searched extensively for published research on the natural occurrence of PEA in Aphanizomenon flos-aquae, the only reference I could find was a patent filed in 2009, and a questionable wikipedia citation. The patent refers to a propriety product trademarked as Phycomin® for which no other information is given, nor can be found anywhere on the internet including PubMed, stating that it is concentrated PEA-extract derived from Aphanizomenon flos-aquae. Interestingly enough, however, this patent doesn’t call for using AFA as a source for PEA, but just pure phenylethylamine itself, which anyone can buy at a bulk nutrition shop for next to nothing compared E3Live® BrainON®.

But what about the phenylethylamine added to E3Live®, as the BrainON® component – does it do what the marketing claims? Does it “promote mood balance and enhanced focus”? Unfortunately, an oral dosage of phenylethylamine has at most a very temporary effect in normal individuals. This is due to the presence of a natural enzyme in the body called monamine oxidase (MAO-B), which rapidly breaks down any oral dose of PEA into it’s constituent components. Research pharmacologist Alexander Shulgin states that PEA taken orally in doses up to 1600 mg has no effect, but sensitive individuals may indeed experience a temporary high. Several years ago, researchers thought that phenylethylamine was responsible for the mood altering effects of chocolate, but this was eventually dismissed. To elicit any kind of sustained effect, PEA must be taken with a MAO inhibitor, such as selegiline, deprenyl or Syrian Rue (Peganum harmala), and when this happens, PEA can become a seriously addictive drug. According to the “certificate of analysis” provided above, E3Live® BrainON® contains 1 g of PEA per 100 g of the product, and thus a typical 2-4 gram daily dose of E3Live® BrainON® only contains 200-400 mg of phenylethylamine. Although the PEA in E3Live® BrainON® will have little to no stimulatory effect in healthy individuals, in those taking taking antidepressants or MAO inhibitors, as well as those suffering from schizo-affective disorders in which MAO may be diminished, it could be that a large dose of E3Live® BrainON® could be strong enough to have serious side-effects and/or cause psychosis. Unfortunately, I don’t see this warning stated anywhere on the E3Live® website.

While PEA may have been added to E3Live® BrainON® to boost the claim that it has cognitive benefits, the “rush” that consumers sometimes experience with this product could be something else altogether. As John M. McPartland noted above in his Townsend Letter article, one of the toxins found in Aphanizomenon flos-aquae not apparently tested for in E3Live® BrainON® is anatoxin, which is structurally similar to cocaine and has similar stimulatory effects upon catecholamine secretion as phenylethylamine. Unlike phenylethylamine, however, anatoxin is directly toxic to neurons, and in high doses causes respiratory failure. Unfortunately, the effect of chronic administration of anatoxin isn’t known. Thus while the PEA issue seems to me to be no more than deception, I cannot in good faith recommend to anyone that they ingest neurotoxins to get a “rush”.

The bottom line

Based on the evidence, I can’t recommend to my pregnant patient that she takes this product, and I would council all pregnant women to avoid it as well – even if we just consider the high retinoic acid content. As well, due to its potential neurotoxic effects, I also suggest that children and the elderly avoid this product as well. While I am open to the idea that AFA, like other algae such as Chlorella, might be beneficial for human consumption, I am worried that the levels of hepatotoxins and neurotoxins might be too high in E3Live® products. The only way to resolve this issue is for E3Live® BrainON® to actively publish their testing data and guarantee the safety of this product for regular human consumption.

Preventing constipation naturally

Preventing constipation naturally

Constipation is a frequent complaint that affects upwards of 100 million Americans on a regular basis, and in traditional systems of medicine such as Ayurveda, is considered to be a precursor to any number of more serious health issues. By some medical definitions constipation is only diagnosed if the patient hasn’t had a movement for more than one week. This designation is based purely on statistical averages, i.e. what is “normal” in society. Some people have frequent BMs, whereas others only poop 1-2 times a month. But statistical averages say nothing about the condition itself, nor about the importance that it plays in health and disease.

Part of the issue is that “constipation” is a subjective term. Some of my patients tell me they are constipated even though they have regular BMs – it’s just that they don’t feel “empty” or properly “satisfied” after a BM. Other people only have a BM every couple days, and think that this is normal and natural. According to Ayurveda, everyone should have between 1-2 bowel movements a day, and so if you are having at least one BM a day we cannot say that you are constipated. However, it doesn’t necessarily indicate that you are having healthy BMs, and this is sometimes what people mean when they say they’re “constipated”.

Which brings us to the subject of poop itself – what is it? Mostly it is bacteria – over 60% by volume – and whatever indigestible fibers and foodstuffs the bacteria have been fermenting. If the BM is particularly smelly, it says something about the weakness of your stomach and gastric digestion – probably there is too much undigested protein making its way to the large intestine, encouraging bacterial putrefaction rather than fermentation. If this is you, reduce the protein in your diet so you can digest it properly, and take more bitter-tasting leafy greens and herbs like gentian or barberry before meals to stimulate the stomach and liver. And if it smells too fermented, sort of like a sweet compost-like odor, cut back on the carbs and other sweet foods, and take pungent-tasting herbs to enhance digestion such as garlic and ginger.  What you eat has a tremendous impact upon your digestive health, so pay attention! As you can see, I also recommend that you smell your poo, since as gross as it might sound, it provides good information about the nature of the bacteria that live in your gut. Normally a BM doesn’t have a particularly strong smell, apart from the fact that its poop and so still smells rather…well… “poopy” – but in a good way. Hey, nobody said we’re talking about roses here!

Since your BM is mostly bacteria, this is a good place to start when dealing with constipation. In essence, constipation is a deficiency of the “probiotic” bacteria such as Lactobaccillus and Bifidobacteria that live and grow inside your colon to produce a healthy BM. Thus an important place to start with constipation is in restoring the GI ecology. The best way to do this is to regularly eat live culture foods, and in particular, fermented vegetables. Unlike fermented foods such as kefir, kombucha, sourdough, wine, mead and beer which contain yeasts that can inhibit a healthy gut ecology, fermented veggies are totally bacterial, and totally beneficial. In my book Food As Medicine, I describe the simple process of making fermented veggies, and include recipes of common examples such as sauerkraut, kimchi, carrot pickle and relish. Compared to expensive store-bought probiotic supplements that are almost entirely dead by the time they get to your fridge, home-made fermented veggies are powerhouses of healthy bacterial colonies that only cost pennies a day. I recommend eating fermented veggies on a daily basis as a good way to prevent constipation. Sometimes it takes a little bit to get used to them, but once you experience their benefits, you will probably come to crave these foods.

Some people are constipated because they’re simply too dry. Drinking 1-2 large glasses of warm water first thing in the morning is a good way to get things moving, particularly if you get up early, before sunrise. In Ayurveda, sleeping in promotes constipation by countering the natural flow of vata dosha, which reaches its full expression just before sunrise. If drinking warm water alone doesn’t help, mix 1 tsp of triphala churna (powder) in with the first glass of water. While triphala is frequently recommended, there are many other herbs that are equally as useful, and can be taken first thing in the AM too. Yellowdock root tincture is particularly good for constipation, as is dandelion root and barberry rootbark. All three of these herbs as well as triphala are bitter in taste, stimulating bile release from the liver and gall bladder, which in turn stimulates intestinal peristalsis. Ensuring that the liver is properly stimulated, you can also try to introduce fattier foods into the diet, which helps to lubricate the intestine. Examples include meat soups and stews, eaten with steamed buttered vegetables or vegetables sauteed in fat. Likewise, taking demulcent herbs such as aloe, marshmallow and slippery elm can be helpful as well. For painful, difficult evacuation, you can even inject 2-3 ounces of warm sesame oil prepared with a pinch of rock salt into the rectum before bed.

There are many factors involved in constipation, and here I am only covering a few. To get more detail please visit my website at, and my monograph on constipation.

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