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 http://www.haciendapub.com/article27.html

 Medical Sentinel (Volume 4, No. 6, November/December 1999)
 Feature Article

    Food Additive Excitotoxins and Degenerative Brain Disorders

                      Russell L. Blaylock, MD


 There are a growing number of clinicians and basic scientists who
 are convinced that a group of compounds called excitotoxins play a
 critical role in the development of several neurological disorders
 including migraines, seizures, infections, abnormal neural
 development, certain endocrine disorders, neuropsychiatric
 disorders, learning disorders in children, AIDS dementia, episodic
 violence, lyme borreliosis, hepatic encephalopathy, specific types
 of obesity, and especially the neurodegenerative diseases, such as
 ALS, Parkinson's disease, Alzheimer's disease, Huntington's
 disease, and olivopontocerebellar degeneration.(1)

 An enormous amount of both clinical and experimental evidence has
 accumulated over the past decade supporting this basic premise.(2)
 Yet, the FDA still refuses to recognize the immediate and long term
 danger to the public caused by the practice of allowing various
 excitotoxins to be added to the food supply, such as monosodium
 glutamate (MSG), hydrolyzed vegetable protein, and aspartame.(*)
 The amount of these neurotoxins added to our food has increased
 enormously since their first introduction. For example, since 1948
 the amount of MSG added to foods has doubled every decade. By 1972,
 262,000 metric tons were being added to foods. Over 800 million
 pounds of aspartame have been consumed in various products since it
 was first approved. Ironically, these food additives have nothing
 to do with preserving food or protecting its integrity. They are
 all used to alter the taste of food. MSG, hydrolyzed vegetable
 protein, and natural flavoring are used to enhance the taste of
 food so as to mask disagreeable taste and magnify desired taste.
 Aspartame is an artificial sweetener that goes by various brand
 names such as NutraSweet and Equal.

 These toxins (excitotoxins) are not present in just a few foods,
 but rather in almost all processed foods. In many cases they are
 being added in disguised forms, such as natural flavoring, spices,
 yeast extract, textured protein, soy protein extract, etc.
 Experimentally, we know that when subtoxic levels of excitotoxins
 are given to animals in divided doses, they experience full
 toxicity, i.e., they are synergistic. Also, liquid forms of
 excitotoxins, as occurs in soups, gravies and diet soft drinks are
 more toxic than that added to solid foods. This is because they are
 more rapidly absorbed and reach higher blood levels.

 So, what is an excitotoxin? These are substances, usually acidic
 amino acids, that react with specialized receptors in the brain in
 such a way as to lead to destruction of certain types of neurons.
 Glutamate is one of the more commonly known excitotoxins, but over
 seventy have thus far been identified. MSG is the sodium salt of
 glutamate. Glutamate is a normal neurotransmitter in the brain. In
 fact, it is the most commonly used neurotransmitter by the brain.
 Defenders of MSG and aspartame use, usually say: How could a
 substance that is used normally by the brain cause harm? This is
 because, glutamate, as a neurotransmitter, exists in the
 extracellular fluid only in very, very small concentrations --- no
 more than 8 to 12uM. When the concentration of this transmitter
 rises above this level, the neurons begin to fire abnormally. At
 higher concentrations, the cells undergo this specialized process
 of delayed cell death, excitotoxicity. That is, they are excited to
 death.

 It should also be appreciated that the effects of excitotoxin food
 additives generally are not dramatic. Some individuals may be
 especially sensitive and develop severe symptoms and even sudden
 death from cardiac irritability; but, in most instances, the
 effects are subtle and develop over a long period of time. While
 the food additives, MSG and aspartame, are probably not direct
 causes of the neurodegenerative diseases, such as Alzheimer's
 dementia, Parkinson's disease, or amyotrophic lateral sclerosis
 (ALS), they may well precipitate these disorders and certainly
 worsen their pathology as we shall see. It may be that many people
 with a propensity for developing one of these diseases would never
 develop a full blown disorder had it not been for their exposure to
 high levels of food borne excitotoxin additives. Some may have had
 a very mild form of the disease had it not been for the exposure.
 Likewise, food borne excitotoxins may be harmful to those suffering
 from strokes, head injury and HIV infection, and certainly should
 not be used in a hospital setting.



                  How Excitotoxins Were Discovered


 In 1957, two ophthalmology residents, Lucas and Newhouse, were
 conducting an experiment on mice to study a particular eye
 disorder.(3) During the course of this experiment, they fed newborn
 mice MSG and discovered that all demonstrated widespread
 destruction of the inner nerve layer of the retina. Similar
 destruction was also seen in adult mice but not as severe as the
 newborns. The results of their experiment was published in the
 Archives of Ophthalmology and soon forgotten.

 For ten years prior to this report, large amounts of MSG were being
 added not only to adult foods but also to baby foods in doses equal
 to those of the experimental animals.

 Then in 1969, Dr. John Olney, a neuroscientist and neuropathologist
 working out of the Department of Psychiatry at Washington
 University in St. Louis, repeated Lucas and Newhouse's
 experiment.(4) His lab assistant noticed that the newborn of MSG
 exposed mice were grossly obese and short in stature. Further
 examination also demonstrated hypoplastic organs, including
 pituitary, thyroid, adrenal as well as reproductive dysfunction.
 Physiologically, they demonstrated multiple endocrine deficiencies,
 including TSH, growth hormone, LH, FSH, and ACTH. When Dr. Olney
 examined the animal's brain, he discovered discrete lesions of the
 arcuate nucleus as well as less severe destruction of other
 hypothalamic nuclei.

 Recent studies have shown that glutamate is the most important
 neurotransmitter in the hypothalamus.(5) Since this early
 observation, monosodium glutamate and other excitatory substances
 have become the standard tool in studying the function of the
 hypothalamus. Later studies indicated that the damage by monosodium
 glutamate was much more widespread and included such areas as the
 hippocampus, circumventricular organs, locus ceruleus,
 amygdala-limbic system, subthalamus, and striatum.(6)

 More recent molecular studies have disclosed the mechanism of this
 destruction in some detail.(7) Early on, it was observed that when
 neurons in vitro were exposed to glutamate and then washed clean,
 the cells appeared perfectly normal for approximately an hour, at
 which time they rapidly underwent cell death. It was discovered
 that when calcium was removed from the medium, the cells continued
 to survive. Subsequent studies have shown that glutamate, and other
 excitatory amino acids, attach to a specialized family of receptors
 (NMDA, kainate, AMPA and metabotrophic) which in turn, either
 directly or indirectly, opens the calcium channel on the neuron
 cell membrane, allowing calcium to flood into the cell. If
 unchecked, this calcium will trigger a cascade of reactions,
 including free radical generation, eicosanoid production, and lipid
 peroxidation, which will destroy the cell. With this calcium
 triggered stimulation, the neuron becomes very excited, firing its
 impulses repetitively until the point of cell death, hence the name
 excitotoxin. The activation of the calcium channel via the NMDA
 type receptors also involves other membrane receptors such as the
 zinc, magnesium, phencyclidine, and glycine receptors.

 In many disorders connected to excitotoxicity, the source of the
 glutamate and aspartate is endogenous. We know that when brain
 cells are injured they release large amounts of glutamate from
 surrounding astrocytes, and this glutamate can further damage
 surrounding normal neuronal cells. This appears to be the case in
 strokes, seizures and brain trauma. But, food borne excitotoxins
 can add significantly to this accumulation of toxins.



                         The FDA's Response


 In July 1995, the Federation of American Societies for Experimental
 Biology (FASEB) conducted a definitive study for the FDA on the
 question of safety of MSG.(8) The FDA wrote a very deceptive
 summary of the report in which they implied that, except possibly
 for asthma patients, MSG was found to be safe by the FASEB
 reviewers. But, in fact, that is not what the report said at all. I
 summarized, in detail, my criticism of this widely reported FDA
 deception in the revised paperback edition of my book,
 Excitotoxins: The Taste That Kills, by analyzing exactly what the
 report said, and failed to say.(9) For example, it never said that
 MSG did not aggravate neurodegenerative diseases. What they said
 was, there were no studies indicating such a link. Specifically,
 that no one has conducted any studies, positive or negative, to see
 if there is a link. A vital difference.

 What we find is that there are many gaps in our knowledge
 concerning the toxicity of food additive excitotoxins. For example,
 virtually no long term studies have been done on the neuroendocrine
 effects of chronic excitotoxin additive feeding in humans.
 Likewise, there are no studies of regionally distributed brain
 levels of glutamate, aspartate and cysteine following chronic
 excitotoxin feeding. Most important, there are no studies of the
 effect of these excitotoxins on the physiology of the nervous
 system under conditions of low brain energy supply. In examining
 the research literature, virtually all studies of this problem,
 other than behavioral effects, are centered on microscopic
 pathologic changes and not functional alterations of either the
 neurons themselves or of the entire brain itself. This is of vital
 importance, since we know that neurons can have severely altered
 function without pathological change as seen on either light or
 electron microscopy. Several studies have been done that
 demonstrate significant alteration in brain neurochemistry with
 acute MSG exposure.(10,11)



                       The Corporate Response


 Unfortunately, for the consumer, the corporate food processors not
 only continued to add MSG to our foods, but they have gone to great
 links to disguise these harmful additives. For example, they use
 such names as hydrolyzed vegetable protein, vegetable protein,
 textured protein, hydrolyzed plant protein, soy protein extract,
 caseinate, yeast extract, and natural flavoring. We know
 experimentally that when these excitotoxin taste enhancers are
 added together they become much more toxic than is seen
 individually.(12) In fact, excitotoxins in subtoxic concentrations
 can be fully toxic to specialized brain cells when used in
 combination. Frequently, I see processed foods on supermarket
 shelves, especially frozen or diet foods, that contain two, three
 or even four types of excitotoxins. We also know, as stated, that
 excitotoxins in liquid forms are much more toxic than solid forms
 because they are rapidly absorbed and attain high concentration in
 the blood. This means that many of the commercial soups, sauces,
 and gravies containing MSG are very dangerous to nervous system
 health, and should especially be avoided by those either having one
 of the above mentioned disorders, or who are at a high risk of
 developing one of them. They should also be avoided by cancer
 patients and those at high risk for cancer, because of the
 associated generation of free radicals and lipid peroxidation.(13)

 In the case of ALS, we know that consumption of red meats and
 especially MSG itself, can significantly elevate blood glutamate,
 much higher than is seen in the normal population.(14) Similar
 studies, as far as I am aware, have not been conducted in patients
 with Alzheimer's disease or Parkinson's disease. But, as a general
 rule, I would certainly suggest that person's with either of these
 diseases avoid MSG containing foods as well as red meats, cheeses,
 and pureed tomatoes, all of which are known to have higher levels
 of glutamate.

 It must be remembered that it is the glutamate molecule that is
 toxic in MSG. Glutamate is a naturally occurring amino acid found
 in varying concentrations in many foods. Defenders of MSG safety
 allude to this fact in their defense. But, it is free glutamate
 that is the culprit. Bound glutamate, found naturally in foods, is
 less dangerous because it is slowly broken down and absorbed by the
 gut, so that it can be utilized by the tissues, especially muscle,
 before toxic concentrations can build up. Therefore, a whole tomato
 is safer than a pureed tomato. The only exception to this based on
 present knowledge, is in the case of ALS. Also, the tomato plant
 contains several powerful antioxidants known to block glutamate
 toxicity.(15)

 Hydrolyzed vegetable protein is a common food additive and may
 contain at least two excitotoxins, glutamate and cysteic acid.
 Hydrolyzed vegetable protein is made by a chemical process that
 breaks down the vegetable's protein structure to purposefully free
 the glutamate, as well as aspartate, another excitotoxin. This
 brown powdery substance is used to enhance the flavor of foods,
 especially meat dishes, soups, and sauces. Despite the fact that
 some health food manufacturers have attempted to sell the idea that
 this flavor enhancer is "all natural" and "safe" because it is made
 from vegetables, it is not. It is the same substance added to
 processed foods. Experimentally, one can produce the same brain
 lesions using hydrolyzed vegetable protein as by using MSG or
 aspartate.(16)

 A growing list of excitotoxins are being discovered, including
 several that are found naturally. For example, L-cysteine is a very
 powerful excitotoxin. Recently, it has been added to certain bread
 dough and is sold in health food stores as a supplement.
 Homocysteine, a metabolic derivative, is also an excitotoxin.(17)
 Interestingly, elevated blood levels of homocysteine has recently
 been shown to be a major, if not the major, indicator of
 cardiovascular disease and stroke. Equally interesting, is the
 finding that elevated levels have also been implicated in
 neurodevelopmental disorders, especially anencephaly and spinal
 dysraphism (i.e., neural tube defects).(18) It is thought that this
 is the protective mechanism of action associated with the use of
 the prenatal vitamins B12, B6, and folate when used in combination.
 It remains to be seen if the toxic effect is excitatory or by some
 other mechanism. If it is excitatory, then unborn infants would be
 endangered as well by glutamate, aspartate (part of the aspartame
 molecule), and the other excitotoxins. Recently, several studies
 have been done in which it was found that all Alzheimer's patients
 examined had elevated levels of homocysteine.(19)

 One interesting study found that persons affected by Alzheimer's
 disease also have widespread destruction of their retinal ganglion
 cells.(20) Interestingly, this is the area found to be affected
 when Lucas and Newhouse first discovered the excitotoxicity of MSG.
 While this does not prove that dietary glutamate and other
 excitotoxins cause or aggravate Alzheimer's disease, it is powerful
 circumstantial evidence. When all of the information known
 concerning excitatory food additives is analyzed, it is hard to
 justify continued approval by the FDA for the widespread use of
 these food additives.



                             Conclusion


 In this brief discussion of a most complicated and evolving
 subject, I have had to omit several important pieces of the puzzle.
 For example, I have said little about the functional components of
 the receptor systems, the glutamate transporter and its relation to
 ALS and Alzheimer's dementia, receptor decay with aging and
 disease, membrane effects of lipid peroxidation products, membrane
 fluidity, effects of chronic inflammation on the glutamate/free
 radical cycle, stress hormones and excitotoxicity, the role of
 insulin excess on the eicosanoid system, or the detailed physiology
 of the glutamatergic system. I have also only briefly alluded to
 the toxicity of aspartame and omitted its strong connection to
 brain tumor induction.

 But, I have tried to show the reader that there is a strong
 connection between dietary and endogenous excitotoxin excess and
 neurological dysfunction and disease. Many of the arguments by the
 food processing industry have been shown to be false. For example,
 that dietary glutamate does not enter the brain because of
 exclusion by the blood-brain barrier, has been shown to be wrong,
 since glutamate can enter by way of the unprotected areas of the
 brain such as the circumventricular organs. Also, as we have seen,
 chronic elevations of blood glutamate can breech the intact
 blood-brain barrier. In addition, there are numerous conditions
 under which the barrier is made incompetent.

 As our knowledge of the pathophysiology and biochemistry of the
 neurodegenerative diseases increases, the connection to
 excitotoxicity has become stronger.(21) This is especially so with
 the interrelationship between excitotoxicity and free radical
 generation and declining energy production with aging. Several
 factors of aging have been shown to magnify this process. For
 example, as the brain ages its iron content increases, making it
 more susceptible to free radical generation. Also, aging changes in
 the blood brain barrier, microvascular changes leading to impaired
 blood flow, free radical mitochondrial injury to energy generating
 enzymes, DNA adduct formation, alterations in glucose and glutamate
 transporters and free radical and lipid peroxidation induced
 alterations in the neuronal membranes all act to make the aging
 brain increasingly susceptible to excitotoxic injury.

 Over a lifetime of free radical injury due to chronic stress,
 infections, trauma, impaired blood flow, hypoglycemia, hypoxia and
 poor antioxidant defenses secondary to poor nutritional intake, the
 nervous system is significantly weakened and made more susceptible
 to further excitotoxic injury. We know that a loss of neuronal
 energy generation is one of the early changes seen with the
 neurodegenerative diseases. This occurs long before clinical
 disease develops. But, even earlier is a loss of neuronal
 glutathione functional levels.

 A word about ascorbic acid: Few are aware of the importance of
 adequate ascorbate levels for CNS function and neural protection
 against excitotoxicity. We are finding out that ascorbic acid plays
 a vital role in neurobehavioral regulation and the dopaminergic
 system as well, which may link ascorbate supplementation to
 improvements in schizophrenia.

 Our knowledge of this process opens up new avenues for treatment as
 well as prevention of excitotoxic injury to the nervous system. For
 example, there are many nutritional ways to improve CNS antioxidant
 defenses and boost neuronal energy generation, as well as improve
 membrane fluidity and receptor integrity. By using selective
 glutamate blocking drugs or nutrients, one may be able to alter
 some of the more devastating effects of Parkinson's disease. For
 example, there is evidence that dopamine deficiency causes a
 disinhibition (overactivity) of the subthalamic nucleus and that
 this may result in excitotoxic injury to the substantia nigra.(22)
 By blocking the glutamatergic neurons in this nucleus, one may be
 able to reduce this damage. There is also evidence that several
 nutrients can significantly reduce excitotoxicity. For example,
 combinations of coenzyme Q10 and niacinamide have been shown to
 protect against striatal excitotoxic lesions. Methylcobolamine,
 phosphotidylserine, picnogenol and acetyl-L-carnitine all protect
 against excitotoxicity as well.

 Of particular concern is the toxic effects of these excitotoxic
 compounds on the developing brain. It is well recognized that the
 immature brain is four times more sensitive to the toxic effects of
 the excitatory amino acids as is the mature brain. This means that
 excitotoxic injury is of special concern from the fetal stage to
 adolescence. There is evidence that the placenta concentrates
 several of these toxic amino acids on the fetal side of the
 placenta. Consumption of aspartame and MSG containing products by
 pregnant women during this critical period of brain formation is of
 special concern and should be discouraged. Many of the effects,
 such as endocrine dysfunction and complex learning, are subtle and
 may not appear until the child is older. Other hypothalamic
 syndromes associated with early excitotoxic lesions include immune
 alterations and violence dyscontrol.

 Over 100 million American now consume aspartame products and a
 greater number consume products containing one or more
 excitotoxins. There is sufficient medical literature documenting
 serious injury by these additives in the concentrations presently
 in our food supply to justify warning the public of these dangers.
 The case against aspartame is especially strong.



                              Footnote

 (*) See FDA position papers at:

 http://www.fda.gov/opacom/backgrounders/msg.html and
 http://www.fda.gov/bbs/topics/ANSWERS/ANS00772.html.



                             References


 1. Ikonomidou C, Turski L. Glutamate in neurodegenerative
 disorders, in Stone TW (Ed.), Neurotransmitters and
 Neuromodulators: Glutamate. CRC Press, Boca Raton, 1995, pp.
 253-272.

 2. Whetsell WO, Shapira NA. Biology of Disease. Neuroexcitation,
 excitotoxicity and human neurological disease. Lab Invest
 1993;68:372-387.

 3. Lucas DR, Newhouse JP. The toxic effect of sodium L-glutamate on
 the inner layer of the retina. Arch Ophthalmol 1957;58:193-201.

 4. Olney JW. Brain lesions, obesity, and other disturbances in mice
 treated with monosodium glutamate. Science 1969;165:719-721.

 5. Pol ANV, Wuarin J-P, Dudek E. Glutamate, the dominate excitatory
 transmitter in neuroendocrine regulation. Science
 1990;250:1276-1278.

 6. Coyle JT, et al. Excitatory Amino Acid Neurotoxins: Selectivity,
 Specificity, and Mechanisms of Action. Neurosci Research Bull
 1981;19(4).

 7. Blackstone CD, Huganir RL. Molecular structure of Glutamate
 Receptor Channels, in Stone TW (Ed), CNS Neurotransmitters and
 neuromodulators: Glutamate. CRC Press, Boca Raton, 1995, pp. 53-67.

 8. Analysis of Adverse Reactions to Monosodium Glutamate (MSG).
 Life Sciences Research Office, FASEB, July 1995.

 9. Blaylock RL. Excitotoxins: The Taste That Kills. Health Press,
 Santa Fe, NM, 1997, pp. 248-254.

 10. Dawson R, Simpkins JW, Wallace DR. Age and dose-dependent
 effects of neonatal monosodium glutamate (MSG) administration to
 female rats. Neurotox Teratol 1989;11:331-337.

 11. Dawson R. Acute and long lasting neurochemical effects of
 monosodium glutamate administration to mice. Neuropharmacology
 1983;22:1417-1419.

 12. Olney JW. Glutamate: a neurotoxic transmitter. J Child Neurol
 1989;4:218-226.

 13. Choudhary P, Malik VB, et al. Studies on the effect of
 monosodium glutamate on hepatic microsomal lipid peroxidation,
 calcium, ascorbic acid and glutathione and its dependent enzymes in
 adult male mice. Toxicol Lett 1996;89:71-76.

 14. Plaitakis A, Caroscio JT. Abnormal glutamate metabolism in
 amyotrophic lateral sclerosis. Ann Neuro 1987;22:575-579.

 15. Blaylock RL. Neurodegeneration and aging of the central nervous
 system: Prevention and treatment by phytochemicals and metabolic
 nutrients. Integrative Med 1998;1:117-133.

 16. Olney JW. Excitotoxic food additives: functional teratological
 aspects. Prog Brain Res 1988;18:283-294.

 17. Parsons RB, Waring RH, et al. In vitro effect of the cysteine
 metabolites homocysteic acid, homocysteine and cysteic acid upon
 human neuronal cell lines. Neurotoxicology 1998;19:599-603.

 18. Esskes TK. Neural tube defects, vitamins and homocysteine. Eur
 J Pediatr 1998;157:Suppl 2:S139-S141.

 19. McCaddon A, Daves G, et al. Total serum homocysteine in senile
 dementia of Alzheimer type. In J Geriatr Psychiatry 1998;13:235-239.

 20. Banks JC, et al. Retinal pathology in Alzheimer's disease. I.
 Ganglion cell loss in foveal/parafoveal retina. Neurobiol Aging
 1996;17:377-384.

 21. Lipton SA, Rosenberg PA. Excitatory amino acids as a final
 common pathway for neurologic disorders. New Eng J Med
 1994;330:613-622.

 22. Rodriguez MC, Obeso JA, Olanow CW. Subthalamic nucleus-mediated
 excitotoxicity in Parkinson's disease: a target for
 neuroprotection. Ann Neurol 1998;44:(Supp 1) S175-S188.



 Dr. Blaylock is a neurological surgeon in Jackson, Mississippi, and
 a member of the Editorial Board of the Medical Sentinel. E-mail:
 [EMAIL PROTECTED]



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