She cured herself, of course
My last blog was about the domino effect involved in the development of #vitiligo. In truth, all disease could be described as a process of cause and effect. But just how many dominoes are involved in the chain reaction leading to full-blown symptoms varies from one condition to the next. In the case of vitiligo there certainly appears to be a complex knock-on effect at play, involving genes, hormones, the digestive and immune systems, as well as environmental and life-style factors. Trying to determine which domino belongs where, or even if the same sequence of events occurs in all cases of vitiligo is no easy task – which, presumably explains the frustratingly slow rate of progress in vitiligo research.
Whilst researchers and specialists in this field are well aware of the complexities of vitiligo, most medical practitioners who deal with vitiligo patients are not. A frighteningly high proportion of these doctors dole out the same tired old phrases: “harmless skin condition”… “no cure”… “try this steroid cream or else just ignore it”… “stay out of the sun”, “blah, blah, blah”. If you are lucky, your dermatologist might recommend phototherapy. But, even then, temporarily helpful as this may or may not prove to be, the doctor's focus is still firmly fixed on the very last domino to fall: i.e. the white patches. Try to talk to your doctor about genes, hormones, digestion, nutrition or even autoimmunity and you are likely to be met with a glazed expression, if not a patronising one.
In spite of everything that has been discovered and published about the aetiology of vitiligo, in spite of all the clinical studies, scientific papers and ongoing research pointing to systemic involvement in the development of those white patches, very little of it has filtered down to the men and women who diagnose and treat them day in and day out.
As pointless as polishing a rusty car
Call me simple, but I think that trying to treat a vitiligo patch without first treating the human body that has produced it is about as pointless as polishing a rusty car. Of course, I am not telling you anything you didn't already know. I think we all accept that our mainstream health system in the western world is, for the most part, based on the principle of treating the symptom rather than the patient. All too often this means superficial diagnosis rather than in-depth investigation, prescribing drugs rather than promoting healing and reducing waiting lists instead of reducing disease. Such a system is not suited to ensuring the long-term vitality and well-being of individuals with complex, chronic conditions.
I am not saying that this is a deliberate policy. I am not a conspiracy theorist. I don't think that the medical profession is trying to keep us all sick so that they can keep making money from us. I am sure that the majority of doctors enter the profession because they want to heal people. (I'm not so sure about the drug companies though: they have a huge vested interest in keeping us sick and, of course, they are massively influential in how doctors treat their patients.) But the harsh reality is that the system has become a colossal industrial machine in which patients are sorted, tagged, processed, stamped and ejected the other end of the conveyor belt as efficiently as possible. This is not necessarily all bad. For someone with a broken leg this is a system that works pretty well. But for the person with a chronic condition which has no simple cure and crosses multiple medical disciplines (dermatology, genetics, endocrinology, gastroenterology, neurology, immunology, rheumatology, etc.) it is often an unmitigated disaster. This is why so many vitiligo patients end up feeling worse when they leave the doctor's office than they did when they first walked into it.
Layers of causality
My view of the health system is not so jaundiced that I would ever advise against consulting your doctor. On the contrary, it is usually the very first thing that I advise, if only to get an accurate diagnosis. But it is a question of having realistic expectations of what will happen after that. Because of the way our health system works, most doctors simply don't have the time or specialist skills to drill down through the layers of causality in non-life-threatening, chronic illnesses like vitiligo. This is why most patients who actually do find long-term effective treatments do so either by going to complementary medical practitioners for natural and holistic solutions, or by doing their own research and using the trial-and-error method of self-treatment at home, as I did myself.
The process of discovering what treatment will work puts me in mind of the old nursery rhyme “There was an old lady who swallowed a fly”. Getting to grips with the mystery that is vitiligo is like looking at the end result (i.e. the white patches - or the dead lady who swallowed a horse) and working your way back through the steps that led there. Was it the cow that caused the old lady to swallow the horse? Well, yes – but she wouldn't have swallowed the cow unless she had previously swallowed the dog, etc., etc.
Some experts believe that vitiligo is caused by melanocytes being either killed or “disabled” and they stop at that. Others offer the explanation that the loss of functioning melanocytes is a result of inflammation. But what causes the inflammation? We are often told that this inflammation is a consequence of various stresses: physical (i.e. injury or friction), emotional (mental trauma or pressure) and oxidative stress. As it turns out, inflammation and oxidative stress are also associated with both raised histamine levels and autoimmunity. But which came first? Does it really matter which came first, when it comes to finding an effective treatment? If - as I suspect - all of these phenomena form a vicious cycle, which came first is not entirely relevant. The most important thing is to break the cycle at some point, any point - preferably at every point.
Some say that faulty genes are at the bottom of all these adverse reactions but that vitiligo only occurs in cases where an environmental trigger is present. If genetics are at the root of the problem, you could liken that to the fly. It would have been better for the old lady never to have swallowed the fly in the first place. But it is what it is – it's too late to correct that now. This is not a point at which we can break the cycle without more scientific research and medical intervention. But at every subsequent stage in the chain of cause and effect there are ways we can intervene in order to stop the old lady from dying of horse-induced ingestion and 1% of the population from losing random chunks of their treasured skin colour.
As I said in my last blog. It makes sense to me to intervene at as many stages as it takes to get the job done. In other words, we may not be able to tackle the genetics involved, but there are multiple ways we can reduce stress, histamine and inflammation, increase antioxidant levels, avoid triggers and balance our immune system. After all, it wasn't the fly that killed the old lady. It was what came after.
The moral of the tale
Well, if you have made it all the way down to this point in my ramblings then I congratulate you! You are probably about ready to eat a horse yourself by now. So I will get to the point. My point is that, for most of us, our family doctor and our dermatologist will not be able to cure our vitiligo. They may or may not be able to improve it. But the chances are that any improvement will be temporary (as with phototherapy alone) or may come at the cost of side effects (as with steroid treatments).
The only person who will be willing and able to devote the time to sift through the layers of causality that have resulted in your pigment loss is your holistic practitioner (for which you will pay – but, if successful, it would be worth it) or YOURSELF.
I chose to do it myself. This old lady may have been unfortunate enough to swallow a fly but, thankfully, she didn't rely on a doctor's prescription for indigestion tablets to solve her horse problem. She was lucky enough to stumble on a simple home treatment that worked for her and this prompted her to take responsibility for her own health and well-being by continuing to learn as much as possible about her condition and find as many safe and effective ways as possible to support her own body in its efforts to heal itself. If you haven't already read her story you can do so here.
In the course of writing this post, I decided to go for a walk in the fresh air to clear my head. And, by a strange quirk of fate, guess what happened along the way?... I swallowed a fly!
Interrupting the domino effect
As you will know if you have read my blog before, I am not a scientist. So I tend to draw everyday analogies between the technical information I read and concepts that are more familiar to me. Hopefully, these comparisons are helpful to others whose scientific studies also ended when they left school.
My view of #vitiligo is not that it is “an incurable skin disease” but that it is a symptom of a domino effect occurring inside the body. Research suggests that the root cause (the first domino to fall) is at the genetic level. However, until the boffins find a way of reprogramming the three rogue genes thought to be responsible, we do at least have multiple options for interrupting the sequence of events leading up to de-pigmentation at some point along the line of dominoes. This is possibly one reason why different remedies apparently work for different people.
If we accept that each domino that topples is a threat to the health of our entire body (a systemic issue) then it makes sense to try to stop the chain reaction, either as early in the process as possible (in order to limit systemic damage), or else to interrupt the process at as many different stages as we can (i.e. prop up several of the dominoes at once). This may not constitute a “cure” in the widely accepted sense of the word but if it improves overall health and reduces or eradicates the visible symptoms (the white patches) then that is surely good enough for the time being.
Vitamin and mineral supplementation, herbs, diets and other lifestyle changes, topical treatments, phototherapy and surgical procedures have all been variously reported to bring about a halt or reversal of pigment loss, a fact that supports the theory that vitiligo is multi-factorial.
This has made it difficult for scientists to find a one-size-fits-all cure but, on the other side of the same coin, it presents us with multiple opportunities to arrest the onset of symptoms at any one (or more) of the stages that lead up to eventual de-pigmentation. In other words, if we look at the considerable body of therapeutic evidence that has built up over the years, we can use as many of the helpful (and safe) therapies as we need to in order to put up roadblocks at sites along the route between point A and point B (point A being the first domino: our original predisposition to vitiligo, and B being the eventual appearance of white patches).
Taking a multi-pronged approach to a multi-factorial condition seems to me to be a logical thing to do. It also allows for the likelihood that the exact combination of physiological events leading up to pigment loss may well vary in relative importance from one individual to the next. For example, not everyone with vitiligo experiences the same degree of reaction to physical or mental trauma. Not everyone with vitiligo experiences itching or visible inflammation at the site of new lesions. And not everyone with vitiligo experiences noticeable digestive symptoms. So the value of focusing on any one of these issues will most likely vary from one person to the next.
The fact that there are many approaches that can, and do, improve vitiligo - and that some of these approaches can be used in combination as multiple "roadblocks to de-pigmentation" - has become a guiding factor in my choice of topics for this blog and also in my choice of new additions to Vitiligo Store.
The latest, and potentially the most exciting, in a number of recent additions to the site is the partner product to Vitix Gel: Vitix tablets. I was asked recently if I recommended them and was surprised to realise that I was not even aware of them. So I read up on their ingredients and supporting evidence and have started trying them for myself.
The tablets are designed to work - ideally, together with the gel - to reduce oxidative stress inside the body, whilst the gel does the same topically. (I first tried Vitix Gel about a year ago and found that it helped to re-pigment some patchy pigment loss that had reappeared on my chest following a particularly nasty sunburn. Ever since this sunburn I had noticed that this area was not as resistant to burning as it previously had been and frequently felt itchy and inflamed, even when protected from the sun by clothing. Significantly, this problem has resolved since starting to take Vitix tablets. I have only been taking them for a week so far and noticed a difference from the very first day. It is too soon to tell if they will also help even out the freckled skin tone that I now have in this area but if all they do is continue to prevent itching and irritation and allow me to stay in the sunshine for a reasonable period of time without feeling as if I am burning I will be happy.)
From what I have read about the formulation of the tablets, they are clearly aimed at interrupting the domino effect I referred to earlier at the inflammation / oxidative stress stage (a distinct, but compatible, approach to Boost capsules which appear to work by replenishing depleted nutrients involved in the pigmentation process itself). Based on a melon extract called Extramel-v, which contains high levels of the antioxidants SOD and catalase, this is the first formulation I have come across that that contains both primary and secondary antioxidants (in fact I didn't know there was such a distinction). According to the literature (below), SOD and catalase are the primary antioxidants and act at source on the production of free radicals and reactive oxygen species (ROS) in order to limit cellular damage. The secondary antioxidants are vitamins C, E, B9, B12, Selenium, Copper and Zinc. Evidently, the primary antioxidants eliminate free radicals by a continuous action (non-stoichiometric action) so that secondary free radicals are not given the chance to reappear. And the secondary antioxidants eliminate secondary free radicals using stoichiometric action. (Another two-pronged approach!)
So I am grateful to the vitiligo friend who asked my opinion of Vitix Tablets. I will keep you posted on my own results and hope to hear that this information has helped others too. After all, the dominoes in our picture at the top of this blog may need to be covered with white spots but, in my opinion, we most certainly don't.
The Vitiligo Plot Thickens
In my last blog post I likened #vitiligo to a convoluted murder mystery, full of contradictions, plot twists, red herrings and a cast consisting of scores of suspects, one of which is histamine. Like all good whodunnits, the mystery of what causes vitiligo continues to keep everyone guessing and, just when you think you have identified all the likely suspects - genes, physical trauma, leaky gut, autoimmunity, oxidative stress, etc. etc. - another unexpected one pops up.
Personally, I had never considered that my allergic rhinitis (one of those annoying, life-long conditions that you learn to live with and almost come to think of as normal) could be connected in any way to my vitiligo. And yet, it is not an unreasonable leap of deduction to suspect that inflammation caused by allergic reactions might not be limited to those symptoms we usually associate with them, like itchy, watering eyes, sneezing, hives and other rashes. Why should we assume that there are no other parts of our body under attack from inflammation when we have elevated levels of #histamine surging through our system? I am not saying that too much histamine in the body is the main cause of vitiligo but I do believe it is involved in the process somewhere along the line. Think of it as an accomplice, rather than the murderer. In fact, now that I come to think of it, our vitiligo detective story is beginning to look a lot like Murder on the Orient Express. (If you are one of the handful of people on the planet who have not read it or seen one of the film versions, I will not spoil it for you. The rest of you know what I mean.)
Following my previous post on this subject, I received an email from a vitiligo friend (who, I am glad to say, has been re-pigmenting well using the same protocol as I did) and this is what he had to say:
I read your article about histamine the other day and interestingly, just before mine started, I had began to suffer with extreme hay fever for the first time in my life. May be a total coincidence but thought I'd drop you an email and let you know…
Evidence that there is histamine involvement in the development of vitiligo is not purely anecdotal. A number of clinical studies have been conducted that support this. For example, the Role of Histamine as a Toxic Mediator in the Pathogenesis of Vitiligo, published in 2013 in the Indian Journal of Dermatology, concludes that:
Histamine appears to play a significant role in the pathogenesis of a particular type of vitiligo characterized by faint hypopigmented patches with significant itching.
I am certainly much more aware than before of the need to avoid any sort of skin irritation, making sure that I don't allow my skin to come into contact with the harsh chemicals that lurk in every day products and clothing. And, from now on, I shall be more careful about the environmental and dietary triggers that can raise histamine levels.
To help you make some diet and lifestyle changes that will minimise so-called Histamine Intolerance (which is actually just the overproduction of histaminhe, rather than an intolerance to it), here are some useful websites.
Natural Remedies for Histamine Intolerance pulls together advice from a number of authority sources and is informative and easy to read.
Another site called Diagnosis Diet features a useful article called Histamine Intolerance: Understanding the Science which explains simply and clearly the science behind food sensitivity reactions caused by histamine.
Joe Cohen, who writes a great blog called Selfhacked, also sheds valuable light on histamine intolerance on this page and suggests a variety of ways of dealing with it.
And further dietary advice aimed at lowering histamine can be found on the Live Strong website by clicking here.
The difference between our vitiligo mystery and a whodunnit
As a result of the reading I have been doing over the past few weeks into ways of reducing inflammation in general, and histamine in particular, I decided to start supplementing with #Quercetin and Bromelain (which together have natural anti-histamine, anti-inflammatory and antioxidant properties) and have also added this to the Nutrition section of Vitiligo Store for anyone else who would like to include it in their protocol. (Just put Quercetin into the search box at the top of the page if you want to find it quickly.)
So, that wraps up this topic for now. But I would like to end this post by pointing out a crucial difference between the hunt for effective vitiligo treatments and solving a typical whodunnit, a difference that I hope you will find as encouraging as I do. Even the best homicide detective in the world, once he has found all the clues and solved the murder, is not able to bring the victim back to life. But we vitiligo sleuths have the power, with each piece of the puzzle we uncover, to tweak, prod, nurture and coax our body back to full health. And I believe that the holistic nature of this approach, which recognises vitiligo not as a “skin disease” but rather as a symptom of deeper systemic health issues, has a cumulative effect. This means that the results we can achieve using a variety of daily protocols end up being greater than the sum of the parts. In other words, by tackling a number of the known suspects simultaneously, we can reduce harmful influences, increase beneficial ones and support our whole system in its natural tendency to heal itself and, as we do so, each of these individual improvements adds fuel to the others.
I hope that you have found this topic interesting and that it will have provided another small step in your journey to full re-pigmentation. If it has, that will prove that a little bit of histamine knowledge is not to be sneezed at :)
My name is Caroline.