Metabolomics and the Caduceus: new science and ancient concepts

Hugo Rodier, MD.

"Doctors routinely measure chemicals in the body to get health information, such as cholesterol and triglycerides. METABOLOMICS, however, involves measuring hundreds or thousands of chemical processes, such as the breakdown of nutrients from diet, going on in the body at the same time, which could yield a lot of information. [METABOLOMICS] can also account for environmental factors, such as how well a patient is absorbing medications. Since METABOLISM-energy generation and breakdown-gets disrupted in many diseases, figuring out how these metabolic pathways change could potentially yield better ways of diagnosing or treating a wide range of diseases."[1]

The number of physicians who are adopting the new science of METABOLOMICS is growing exponentially. The simple concept[2] that our 50 trillion cells need Energy and Information to be structured and to function properly is at the heart of significant healing in patients who are willing and able to change their lifestyles and diets.

"It is a mistake to imagine that complex disease may not be solved by simple approaches or that their causes are not simple. The grave danger that terms such as 'multifactorial' or 'complex' is that they may justify the belief that solutions will come only from large and expensive managed projects rather than from simpler approaches. When perturbed, networks alter their output of matter and energy which, depending on the environmental context, can produce either a pathological or a normal phenotype."

"Diseases don't exist in their own right but as alterations in complex systems of homeostasis. Medicine has little regard for complete description of how a myriad of pathways result in any clinical state. The linear paradigm accounts for some of the crisis in patient-oriented research and a degree of slowing in therapeutic advance."

"Almost all advances in therapy in the last 30 years have been centered around clinical observation and insight from the clinic... Most key insights came from clinical investigators with a history of success in more than one field...The ability to experiment or make observations at the level of the whole human is incredibly important.Clinical science is as basic to medicine as biochemistry.Clinical science remains distinct: solving disease based on the experience of seeing, thinking about and treating individual patients. How did we forget?"[3]

"How did we forget?" Indeed. "There is nothing new under the Sun;" lifestyle issues have been documented to prevent and treat 80%[4] of the chronic medical problems that are breaking our health care system.[5] Yet, up to now "We have been barbarians at the gates of cellular function."[6] Fortunately, modern science is unlocking the cellular mechanisms that explain how healing takes place at the cellular level (METABOLOMICS,) is inspiring many doctors to take the time to do the arduous work of teaching patients and motivate them to make those difficult changes.

A notable Physicist, David Deutsch, predicted that the day would come when physicians would make significant breakthroughs in understanding and treating diseases by adopting the Quantum Principles physicists have studied for over a century.[7] METABOLOMICS is basically an application of the Laws of Thermodynamics at the cellular level. After all, we are "Living in a Quantum World."[8] In such a Quantum Universe, as proposed by Einstein and many other physicists, we may state, for simplicity's sake, that "LIGHT = Energy and Information, E&I."[9]

The most practical way to fuel our cells with E&I is the food we eat.[10] Most people are familiar with calories (Energy) in food, only to ignore or put very little emphasis on the micronutrients (Information) therein:

"It is essential that practicing physicians develop a working knowledge.of these emerging findings in order to best advise their patients on the value of health promoting diets in disease and prevention. These are heady days for nutritional scientists as newer understandings of food and health promise to bring clinical nutrition to the forefront of clinical medicine. Practitioners must become nutritionally educated and oriented if they are to maintain their patients' confidence and stay abreast of this aspect of continuously evolving modern medicine."[11]

"As medical research comes up with deeper explanations of health/disease processes, understanding increases. More general concepts are replacing more specific ones as common, underlying mechanisms are found for dissimilar diseases in different parts of the body. Physicians coming across an unfamiliar disease or a rare complication can rely increasingly on explanatory theories. [and] may be able to apply a general theory to work out the required treatment, and expect it to be effective even if it never been used before.[12]

All physicians are involved with nutrition, for it is not the disease that is important, but the person who has the disease, and each person is the product of his nutrition. What is nutrition? It is the cornerstone of preventive medicine, the handmaiden of curative medicine and the responsibility of every physician."[13]

But, the most effective way to deal with E&I is to optimize the way we think about health and disease; our intellect and beliefs have a powerful effect on cellular function. Physicists like John Wheeler maintain that "Consciousness is Energy,"[14] a concept that lies at the very heart of mind-body issues. Drs. Dean Ornish,[15] Bruce Lipton[16] and many others are pioneering the concept that our cells are also fueled by spiritual, intellectual, and emotional issues. It may be said that they are also E&I constructs.

Another vital concept is the flip side of METABOLOMICS: catabolism, or the elimination of the by-products of Energy processing (think of any engine and combustion products.) Toxins in the environment and oxidants/free radicals produced at the cellular level must be efficiently processed and eliminated so our mitochondria's phosphorylation is not jeopardized.[17]

These basic concepts are often relegated to "alternative medicine" status, despite the expanding research to back them up.[18] Science's reductionists approach has served us well in many areas, but, focusing on minutiae may have inadvertently resulted in losing track of the "big picture." We need integrative thinkers, or generalists to keep science's narrative cohesive, grounded and simple enough to be practical and easy for patients to grasp. Otherwise, science becomes elitist and detached from the very public is it meant to serve. These concerns are fueling an:

"Ongoing public process of negotiating and renegotiating the meaning of science. It argues for a broader view of science (and science education), one that has the potential to make of science shared human stories of exploration and growth ... in which all human beings are involved and take pride.[19]

The simple concepts outlined above may be more accessible to our patients and medical students through story-telling.[20] The very symbol of the medical profession, the Caduceus,[21] tells a compelling story, one that resembles METABOLOMIC concepts. Before dismissing ancient wisdom on the grounds that modern science has superseded it, it is worth pausing to contemplate the state our society is in general and in health care in particular. Also, it is worth considering that the EnLIGHTenment during the Renaissance was fueled by Hermetic principles that are also symbolized by the Caduceus.[22] Copernicus, Galileo, Newton and many others were inspired to a large extent by Hermetic principles. In fact, our modern scientific method is based on Hermetic ideas, like "follow nature" and the "interconnectedness of all reality."[23]

The Caduceus is composed of two feathered serpents coiling around a staff topped by Hermes' helmet. The serpents represent the opposite forces of nature, the masculine and feminine, or, the Ying and Yang. Today we could say they are "1s" and "0s" or the basis of Information Technologies. The snakes seek a balance, or the staff in the middle of the Caduceus. Of all the ancient symbols for the snake, "Energy," or "burning"[24] seem to fit better, especially when the snakes are "feathered," or accompanied by birds, or wings. The latter often represent "Information," or "messenger."[25]

In other words, the Caduceus, a representation of the God Thoth in Egypt and Hermes/Mercury in the Mediterranean, and the God of Light of the Sun in Mesopotamia[26] is a symbol of E&I for healing and balance, or homeostasis. METABOLOMIC (and catabolomics) concepts are evident in the common representation of Thoth holding the Ankh, a cross that looks like a key; it is a representation of "Creation-Destruction," as are the ancient Ouroborus, a feathered snake eating its own tail, and the Dance of Shiva.[27]

A central principle of METABOLOMICS is that our 50 trillion cells need E&I to fuel them for proper function and structure. New cells may then be optimally generated ("Creation-Destruction,") a process seen in all of nature. David Deutsch's prediction that physicians would adopt the quantum principles of E&I physicists have been studying for over a hundred years could be said to be coming true.[28] Another physicist, Nobel Prize-laureate Dr. Schrödinger (best known for his "cat in the box" thought experiment) summarized these concepts by stating that life is the ability to metabolize Energy and Information.[29] Two more aspects of Physics are worth mentioning at this point. One, the concept that everything in the Universe, as Einstein maintained, is E=Mc², and, two, the corollary that reality boils down to the Energy and "Information in (a) Holographic Universe."[30]

In more practical terms, the 2001 Status of Health Care report by the National Institute of Health[31] acknowledged that the system is broken (in my opinion, because we continue to finance a system that treats symptoms, not the root causes, a notion discussed in the Journal of the American Medical Association in 2009.[32]) Not coincidentally, the NIH suggested that significant improvements may be attained by applying modern Physics, specifically. "Complex Adaptive Systems," or the "Hermetic" concept that all of reality is interconnected, including the cellular processes in our body.[33]

We are not far removed from the day when METABOLOMICS are applied in all our clinics when the cover of the Science (December 3^rd 2010) is on METABOLISM. This is just a more scientific way of expressing what Hippocrates and Sir William Osler emphasized: "Food is the best medicine." After all, why would our body not obey the same laws of thermodynamics that rule the Universe? Our link to the environment (diet, toxins, relationships,) from whence we get everything our body is exposed to vitally important for our survival. Yet:

"When medical students enter medical school they care about the whole person and by the time they graduate, all they care about is the hole in the person.There is a competition in all human endeavor between keeping things whole complete and general and the tendency to distinguish, sort and reduce. A broader generalist view has become imperative in the face of the changing epidemiology of illness in industrial societies. Chronic conditions, not acute ailments, are now the most common problems in health care... [when] care of the whole person is paramount. Studies demonstrate the futility of reductionistically carving up patients on the basis of individual. What is needed is a model of care that addresses the whole person and integrates care for the person's entire constellation of co-morbidities.Nothing short of a fundamental redesign of primary care systems is required."[34]

            This would seem like a vital thing to do, since 75-85% of what we are now doing in health care is unproven, and often driven by monetary gain by the few who stand to benefit the most.[35] By the Way, Hermes also stands for commerce and. bandits.[36] In contrast, by focusing on Mother Nature's METABOLOMICS we may be able to manage our patients' problems more successfully, and at the root of dysfunction, not symptomatology:

"Think beyond drugs: seek drug alternatives as first rather than last resort. Treat underlying causes, rather than solely treating symptoms. Look for prevention opportunities, rather than exclusively focusing only on established disease or symptom amelioration. Without a more cautious and more skeptical approach to using drugs, prescribers will lack the will and the skills to resist ubiquitous promotional messages encouraging them to reach for newer and often more expensive medications."[37]

Then, the most common chronic problems in our society, insulin resistance and obesity,[38] as well as practically all diseases, may be seen as E&I not getting into cells properly, due to cell membrane "TOILing;" the cell membrane is:

Toxic,[39]

Oxidized,[40]

Inflamed,[41] and has

Less than optimal mitochondrial function.[42]

Our cells need E&I for ALL their functions, including reproduction; our DNA requires optimal E&I to replicate properly. A lack thereof increases the chances of mutations that may lead to cancer and to genetic tendencies toward chronic diseases. The fields of Toxicogenomics,[43]  Epigenetics,[44] Nutragenomics, and Nutragenetics[45] maintain that genes are not functional until they are "transcribed" or copied into functional glycoproteins, or cell communication messengers.[46] The 2009 Nobel Prize in Medicine was awarded to researchers who showed that the longer the Telomere, the longer we live and with less morbidity; antioxidants that address TOIL increase the length of the telomere.[47] In other words, genes are less likely to express their deleterious potential if we live in clean environments, with good food and nurture good relationships. In fact, antioxidants and micronutrients in whole foods provide better E&I for our genes to the point that 2/3 of cancers may thus be prevented: "The two major pathways that initiate apoptosis are extrinsic (death receptor-mediated,)[Information] and intrinsic (mitochondrial mediated) [Energy.]"[48]

Cell membranes are made up of proteins, fats and sugars. A diet of whole foods containing no more than the necessary calories (Energy) and optimal amount of those macronutrients, plus antioxidants and anti-inflammatory micronutrients (Information) will counteract TOIL, fix cell communication and optimize the metabolic use of E&I. "Cells and microorganisms adjust their intracellular machinery in response to changes in the environment, food availability and developmental state."[49] This simple approach naturally leads to a better functioning Psycho-Neuro-Immune-Endocrine network of cell communication of E&I:

"Contemporary science recognizing the importance of wholeness, defined as problems of organization, phenomena not resolvable into local events not understandable by investigation of their respective parts in isolation. To understand biology at the systems level, we must examine the structure and dynamics of cellular and organismal function, rather than the characteristics of isolated parts. {Understanding this] may have an impact in the future of medicine."

 "The most feasible application of systems biology research is to create a detailed model of cell regulation, focused on signal transduction and molecules for system-level insights. A transition is occurring in biology from the molecular level to the system level that promises to revolutionize our understanding of complex biological regulatory systems and to provide major opportunities for practical application of such knowledge.. We are confident in predicting an explosion in the development of integrated models of cells, organs and systems."[50]

Many doctors are undergoing a profound "reconfiguration of medical thought"[51] that is emphasizing the common molecular pathways of diseases[52] (METABOLOMICS,) rather than the nomenclature of diseases and focusing on disparate diagnoses:

"Medicine is undergoing a revolution in how diseases are diagnosed, classified and treated. The next phase of medicine has arrived. It is descriptive of what is causing disease at the most basic level, the cell and the nucleotide."[53]

Other than optimizing our relationships (family, friends, community and the environment itself,) improving our diet is the most practical way to fix TOIL; basically, this means focusing on our national addiction to refined foods, particularly refined sugars.[54] Emphasizing the Mediterranean/Low Glycemic Index diets provides a good portion of the nutrients mentioned above.  The recent replacement of the Food Pyramid with My Plate is a step in the right direction, since ½ of the "plate" is fruits and vegetables, the foods with the most Information (antioxidants and micronutrients) and the least Energy (calories.)That these foods contain the most fiber is quite significant as well. Fiber (prebiotics) feeds our intestinal probiotics; together these two elements are now referred to as "synbiotics."[55]

Optimizing intestinal function is critical to better metabolize and absorb the E&I we consume in whole foods.[56] This function is significantly influenced by our microflora, or benign bacteria (probiotics.) Since Dr. Metchnikoff won the Nobel Prize in Medicine in 1908 we have known that optimizing the function of our intestinal organisms has a significant impact on our health. Probiotics, and their bioactive molecules,[57] are already predicted to be the next wave of pharmacology,[58] justly so for many reasons. Firstly, our friendly organisms compose about 60% of our immune system:[59]

"The gastrointestinal tract is the largest immunologic organ in the body, possesses the greatest surface area exposed to the outside environment and is confronted with the largest antigenic load in the form of dietary proteins, commensal organisms (healthy organisms) and pathogens."[60]

Consequently, probiotics are vital for METABOLOMICS and catabolism, hence, their usefulness in practically all diseases, beyond Irritable Bowel Syndrome and Inflammatory Bowel Disease:[61]

"Food allergies are an immune problem of fermentation of bacteria in the colon. It could be called 'enterometabolic disorder.' Modern microbiology has opened the road to manipulate the flora [of the intestines] and correct food intolerance and consequently, the control of many diseases."[62]

In fact, imbalances of intestinal flora have been linked to heart disease,[63] even on young people with no cardiac factors.[64] Many other diseases, like cognitive disorders,[65] fibromyalgia, fatigue[66] and even arthritis[67] have also been associated with dysbiosis, or an imbalance of intestinal microflora. As previously stated, consuming whole foods high in fiber feed probiotics ("prebiotic" effect.) This is why a diet high in fiber lowers morbidity and mortality beyond cardiovascular disease.[68]

The journal Science has highlighted METABOLOMICS[69] and the importance of microbiota to maintain health and avoid so many diseases, including Central Nervous system inflammation and metabolic problems like obesity and diabetes.[70] The journal Nature has made it clear that our "microgenome," or the genetic material of our microbiota, outnumber our somatic cells' DNA by 150/1,[71] a fact that must be put into practice in our clinics:

"It is the integration of these technologies that provides the optimal means to unravel the effects of a biological challenge on an organism; thus, the concepts of systems biology, or integrated metabolism."[72]

"Our entire evolution is essentially a side effect of the requirements of the microbes in our guts? Maybe those organisms needed to modify their hosts to be more efficient in finding certain foods for them. If so, it's about time we turned the tables. From now on, by gosh, they work for us."[73]

"Nutrition has done significantly more to improve the quality and duration of life during this past century than surgery and pharmaceuticals combined. Building on this established importance of nutrition in health, it is time for health professionals to take into consideration the role of the human flora in the maintenance of health and the prevention of disease and the role that the consumption of probiotics and prebiotics may play in this process. The scientific establishment of [this] 100 year-old [concept] will require multidisciplinary investigative strategies that integrate microbiology, ecology, cell biology, genomics, bioinformatics, food science and medicine."[74]

METABOLOMICS is the integration of cutting edge science that reminds us of the Hermetic concepts the Caduceus, the symbol of our honorable profession represents.