This site is not to encourage you to treat yourself without a doctor.This site is intended to share my ideas about neurology and the function of the body to help you understand neurologic problems. My intention is that you share these ideas with your doctor to help both of you learn and make your treatment more successful. Everything on this site is based on published science but I have taken it a step further to try to put the whole picture together. They are hypotheses or guesses about how our bodies work.
I began to think about making this site when I realized that the explanations I give my patients about their neurologic problems are really “best guesses”. Some are my ideas, others are from books. The explanations that come from books are also ideas, they’re just written down by other neurologists. Doctors have certain building blocks of science that we all agree on: DNA, the structure of the cell, etc. but most of the “explanations” of neurologic illness, from headache to Parkinson disease, are hypotheses. They are ideas that a neurologist proposed that have been generally accepted by other neurologists. That does not mean that they are “the truth”. Our bodies did not come with a user’s manual. We are piecing together information to try to figure out how it works. There is no book to look in to confirm that our ideas are “right” or “wrong”. Now that I’ve been in practice for several years I’ve realized that what I tell you today may not be the truth in another 10 years.
Most of the drugs that we have devised to help humans feel better act on receptors on our cells. This implies that our drugs are actually just duplicating chemicals that are normally made in healthy humans to act on those receptors.The receptors were there way before drug companies or doctors existed. Lack of a certain chemical, such as serotonin, or insulin, or testosterone, or dopamine, causes a “disease”. Once the disease is common in the population a drug company becomes interested in how to “treat” it, and figures out which chemical makes the symptoms better. Often there is a “genetic weakness” or genetic mutation acting in the person who has the disease that means that they don’t make enough of their own chemical.
However, any person who has a genetically inherited disorder such as tremor, epilepsy, diabetes, migraine, who develops that disorder later in life, even at age 15, had that gene mutation at birth. Why did they only develop the “deficiency” of that chemical at a later age, why not at birth? In families with a gene for epilepsy why do some people develop it at 14 and others at 44? If the genetic mutation has been present since birth, but the disease did not cause symptoms until age 15, it suggests that the body was able to “shore up” that genetic weakness for fifteen years. I believe that all of the millions of chemicals we need to make our body run correctly are made while we are in deep sleep. We usually make enough to last only about 16 hours and then we run out. We have to sleep in order to make more. This idea grew out of watching my patients wear sleep apnea masks that allowed them to stay in deep sleep longer. They would notice that at first they woke with no tremor ( or headache, or burning, or dizziness) but it came back as soon as they got up. Then, as they wore the mask more and more nights and had more time spent in deep sleep, their symptom would take longer to appear,i.e. in the first month they woke without a headache but it came at 10:00 am, the next week the headachce started at noon, and the next week at 3 pm. This implied to me that they made enough of whatever chemical it was that “turned off” the head pain system, but they only made enough to last an hour at first. As time wore on, and they stayed in deep sleep each night long enough to make more chemical, they could keep the switch in the “off” position for a longer period of time, until eventually they could keep it in the “off” position all day long. Then, like a normal person, it would only “turn on” if they hit their head. The same idea can be applied to epilepsy or vertigo. The seizure medications that we use are usually sodium channel stabilizers. Many of the inherited seizure disorders are caused by channel mutations. Thus the medication I pick may have a close duplicate in the patient’s body. They were making enough of their own “channel stabilizer” until they stopped sleeping normally, then they had a seizure and they needed some of my chemical, a seizure medication.
As I saw the same trend in the tremor or dizzy or “burning in the feet” patient I began to think of these symptoms in a different way. Perhaps they were symptoms that were caused by a part of the nervous system “turning on” inappropriately. Perhaps patients with burning in the feet have nerves that are “on” when they wake in the morning, instead of “off”. Perhaps it’s because of a lack of maintenance during the night, or not enough of the proper chemical is made at night to keep them in the “off” state until the patient accidently steps in the fire.
This implies that there are many neurologic diseases that can be treated or improved by allowing the patient to stay in deep sleep longer. It seems to work in my practice, for headache, dizziness, attention deficit, tics, epilepsy, vertigo, parkinsons, cerebellar ataxia, and depression.
The above are just ideas, they may or may not turn out to be “true”. But it seems to me that there are many “explanations” in neurology, particularly about headache and sleep, that are commonly accepted but don’t really turn out to be “true”. The only absolute truth in medicine is your observations about your body. We doctors then “interpret” your observations to try to tell you “why”. But if my explanation doesn’t fit your experience with your own body it may not really be the “truth”. All of the ideas on this site are open to interpretation by you and your doctor. Take what seems to make sense and fits with your experience and leave what doesn’t. Don’t be afraid to have your own ideas. We doctors have much to learn from our patients. The internet has brought you as the patient the opportunity to be an equal participant in your own care.
The ideas expressed on this site are built upon the extensive scientific work of Dr. Walter Stumpf who, sadly, passed away at the end of 2012. He was an amazing scientist who single handedly clarified one of the most important aspects of our endocrine system. Despite widespread resistance to his ideas and repeated rejections of his submissions by various scientific journals he continued to believe in the validity of his concept of “soltriol”. His many journal articles describe Vitamin D’s actions, and its integration into the other parts of our endocrine system making up a triad of gonadal, adrenal and dermal steroids. It is a brave thing indeed, to face absolute resistance and severe criticism by one’s colleagues for 30 years of professional life and still hang on to one’s beliefs. It was my pleasure to meet Walter and to get to know him before his death. Together we added the idea that soltriol is pivotal to normal sleep. I think of him daily as I teach my patients about the important role vitamin D plays in our biology. Lack of attention to Walter’s work over the last 25 years has produced epidemics of pain, suffering and death throughout the developed countries of the world that might have been prevented had his ideas been accepted earlier. It is my passionate hope that, when the rest of the scientific community finally catches on, Walter will receive a posthumous Nobel Prize for his work. I also believe that the name of this hormone should be changed to the term that he coined for it; “soltriol”. Partly out of respect for Walter but also because it is a term that more appropriately expresses our biological connection to the sun.
Stasha Gominak, M.D.