About Mermaid Central Medical Research
Mermaid Central Medical Research facility was formalised in 2017 to continue research initially started in 2008 by Dr Graham Exelby in retinal photography as a means of identifying vascular risk. Increasing interest in the linking of autonomic dysfunction and inflammatory processes has culminated in the major work currently underway in Postural Orthostatic Tachycardia Syndrome (POTS) with its comorbidities which include Fibromyalgia, Migraine and various autoimmune diseases.
From this evolved a vascular assessment based on actual arterial appearance by combining carotid intimal thickness scanning with retinal photography, again providing a way of determining success or otherwise of management programs. It also provides a means of early identification of risk based on actual vessel state, rather than the usual cholesterol and blood pressure measurements. These have now been complemented with genetic profiling.
Dr Mervyn Garrett, who pioneered food intolerance in Australia provided initial inspiration for the other areas of research. Looking at disease processes for cause and not relying on medication underpins all the following projects underway.
Other areas of research include:
- Aortic root and arch dilatation
- Pathogenesis and management of POTS , fibromyalgia, dysautonomia, migraine, hashimotos disease and other autoimmune diseases
- Nicotinamide in osteoporosis
- Restless legs syndrome
Around 20 years ago, I was fortunate to meet, and later work with, one of the great pioneers in food related disease, the allergist Dr Mervyn Garrett. For decades, he has been able to prove the relationship between types of food to diseases such as eczema, irritable bowel, colic, reflux, and many more. Sadly, he was largely ignored for most of his working life, but changes are slowly happening.
Current ongoing research in POTS has opened a new chapter in areas where DNA mutations and mechanical and other trauma can precipitate this condition, activating mast cells thus increasing food intolerance as the body’s immune system kicks in to defend itself, then increasing co-morbidities such as Hashimotos disease and fibromyalgia. This has now opened another door in my journey looking for causes of diseases rather than medication to manage it. The linking of autonomic instability and inflammatory processes has enabled an insight into the underlying cause of POTS and its comorbidities.
The same patterns are found in Fibromyalgia Syndrome, a chronic disabling condition of pain and fatigue. By addressing DNA mutations, especially COMT and oxidative stress mutations, and looking at activators and drivers (usually food, spine, vascular compression, stress, mould etc) it became possible to turn off the problems causing the symptoms and again give many people symptom control, and in some, complete resolution.
There is a tsunami of people around who feel they are lactose and gluten intolerant. They generally feel better avoiding these foods. But looking deeper, when you eat a food the body sees as a threat it activates inflammatory pathways that have implications far beyond that of simple abdominal discomfort, as discussed in “Irritable Bowel Syndrome.”
Advice from Dr Pete Smith, an allergist / immunologist from the Gold Coast provided the link between all these, namely the activation of our innate immune system, the triggering of the Toll-Like Receptors (TLR’s). When triggered by things like foods, stress, or spine, these receptors produce inflammatory responses that produce the symptoms of IBS, fatigue, or dysautonomia. He then added the data on mitochondrial dysfunction, baroreceptors and ion-channels, the subject of some excellent research from Griffith University in chronic fatigue.
It takes patience to work through these problems, from both myself and the patient. There are no established guidelines to follow. Modern medicine provides safety against improper or experimental practices through “Cochrane Guidelines” which provides doctors a safe way of dealing with their patients, but unfortunately these guidelines do not apply in these research areas.
Using high quality retinal photography provides us with a look at the blood vessels in the brain, so it should be a useful tool in managing problems such as dementia. This data was published a few years ago by Australian optometry researchers, but it has been slow to be utilized by medical practitioners. So too is ultrasound scanning of the lining of the carotid arteries. This knowledge is over a decade old, and although difficult to use effectively as it needs a dedicated technician to assess small changes, when used correctly, it gives us a clear picture of what is happening over a period of time, so we are not limited to blood pressure or cholesterol measurements to determine whether treatment is needed, or is effective managing arterial disease. There are now accurate CT angiograms that show exactly what is in the coronary arteries in high risk people as well as the more commonly used echocardiograms and exercise ECGs. It is the current research in areas such as Minoca that provides an insight into cardiovascular and cerebrovascular disease that causes the disease that is not explainable through simple cholesterol, hypertension and smoking. This is dealt with more closely in “Preventing Vascular Aging.”
Inflammation, the immune response of body tissues to injury or infection, is an important part of our innate immunity. Acute inflammation is a normal process that protects and heals the body following physical injury or infection. However, if the agent causing the inflammation persists for a prolonged period of time, the inflammation becomes chronic. This can result from many sources, eg viral or microbial infection, environmental antigen (e.g., pollen), autoimmune reaction, or persistent activation of inflammatory molecules.
In chronic inflammation, damaged tissues are repaired through replacement with cells of the same type or with fibrous connective tissue. In some instances, the body is unable to repair tissue damage, and the inflammatory cascade continues. Chronic inflammation is abnormal and is involved in a number of disease states.
Many diseases are inflammatory in nature, including asthma, rheumatoid arthritis, polymyalgia rheumatica, tendonitis, bursitis, gastritis, coeliac disease, diverticulitis, and inflammatory bowel disease, to name but a few. Additionally, a number of chronic diseases have inflammatory components, such as hypertension, atherosclerosis, obesity, diabetes mellitus, cancer, and even Alzheimer’s disease.
Turning off the causes that drive the TLR’s driving this inflammation is vital. There are medications that can be helpful that are known to do this, but looking at diet and lifestyle and how to deal with injury is more important in most people. The defects from the methylation mutations can usually be managed with suitable vitamin supplementation, and other genetic mutations can often be managed by attention to the causes of the activation. This is not an expensive exercise, but as mentioned, it requires patience.
I look forward to these continuing advances, and strive in my way to deal with the diseases such as POTS, migraine, IBS, fibromyalgia and dysautonomia, by looking at activators and drivers rather than medication to control symptoms, as well as the intolerance-related diseases such as IBS, eczema, oesophagitis and colitis
Dr Graham Exelby