Ciguatera Poisoning & Chronic Fatigue Syndrome

Ciguatera Poisoning & Chronic Fatigue Syndrome
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The effects of the neurotoxins that can contaminate fish like red snapper and grouper can last for decades.

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Ciguatera is one of the most common forms of food poisoning, which occurs after the consumption of fish contaminated with neurotoxins, produced by certain microalgae that build up the food chain. Just a few bites can be sufficient to induce the condition. Disturbingly, affected fish looks, smells, and tastes normal, and ciguatoxins are resistant to all forms of cooking, so there is no straightforward method to predict whether your tropical culinary dream will be followed by a ciguatera nightmare.

Literally, it can cause nightmares; about 1 in 6 may experience signs of hallucinatory poisoning: lack of coordination, hallucinations, depression and nightmares. Most suffer some kind of neurological symptoms, tingling, numbness and a burning cold sensation. For example, ciguatera sufferers have reported that a refreshing dive in the ocean actually caused burning pain, or that drinking cool beer felt like too hot coffee.

Sometimes a reversal of temperature sensation occurs, like cold objects feel hot and vice versa. The toxin itself may also be apparently sexually transmitted either direction after fish consumption, or as one of my favorite public health bloggers put it, when hot sex turns, cold and painful, blame it on dinner.

And the symptoms can persist for months or even years. Ongoing research has shown that people with chronic fatigue syndrome may actually be suffering the long-term effects of this fish food poisoning, or a condition called polymyositis, which causes diffuse muscle aches, pains, and inflammation. Some individuals intoxicated by fish consumption 25 years can previously experience a recurrence of the main neurological disturbances during periods of overwork, fatigue, or stress. You can still find the toxins stuck in their body decades later.

Recent outbreaks in New York City have drawn attention to the problem. A man eats grouper at a Manhattan restaurant, and goes from swimming two miles a day to having difficulty walking that lasts for months. But these aren’t just rare anecdotes. Ciguatera fish poisoning affects an estimated 15,000 Americans every year, causing hundreds of hospitalizations and even a few deaths. Again, the toxins are colorless, odorless, tasteless, and are not destroyed by cooking. Therefore CDC scientists suggest education efforts aimed at the prevention of seafood intoxication by avoidance of high-risk fish altogether. The AMA put out a similar advisory, suggesting that the only way to prevent it is to avoid eating fish like red snapper or grouper, but the problem is that a third of fish sold in the United States is mislabeled, so you don’t know what you’re getting. Some suggest feeding a large fish flesh meal to a cat, treating them like a court tester, and if they’re okay six hours later, you can dig in, but this is considered inhumane. But if it’s inhumane to feed it to your cat, how is it not inhumane to feed it to other members of the family?

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

 

Images thanks to NEON ja and Richard Bartz via Wikimedia Commons.

Ciguatera is one of the most common forms of food poisoning, which occurs after the consumption of fish contaminated with neurotoxins, produced by certain microalgae that build up the food chain. Just a few bites can be sufficient to induce the condition. Disturbingly, affected fish looks, smells, and tastes normal, and ciguatoxins are resistant to all forms of cooking, so there is no straightforward method to predict whether your tropical culinary dream will be followed by a ciguatera nightmare.

Literally, it can cause nightmares; about 1 in 6 may experience signs of hallucinatory poisoning: lack of coordination, hallucinations, depression and nightmares. Most suffer some kind of neurological symptoms, tingling, numbness and a burning cold sensation. For example, ciguatera sufferers have reported that a refreshing dive in the ocean actually caused burning pain, or that drinking cool beer felt like too hot coffee.

Sometimes a reversal of temperature sensation occurs, like cold objects feel hot and vice versa. The toxin itself may also be apparently sexually transmitted either direction after fish consumption, or as one of my favorite public health bloggers put it, when hot sex turns, cold and painful, blame it on dinner.

And the symptoms can persist for months or even years. Ongoing research has shown that people with chronic fatigue syndrome may actually be suffering the long-term effects of this fish food poisoning, or a condition called polymyositis, which causes diffuse muscle aches, pains, and inflammation. Some individuals intoxicated by fish consumption 25 years can previously experience a recurrence of the main neurological disturbances during periods of overwork, fatigue, or stress. You can still find the toxins stuck in their body decades later.

Recent outbreaks in New York City have drawn attention to the problem. A man eats grouper at a Manhattan restaurant, and goes from swimming two miles a day to having difficulty walking that lasts for months. But these aren’t just rare anecdotes. Ciguatera fish poisoning affects an estimated 15,000 Americans every year, causing hundreds of hospitalizations and even a few deaths. Again, the toxins are colorless, odorless, tasteless, and are not destroyed by cooking. Therefore CDC scientists suggest education efforts aimed at the prevention of seafood intoxication by avoidance of high-risk fish altogether. The AMA put out a similar advisory, suggesting that the only way to prevent it is to avoid eating fish like red snapper or grouper, but the problem is that a third of fish sold in the United States is mislabeled, so you don’t know what you’re getting. Some suggest feeding a large fish flesh meal to a cat, treating them like a court tester, and if they’re okay six hours later, you can dig in, but this is considered inhumane. But if it’s inhumane to feed it to your cat, how is it not inhumane to feed it to other members of the family?

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Katie Schloer.

Please consider volunteering to help out on the site.

 

Images thanks to NEON ja and Richard Bartz via Wikimedia Commons.

Doctor's Note

Many more are killed by more conventional food poisoning bugs (Chicken Salmonella Thanks to Meat Industry Lawsuit), but isn’t that crazy? Reminds me of my Amnesic Seafood Poisoning video.

Other neurotoxin videos include Preventing Parkinson’s Disease With Diet and Essential Tremor and Diet.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

120 responses to “Ciguatera Poisoning & Chronic Fatigue Syndrome

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  1. Wow! That’s an amazing report. One more reason to simply stay away from fish!

    What proportion of all cases of reported chronic fatigue are related to physical causes?, such as this type of food poisoning, versus psycho-social causes, such as depression-related disorders? On a recent visit to my family doctor, while she was willing to do a full blood profile to exclude some possible physical causes of fatigue, she reported that very often there’s no physical cause and that fatigue is normally psycho-social… I mentioned Fibromyalgia and she accepted this as a possible exception.

    How much we know about the root causes of feelings of chronic fatigue? Maybe a lot more of such problems are based on physical causes. Maybe viewing them as psychological simply makes for easier diagnosis and treatment with medication (anti-depressants). What the story here?

    1. A couple of things I find irrelevant. One, the fibromyalgia diagnosis is a warm blanket diagnosis. Covering the bases for insurance coding to get paid. If a dr. Diagnosis is fibromyalgia, then you can bet an on going future of taking something like lyrica is on your chart. So, they get perks pushing the pill, and you’re no closer to health, or answers for poor health then when you walked into the office.

      Two, this world has become toxic, there is hardly anything you can consume that has not been affected by pollution and Toxins. There are ways to mitigate the destructive levels of toxins in your environment by choosing eco friendly products for your house hold, placing a water filter for the entire water supply to your home.

      1. Sorry, I can’t accept that fibromyalgia isn’t a real disorder, as you imply here. I’m not an expert but it clearly appears to be a real problem.

        1. Trust me, whatever it is caused by, it is very real and can be very painful and disabling and I sure had my share of pharmaceuticals to “help”. When I switched to a WFPB diet the symptoms got a lot better and flares are rare, but it is still a mystery I would love to know the answer for!

      2. Totally agree…..has anyone read the symptoms of fibromyalgia? It mimics an array of cold-flu, depression, muscle soreness, lack of exercise, etc…. Any “new” chronic disease comes with it the promise of lifetime drug prescriptions. Maybe Tobias hasn’t heard of medchecks…..the money docs receive every month? week? 1/4ly? for their prescription practices… Chrons, Hep C etc…all have pharma interests and corporate biological interests behind them. Medicine is corrupt since polio and then HIV…….. Read “Inventing the AIDS Virus” by Duesberg to get an idea of how this happens in what is supposed to be a academically, forthright and honest profession. What a lie. It’s all about the $$$

    2. I have Chronic Fatigue Syndrome and I assure you that it is not a psychological/social disorder. It is physical, it is real, and it has made me disabled. I am not depressed. I was working in my dream job when I became ill. I am part of a very supportive family and social community. Many doctors do not understand Chronic Fatigue Syndrome, and do not want to accept that there are illnesses that Western medicine is pretty clueless about at this point. I have found the most relief from Acupuncture and Chinese herbal medicine. There are some excellent resources on the web if you want to learn more about Chronic Fatigue Syndrome.

        1. Thanks! I saw this when it was originally published. I found a wonderful recipe – I think it was on Dr. fuhrman’s website, for hot cocoa that uses almond milk, dates, cocoa and vanilla- and my Vitamix! I treat myself to it on a regular basis.

      1. Is your level of fatigue similar day to day? I’m curious about conditions where you’re fine one day but fatigued the next day.

        1. There is a base level of fatigue day to day, but then there are other symptoms in addition that vary day to day. That may be a more debilitating fatigue, or what we call flu-like symptoms, or cognitive impairment or muscle pain… There are many. But I never feel “fine”- there is always a base level of symptoms. Some days I feel better than others, thank goodness! I find that,for me, a predominantly plant-based diet of whole foods has helped enormously. And no sugar.

          1. I have the same illness – daily fatigue, flu like symptoms, cognitive issues, varies from day to day, but I am working in the field of environmental research, so this is really killing my ability to work. Doctors are trying to treat it with antidepressants, doesn’t help much :( Switched to a plant based diet about 7 moths ago, a bit better but not so much… Hanna, maybe you have some advice?

            1. I am wary of offering advice because we all vary so much. I am so sorry that you are suffering with this. i would recommend that you start with solvecfs.org. This is the organization that advocates for us and has many useful articles about treatment and how to take care of yourself. it also sponsors research to try to learn more. As I said above I also found acupuncture and Chinese herbs to be very helpful, but you have to find a good local acupuncturist and, sadly, acupuncture is often not covered by health insurance. I wish you a heartier new year!

              1. this may be way way off but if you smoke anything including weed it can causes all of those above issues- the fatigue, the flu like symptoms for sure obv cognitive issuesmany think that weed can be helpful and it can but it can also go the other way- also inflammation from allergies could be bypassing typical ENT receptors and going straight into your system manifesting in whole body flu like symptoms and fatigue.

                1. One of the problems in diagnosing CFS is that the symptoms are so similar to so many other things, including Lyme Disease, Depression, mono, and so on. It is important to work with a good doctor to rule out other possibilities. There is also the possibility that CFS can be masking another illness with similar symptoms. It took me two years to get a diagnosis, and my experience is not unusual. In addition, there are often concurrent illnesses – in my case, for example, I have multiple chemical sensitivities. This is not instead of CFS, but rather, in addition to CFS.

            2. There are doctors and GPs who specialise in chronic fatigue (it is called a syndrome because it basically describes a list of symptoms not a specific disease), sometimes the causes can be identified; sadly often not. Different people can respond quite differently to different management programs. Self-care is really important, especially in terms of not pushing yourself. It is a serious and debilitating condition that even many health professionals are confused about. I would recommend contacting a local support group (often run by ex-suffers or people caring for those still dealing with it, as the people themselves usually don’t have the energy) to find out who they recommend you see who has the background necessary to really help with a diagnosis and if not at least a realistic management plan.

            3. Advice is hard if not impossible. While it seems discovering an absolute single cause I perfer to focus on what may help. I researched testing and found I had high virus loads (Epstein barr/HHV6&7 etc) Still not the root. Dumped sugar especially since it feeds virus. Then we discovered the mysterious reason B12 helped was the genetic issue of MTHFR. I have a base functioning much better than the last 5 years but all virus testing is the same along with diminished natural killer cell function. Currently since this has landed me with the lack of effective digestion Im using Ayurveda when other dietary paths made it worse. They aren’t bad-just didnt work for my body. The body is so complex one has to do the best guess of what direction might help. While NOT a psychsomatic illness still can consider attending to the emotion/mental/spiritual well being for coping positively. Take good care!

        1. Hi Sandy. I see an acupuncturist who is also a Chinese herbalist. Many acupuncturists are trained as herbalists as well. the combination of acupuncture and Chinese herbs has been very powerful for me. You will need to find someone who is local to you. The problem is that often acupuncturists are not covered under health insurance. In my experience, it is most important to find someone who understands the Chinese medicine approach, rather than a Western doctor who does acupuncture as just one more trick to pull out of the treatment bag. You may find that someone in a local support group can recommend a local acupuncturist. Sorry I can’t be more specific, but the herbs are recommended in the context of the larger treatment plan.

      2. Do you mind sharing which herbs have helped you? I’m going to ask my acupuncturist for help. I’m pregnant and due any day now. I’m hoping the herbs will be safe to use while breastfeeding.

      3. Hi Hanna,

        It would be nice to learn which herbs you are been taking, if possible including dosages and providers.

        Thanks a lot!

    3. Hi, I am aware of a few people who have been diagnosed as Fibromyalgic for years only to go to Dr.s outside of the area and found to have tick bite illnesses. One being my vet’s wife who now after about 20 some years of fibromyalgia diagnosis is unable to walk because of the debilitating diagnosis of a second tick disease which eats away cartilage.

      I am wondering if any of the people reading here have been tested for tick bites. Worth a shot for some people.

    4. i think that sometimes the two are hard to separate because it is not as simple as one against the other. As someone who has CFS I think that the ups and downs have been related to both. I got sick again over 2 years ago when I caught a cough and haven’t worked fulltime since. I was vegetarian and at that time felt good and so probably was eating the worst that I had for a while. Probably some of the stress in my life contributed to me being vulnerable as well. I had been unwell in my twenties as well with chronic fatigue and back then it was so uncool…….everyone assumed that it was something in your head I went whole food plant based about 15 months ago since it works for so many illnesses and did the plant based nutrition course through the T.Colin Campbell foundation. I’ve tried short fasts since I’m in NZ, the first for 7 days and then this year for 5 days. Some Chinese medically trained people have suggested that meat is an easier form of energy. However, I’m also ethically vegan now. Because i have trouble with keeping warm, particularly my Chinese friends suggest i eat nothing raw or cold…..sometimes not even fruit (I’m not good at this). I have drunk a lot of ginger tea which is a good detox (thanks Dr Greger)……..the traditional chinese version with the dates in it. Because I thought there was a stress component, I’ve also been studying and doing the emotion code and body code work. It measurable to me because I’m using muscle testing to find what I need to clear – whether it is emotional, toxins, spiritual, or things that you need to change about your diet and lifestyle. At the moment the muscle testing is telling me to include nettles, cranberries and use an infrared sauna to detox (fun). I also have a background in counselling and pyschology and have seen people with these issues long term which is really depressing. I wouldn’t want to get stuck there. Personally I don’t feel depressed….maybe traumatised and anxious…..so haven’t used anti depressants. I up the food which help create neuro transmitters if I feel down. I’ve seen people who haven’t trusted anything alternative to those who have spent too much money and hope that muscle testing will point me in the right direction. I hope to put together some ideas on how to deal with CFS when I’m feeling better and what has helped from the whole food plant based perspective.

    5. Bad memory of a former colleague being fobbed off with ‘psych-social”: took years for the Epstein-Barr to get diagnosed and treated.
      Didn’t have anything to do with her being female, no?

    6. Hey Tobias, if you want to learn more about the state of the science on chronic fatigue syndrome, check out this lecture given at the Stanford School of Medicine: https://www.youtube.com/watch?v=VCowKm4N2Ow
      Like others, I have CFS and can assure you that it’s not psychosocial. It can make you feel depressed in time, but that’s true of any chronic, debilitating illness.
      Anyway, thanks for your curiosity about this illness—I hope more and more people become curious too and that a growing public concern will get research money flowing to finding cures and treatments. Take care.

    1. I am a vegan, and I use a B12 supplement, eat a lot of B12 fortified yeast, and also take chlorella daily. In my last panel, my B12 level was actually a few points higher than the high end of “normal” (something my doctor was not concerned about). Perhaps my B12 level is in part coming from chlorella. But after this scary video, I am also wondering about chlorella. I’ve never experienced any of the symptoms mentioned here, and I’ve taken it for years – the Sun Chlorella brand (sorry, don’t mean to make this an ad). I would also like to know if it’s prudent to avoid all algae. Are there any cases traced to algae supplements? Are the supplements ever tested for this toxin?

  2. Nice Piece!
    I really love the opening artwork I have been seeing on your videos.
    Looks like today was a color enhanced electron micrograph of ciguatera. Really cool looking.

    1. The longest living population in Japan, the Okinawans, get 4% of their calories from animal sources and 70% of their calories come from sweet potatoes. They have the most centenarians per capita, fish clearly is not where their longevity comes from, as it comprises a total of 1% of their total caloric intake. Basically, its a condiment.

      Caloric Restriction, the Traditional

      Okinawan Diet, and Healthy Aging

      The Diet of the World’s Longest-Lived People and Its Potential Impact on Morbidity and Life Span

      Ann. N.Y. Acad. Sci. 1114: 434–455 (2007).

      TABLE 1. Traditional dietary intake of Okinawans and other Japanese circa 1950

      Total calories 1785

      Total weight (grams) 1262

      Caloric density (calories/gram) 1.4

      Total protein in grams (% total calories) 39 (9)

      Total carbohydrate in grams (% total calories) 382 (85)

      Total fat in grams (% total calories) 12 (6)

      Saturated fatty acid 3.7

      Monounsaturated fatty acid 3.6

      Polyunsaturated fatty acid 4.8

      Total fiber (grams) 23

      Food group Weight in grams (% total calories)

      Grains

      Rice 154 (12)

      Wheat, barley, and other grains 38 (7)

      Nuts, seeds Less than 1 (less than 1)

      Sugars 3 (less than 1)

      Oils 3 (2)

      Legumes (e.g., soy and other beans) 71 (6)

      Fish 15 (1)

      Meat (including poultry) 3 (less than 1)

      Eggs 1 (less than 1)

      Dairy less than 1 (less than 1)

      Vegetables

      Sweet potatoes 849 (69)

      Other potatoes 2 (less than1)

      Other vegetables 114 (3)

      Fruit less than 1 (less than 1)

      Seaweed 1 (less than 1)

      Pickled vegetables 0 (0)

      Foods: flavors & alcohol 7 (less than 1)

      Data derived from analysis of U.S. National Archives, archived food records, 1949 and based on survey of 2279 persons.

      1. What I find most revealing is that they pull this diet off with very little fruit, thus very little fructose sugar. I sometimes wonder if that is what has helped them, but I am not sure if sweet potatoes would raise the blood sugar in most people to a the same degree (less or more) than modern-day overly sweet fruit that is bred {grown} to pack in the sugar dose. Do you think this minimal fruit intake might have helped the Okinawans to a significant degree?

        1. I thought that was interesting too. But I don’t think so, every study I know of (except for a couple outliers that show neutral benefit due to improper methodology) with fruit intake show better health outcomes and protection from chronic disease. If you haven’t already, you should see this video on fructose
          http://nutritionfacts.org/video/if-fructose-is-bad-what-about-fruit/

          And these few on sweet potatoes
          http://nutritionfacts.org/video/anti-cancer-potential-of-sweet-potato-proteins/
          http://nutritionfacts.org/video/the-best-way-to-cook-sweet-potatoes/

          1. In the first link on sweet potatoes you provided, Dr. Greger mentions “Remarkably, though, this class of proteins doesn’t just survive digestion, but may be absorbed into the bloodstream intact,..”

            This is likely the reason my body reacts poorly and suffers greatly when I ingest sweet potatoes (and maybe this is why for regular potatoes as well). My GI specialist theorizes that when proteins are ingested and not completely digested and absorbed, they are left to wander into the blood and possibly other areas of body and these proteins can wreak havoc in some patients. Autoimmune reactions, food sensitivities, neuro-issues, etc.

            Really upsets me as I love the taste of sweet potatoes and would prefer to eat several a day over many other plant foods, to get calories, but I get exhausted like I am coming down with the flu after eating these. Maybe it is these undigested proteins, while good for most people, not so for a few. Maybe this is why I can’t eat wheat and rye as well, undigested proteins traveling into blood. I wanted to doubt the GI specialist but now that I’ve seen the video you mentioned, I have to further consider that these undigested proteins might not be good for me. Thanks for now, and maybe you know of a way to cook sweet potatoes so that there are no undigested proteins left.

            1. Interesting point of view. I can’t give you any clear answers on that one. I can tell you that the leaky gut theory usually applies to animal proteins, not plant, because animal proteins resemble that of human proteins which is why it is troublesome. I am sorry about that though, this would be a question to email Dr. Greger about.

            2. I have found that steam cooking works best for me and i feel the smallest degree of symptoms you described. But the best way i found so far is still to reduce carbs.

            3. i think that what people react to can be quiet individual and it can depend on what antibodies are formed rather than necesarily whether they have passed into the blood stream. It could suggest some sort of efficiency too. There is still little known about what makes the gut lining healthy though Dr Greger has an article on brocolli thats interesting. I think that when there is an auto immune response to animal based foods the results are more extreme because fo the confusion with our own flesh and blood…..MS and type 1 diabetes are examples. However anything that we have developed antibodies too, it is a good idea to eliminate until this type of reaction clears

    2. So far in Adventist Health II, vegans and pescetarians are [running neck and neck. As with just about any whole food, one can point to beneficial components in fish: B12 and EPA/DHA (both of which Dr. Greger recommends), and taurine, carnitine, creatine, and carnosine, which like the long chain omega-3s, are semi-essential, with lower status in vegetarians and possible health benefits. Alas, fish also bioaccumulates methylmercury, persistent organic pollutants, and ciguatera toxin, as well as being a major source for biogenic amines, and perhaps most importantly, current global seafood consumption isn’t sustainable and is decimating long-term viability of ocean ecosystems. If an optimum diet for healthy aging ensures adequate amounts of beneficial components while minimizing harmful ones, it seems reasonable to eliminate the harmful ones wherever practicable, adding back in alternative sources of beneficial components. Matching omnivore intakes of the so called “carninutrients” can be done for pennies a day, so its unfortunate that none of the supplement manufacturers offer a convenient product aimed at the health oriented vegetarian market.

      1. I read through these links. Interesting stuff. I was not aware that the research/science used in “The China Study” showed that eating fish was actually beneficial “.Vegan admirers of the China Study, which provided
        important evidence for the protective merits of plant-based diets, should be aware that this study also
        correlated increased fish consumption with improved health outcomes, likely reflecting a protective role
        of long-chain omega-3s.83”

        Such irony but yes, it lends credence to your thoughts above, and the potential merits of the need to supplement certain carninutrients for vegans who fail to thrive. My biggest concern is ingesting factory made amino acids in order to be 100 vegan.

        1. That reanalysis of China Study data found incidence of most chronic diseases was lower, though diabetes and liver cancer were higher, in coastal Chinese villages where fish intake, determined by blood DHA, was higher. The correlations were in general smaller than that seen for reduction of total animal protein/saturated fat intake in the earlier Campbell authored papers.

      2. Which of these carninutrients do you supplement with? All of them? I’m sure the B12 is on your list, but curious about the amino acid types.

      3. I’ve read through the entire website where the last link you provided in the last post “carninutrients”.

        http://catalyticlongevity.org

        Real interesting stuff these guys have to say. I was a bit thrown off by their strong belief in spirulina, but other than that
        they seem to have put together some thought provoking and informative ideas and data. My guess is is that they feel that amino acid supplementation (certain amino acids) might be a necessity for a 100 percent vegan diet.

        1. Bear in mind Mr. McCarty owns a small supplement firm, so there is possible bias, and I take his more unusual recommendations with a grain of salt. On the other hand, I’ve learned a great deal from his wide ranging “medline synopses” and perusing his hundreds of publications, most appearing in the non-peer reviewed Medical Hypotheses, offers a useful introduction to some likely mechanisms for plant based diet benefits. There are few on the planet who’ve read as much of the biomedical literature, so McCarty’s advocacy of whole-plant based diets was very reassuring.

          Besides B12, none of the so called carninutrients are essential, but as with EPA/DHA, strict vegetarians have lower tissue levels of all of them. Omnivore daily intakes in the literature run: 655 mg creatine (1034 mg in males), 332 mg β-alanine, 60 mg taurine (but > 125 mg better according to WHO-CARDIAC), 64 mg carnitine. A two year supply at near those levels was about $70 in bulk powders and a slow night with a capsule filler. I can’t claim any striking benefits after a year, but my blood results remain fine and I don’t experience the malaise some strict vegetarians report, so this n=1 experiment appears to have done no harm.

    3. Hi Kirk, since the meltdown of the nuclear reactor a few years ago that polluted the Pacific ocean with nuclear waste, the fish now around Japan would be best avoided. After the melt down from the tsunami, indicators in Hawaii had a 18000% increase for nuclear waste. Please read http://www.drapsley.com All the best and God bless

      1. Hi Wyman, i agree 100%! In fact, I spoke with a butcher at a Whole Foods in Rochester Michigan within a few months of the nuclear meltdown and he informed me that a customer came in with a Geiger counter and tested some of the “fresh” salmon that had just come in from the Pacific Ocean. The butcher said the customer got a hgh reading and turned around and walked out. :-)

        I think there is more to Taurine than meets the eye. I know it may have saved my life on at least one occasion after I found out through some testing I did on myself with the world’s most advanced LONGEVITY Nutrition BioSurvey via my Zyto ELITE technology. :-)

    4. Is there also a possibility that the Japanese may have some sort of immunity against these neuro-toxins after a few thousand years of eating a plant based diet with fish?

    5. Dr.Kirk MacAnsh, yes, Japanese live long lives but the interesting fact is that in the last 20 years the mountain men have been living the longest, while mountain women took the lead about 5 years ago. Okinawa people were number 1 in longevity when they were eating as per what Mr.Toxin mentioned below, in 1950!!!! Do you know that MacDonald was introduced in Japan in 1967 and also early on in Okinawa? So the kids and parents switched their preferences from traditional healthy food to the new and appealing playground having American imported fast food restaurants. The result, 60 years later: Okinawa loses the lead in longevity for both men and women. Nagano prefecture, with no access to the sea is number one in man and women longevity. But again, the difference is small.

  3. Plant-based diabetes pre-diabetes help!!!

    I’m finding that if I eat a diet of beans and grains and
    fruit and plant vegetables my blood sugar goes up high and stays up for 4 hours if I am sedentary, but if I go for a walk – 45 minutes –
    rest for a while, and then do more physical activity off and on for next few hours, BS levels stay normal and low for the entire four hours.

    Is it normal not to be able to eat a bowl of beans and barley and steamed greens and not be able to go back
    to work (sitting down for hours on end) and get my BS levels down without constantly exercising after each meal?

    I assume humans are designed to be in motion. Sedentary work not normal I guess. Anyone here – including Dr. Greger,
    who can help me understand this I would be thrilled to read your advice. I do wonder if I will develop diabetes if I continue
    to eat my plant-based foods (low in fat) and don’t take up the exercise routine.

    1. Go to postings under the Greger video “How Fatty Foods May Affect Our Love Lives” and look at the comments that some of us have made on this. Lots of info to share there that will help you!

      1. Even if I eat low fat I am dependent on lots of exercise. Is this normal to have to exercise after every meal for vegans in order to keep blood sugar stable?

        1. This site recommends for diabetes hibiscus tea, flax seed meal, amla, beans, and cinnamon. Dr. Greger said that a teaspoon of cinnamon a day can bring blood sugar down to normal levels, but only the specific toxic variety, if it helps, he has recommended cinnamon elsewhere. He has a video which said that amla is effective as the leading prescription without the side effects. Whole grains like whole grain rice can reduce your risk of diabetes by 18 percent, Dr. Greger said in one video, and so could be useful in treating or limiting it. Whole grain rice is available at Walmart or in Minute Rice form at most grocery stores. Many medicines have pre-diabetes as a side effect. Fenugreek can cause weight loss which can limit the effect of diabetes. Amla http://nutritionfacts.org/video/amla-versus-diabetes/ Lifestyle Intervention http://nutritionfacts.org/video/how-to-prevent-prediabetes-from-turning-into-diabetes/ Lifestyle as medicine http://nutritionfacts.org/video/lifestyle-medicine-is-the-standard-of-care-for-prediabetes/ Dr. Greger shows that the Vegan diet is effective at treating diabetes after just two weeks. http://nutritionfacts.org/video/how-to-treat-diabetes/

    2. martygobi , i have the same very problems. if i eat starches which are supposed to keep me full my sugar level goes up and i start feeling bad without physical activity thereafter. if i eat leafy greens the sugar is significantly lower but that way i have to eat very often bc it doesn’t keep me full long enough.

      if you or someone find an appropriate solution and share it that would be much appreciated! Oherwise I have to eat dairy and eggs as they have little carbs and i don’t feel that feverish with high sugar in my blood after after meals :(

    3. martygobi: Have you read the book, “Dr. Neal Barnard’s Program for Reversing Diabetes: The scientifically proven system for reversing diabetes without drugs”? The diet is high in bean and grains and veggies, BUT many of the people in the clinical trial were able to get off most or all of their diabetes drugs AND the program did not require specific exercise. (Which isn’t to say that exercise isn’t great and important.) And their cholesterol levels went down, so that they didn’t have to worry about statins. If your diet is truly in line with the diet in the book (and the devil is in the details!), the data suggests that you wouldn’t get diabetes. If you are interested, here is the book, with recipes in the back!:
      http://www.amazon.com/Neal-Barnards-Program-Reversing-Diabetes/dp/1594868107/ref=sr_1_1_twi_1?s=books&ie=UTF8&qid=1420244493&sr=1-1&keywords=dr.+neal+barnard%27s+program+for+reversing+diabetes

      It’s very affordable and I suspect that many libraries carry it. Good luck!

    4. There are some great recipe books (also available on kindle) for Plant based(vegan) & diabetic /pre-diabetes on online book stores that you may find helpful.
      Having portions which are no bigger than the size of my fist, and grazing several times per day instead of having 3 square meals worked quite well too.
      Making the time to walk at least twice per day in the morning before breakfast and after dinner (30 – 40 mins) and work-out sessions with weights (short/frequent workout routine)also helped. Good luck.

        1. My apologies …In my haste I typed “no bigger than the size of my fist” – I meant the portion for beans or starch .but for other vegetables and fruit I consume whatever portion I can without feeling too full.
          I avoid pumpkin because of the high G.I.

  4. Wow! I don’t even know what to say or think. Could fish I ate years ago before become vegan be the culprit of the crazy energy crashes I am privileged to experience from time to time?

  5. All his videos are amazing but there is an ulterior motive that has nothing to do with health. He is an animal rights advocate and commonly leaves out contrary evidence when it does not suit his arguments.

    1. What contrary evidence are you talking about? Please, give us the facts, show us the links to studies you’re talking about. Thanks in advance.

      1. Recently the USDA’s Nutrient Data Laboratory (NDL) removed the USDA ORAC Database for Selected Foods from the NDL website due to mounting evidence that the values indicating antioxidant capacity have no relevance to the effects of specific bioactive compounds, including polyphenols on human health.
        sure: http://www.ars.usda.gov/Services/docs.htm?docid=15866

        “There are a number of bioactive compounds which are theorized to have a role in preventing or ameliorating various chronic diseases such as cancer, coronary vascular disease, Alzheimer’s, and diabetes. However, the associated metabolic pathways are not completely understood and non-antioxidant mechanisms, still undefined, may be responsible. ORAC values are routinely misused by food and dietary supplement manufacturing companies to promote their products and by consumers to guide their food and dietary supplement choices.

        A number of chemical techniques, of which Oxygen Radical Absorbance Capacity (ORAC) is, one, were developed in an attempt to measure the antioxidant capacity of foods. The ORAC assay measures the degree of inhibition of peroxy-radical-induced oxidation by the compounds of interest in a chemical milieu. It measures the value as Trolox equivalents and includes both inhibition time and the extent of inhibition of oxidation. Some newer versions of the ORAC assay use other substrates and results among the various ORAC assays are not comparable. In addition to the ORAC assay, other measures of antioxidant capacity include ferric ion reducing antioxidant power (FRAP) and trolox equivalence antioxidant capacity (TEAC) assays. These assays are based on discrete underlying mechanisms that use different radical or oxidant sources and therefore generate distinct values and cannot be compared directly.

        There is no evidence that the beneficial effects of polyphenol-rich foods can be attributed to the antioxidant properties of these foods. The data for antioxidant capacity of foods generated by in vitro (test-tube) methods cannot be extrapolated to in vivo (human) effects and the clinical trials to test benefits of dietary antioxidants have produced mixed results. We know now that antioxidant molecules in food have a wide range of functions, many of which are unrelated to the ability to absorb free radicals.

        For these reasons the ORAC table, previously available on this web site has been withdrawn.”

        1. You make the above statement based on the antioxidant chart being removed? This video has nothing to do with antioxidants. That being said, this is the most important part of your post.

          “ORAC values are routinely misused by food and dietary supplement manufacturing companies to promote their products and by consumers to guide their food and dietary supplement choices.” Supplements are the key here. Companies take advantage and make pills to “supplement” our diets.

    2. If everyone who owned a dog, cat, bird, fish, hen, rabbit, guinea pig, hamster, gerbel, ferret, racoon, possum, lizzard, snake, turtle, horse, goat , llama, or duck, or whatever, were somehow prejudiced in their views and thus not qualified to make such comments – well, there would be no blogosphere, no newspaper editorials, no…..errr……wait……I temporarily forgot…….I own a yellow lab, I’d better say no more………………………………………………..

          1. PS – And to be more clear: your above comment therefore, unintentionally, some might say, by extension, agrees with my ‘pet’ premise above that it is possible to be “an animal rights advocate” in Dr. Greger’s case (though I have no idea if he is or not) (but in my example above; be a pet owner who by assumption presumably loves pets/animals) and still be objective in presenting ‘whatever’ studies. I appreciate your right to voice your belief, and your courage in doing so, but I don’t see your critique acting in Dr. Greger’s work at all. Your dog may not agree with me, probably preferring to consume a rare steak over black bean curd with oregano sprinkled on it, but he doesn’t get a vote, or in his/her case a ‘WOOF’. LOL. Peace.

        1. It isn’t possible to have unbiased views about diet. Food is a cultural force. It’s central to most of our lives.

          Identifying that, and trying to avoid defensive reactions is critical if you are trying to do research into nutrition. Don’t try to defend your beliefs… instead suspend them and consider others point of view. It’s a better way to live life.

    3. Ima44: I disagree. Dr. Greger doesn’t bother us with invalid information or information that doesn’t fit the body of scientific evidence. But that is not the same as leaving out actual good evidence. I think Dr. Greger does a good job of addressing this criticism on the FAQ page. Check out the section titled:
      “Why does the site seem biased against certain foods?”
      http://nutritionfacts.org/faq

      1. Wow Thea, great link. I am surprised I haven’t even glanced at the FAQ page in my years with NF. I like that tobacco reference and the studies FOR tobacco analogy.

        1. Toxins: I agree. I asked Dr. Greger to address this particular criticism in the FAQ page, and he not only did it very well, but also very succinctly. Ever since the new site went up, I’ve been dying for someone to post this criticism in just such a way that it would make sense for me to point out the FAQ section. I’m grateful for Ima44’s post for that reason. :-)

      1. Hi Toxins–Happy New Year! She seems to be upset about Dr Greger using the antioxidents chart to rate foods. I am not sure what that has to do with fish but that is ok. I think it was appropriate for the USDA to remove that list. Supplement manufacturers probably were using that link to sell their products.

    4. From what I’ve observed Dr. Greger always notes conflicts of interest regardless of bias. That you are aware of his activism proves the point – nothing to hide.

  6. Dr. Greger,

    Is it reasonable to consider the possibility that the microalgae Ciguatera toxins that grow on seaweed and other surfaces also buildup on blue green algae and spirulina and contribute to those making people sick when they ingest them as supplements? (And this may account, at least in part, for why those make people ill neurologically?) Perhaps at least contributing to sub clinical levels of mass cases of illnesses? And because they’re sub clinical illness levels this phenomena has never been medically recognized? Potentially, this then could account for many forms of illness over mass populations (especially as more and more yard pesticide runoffs into lakes contributes to algae growth?) Since it’s a microalgae wouldn’t it be even more susceptible to being aerosolized and thus spreading out into the larger population around lakes? (see Scientific American article below regarding lakes and aerosolization of algae). I realize this is considered a sub-tropical blight, but perhaps not in the warmer Northern months or warmer areas?

    After all – if you can get it just by swimming – why not in this manner also? – Or just by living near lakes as it gets aerosolized? (see FYI below).

    JM

    FYI – Re: Dr. Greger’s warnings to avoid spirulina and blue green algae – once again confirmed herein.
    http://www.scientificamerican.com/article/are-algae-blooms-linked-to-lou-gehrig-s-disease/

  7. Since the meltdown of the nuclear reactor in Japan a few years ago that polluted the Pacific ocean with nuclear waste, the fish now around Japan would be best avoided. After the melt down from the tsunami, indicators in Hawaii had a 18000% increase for nuclear waste. Please read http://www.drapsley.com All the best and God bless

  8. I find difficult to stay away from fish because a “report” at this one, I have eaten fish for years, lots of friends, family, neighbors, thousands of people in my area eat fish in all kind of preparations, eat it raw is common, I have seen not a single case of anyone being sick as a result. Probably the algae that produces ciguatera is not present in the area I live (yucatan, Mexico), in any case it would be good complement of this video to show where is the algae is known to be present, where the known cases took place and any extra info that helps avoiding fish from that origin. The author mention red snapper and grouper as the varieties that can carry the desease whereas most other sources mention barracuda as the only variety that transmit ciguatera, evidently more research has to be done.

  9. Dr. Greger would you mind commenting on the recent study by Dr. Bert Vogelstein from Johns Hopkins about how cancer is all just random chance and lifestyle doesn’t matter. The journalists name was Will Dunham and it was published by Reuters. I believe this is irresponsible journalism as it gives people permission to get their bacon could cheeseburger!

  10. ¿Hi there Dr. Greger, I wrote a question in one of your youtube videos…. I know, I know this qestion has nothing to do with this specific subjec, but hey, it’s all connected to food so here it is….:

    I wanted to ask you a serious question, that I probably already know the answer about, but i do want a more specific answer to:
    I
    am a vegan (luckily because of you) yet my boyfriend and his kids are
    not… His kids, 7 and 10 are like the American (no offense to
    Americans..) kids in Jamie Oliver’s tv series that have Noo idea what a
    tomato looks like or god forbid spinach… They eat mostly mostly breast
    chicken (with no oil salt or pepper), chicken wings that are already
    peppered from the supermarket, clean white pasta with tuna (and the oil
    of the tuna) or with heavy cream, french fries and also eating out
    McDonalds, drink a lot of juice (that one you don’t even put in the
    fridge it can stay outside…), eat juck like cerious, candy, olives in
    salt, Cheese (a lot of fatty cheese…Italians…) kinder delice…..
    junk junk junk.
    Anyways… MY QUESTION IS

    Where do they go from here? kids that their menu looks just like that? how long can they keep on going?
    Oh
    p.s one kid 10 y/o is a bit overweight and the little one, 7 y/o is
    actually underweight (he’s teeth are startign to fall out just now)

    1. Coral: You are in a difficult position, and you are not alone. We see posts here all the time from people who are trying to eat healthy themselves, but who are surrounded by loved ones who have terrible diets. It is particularly difficult when the people being discussed are children.

      I don’t fully understand your question. No one knows how long a person “can keep going” on a terrible diet. We see example of people who manage to make it decades. And some who are no so luck. But a bad diet usually catches up with people at some point.

      But if your question is: Can anything be done? I would say, “yes”. At 7 and 10, it is not too late! But unless the kids have adults in their lives who will help them change to a healthier diet, they are certainly not going to change on their own. And I’m guessing that you have limited influence. So, if you real question is, “What can I do about it?”, then I think the best you can do is little things like: Continue to be a good role model. Encourage the kids to taste healthy food. Sneak healthy food into less healthy food. (Dr. Greger has a video about sneaking extra veggies into sauces and how changing the names of healthy food can make kids eat more of it.) Etc. It’s not much. And you have to be careful not to cross boundaries that will get you in trouble with biological parents. But I think it is all you can do. Actually, I guess one other thing you can do is try to educate the biological parents. Showing some of the videos on this site might help. But if there is no interest in learning, then again, there is not much you can do.

      Not sure if I answered your question, but I hope that helps. Good luck!

  11. So I’ve read a lot of the comments here and there is no mention of treatment or detox. Is there no way to neutralize or counteract these toxins? Do they just live on in your body forever?

  12. Dr. Greger, this video opens up the possibility of fish oil DHA supplements possibly containing ciguatera, does it not? And there are lots of other supplements that use fish innards for “inactive” ingredients. I wonder if they even test for ciguatera in these supplements, as often they do not even list on the label the source of “inactive” fish ingredient, just that it was sourced from fish.

    And farmed raised salmon possibly being fed fish pellets from fish that had ciguatera? Interesting possibility, no?

  13. Thank you, Dr. Greger, for posting another video about CFS. I’m a CFS sufferer, going on 7 years now, and I’m grateful when doctors treat this debilitating condition with respect and when they work to raise awareness. I don’t think that I was ever exposed to red snapper or grouper, but who knows.
    I hope that you’ll keep your eye on CFS in the medical literature and share with us any little thing that we CFS folks can do to get even pieces of our life back. Anything we can do to get, say, 10% or 15% of our old energy back really can mean the world for us, and most of us seem to adopt this kind of piecemeal strategy to dealing with our condition. Thanks again for this and for everything you do, Dr. G.

  14. Our bodies can heal themselves if they are given what they need and if we get our gallbladder, liver, kidneys and bowel cleaned. If you are not clean in these organs it’s helpful to go to the vegan foods. Organic vegetables would be the best to start helping but when your clogged it takes forever. Just a suggestion but check out The Herb Doc website and read his blogs. A little expensive but hey, we’re only talking about your health, it’s worth the try I feel. Good luck to you all

  15. FYI – I would not suggest anyone to go vegan if they are healthy with a balanced diet and minimal red meats, chicken and fish but if you do contract a disease or syndrome then YES, vegan would be the best way. Another study that was interesting. Stay away from hydrogenated oils (vegetable which is just soy (all history shows no consumption of it only used as a condiment on occasion and not a lot at that), canola (rape seed-poisonous) and only use coconut, grape, peanut and extra virgin olive oil. All soy based products-which is in everything packaged, corn, and wheat-which is in everything packaged are not healthy. All three if not Certified Organic are genetically altered and are most of the cause of diseases because the whole food has been changed from its original good source of nutrition to not being able to be used by your body. Soy is recommended by the medical establishment due to the protein but you can get loads of protein from lentils. Soy is associated with all kinds of bad health because it acts as false estrogen in our systems. How many of us, men and women, need more estrogen? LOL Research, research and research again on everything that you are told before you do it if possible.

  16. Lets hope we find a way to get these toxins OUT of the body or mitigate the effects. As someone suffering from chronic fatigue can attest to it not being a barrel of laughs. Will defiantly be keeping an eye out over the next 10 years to see what happens with research in this area.

  17. Thanks for this video . . . I wonder how we know for sure that our chlorella & other algae supplements are free of these toxins (the toxin is made by dinoflagellates that adhere to the algae eaten by tropical reef fish). Hopefully we’re ok as long as they’re not farmed/ harvested anywhere near a coral reef.

  18. Last Tuesday, I cheated on my plant based diet and had “ahi poke” for the first time in 90+days. The very next day, I had numbness and pain in my finger joints, my shoulders, numbness and pain in my knees. I felt very depressed, lethargic (over slept that day) and actually nodded off at work that day. I decided that it was because I needed to go for a long walk. It took me 80 minutes to walk 5 miles which normally takes 65 because I jog about 2 miles of it. My husband mentioned to me that there were neurotoxins in fish. Never heard of this before. Thursday morning, after eating my normal diet, I felt a lot better and my energy returned, I’ve been fine since. This had never happened to me before. It could be a coincidence but let’s just say that I won’t that again.

  19. This article was forwarded to me by a friends because 27 years later I am suffering from a catastrophic reoccurrence of this condition. Because of age now and another condition, the symptoms were much much worse. It’s been 10 months and slowly improving. If this is happening to you a few words of advice: absolutely NO alcohol or ANYTHING from the ocean. Sorry folks but these items ,are for some of you, off limits. I didn’t know that consuming these was a slippery slope. I had very slowly resumed my fish consumption and joined a wine tasting club in January. That was all it took. I even cut back on nuts which for some molecular reason can trigger it too. On that, the science as to why is unknown.
    It almost killed me. I am under the advisement of a world expert now and a pain management MD who is helping me go forward. In Califonia, where I reside, I’ve learned that neurologists don’t handle this kind of event; nor do many other Medical specialties. It took months to find anyone. I am an NP so I speak with some authority on the struggle to locate help. One other note is that the syndrome, if you have it so far out as I do ,is that is reacts like post polio syndrome. Read up on that so you understand better how you may care for yourself and seek attention.
    This has been an awful journey. Looking back ; I now see how so much of how I suffer through the years blaming things on myself or self criticism of my low energy was most likely due to the original intake , poisoning, CV collapse and sequellae which put me out of work for 14 yrs because I had to regain my ability to read and spell ( from anoxia); was still due to the lasting effects of what the toxin did to my nervous system.
    Best luck and health to you all and beware of natural dangers !
    Lisa Gabriel

    1. Hi Lisa can you please help me? Which foods should I avoid and which are safe/beneficial? I am in Los Angeles and got ciguatera in Havana, Cuba on 2-2-16. I care for my 2.5 year old and have no energy. Whenever I eat or drink anything, I feel itchy/tingling palms, itchy mouth and have to lie down because of vertigo and fatigue. I also have constipation and the reversal of cold as hot. My legs feel like they’re ready to give out. I have brain fog and history of depression so I’m trying to stay positive. I had no internet in Cuba so I continued to consume fish, coffee, eggs, chicken, rum and nuts until I read they should be avoided. The doctor sent me home with acid reflux medicine and has no clue about ciguatera. I would greatly appreciate any help you can offer. Thank you!

  20. I need help! I has a hysterectomy Feb. 28th, 2017.
    I have had many issues since then. I have an infection inside me from the hysterectomy. In October they started treating me with Silver Nitrate. Since then I have been having neurological issues all on my right side that they are treating. No one will admit that the silver nitrate is causing this for me. I had an MRI and it was clear, but I present like MS or a brain tumor. I can’t use my right hand very well, I have pain, tingling, numbness, right eye twitching, electrical shock like stabbings into my throat, metallic taste in my mouth, dizzy all the time. I live in SC and none of the doctors will even test me for the silver screening. Boston poison control sent me a silver nitrate toxicity report and it’s all my symptoms. I need someone to help me.
    Thank you,
    Tammy

  21. This was the first test we had for Chronic Fatigue Syndrome, ciguatera. More information as I understand or try, that radiation all so plays part all so. Polonium in the water thank you for Japan and many other dumps in the water, now travels up the food chain and now concentrated .
    Water vapors carries it up in the air currents into the atmosphere, and comes down in rain and snow. Now all so added to the food chain. Now if understand today CFIDS/ME is due to alpha radiation due to ingestion or inhalation. All the testing non-government points to this. The study was done by The National CFIDS Foundation http://www.NCF-NET.org
    The world still won’t look at this information with out laughing, but we move ahead looking for away to control this in our bodies.

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