Al final va a ser la histamina...

A friend showed me a journalistic report of a presentation with great fanfare at the Congress of Deputies, a study which showed that, amongst the group of people with migraine, low levels of an enzyme, diamine oxidase, have been found. A consequence of this deficit would be a low inhibition of histamine, a molecule defined as a potential source responsible for migraines.

They do not say clearly what the role of histamine in the origin of the crisis is. It suggests that migraine has a vascular origin (we know that’s not true) and that histamine would generate a violent expansion of the temporal arteries (which are marked on the temples). Food contains histamine, some more than other. Some medications (including those used to combat migraine) may act by inhibiting, slowing the activity of this holy enzyme that contains the damn histamine.

If all this were true... identifying those citizens that, because of their genes or their habits, find themselves living in an organism that can not restrain the excesses of histamine would be crucial, and then proceed to give advice on not recommended food and medicines.

The presentation of this discovery has had an incredible paraphernalia launching to the world as if it were a milestone in resolving the cumbersome problem of migraine.

The promoters of this study have developed the "Manifesto of Madrid", a call to sensitize all professional and social sectors to redouble their efforts. That includes more information, a consideration of chronic disease disabling entitled to the subsidies given to the classic diseases, more funds for research, promises of new medications...

When it rains, it pours. Arteries, histamine, genes, triggers ...

The biochemistry of the sapiens (ma non troppo) is the same as that of other bugs as far as histamine is concerned. Strains of animals with a deficit of diamine oxidase could be selected and then cause them a forbidden bellyful, and see if they behave as if they had a migraine.

My proposal about the origin of migraine is known to readers of this blog. I think it is a cultural product that promotes defensive alarmism. I have had a lot of patients with migraine that after eating chocolate, cheese and other delicacies have understood what I explained to them and declassified forbidden fruits proceeding to eat them with relish and no fear, without any consequences. I also know some cases in which crises have gone away when removing a kind of food from their diet. There are data for all likes and dislikes.

I fear all these solemn proclamations. My duty for the small group of followers of this humble blog is to show my concern about these media circuses.

Meanwhile, the memes of migraine still make their killing. They increasingly find it easier to spread around the socialized neuronal network.

In Madrid, histamine was proclaimed the responsible for the migraine hell.

Histamine is the new scapegoat. It will try to displace serotonin.

The promoters of molecular scapegoats are always behind all of this.

"Qui prodest? (Who benefits from this?). The Manifesto promoters think it is the sufferer. Let's hope so, but I doubt it.

Neurons

- Oh! So the body has neurons? I thought they only existed in the head ...

A patient was surprised to know that every point of the organism is filled with neurons. Nothing escapes their control. Neurons register everything that happens and transfer it to the net, an area of endless gossip where everything is known.

The organism model used by Medicine is not very aware that everything we perceive, feel and do comes from neuronal activity.

Pain is a neuronal product ... always.

The doctors’ lack of interest towards the neurons’ management of the organism is starting to get scandalous.

Muscles, bones, joints, tendons, ligaments... they all deserve to be considered by professionals. Neurons are invisible. The neck hurts, muscles hurt...

Nobody says: neurons hurt ... it sounds weird.

Neurons are cells specialized in detecting events and memorizing them in order to build knowledge, anticipative capacity. They are sensitive individuals with a past, a present and a future mixed in their membrane.

Neurons imagine the reality, they dream about it at all times and make decisions that protect us from what they have learned to fear.

Neurons of all living creatures are equal. Sapiens (ma non troppo) do not have any kind of exclusive neuron. We just have a higher density of connections. Thus we can imagine more than other species. We are not tied to what happened. We dream.

The neuronal dream is inevitable.

Sometimes nightmares show up, irrational fears, phobias, superstitions. Neurons do not always distinguish the real reality from the dreamt one.

A migraine is a neuronal nightmare, fibromyalgia is the neuronal conviction of inhabiting a sick body.

Symptoms unmask the neuronal sleep, they let us know what neurons think, fear ...

Culture feeds the neuronal dream, it’s a fundamental biological component.

We indoctrinated citizens with the absurd fear to chocolate, southern wind and hormonal fluctuations while we let the neurons build all kinds of alarmist dreams.

- The migraine is a neuronal dream... wake your brain up, convince him that everything is a product of the imagination...

- So it hurts me because I imagine it's going to hurt?

- Not at all. It hurts because neurons dream of the possibility that something terrible is happening in your head. In reality, nothing special is happening.

All of this sounds weird and often causes rejection but it is real. Why aren’t neurologists interested in regular neurons?

I don’t know. They are dazzled with genes and drugs, labels and classifications of over a hundred types of headaches that have been described ...

"Okay. Everything is chemistry, but it’s a chemistry with history, memory, imagination ...

Not only is memory in the nucleus, in the DNA. There is also memory in the neuronal membrane. From this memory, dreams emerge (right guesses and mistakes).

Neuroscientists only see DNA in migraine, nucleus ... They forget the membrane.

     

Muscular Pain

Muscles have become the reference points for our welfare. An exquisit muscle care is necessary  to cope with the burdens of our bipedal condition, a condition that we don’t seem to be adapting to, despite the 5 million years that we have been standing erect.

Our muscles have bad press. Apparently, they are delicate: they are overloaded, distended,  they contracture, atrophy, cool and tear easily. Before using them, we must warm up and stretch if we want to avoid bad surprises and a massage is necessary to activate the circulation and remove those toxins accumulated with the effort. It is not understood how we have been able to overcome the exigent evolving conditions before our actual civilization with such deplorable muscles.


The human muscle-skeletal system, if we listen to the gossip, might be the biggest botched job of Evolution. Our brains are big and we have great intelligence but that’s useless, because our plans are coming down because of some bones, joints and, especially, muscles that can’t carry the burden of our purposes.


Each cell system has a set of sensors of damage that draws limits on the conditions it can handle. Muscles require the following to do their job: plenty of oxygen, no sudden and surprising stretches and not exceeding a specific time of sustained contraction. If you violate these conditions, the necrotic damage sensors will activate and send distress signals to the brain causing it to activate the pain program, forcing the individual to suspend the action. If he or she obeys, pain goes away, if irreparable damage has not yet occurred. The pain of angina pectoris shows the patient the limit of his or her effort ("don’t go too far with this...") and pain of a heart attack points out cell death ("you’ve gone too far...").


Under conditions of proper oxygenation and manageable load, the necrotic muscular damage sensors remain silent and therefore there is no pain. However, many men and, indeed, women feel their muscles sore, unmotivated and tired without having made any effort previously.


Chronic fatigue syndrome, fibromyalgia, neck pain ... they generate a belief that muscles are not fine. However, there’s no evidence that the muscle is causing the problem.


Little is known about muscle pain. We still don’t understand the mechanism of stiff muscles, myofascial pain or contractures. We blame the muscles with no evidence and condemn them to hard work in the gym, swimming and boring relaxation sessions.


There is a small detail that, from my perspective as a neurologist, has always disconcerted me about this: the muscle is submitted since the first neurons of the embryo appear at the orders of the nervous system. Muscle fibers shrink only (usually) if the various neural centers that program actions demand it. The logical thing is to analyze these orders, not who does them by obedience.


If we assume that the muscles are not made to make lots of effort, it does not make sense that the brain wants them to work and, indeed, that's what happens: the brain activates the pain and exhaustion so the individual stops moving. The brain protects muscles from the individual’s desire of moving them.


Then... which one is right? The muscles are well and, therefore, they can and must work or are they defective and the brain has to protect them?


Everything suggests that the muscles can and should work, and that the one that is not working is the brain: it erroneously assumes that the muscles are defective and protects them unnecessarily.


In all this matter of widespread pain, the poor muscle takes the blame while the real culprit, the brain, just locks it in a dungeon for no reason.


Muscles are innocent. The boss, the brain, goes around doing whatever it wants and no one seems to want to incriminate him.


Incomprehensibly, citizens with imprisoned muscles do not want to hear about this innocence. They want their muscles to remain submitted to the brain, which apparently is not guilty...

Abs, memory... and SSRIs

We are a mobile species. Our survival depended (before the implementation of agriculture-livestock) on our mobility, walking around looking for a shelter, sustenance and company. Mindless mobility would only be used to waste energy or take unnecessary risks. 

Therefore, us mobile species have an extensive neural network whose mission is to select smart decisions, those which optimize cost-effectiveness.

We need muscles and neurons: strength and memory, gyms and memory workshops, weights and crosswords.

I studied piano in my town with the band director. I received lessons at noon, when the teacher had just woken up. He used to listen to me from his bed or the bathroom, and from time to time, would yell at me to correct: “F sharp!!” He rarely observed or corrected my piano "technique”. I learned how to play by what God or the devil gave me. For me, playing the piano was a muscular issue, I had to take strength in the fingers and design systems of gums to exercise the flexors, which I thought were responsible for lowering the keys.

Around the same time came the "Friars School”, where pedagogy focused on memorizing each and every one of the texts as fast and accurately as possible. Interestingly, the piano teacher flatly forbade me to learn the songs by memory and I had to keep my eyes fixed on the sheet.

I exercised my finger flexors and memorized lists of rivers and Visigoth kings but could not retain any music sheet. The lists are missing now, the flexors have recovered its normal and desirable volume, and when I play the piano I have to make up the notes.

We are in the age of fitness, of muscular and neuronal crush, of obsession to highlight the abdomen muscles and the brain (although not visible). We need abs to do more sit-ups, like Cristiano Ronaldo, and solve puzzles to solve more difficult ones. The intent, meaning and complexity of the task don’t matter. 

Reductionism is raging: to have a good response capacity, we need shaped abdomen muscles and an incredible memory capacity. Gym and memory workshop.

A laboratory mouse in a cage with no gym and no stimuli is left without hippocampal neurogenesis (generation of new neurons in the hippocampus: an essential brain area to deal with the new). If we make the mouse exercise, making him spin eternally in that absurd wheel, the hippocampus renews its production of new neurons. If there is no muscle or newness to remember, we discourage, apparently because our serotonin goes down.

We don’t need to worry if serotonin wanes. We can improve its availability by preventing the neuron that released it from swallowing it back without even letting it take its time to make effect: we can block the "reuptake" (an absurd gesture of evolution with no apparent purpose) so it becomes instantly solved. The Serotonin-Specific Reuptake Inhibitors, the SSRIs, complete a survival kit for these turbulent times:

Abs and puzzles and SSRIs just in case.

- Doctor, could you give me something to forget about all this? Lately I haven’t been able to forget anything. With today's advances...

- Sorry, but we have nothing to improve your forgetfulness.