Aches and Glutamates

The other day I went across the street to a farmer’s market and bought a block of my favorite cheese, a lightly smoked artisanal cheese from an organic creamery in a nearby town. Having consumed small amounts of New Zealand cheddar without developing symptoms, I decided to try two big slices of the smoked cheese.

Shortly after eating, I noticed a jaw ache, and then a mild headache. I remembered eating with someone at a Chinese restaurant who got a jaw ache and who believed it was due to monosodium glutamate (MSG). I went online and learned that some have linked glutamates to neurological diseases. I also found a site that listed cheese as a source of glutamates.

I stopped my research there. I didn’t want to get lost in inner space. Medical detection begins with sketching a big picture that may guide us to the right details. For example, myalgic encephalomyelitis (ME) is far more common in women and tends to follow childbirth. Is it the loss of newly accumulated fat tissue and its stores of biocides? I don’t know. To my knowledge this gender pattern has never been used as a clue in the investigation of the causes of ME. Until we do this detective work, we will be wise to take any molecular theory with a grain of salt, and to put our molecular notions into perspective. Bodies  dazzle us with their myriads of molecules and their fascinating patterns of action and consequence, and yet to try to find in them the causes of an emerging epidemic is like trying to comprehend the weather by fixing our gaze on a few droplets of moisture coalescing inside a cloud.

I also didn’t want to treat incidental findings. I had recently learned that I had high levels of mercury and had taken a chelating agent to free my body of mercury. The agent extracted all of my divalent cations, including those essential to life. I felt far worse than before. And, in addition to removing the mercury from my bones and bringing it into circulation, it release the mercury into wastewater and then into my ecosystem, where it could do unintended and unexpected harm.

Furthermore, I had resolved to practice empirical medicine—with the active support of my new doctor—by prudently experimenting with means to realize healing as relief, wellbeing, and transformation and cure as a new and better life. This meant avoiding the dependency model in which pills perpetuated disease and dependence. I had been hard pressed to get off the pills I had taken for indigestion and depression, or to penetrate the masking of signs and symptoms to discover clues as to the causes of my ailments or the chances for lasting healing and cure.

On the other hand, my doctor was taking the glutamate theory seriously. He had recently identified an MHTFR mutation in a patient like me and had realized a late cure through methyl folate treatment. When my doctor tested me for those mutations he found two. He recommended that I try methyl folate.

I met his kind suggestion with skepticism. Drug companies are marketing methyl folate to 40% of the population, which means, as Stephen Colbert has pointed out in his satires, that the company is selling this drug as a treatment for normalcy. Moreover, because I have been around long enough to see drug fads come and go, I wondered if  the high price of this drug was a sign that the company didn’t expect to sell it for long. Plus I would have preferred to try something for  Gilbert’s syndrome, a condition that I have that slows the breakdown of bilirubin and that may contribute to ME.

Nevertheless, in the spirit of collaborative empiricism, I was game to give the medicine a try. I took two doses. Shortly after, I felt better. Shortly after that, I noticed that I was not functioning better. For example, I couldn’t send a text message. I didn’t want to attempt anything that required competence, such as driving. The interesting thing was that I didn’t mind my new incompetence; my mood remained bubbly . It was, I imagine, like being stoned. The drug’s effects seemed lateral to my problems. Even so, I knew that to give it a fair trial I would have to cooperative with its effects and attempt to adapt to them. I decided to try the rest of the pills later, while on retreat.

Now, though, having eaten my favorite cheese and noticed jaw pain and headache, I wondered if I was having symptoms related to glutamate. I took a third methyl folate pill and shortly afterwards lay down for my regular afternoon rest. My headache and jaw ache eased. I had so much energy that I sprang up from the sofa from time to time to do simple tasks. After my rest, I went out for a walk during which I felt better than usual and seemed to function adequately.

As I walked, I thought of my grandmother, who had suffered migraines, which can be brought on by red wines and cheeses. In the medical context doctors see migraine as a chronic illness and foods as precipitating factors of flares of the illness. It would make more sense to see foods as the cause and migraines as a consequence, but the patterns might be difficult to see with clarity. Causes generally act in combination and incompletely. Poliovirus, for example, leads to paralysis in a minority of those infected, and broad beans cause hemolysis—favism—only in those who are genetically predisposed.

With this in mind, I pondered the effects of cheese on my symptoms. I I had not reacted to glutamates or to this cheese in the past, and could infer that it was not genetic because my genes had not changed. I may have missed the symptoms in the past, or some  factor may have altered my system—such as the virus I picked up while traveling, or the earlier trial of methyl folate, which had left a persistent taste in my mouth and may have induced different xenobiotic enzymes (if methyl folate  caused the symptoms is was intended to remedy, it would create perfect conditions for perpetual use).

Or, the cheese company might have started adding glutamates during production. To follow up on this possibility I contacted the cheese maker, who kindly took time to speak with me. He said that  production had not changed, but pointed out that the smoking process could cause symptoms. This was a good point; I have reacted to charred foods, presumably because of direct toxins or toxic byproducts formed by the liver during digestion/detoxification.

I became confused. I felt like I was finding too many causes too quickly. I wanted to slow things down, to vary one thing at a time. If I were to be the canary in the mine, I wanted to know which mine I was in. I might not be able to control the biocide profiles created by the foods I ate, which would vary by farm and over time, I could cook from scratch, use vitamin supplements and probiotics, and, after returning to baseline, give methyl folate a fair trial.

Next Time: Nuts and Rashes

To read about favism, you can consult Wikipedia. To learn more about wine and cheeses and their role in headache, you can consult WebMD. Note that the information on food triggers is based on conventionally accepted conclusions that may change in response to new ideas or inferences;  it is also  general and therefore potentially irrelevant to any given individual (e.g., one size does not fit all.)