However, there may be additional factors to trigger an attack. A relevant observation is the presence of acetylcholine receptors in various bacteria, especially in E. coli, the most common type of bacteria in the large intestines. If the intestinal wall is weak, bacterial proteins or endotoxins can pass from the intestines into the bloodstream and cause antibodies to develop against any bacterial receptors. These antibodies, originally formed against E. coli receptors may, in turn, initiate the attack on thymus receptors in the presence of manganese deficiency. A surplus of antibodies spills over into the bloodstream and will then attack healthy muscle receptors.
The thymus, attacking itself, is unable to obtain sufficient manganese from a diet with marginal manganese levels, even after the invasion of E. coli endotoxins has stopped. Therefore, symptoms of MG persist until a sufficiently high manganese intake allows the thymus receptors to restructure and the attack by its own antibodies to stop.
The most common causes for a weak intestinal wall that lets endotoxins invade the bloodstream are inflammatory conditions due to gluten sensitivity, food allergy, and Candida overgrowth. It may also be due to general dysbiosis of the intestinal tract as caused by prolonged or repeated antibiotic treatment. Commonly this is combined with a malfunctioning ileocecal valve, which normally prevents bacteria from the large intestines to invade the small intestines. It is possible that the same inflammatory changes that allow bacterial toxins to pass the intestinal wall also reduce the absorption of manganese.
An alternative or additional model of MG may be based on the observation that MG frequently starts during or following a prolonged period of intense stress. Commonly, this is emotional stress but may also be due to malnutrition, chemical exposure, or food sensitivity. This tends to lead to weakness or exhaustion of the adrenal glands, which manifests as an unusual sensitivity of myasthenics to stress.
The adrenal glands have a direct influence on the thymus in that a high level of adrenocortical steroids leads to its atrophy, while adrenal exhaustion, as in Addison’s disease, tends to retard or prevent the normal involution of the thymus after puberty. With MG this adrenal weakness may either prevent the thymus from utilizing manganese or it may be combined with manganese deficiency to produce faulty thymus receptors. This, then, leads to the formation of antibodies that attack healthy muscle receptors as an unintended side effect.
Manganese deficiency may also be due to a diet high in refined food - white bread, for instance, has only 5% of the manganese content of whole meal bread. Produce grown organically in mineral-rich soil can have more than a hundred times the manganese content than if grown commercially with synthetic fertilizers. The highest and lowest values for manganese found in lettuce were 169 ppm and 1 ppm respectively.
Furthermore, a lack of gastric acid leads to reduced mineral absorption, while inorganic (ferric) iron makes manganese unavailable and destroys vitamin E. Also prolonged use of antibiotics can cause manganese deficiency. Finally, even manganese-rich whole meal bread may not be of much help, because the high phytate content of whole meal binds and makes manganese and other minerals unavailable. Minerals only become readily available after phytates break down. This happens when seeds are sprouted or properly fermented as in sourdough bread.
Several factors may come together to upset the utilization of manganese by the thymus, such as a marginal intake or malabsorption, a low level of anti-stress vitamins during a stressful period, infection, food allergy and exposure to toxic chemicals.
Sometimes, especially in milder conditions, the symptoms of MG may disappear even without additional manganese when high-level anti-stress vitamins are supplied, as these may reduce inflammatory conditions and improve the efficiency of the thymus in utilizing manganese. Similarly, a high-quality low-allergy or raw-food diet may have the same beneficial effect. It supplies increased amounts of manganese and may at the same time correct intestinal conditions. With a normalized manganese metabolism in the thymus, the faulty acetylcholine receptors can be quickly repaired and the production of receptor antibodies stops.
The remaining question is why the thymus becomes enlarged. Josephson suggested that the thymus reacts in a similar way to manganese deficiency as the thyroid gland to iodine deficiency. Both react with hypertrophy. He saw the proof for this assumption in the observed rapid shrinking of the enlarged thymus with manganese supplements, in the same way as the enlarged thyroid shrinks with iodine supplements.
Raw-food diets have generally been show to improve and possibly cure MG. Therefore it is advisable to use a high percentage of food raw and in easily digestible form, such as freshly pressed vegetable juice. This may require a dedicated helper. Grass juice grown in mineral-rich soil is high in manganese. The best juice is made from mixed wheat and barley grass together with red beet. Add other vegetables as available; possibly flavor with apple, ginger root and bee pollen. Drink a glassful very slowly before most meals.
Another excellent food is sprouted seeds. They are high in enzymes and their minerals can easily be absorbed. Easy to sprout are mung beans, brown lentils and fenugreek. If chewing is difficult, these may be juiced as well or pureed or even cooked. If chewing is not a problem, then use sprouted seeds as part of a vegetable salad prepared with gelatin and finely grated root vegetables, such as red beet, carrot and turnip. As salad dressing use lemon juice, extra-virgin olive oil, herbs, spices and possibly the yolk of a free-range egg.
As cooked food use mainly fresh vegetables, arrowroot, sago, tapioca, rice and lentils. Buckwheat flour may be used for binding instead of gluten flour. Instead of cows' milk use rice milk or almond milk; also yogurt, cheese or cottage cheese from goats' milk. Tealeaves and walnuts are high in manganese (15 mg /100 g). Use fruits cautiously before or between meals.
Frequently use beef broth, also for flavoring salads. While beef is often beneficial for muscle strength, it should be in an easily digestible form, such as steamed or boiled minced meat. Better still is raw beef or lamb, see Raw Food Diet. In addition, simmer fish heads for several hours with the addition of vinegar or lemon juice in a non-metal pot. Blend and strain the broth as a source of gelatin and minerals. Steamed fish or seafood is fine. Use only beef that has been grass-fed and fish low in mercury/
Initially avoid and after recovery and allergy testing minimize:
- cows' milk products, except butter;
- wheat products, initially also other gluten grains (oats, rye, barley);
- sweeteners and sweetened food; commercial fruit drinks and soft drinks;
- fried food, polyunsaturated oils, margarine and other hydrogenated oil or fat;
- processed foods with added chemicals, such as colors, flavors, aspartame;
- alcohol, tobacco, chlorinated or fluoridated water or toothpaste;
- meat or chicken from feedlots or factory farming;
- soy, corn and other genetically modified or microwave-heated food;
- solvents and household cleaners and exposure to their fumes;
- contact with chemicals; pesticides or aerosol sprays around the house.
This means basically to use only fresh whole foods, preferably organically grown and nothing that has been processed. Salted food is beneficial with weak adrenal glands and low blood pressure (below 120/80).
After recovery you may carefully introduce new foods to this strict diet. Test your muscle strength before and after each new food; also compare the pulse rate before and 30 and 60 minutes after meals. An unusual rise is a sign of allergy.
This MG diet is only a start and a generalization. You then have to adjust the diet to your specific body conditions as with food allergy testing or closely observing how your body strength changes with different foods and keeping a diary about it. If you deteriorate again after adding new foods, then return to the strict diet and when improved repeat the testing. For more detailed information about any aspects of this diet see Healing Foods.
continue to supplements in Myasthenia