The idea of homeopathic susceptibility is nothing more than the application of the scientific understanding of the origin of disease- Type 1 Diabetes. By: Alia Donato, HOM, DCHM, Bsc CCHM Alumnus 2020
Am (2002) describes the etymology of diabetes which in Greek means increased urine output, and Mellitus in Latin is defined as honey referring to urine’s sugar content. Type 1 diabetes (T1D) is a chronic autoimmune disease and is a heterogeneous ailment identified by the destruction of pancreatic beta cells, culminating in absolute insulin deficiency. The majority of T1D cases are attributable to autoimmune-mediated destruction of beta cells (type 1a) while a small minority of cases result from idiopathic destruction or failure of beta cells (type 1b) (Michels and Gottlieb 2000). Maahs(2010) says statistically, on a worldwide scale, TID measures up 5-10% of diabetes cases. The epidemiological patterns of this autoimmune disease are increasing both in incidence and prevalence globally with overall annual increases in the incidence of about 2-3% per year (Green 1992 ; Karvonen 1997) according to US data from 2001 to 2015 concluded that about 22.9 cases per 100 000 were younger than 65 years showing similar incidences from other data regions making incidence of type 1 diabetes prominent among children younger than 15, particularly in children younger than 5 years (Gale and Gillespie 2001; Forga Llenas 2015).
The causes of TID are unknown, though several risk factors have been identified, according to Mayo Clinic (2020) some of these risk factors include:
1. Family history, anyone with a close family member like a parent or a sibling may have a slightly increased chance of developing diabetes,
2. Genetics the presence of certain genes.
3. Environment exposures.
4. Nutritional factors and their interactions. According to different fundamental and clinical research they have suspected that these circumstances and vulnerabilities are the leading causes for the individual who may be susceptible to T1D.
Furthermore, to gain more insight into how these diseases come about, more research is now being conducted to study mechanisms of susceptibility, molecular epidemiology, and functional genomics that helps to understand and identify genes involved in individual susceptibility (Mohammad Panah n.d.). Susceptibility is when a person may be liable to certain things within their environment. It also investigates the vulnerability or sensitivity of an individual and how their defensive mechanism in the human body may work. In other words, it is the state of being predisposed and/or sensitive thereby lacking the ability to resist a specific pathogen, familial disease, or a drug. Often when there is susceptibility, the individual may easily be harmed or affected by things that he/she may be overly sensitive to. The way the human organism receives or reacts to stimuli is determined by susceptibility which is important and fundamental to one's health.
This paper will review the two sides of medicine using Homeopathy by understanding susceptibility in the disease and conventional science in analyzing Type 1 diabetes susceptibility. Comparing and referring to studies that include viewpoints and statements on disease susceptibility in Homeopathy and T1D.
Homeopathy and genetic susceptibility in TID
Considering genetic disease susceptibility, it is understood to have a role in chromosomal and metabolic disorders displaying often in most medical conditions. Anon (2020) states that genetics is a structural production of proteins and enzymes where it occurs through transcription, processing, and translation. The basis of that variation is mutation or change in the DNA sequence, mutation occurs in every cell and when they occur in monogenic (single-gene) diseases like diabetes can occur. These are seen in certain variants of the human leukocyte antigen (HLA) complex genes when these genes are combined, they are called a haplotype. Certain HLA haplotypes are correlated with developing risk of TID increasing an inappropriate immune response to beta cells. Certain variations of mutations are silent or benign stating that the variation in the severity of a genetic disease (polymorphisms), whereas others produce profound consequences.
Dr. Hahnemann the founder of homeopathy established the Homeopathic art of science medicine in the late 1800s and mentions in his Organon in aphorism 78- the true natural chronic diseases are from the rise of chronic miasms and is a hereditary susceptibility, it is invisible and a dynamic disease-producing potential (Kaur 2020)- it is termed as prima causa Morbi that causes all natural disease. And if left unchecked may increase in pain or growth of the ailment which will leave the individual suffering in pain & aggravation, during the duration of his/her lifetime. Just like genetic susceptibility, a miasm will create obstacles in the curing process because of its defense mechanism at a genetic level. The three underlying miasms of chronic diseases are Psora, sychotic and Syphilis, these miasms carry their characteristics of symptoms and can often appear together or separately in diseases. In T1D there is a combination of all the three miasms reflecting a syphilitic miasm where there is auto-immune destruction of the b-cells, and lack of insulin resulting in I.D.D.M(T1D), psora leading to functional disturbance resulting diminished effectiveness leading to N.I.D.D.M(Type 2 diabetes) and sycosis due to its endocrine disharmony and dysfunctional feedback metabolism (R. Rughani 2016).
Environmental disease influences T1D
Many years ago, Dr. Samuel Hahnemann pointed out that there are two basic factors for an individual to become sick and they are an individual susceptibility and the exposure to natural diseases and their present stressors. He then began separating true chronic disease that was caused by mechanical or exterior conditions (aphorism 77). Dr.Herbert A (1868-1940) In The Principals and Art of Cure by Homeopathy he found that connecting the principles of homeopathic healing and principles and laws that govern life where he defined susceptibility as a reaction of protective immunity against environmental conditions. He gave a sample of how certain humans/animals even though are related may react differently in their external/internal defence system based on the geographical conditions e.g., one individual's perniosis (skin abnormality) may improve by the seashore while the other may fall ill, this also applies to colder and hotter climates, as well as the person's nutrition and their inability and ability to digest certain foods is reflected in the internal and external susceptibility (A. Roberts 2003).
Presently, in conventional scientific research, non-genetic factors are being shown favourably in the development of T1D placing value in environmental causation and host-related factors. An example of this determination is on the study of monozygotic twins which indicates that 13-33% are pairwise concordant for T1D (Barnett 1981; Kaprio 1992), meaning that during post conception there may have been a collection of genetic discordance or exposure to different putative exogenous material. Like this concept- Vithoulkas 1932 in his book The Science of Homeopathy, stated miasmatic susceptibility is not just DNA or genetic composition, the influence disease parent may transmit to their child as early as conception due to its weakened and ill vital force which can affect the child's electrodynamic field thereby weakening its immunity. Another scientific study example that the environment influences T1D conditions is that Finland has an increase of T1D of 5.4-fold from the early 1950s indicating that a high increase cannot be due to genetic disease susceptibility but mostly in the improper changes in lifestyle and environmental conditions (Knip and Simell 2012). Including that the evidence accumulated states that a percentage of the subjects with an elevated risk of HLA genotypes has declined in the past decade compared to the new diagnosis of T1D. Even for individuals with low and protected risk of HLA genotypes has increased (Hermann 2003; Rewers and Zimmet 2004)
In this perspective both sides of medicine have acknowledged genetics and epigenetic and environment can affect phenotype outcomes that give rise to T1D.
Natural history of fetal and perinatal occurrences in the risk of TID
Gluckman (2008) states Many lines of evidence, including epidemiologic data and data from extensive clinical and experimental studies, indicate that early life events play a powerful role in influencing later susceptibility to certain chronic diseases.
A child's immune system starts to function already in the womb. In a 2001 article Atkinson and Eisenbarth (2001) posits that individuals are born with various degrees of genetic susceptibility for T1D and might occur as early as in utero and the first few months of life(Warram 1984; Harjutsalo 2006). A mother with TID has a 2-3-fold lower risk of affecting her offspring than TID fathers with a 7% risk (Hämäläinen and Knip 2002). Studies observed that infants of mothers with T1D have an elevated level of regulatory T-cells in the cord blood than unaffected TID mothers and the regulatory T-cells from infants with the affected T1D mothers are upregulated in vitro by insulin(Luopajärvi 2012). This was also sought out by the DIABIMMUNE study where researchers analyzed the hygiene hypothesis by investigating infants and young children living in three close countries with a noticeable difference in the standard of living, hygiene, TID and other immune-mediated conditions (Mustonen 2017). Stating that immunomodulation by environmental factors starts to occur during fetal life as there was a study comparing the cord blood in children from Russian Karelia and Finnish infants indicating these facts (Kallionpaa 2014).
Kind (2006, pg. 532-541) expressed that “Maternal nutrition influences the availability of nutrients for transfer to the fetus”. In developing countries, a maternal lack of healthy nutrition is a major factor in contributing to an adverse outcome, with an increased prevalence in high calorie diets resulting in overweight and obesity issues in developed countries, this impact on over-nutrition during pregnancy is a contributing factor for adverse metabolic offspring in his/her later life (Morrison and Regnault 2016). Though studies say that the maternal diet during pregnancy does not bring rise to TID in the offspring (Lamb 2008; Virtanen 2010). This was reflected in a Norwegian retrospective study, where it reported that mothers with T1D consumed less cod liver oil during their pregnancy COD liver oil contains high concentrations of vitamin D and omega 3 fatty acids (DHA/EPA) which are anti-inflammatory, but subsequent studies were not able to connect an association with T1D and offspring and Omega DHA/EPA. Though supplementing with vitamin D has proven to show a decreased T1D risk. Other factor studies analyzed that maternal smoking may reduce the risk of TID (Stene and Gale 2013) speculating that smoking might have a modulatory effect on the immune system or DNA methylation and that later maternal age may also affect the chance of TID (Cardwell 2009), but the significance of these factor associations has been poor and heterogeneous concluding that the effect is minor (Virtanen 2006).
In homeopathy and throughout the Organon Hahnemann stated the importance of diet in various aphorisms. Hahnemann analyzed the effect of foods and poor lifestyle like smoking is the progression of chronic disease and the process of healing, stressing the importance of a simple, nourishing diet and eliminating harmful habits, stating: “the careful investigation into such obstacles to cure is so much the more necessary in the case of patients affected by chronic diseases, as their diseases are usually aggravated by such noxious influences and other disease causing errors in the diet and regimen, which often pass unnoticed” (Organon §260) . Graves (2003) says there are also endogenous and exogenous factors as well as diseases that may influence in the progression in T1D during conception, pre/post-pregnancy and during fetal life and these are: congenital rubella, enterovirus infection -can boost the immune response to bovine insulin in infants with increased HLA-defined disease predisposition high birth weight, prematurity, older maternal age, cesarean section, early infections, CBV infections, rapid linear growth dysbiosis, reduced microbial diversity in the gut, unregulated interferon signature before seroconversion reduced levels of choline-containing phospholipids, changes in expression levels of complement proteins. And early food introduction to cow's milk, cereals and certain fruits and berries.
Now in terms of infections and early use of endogenous/exogenous substances including allopathic drugs. Vithoulkas (1932) explains in his book The Science of Homeopathy that based on the principles of resonance, the organism's susceptibility to the disease-causing agents is not only caused by virus and bacteria but emotional shocks and allopathic drugs may also cause interference. He also states that these external influences and drug triggers can increase his/her
susceptibility to a new variety of ailments increasing infections and virulence (Vithoulkas n.d.). In Aphorism 73 Hahnemann says acute diseases are sporadic and rapid and affects single individuals during various times often brought on by unhealthy and harmful influences or exciting conditions like food poisoning, environmental temperatures; excessive cold or heat, overuse of the body (physical strains), and emotional upsets explaining that "these diseases are passing flare ups of a latent psora". Vithoulkas, Furthermore, discusses in detail the nature of susceptibility which to him is mostly hereditary but can be obtained by strong infectious diseases and current past treatments including vaccinations.
In conclusion, the word susceptibility is the fact that an individual is liable to be affected by external and internal influences including his/her physical environment. It is based on the vulnerability of the individual whose constitution makes up genetics that carries a specific type of genes that designates his/her immune system's ability to contract or fight off diseases. As well as mentioned above genetics (family history of diseases), heritability, genetic variants, exposure to viruses, age, obesity, nutrients, lack of exercise all have a role in T1D. The study of epigenetics has also found links between the environment, diet and lifestyle may affect the gene expression and lead to variant disease phenotypes like T1D.
Hahnemann during his observation of patients noticed that patient that relapsed from chronic treatment had patterns of diseases that were inherited by their families and that these were the true basis of chronic diseases termed as miasms - the predisposition to acquire or inherit certain diseases, applies also to genetic imprinting, and again can be acquired in inheritance or during one's life. Hahnemann thought of contagious diseases as a trigger for miasms, whereas gene imprinting can be influenced by various environmental factors. Now, conventional studies are suggesting that environmental factors that are influential in early life have a considerable risk of developing TID-however, there are a few environmental and host-related determinants that have been confirmed to act as a susceptibility protector and a risk development of TID. But the issue is that in most areas proving questionable data, is making it difficult to draw strong conclusions in susceptibility in T1D factors(Knip 2017). So, is 'The idea of homeopathic susceptibility nothing more than the application of the scientific understanding of the origin of the disease? The answer is yes in most genetic and environmental predispositions the understanding of homeopathic susceptibility in diseases is very much like the origins of Type 1 diabetes.
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