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Emicrania
Da tongkatali.org
Questo articolo avanza l'ipotesi che in molti casi l'emicrania sia una malattia di origine alimentare. I microrganismi causali comuni sono una serie di batteri, tra cui ceppi di Lactobacillus utilizzati nella fermentazione del latte e delle verdure e che influenzano il decadimento di molti alimenti. Questi batteri convertono gli aminoacidi in ammine biogene. Tutti gli organismi dei mammiferi utilizzano alcune ammine come neurotrasmettitori e nel sistema immunitario e possono sintetizzarle da soli nelle quantità necessarie. Le ammine in eccesso, prodotte da un organismo stesso o entrate nell'organismo come cibo, vengono scomposte dagli enzimi amino-ossidasi presenti in ogni organismo di mammifero. Le particolarità di questi enzimi sono codificate geneticamente e variano quindi da persona a persona. Alcune persone gestiscono meglio di altre le ammine che entrano nell'organismo con il cibo. Questo è in linea con il fatto che l'emicrania è diffusa nelle famiglie. Se le amine biogene in eccesso non vengono scomposte tempestivamente, provocano, in casi estremi, un'intossicazione alimentare, anche mortale. Su scala minore, come ipotizzato in questo articolo, l'eccesso di amine biogene mal gestito causa emicrania.
La FDA statunitense, nelle sue pagine dedicate ai consumatori, classifica 16 condizioni come malattie di origine alimentare. [Cosa c'è da sapere sulle malattie di origine alimentare]. Di queste, 14 sono causate da batteri e 2 da virus. L'infezione da salmonella è la più nota tra quelle batteriche, mentre l'epatite A è la più nota tra le malattie di origine alimentare.
La visione tradizionale dell'emicrania la spiegava come una condizione vascolare. Durante la fase dell'aura, si pensava che i vasi sanguigni intorno al cranio fossero contratti (o ristretti). Ciò ridurrebbe l'afflusso di sangue agli occhi, causando i tipici effetti visivi, come lo sfarfallio o i punti ciechi, o altre carenze sensoriali. Poi i vasi sanguigni si sarebbero espansi in modo sproporzionato e avrebbero esercitato una pressione sui nervi intorno al cranio, causando così il dolore.
Si è scoperto che la vecchia scienza si sbagliava. Quando i vasi sanguigni sono stati misurati durante le fasi dell'aura e del mal di testa, non erano costretti o espansi in linea con la teoria. Nel 2009, Brain (una delle principali riviste di neurologia al mondo, pubblicata dalla Oxford University Press dal 1878) ha riassunto il cambiamento di vento nel titolo: "La teoria vascolare dell'emicrania: una grande storia naufragata dai fatti" [Brain, volume 132, numero 1, gennaio 2009].
Qual è dunque il legame tra emicrania e depressione da diffusione corticale? Nessuna interferenza con la depressione da diffusione corticale ha mai fermato un'emicrania e non è mai stato possibile indurre un'emicrania scatenando una depressione da diffusione corticale. Tutte le ricerche sulle depressioni da diffusione corticale sono state condotte su conigli e gatti. Non è stato nemmeno possibile dimostrare l'esistenza di una depressione da diffusione corticale nell'uomo, a meno che una persona non abbia subito una lesione cerebrale estesa. Motivo: la depressione da diffusione corticale si propaga sulla superficie del cervello. Non salta facilmente attraverso i solchi (i solchi delle pieghe cerebrali) dai gyri cerebrali (pieghe rigonfie) ai gyri; ma i cervelli fortemente danneggiati non hanno pieghe divise come i cervelli sani, quindi le depressioni corticali si diffondono più facilmente. Durante gli attacchi di emicrania negli esseri umani, la depressione da diffusione corticale non è mai stata misurata (un fatto per il quale i neurologi hanno trovato molte scuse). [Domande insistenti]
Wow! Solo questo?
Sì.
Come spiegazione scientifica dell'emicrania, la depressione da diffusione corticale ha probabilmente subito una morte cerebrale.
La depressione da diffusione corticale, tuttavia, è ancora molto viva negli sforzi di marketing dei neurologi. YouTube è pieno di filmati caricati da siti web che si occupano di cefalee. I neurologi vogliono che vi affidiate ai loro servizi... diagnosi elaborate, consulenze costose che fatturano alla vostra assicurazione. Circa il 20% degli americani soffre di emicrania [Fonte: The Prevalence and Impact of Migraine]: The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies]. 65 milioni di potenziali pazienti. Se solo la metà si presenta al consulto con i neurologi, sarà una vera e propria miniera d'oro.
I neurologi prescriveranno farmaci neurologici, in genere costosi. Pertanto, Big Pharma è sul carro dei neurologi.
Le teorie vascolari, neurologiche e infiammatorie dell'emicrania si concentrano su ciò che accade durante gli episodi di emicrania. Una prospettiva completamente diversa si concentra sulle cause degli episodi di emicrania. I pazienti che sono guariti perché riescono a evitare le cause degli attacchi di emicrania non si preoccupano molto di ciò che accade durante gli attacchi. In ogni caso, non sono più afflitti.
Le amine biogene, soprattutto la tiramina e l'istamina, sono state a lungo considerate fattori scatenanti dell'emicrania. In dosi sufficientemente elevate, la tiramina e l'istamina presenti negli alimenti fanno ammalare non solo chi soffre di emicrania, ma qualsiasi essere umano.
Gli elenchi di alimenti proibiti e consentiti per gli emicranici abbondano su siti web non accademici. Molti di questi elenchi sono discutibili. Non sono gli alimenti specifici ad avere un impatto su chi soffre di emicrania, ma il contenuto di tiramina e istamina. E per qualsiasi alimento, questi variano da lotto a lotto, a seconda di diversi parametri.
Per fare un esempio drastico, il contenuto di istamina di un panino al tonno può variare di un fattore 1000 se lo stesso panino al tonno viene acquistato nello stesso negozio, ma a distanza di una settimana. Forse il loro frigorifero si è rotto, non si sa mai.
Per uno stesso tipo di frutta, il carico di tiramina può variare di un fattore 100, a seconda delle condizioni in cui è stata raccolta e di come è stata lavorata. Una volta che la tiramina è entrata, non è possibile eliminarla, a meno che l'intero lotto non venga iniettato con enzimi amino-ossidasi che convertono un gruppo amminico in ammoniaca (NH3). La bollitura, l'agitazione o persino la frittura non eliminano la tiramina o l'istamina, ma possono facilmente mascherare un sapore che altrimenti tradirebbe il deterioramento.
Per essere significativi, istamina e tiramina devono essere quantificati. Non è che il formaggio sia "vietato" perché contiene tiramina, mentre frutta e verdura sono "permesse".
Il corpo umano utilizza 20 aminoacidi per sintetizzare le proteine. 9 sono essenziali e devono provenire dall'alimentazione. Essi sono: istidina, isoleucina, leucina, lisina, metionina, fenilalanina, treonina, triptofano, valina. Altri 11 possono provenire dagli alimenti o sono derivati dall'organismo umano da aminoacidi essenziali. Essi sono: alanina, arginina, asparagina, acido aspartico, cisteina, acido glutammico, glutammina, glicina, prolina, serina, tirosina
Gli enzimi umani o gli enzimi dei batteri presenti nel corpo umano o negli alimenti che consumiamo trasformano gli aminoacidi in ammine mediante decarbossilazione (rimozione delle molecole di biossido di carbonio, CO2).
I derivati enzimatici degli aminoacidi comprendono:
istamina (un'ammina cruciale per il sistema immunitario) dall'istidina
La maggior parte di queste ammine ha funzioni importanti nel corpo umano. La cadaverina, la putrescina, la spermidina e la spermina sono necessarie nelle cellule per la sintesi proteica e le membrane. Nella patologia umana, tuttavia, l'istamina e la tiramina sono le più rilevanti. Questo articolo si concentra sulla tiramina.
I seguenti batteri sono stati identificati come produttori di tiramina:
Gram-positivi: Bacillus thuringiensis. Carnobacterium divergens1, Enterococcus durans, Enterococcus hirae, Enterococcus faecalis, Enterococcus faecium, Lactobacillus brevis, Lactobacillus curvatus, Tetragenococcus halophilus
Gram-negativi: Pseudomonas entomophila, Pseudomonas putida, Gluconacetobacter diazotrophicus, Granulibacter bethesdensis [Fonte: Tyramine and Phenylethylamine Biosynthesis by Food Bacteria ].
L'elenco più completo delle misurazioni della tiramina è stato compilato da Gaby Andersen, Patrick Marcinek, Nicole Sulzinger, Peter Schieberle, Dietmar Krautwurst e pubblicato nel febbraio 2019 sulla rivista Nutrition Reviews [Food sources and biomolecular targets of tyramine ]. Preparatevi a qualche sorpresa.
Latticini (eccetto il formaggio)
Latticello, 2,2 mg/kg, Souci et al (2016)
Latte vaccino, nessuno rilevato, Novella-Rodriguez et al (2000)
Panna, 1,7 mg/kg, Souci et al (2016)
Panna acida, 1,4 mg/kg, Souci et al (2016)
Quark, 2,4 mg/kg, Souci et al (2016)
Yogurt, 1,3 mg/kg, Souci et al (2016)
Nessuno rilevato, Mayr & Schieberle (2012)
Nessuno rilevato, Novella-Rodriguez et al (2000)
Su tre test, due sono risultati negativi e l'unico che ha rilevato la tiramina ne ha trovato solo una quantità minima. Ma attenzione: lo yogurt rovinato può essere carico di tiramina fino a livelli pericolosi. Le varietà di lattobacilli, responsabili della fermentazione dello yogurt, sono i campioni nella conversione della tirosina in tiramina.
Cheese
Per i formaggi è stato riportato un ampio spettro di misurazioni. Per il brie, variava da nessun rilevamento a 260,0 mg/kg nei test condotti da un team, per il parmigiano da 4,0 mg/kg a 290,0 mg/kg, per la gauda da 20,0 mg/kg a 670,0 mg/kg, per il roquefort da 27,0 mg/kg a 1100,0 mg/kg. Per l'edam, tre squadre hanno misurato da 13,5 mg/kg a 310,0 mg/kg. Per nessun alimento le misurazioni sono così confuse e diseguali come per il formaggio. Diverse marche o lotti dello stesso tipo di formaggio possono avere una quantità di tiramina più di 50 volte superiore a quella di altre marche o lotti, e non si può sapere perché. Potrebbe trattarsi di un difetto nella coltura, del processo di invecchiamento o di un evento durante il trasporto.
Appenzeller, 55,0 mg/kg, Souci et al (2016)
Brie, nessuno rilevato fino a 260,0 mg/kg, Souci et al (2016)
Camembert, 37,0 mg/kg, Souci et al (2016)
Cheddar, 350,0 mg/kg, Souci et al (2016)
130,0 mg/kg, Tarjan & Janossy (1978)
Edam, 310,0 mg/kg, Souci et al (2016)
13,5 mg/kg, Lange et al (2002)
25,6 mg/kg, Tarjan & Janossy (1978)
Emmental, 42,0 mg/kg, Souci et al (2016)
128,7 mg/kg, Tarjan & Janossy (1978)
Feta, da 152,0 mg/kg a 246,0 mg/kg, Valsamaki et al (2000)
Gorgonzola, 8,0 mg/kg, Lange et al (2002)
Gouda, da 20,0 mg/kg a 670,0 mg/kg, Souci et al (2016)
Gruyère, 37,0 mg/kg, Souci et al (2016)
Leerdammer, nessuno rilevato, Mayr & Schieberle (2012)
Parmigiano, da 4,0 mg/kg a 290,0 mg/kg, Souci et al (2016)
3,75 mg/kg, Mayr & Schieberle (2012)
Roquefort, da 27,0 mg/kg a 1100,0 mg/kg, Souci et al (2016)
152,0 mg/kg, Lange et al (2002)
Tilsit, 32,0 mg/kg, Souci et al (2016)
Carne
Fegato di pollo, 100,0 mg/kg, Souci et al (2016)
50,0 mg/kg, Tarjan & Janossy (1978)
Prosciutto cotto, da 6,0 mg/kg a 108,0 mg/kg, Saccani et al (2005)
Prosciutto, stagionato a secco, 7,5 mg/kg, Lange et al (2002)
da 4,0 mg/kg a 171,0 mg/kg, Saccani et al (2005)
Salsiccia di cipolla, 32,0 mg/kg, Lange et al (2002)
Fegato di bue, 270,0 mg/kg, Souci et al (2016)
Maiale, carne fresca, nessuno rilevato fino a 56,0 mg/kg, Saccani et al (2005)
Salame, 77,1 mg/kg, Mayr & Schieberle (2012)
17,0 mg/kg, Lange et al (2002)
Pesce
Merluzzo, 2,0 mg/kg, Lange et al (2002)
Salsa di pesce fermentata, da 276,0 mg/L a 357,0 mg/L, Kirschbaum et al (2000)
Aringa, nessuna rilevata, Lange et al (2002)
Aringa, stagionata, nessuno rilevato fino a 3000,0 mg/kg, Souci et al (2016)
Sgombro, da 25,8 mg/kg a 27,4 mg/kg, Shakila et al (2001)
Sgombro in salamoia, nessuno rilevato, Shakila et al (2001)
Sgombro essiccato sotto sale, da 398,4 mg/kg a 413,8 mg/kg, Shakila et al (2001)
Salmone, nessuno rilevato, Lange et al (2002)
Sardine, da 16,2 mg/kg a 11,8 mg/kg, Shakila et al (2001)
Sardine in olio, nessuno rilevato, Shakila et al (2001)
Sardina, essiccata sotto sale, da 169,5 mg/kg a 178,1 mg/kg, Shakila et al (2001)
Pesce sciabola, da 9,4 mg/kg a 10,7 mg/kg, Shakila et al (2001)
Pesce sciabola, essiccato sotto sale, da 154,2 mg/kg a 154,1 mg/kg, Shakila et al (2001)
Gamberetti, da 8,8 mg/kg a 12,6 mg/kg, Shakila et al (2001)
Gamberi, essiccati sotto sale, da 693,2 mg/kg a 704,7 mg/kg, Shakila et al (2001)
Tonno, 0,06 mg/kg, Mayr & Schieberle (2012)
Tonno sott'olio, 0,72 mg/kg, Souci et al (2016)
Nessuno rilevato fino a 1,2 mg/kg, Shakila et al (2001)
Bevande alcoliche
Beer, German Vollbier, 1.8 mg/L to 12.0 mg/L, Souci et al (2016)
Beer, alcohol-free, 1.2 mg/L, Souci et al (2016)
6.16 mg/L, Kalac et al (1997)
Wine, port, 0.51 mg/L, Cunha et al (2011)
Wine, red, none detected to 20.0 mg/L, Souci et al (2016)
1.93 mg/L, Mayr & Schieberle (2012)
0.8 mg/L to 2.6 mg/L, Landete et al (2005)
38.8 mg/L, Tarjan & Janossy (1978)
1.40 mg/L, Marcobal et al (2005)
None detected to 0.292 mg/L, Anli et al (2004)
3.1 mg/L, Lüthy & Schlatter (1983)
Wine, white, none detected to 3.0, Souci et al (2016)
110.8 mg/L, Tarjan & Janossy (1978)
1.2 mg/L to 22.7 mg/L, Lüthy & Schlatter (1983)
Mela, nessuno rilevato, Tarjan & Janossy (1978)
Succo di mela, 0,1 mg/L, Maxa & Brandes (1993)
Avocado, 23,0 mg/kg, Souci et al (2016)
Banana, 7,0 mg/kg, Souci et al (2016)
0,9 mg/kg, Lavizzari et al (2006)
Ribes, nessuno rilevato, Tarjan & Janossy (1978)
Succo di ribes, appena spremuto, 3,26 mg/L, Maxa & Brandes (1993)
Uva, 691,0 mg/kg, Tarjan & Janossy (1978)
Succo d'uva, 0,04 mg/L, Cunha et al (2011)
0,1 mg/L, Maxa & Brandes (1993)
Succo di pompelmo, appena spremuto, 0,1 mg/L, Maxa & Brandes (1993)
Nocciola, 1,8 mg/kg, Lavizzari et al (2006)
Arancia, 10,0 mg/kg, Souci et al (2016)
Succo d'arancia, 0,21 mg/L, Maxa & Brandes (1993)
Succo d'arancia, appena spremuto, da 0,1 mg/L a 0,49 mg/L, Maxa & Brandes (1993)
Pesca, nessuna rilevata, Tarjan & Janossy (1978)
Pera, nessuno rilevato, Tarjan & Janossy (1978)
Prugna, nessuno rilevato fino a 6,0 mg/kg, Souci et al (2016)
Nessuno rilevato, Tarjan & Janossy (1978)
Lampone, da 10,0 mg/kg a 90,0 mg/kg, Souci et al (2016)
Succo di lampone, appena spremuto, 66,66 mg/L, Maxa & Brandes (1993)
Anguria, 460,0 mg/kg, Tarjan & Janossy (1978)
Verdure
Barbabietola, 160,0 mg/kg, Tarjan & Janossy (1978)
Cavolo, 670,0 mg/kg, Tarjan & Janossy (1978)
Cavolo cinese, 1,26 mg/kg, Simon-Sarkadi & Holzapfel (1994)
Cavolo, crauti, 20,0 mg/kg, Souci et al (2016)
60,66 mg/kg, Mayr & Schieberle (2012)
6,0 mg/kg, Lange et al (2002)
Cavolo, succo fermentato, da 37,1 mg/L a 73,0 mg/L, Kirschbaum et al (2000)
Cavolo rapa, 930,0 mg/kg, Tarjan & Janossy (1978)
Carota, 0,001 mg/kg, Sulzinger et al (2016)
119,0 mg/kg, Tarjan & Janossy (1978)
Succo di carota, 0,002 mg/L, Sulzinger et al. (2016)
Cavolfiore, 400,0 mg/kg, Tarjan & Janossy (1978)
Cetriolo, 250,0 mg/kg, Tarjan & Janossy (1978)
Indivia, 1,60 mg/kg, Simon-Sarkadi & Holzapfel (1994)
Pisello verde, congelato, 8,7 mg/kg, Kalac et al (2002)
Fagiolo Haricot, 160,0 mg/kg, Tarjan & Janossy (1978)
Lattuga iceberg, 0,94 mg/kg, Simon-Sarkadi & Holzapfel (1994)
Miso, da 24,6 mg/kg a 349,0 mg/kg, Kirschbaum et al (2000)
nessuno rilevato fino a 49,8 mg/kg, Yen (1986)
Olive, nessuna rilevata, Lange et al (2002)
Paprika, 266,0 mg/kg, Tarjan & Janossy (1978)
Patata, 1,14 mg/kg, Sulzinger et al. (2016)
840,0 mg/kg, Tarjan & Janossy (1978)
2,0 mg/kg, Lavizzari et al (2006) Patate fritte, al forno, 1,77 mg/kg, Sulzinger et al. (2016)
Patate fritte, crude, 0,77 mg/kg, Sulzinger et al. (2016)
Radicchio, 2,73 mg/kg, Simon-Sarkadi & Holzapfel (1994)
Ravanello, 200,0 mg/kg, Tarjan & Janossy (1978)
Salsa di soia, da 17,7 mg/L a 172,0 mg/L, Kirschbaum et al (2000)
Da 16,1 mg/L a 1699,0 mg/L, Yen (1986)
Semi di soia, 9,05 mg/kg, Bartkiene et al (2015)
nessuno rilevato, Gloria et al (2005)
Soia, fermentata, da 27,8 mg/kg a 416,1 mg/kg, Bartkiene et al (2015)
Sufu, tofu fermentato, nessuno rilevato fino a 1125,4 mg/kg, Yen (1986)
Spinaci, 3,78 mg/kg, Sulzinger et al. (2016)
286,0 mg/kg, Tarjan & Janossy (1978)
2,2 mg/kg, Lavizzari et al (2006)
Purè di spinaci, congelato, 10,2 mg/kg, Kalac et al (2002)
Spinaci, bolliti, 2,58 mg/kg, Sulzinger et al. (2016)
Pomodoro, 4,0 mg/kg, Souci et al (2016)
1,07 mg/kg, Sulzinger et al. (2016)
4,0 mg/kg, Lange et al (2002)
250,0 mg/kg, Tarjan & Janossy (1978)
Pomodoro ketchup, 33,6 mg/kg, Kalac et al (2002)
Pomodoro, purea concentrata, 7,23 mg/kg, Sulzinger et al. (2016)
10,4 mg/kg, Kalac et al (2002)
Rapa, nessuno rilevato, Tarjan & Janossy (1978)
Zucchine, 0,06 mg/kg, Sulzinger et al. (2016)
Altri
Cioccolato, 3,11 mg/kg, Mayr & Schieberle (2012)
0,3 mg/kg, Lavizzari et al (2006)
Caffè, macinato, da 1,26 mg/kg a 16,14 mg/kg, Restuccia et al (2015)
Caffè, preparato, da 0,25 mg/L a 1,89 mg/L, Restuccia et al (2015)
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Aggiornato il 18 ottobre 2022
Malattie di origine alimentare
Cosa succede durante gli attacchi di emicrania? 
Marketing medico
Fattori scatenanti dell'alimentazione
Decarbossilazione degli amminoacidi
Tiramina dalla tirosina; anche diversi importanti neurotrasmettitori, raggruppati come catecolamine, sono derivati dalla tiramina: dopamina, noradrenalina, adrenalina
Agmatina dall'arginina
Putrescina, spermidina, spermina da arginina, glutammina o ornitina
Cadaverina da lisina, glutammina o ornitina
ß-feniletilamina da feniletilalanina
Serotonina e triptamina da triptofano
Tiramina
Beer, Pilsner lager, 1.4 mg/L, Souci et al (2016)
6.85 mg/L, Kalac et al (1997)
La frutta
Riferimenti:
