Move Over Soul: The Eyes Are The Window Into Overall Health

At a recent family reunion, I was asked by a 50-ish young man what he might do to support his vision. Seemed it was just his reading glasses moment for him, but for me it was a bit of a deep gasp moment: the obvious glycation (think "browning": urgent need for antioxidants), the sagging, lusterless skin (needs EFAs), the sarcopenia (needs protein and/or stomach acid support), the hypogonadism (needs hormone or hormone cofactors support +/- probable help with "cortisol steal," sleep architecture and/or stress management).

(There's actually a kind of cool "nutritional physical exam" that the IFM teaches its students (link to pdf of 2020 interview) where just about anyone can learn to spot some of the most common nutritional deficiencies. Ask me about it and/or I will add it to my blog-entries-to-be list.)

I credit my Chinese medicine professor, Chun Yi Quan at Samra in Los Angeles for first sort of planting the seed for the idea that eye health does not exist on a one-way, linear continuum. Even though she unavoidably saw these matters through the lens of Chinese medicine theory ("Whenever I eat 'dampness'-creating foods (in her case, ice cream), my vision suffers," she told us), still she introduced a way of thinking that was entirely new to me: decline needn't be inevitable.

(Today, some 2,200 years since they first came up with the idea of "dampness," we would probably recognize this as chronic, low-grade inflammation (actually sounds more and more like chronic yeast overgrowth), possibly exacerbated by insulin resistance. Even if their #1 "dampness" generating food was (and still is) dairy! Along with sweet, fried, fatty, gooey (oatmeal, nut butters, cheeses)-- and raw! Still trying to understand their thought process here...)

In my case, I had become enthralled first with Terry Wahls' inspirational if not out-right miraculous reversal of her MS (if you haven't seen her YouTube video on this, "Minding My Mitochondria," it's a must-see) and later Dale Bredesen's dementia reversal program, "ReCode," that essentially advocated the same or very similar type of food plan: judicious inclusion of pasture-raised meats & eggs, wild caught (low mercury) seafood, and cups & cups (& cups) of dark leafy greens, cups & cups of cruciferous veggies, cups of berries and other dark red-blue-black-purple (low-glycemic) fruits, along with generous portions of nuts & seeds, as close to daily as possible.

The actual prescription calls one plate (piled high) of dark, leafy greens, one plate of cruciferous veggies, 1 bowl of berries. Daily. Dr. Wahls' MS diet includes organ meat & sea vegetables 1-2 times a month. (Iodine is key to myelin production & maintenance.)

Wheat and most grains, along with most simple carbs, are also verboten.

Ideally, the greens & cruciferous would appear in soups and stews and braises. But in our fast-paced world, the reality for most people is that a morning "throw it all in" smoothie is likely to be the one and only opportunity. And thus was mine.

Yes, you see chia, flax, pine nuts, both red & black peppercorns, almonds, whole garlic cloves (!!), ginger root, half an orange, half an avocado, (I would say steel cut) oats, basil, flat-leaf parsley, asparagus, in-season/local strawberries/blueberries, curry powder/fresh turmeric and goji berries!

Within a month, maybe sooner, not only did I notice my vision sharper but also my hair fuller, thicker-- even a bit of the gray going-- cue Amy Winehouse-- back to black.

The power of whole food based nutrition!

Kara Fitzgerald introduced me, years ago, to the concept of "Dark Nutrition" (others call it the "dark matter" of nutrition, which kind of makes more sense)-- the idea that there are tons of nutrients we've yet really to discover or characterize. Which makes food all the more powerful. Let's do a post on that one day.

It's your call. Get those reading glasses (or Lasik) and let your body keep falling apart. Or... take a few minutes to figure out WHY your vision is dimming. And make the necessary adjustments.

Win-win.

In terms of eye health, folks focus on all the different elements of the eye: the ocular surface, the lens, the retina, the optic nerve. Each has distinct, if sometimes overlapping, nutrient requirements. And if you pay attention to the sort of "RDA" for many of these, very few of us are getting them. Let's take a look:

Ocular surface: antioxidants (mostly to protect from UV rays and blue light); omega-3 fatty acids, the (primarily for the tears) minerals Na, K, Ca, Mg, Zn, Cu and even Mn; and finally, the amino acids that make up collagen: glycine, proline, hydroxyproline

Lens: here's where glutathione becomes so important. To support not only glutathione synthesis but also its "recharging" from oxidized to reduced states, we are now talking 3 different amino acids (cysteine, glycine, glutamine) plus vitamin C, selenium and niacin. And that's just the glutathione piece. The health of the lens is also dependent on the macular carotenoids: lutein & zeaxanthin.

Retina (& choroid): The nutrient needs of the retina (which I found out actually has NINE different layers!!) overlap much of the aforementioned but add in the B vitamins as well as alpha lipoic acid, N-acetyl cysteine, and a little known zeaxanthin called "meso-zeaxanthin," even if most people say that the "meso" z pretty much comes from the same foods as the regular z. Glutathione, omega-3 fatty acids, the A-C-E type antioxidants and the macular carotenoids all figure in here too.

Optic nerve: the optic nerve requires a tremendous amount of ENERGY. So here you will see all the mitochondria inputs: B2, B3, glutathione, iron, magnesium, manganese, even vitamin D and vitamin B1-- along with the individual Electron Transport Chain facilitators: CoQ10, iron, copper, sulfur, even melatonin! And citicoline (aka CDP-choline), a precursor to phosphatidylcholine.

In addition to cruciferous veggies (which aside from the cabbage-broccoli-cauliflower cousins also includes turnips, rutabagas, radishes-horse radish, collards, arugula, kale, mustard greens, watercress and Bok choy), mushrooms and the entire onion family (which aside of the obvious onions and shallots also includes garlic, leek, chives) are also good sources of sulfur.

Now let's look at what the necessary daily intake of all these things looks like, in tabular form:

Part of Eye	Think:	Specifically	Target Values
Ocular surface	Antioxidants	A-C-E	C: 1.3-2.5; E: 12-20; D: 50-80
	Essential fatty acids	3's, yes, but all EFAs needs to be balanced!	Omega-3 %: >6% but optimal 8-11%
	Minerals	Na, K, Ca, Mg, Zn, Cu, even Mn	Cu, Zn: both 90-110; RBC Mg 5.2-6.5; K 4.5-5.5; Ca 8.5-10.5; Na, Mn no guidance
	Conditionally essential amino acids	the AAs that make up collagen: glycine, proline, hydroxyproline
Lens	Glutathione
	Glutathione precursors	cysteine, glycine, glutamate/glutamic acid	Cysteine (plasma), 9.0-11.0; glycine, 10.0-12.0; glutamic acid, 3.7-6.0
	Glutathione "re-chargers"	vitamin C, selenium and niacin	Se 110-150; niacin, no current guidance
	Macular carotenoids	lutein & zeaxanthin	No lab targets
Retina (& choroid)	B vitamins		B6, 60-100; B9 (folate), 10-25; B12, 500-1500 (or MMA < 500); looking for B2, B3 target ranges
	plus pretty much all of the above, plus	Alpha-lipoic acid	No lab target. Average daily supplement dose: 100-200 mg once or twice daily (taking more than 150 mg at a time causes burning sensation in stomach for some, especially if not taken after large-ish meal)
Optic nerve	ENERGY (aka mitochondria)	B2, B3 (niacin), glutathione, iron, magnesium, manganese, even vitamin D and vitamin B1 (thiamine)	No lab targets yet for B2, B3, Mn. Glutathione 5.0-5.5; RBC Mg 5.2-6.5; vitamin D 50-80; RBC thiamine pyrophosphate 100-150
	Mitochondrial cofactors	CoQ10, iron, copper, sulfur, even melatonin	CoQ10 (serum ubiquinone) optimal range, 0.8-1.2 mcg/mL
	Citicoline (or variants)	CDP-choline	No lab target

But rather than thinking of this in terms of "how much do I need to take?", let's look at "what can I eat, daily, in order to get these nutrients in my diet?" Short answer: we're back to Wahls & Bredesen (among others): 1 plate "piled high" daily each of dark, leafy greens (I cheat & quick-sauté into much smaller quantity), cruciferous (ditto) + 1 bowl daily of blue-black-purple-red berries. Along with nuts & seeds + once weekly & twice monthly, respectively, organ meats & seaweeds. Aren't you sorry you asked?

Key Nutrients and Foods:

• Antioxidants: "Eat the rainbow," especially blue, purple, black, red, orange, yellow, especially berries, dark leafy greens, citrus; nuts & seeds

• Omega-3 Fatty Acids: Found in the SMASH fish (sardines, mackerel, anchovies, salmon, herring), as well as flaxseeds and walnuts

• Lutein and Zeaxanthin: Found in dark leafy greens like spinach, kale, collards, chards, as well as egg yolks

• Zinc: Top sources of zinc include oysters, red meat (like beef, pork, and lamb), poultry, and seafood like crab and lobster. Other good sources are nuts, seeds, legumes, whole grains, dairy products. Fruits and vegetables generally don't contain as much zinc, although there are varying amounts in the fruits avocados, blueberries, blackberries, pomegranates, raspberries, kiwifruit, cantaloupe, apricots, peaches, and blackcurrants and in the vegetables, potatoes, sweet potatoes, corn, soybeans, peas, lentils, and leafy greens like spinach and kale. 

  
  

• Organ meats/offal:

• B Vitamins:

  Organ meats are packed with B vitamins, including B12, folate, riboflavin, and niacin, which are vital for energy production, nerve function, and cell growth. 

• Fat-Soluble Vitamins:

  Organ meats are a great source of fat-soluble vitamins like A, D, E, and K, which are important for vision, bone health, and blood clotting. 

• Iron:

  Organ meats, especially liver, are an excellent source of iron, which is essential for carrying oxygen in the blood. 

• Minerals:

  Organ meats also provide a wide range of minerals, including copper, selenium, zinc, and magnesium, which play crucial roles in various bodily functions. 

• Protein:

  Organ meats are a high-quality source of protein, containing all nine essential amino acids needed for building and repairing tissues. 

• CoQ10:

  Heart and other organ meats are a good source of CoQ10, an antioxidant that supports heart health and energy production. 

• Choline:

  Choline is important for brain health and cell membrane function, and is found in high amounts in organ meats, according to Ferguson Farms. 

My #1 go-to, since about 2018 or so, for 98% of this information (and much, much more, actually) is Genova Diagnostics' NutrEval. Iodine and vitamin K2 are the only two values, as I recall in this moment, that I would like to know and that aren't included in the test. When I started doing it it was around $350 or $375. I think now it's around $420. But...

I recently discovered through superstar functional medicine doc Ann Hathaway that MediCare can be coaxed (or flattered?) into paying for most or all of it. But only if ordered by an MD or NP. So I am working on yet another work-around-- and will report back!

As for the gentleman dispairing somewhat about his failing vision at 55, he turns out to be cut from the cloth of many, many, many folks I have come across since I embarked upon this path some 8 years ago or so: "if my insurance doesn't cover it, I don't do it." Or even more myopic (sorry) still: "if my insurance doesn't cover it, then it can't be of any value." And that's where I kind of wilt (& cry & scream & shake my fists) inside but ultimately stand down.

Starting a talk at a conference or webinar a few months ago, the (HCP) speaker began with a story of a jetliner for which the pilots had mis-programmed the coordinates of their 13-hour flight-- but by only a hair of what the correct ones were. Eight hours or so into the flight, the plane had path of the plane had diverged enough away from the intended flight path that it crashed into a mountain and everyone on board including the pilots were killed.

The metaphor being (if not instantly obvious) that this 50's or 60's health crossroads is for us kind of the final opportunity for course correction. Virtually all of the scary & terrible illnesses that can strike in our 70's, 80's and beyond take root & start to fester 20 years prior.

Whether it's menopause or andropause or the first achy knees or stiff back; the insomnia, the apnea or snoring, the vision or hearing changes; digestive issues... these are ALL opportunities for us to make our own personal comprehensive assessment of the various biochemical (& physiologic) systems that underpin continued good health.

We can "patch over" with black tape or what have you the "engine light" or the "tire pressure light" or the "door ajar" or "brake still engaged" messages-- with reading glasses, with Lasik, with hearing aid, with prescriptions, with surgery, with mouth guards or O2 masks. Or... we can roll up our sleeves, educate ourselves, and yes, probably spend a little money out of pocket, and get to the bottom (the so-called "root cause") of what's causing the vision decline, the insomnia, the apnea, the inflammation-- and fix it. Root issued resolved. Root Resolution. That's what we're about. Why I do what I do.

Our 55 year old family member decided to splurge on backyard patio furniture after he realized there would be no summer vacation this year. Price tag when all said & done? Just shy of two grand. Oh, and $15.99 for a 2-pack (!!) of Costco reading glasses, 2X. Warning light successfully taped over. Now a shoulder is giving out.