Q&A 4/6/23 UTI and Sepsis, Melatonin and Night Shade Vegetables


Question of a relative who developed a UTI that turned into sepsis while in hospital. Is it possible to have side effects from Melatonin? What is the importance of the mitochondria? Is this article on night shade vegetables correct? Information on upcoming Cardiology classes


00:00 Book to be published soon

02:12 Relative developed UTI that turned into sepsis while in hospital.

12:55 Melatonin side effects

15:16 Mitochondria

20:57 Night Shade Vegetables

34:07 Upcoming Cardiology classes

Transcript from Webinar:

Howdy, y’all. This is Dr. John. I’m going to give a few more minutes to let people get on here. I apologize. We’re starting a couple of minutes late, and I’ve got tons of questions, but if you want to send in some more. That’s great. Some really exciting news for me. This morning at 6:30 Kathryn and I had a meeting with some people that are working with us through the process of publishing our book, and it looks like we’ve got a publication date of April 30th to get our book out, which is the sweet spot.


The book is about what your labs can really tell you if you know how to look at them. And these are just really the simple labs. This first book is just on a chemistry panel. In it, I don’t just talk about it. We share lots of information. It’s written in a very layperson’s style. So, I think acupuncturists could certainly get value from it.


Actually, I think anybody would get value from it because it gives you a way to look at your labs when they’re done, when your doctor does them or you do them, and really see where you’re at. Are you kind of barely hanging on in the so-called normal range or are you in the functional medical range? There’s a huge difference. I mean survival can be ten times higher for some values if you’re in the sweet spot versus the ends of the U-shaped curve.


So, I think it’s really potentially valuable for a lot of people, and particularly anybody who wants to have long term good health. So, the book will be out soon. We’re picking covers for that, and we are very excited! If you would like to be included in a mailing list about opportunities for any additional involvement, helping us get the book out, et cetera, we would love to work with some of you, so let us know!


So, I got a bunch of good questions. Let’s see what I want to start with. Oh, here’s a great one.


It says “A relative just died of sepsis …” oh, I’m so sorry to hear that! “… At 79. He had a couple of strokes but was in PT. He developed a urinary tract infection. However, with a couple of strokes, his closest relatives felt he needed hospital care.” Excellent call. Excellent call. A lot of times older people will just kind of blow off urinary tract infections and they can be extremely dangerous.


“The urinary infection may have led to sepsis. He went from being in fairly good shape to dying in a matter of days. Three days prior to death, he was moved to rehab hospital, but sent back to Columbus, Ohio hospital in an ambulance the next day. It seems to me, a non-expert, that the sepsis got worse. He was pumped with antibiotics. The patient had written he did not want to be resuscitated, so relatives chose to leave him on oxygen. He died very quickly thereafter. I think hospitals don’t know how to contain sepsis or perhaps they don’t suspect it till too late. Your thoughts?”


My thoughts are that I agree with your observations completely. UTI’s can certainly trigger sepsis. I had a good friend who passed away at the end of last year who was having trouble with the catheter. He actually couldn’t get it in properly. So, he had an infection. What will happen is it can back up in the kidneys and that’s where the UTI becomes dangerous. If it’s in the urethra, you know, it burns when you pee. Okay. That’s not a life-threatening thing at that moment. If it’s in your bladder, but above your pubic bone, then we have to be a little more concerned. But if it moves to your kidneys, that’s a hospital level event that requires immediate treatment.


I have one patient whose daughter was up in the mountains with her boyfriend and developed a UTI, then started having back pain. If you start having back pain with UTI you go in and get treatment instantly, immediately! So, she didn’t she would sit in the hot tub, which will make kidney problems generally feel better. Finally, she couldn’t take it. Her boyfriend drove her to the hospital, dumped her at the hospital and left her there.


She very nearly died of sepsis. I mean they told her mom she wasn’t going to make it. She did make it, fortunately, but ended up having all of her toes and all of her fingers amputated because the sepsis had damaged the tissue so badly. So, yes, it is very possible that that was the issue. Now, one of the big problems and this is a great thing you pointed out in the last paragraph. The sepsis protocols vary tremendously by hospital and by doctor. There is very little doubt anymore that the Merrick protocol is the best.


So, Dr. Paul Merrick was the number one guy in intensive care medicine in the United States. He trained most of the top intensive care people. He created a protocol, very simple protocol that was astonishingly effective. Unfortunately, most hospitals do not do it. It’s too simple. But his results were phenomenal. For example, in the study that they did, 8.5% of people in his treatment group died. In the regular treatment protocol group, which is probably what your relative got. The death rate was 40.4%. Typically, it’s actually around 50 to 75% mortality with sepsis. How advanced the sepsis is will determine whether the patients fall within the 50% or the 75% range.


Now, actually, in his treatment group, no patients died from complications related to sepsis. They all died from conditions secondary to complications of their underlying disease. That’s important to note. So essentially, nobody in his group died of sepsis and the mortality increases in a very linear fashion. By 72 hours, it’s very, very, very dangerous. That’s where it’ll often lead to over a 50% death rate.


This is how simple Merrick’s protocol is. Intravenous vitamin C, every six hours. 1.5g every six hours for four days or until they’re discharged from ICU. That’s going to cost the hospital a couple bucks. A regimen of Hydrocortisone to put out the inflammation because it’s often the inflammation that’s the killer more than the infection. So, hydrocortisone 50mg every six hours for seven days or until they’re discharged. Then there’s a taper. You’ve got to taper off any of the cortisone. Hydrocortisone is extremely safe. I believe prednisone is 25 times stronger. Hydrocortisone is more on the level of giving you your own cortisol back. What happens is our cortisol levels get greatly depleted with age and, even more applicable to this subject, from infection.


Then they did intravenous vitamin B1, thiamine, 200mg every 12 hours for four days. Okay. You are literally talking less than $5 a day for this treatment. Yet most of the emergency rooms, intensive care facilities are not really doing this. Now, it takes a long time for things to get from scientific research stage to the mainstream setting. The timeline I’ve heard most often is 17 years. However, this one shouldn’t take as long because it was developed in a hospital setting and it would be used in a hospital setting. So, this is something that should spread like wildfire.


Now, one of the problems is that even though Merrick had one of the top, when I say one of the top, I mean the top 5 or 6, success rates at treating COVID.  However, he wasn’t doing Remdesivir or any of the other drugs that were recommended. He’s an intensive care doctor. He was giving them some form of corticosteroid he was giving them vitamin C, vitamin D … Very much different treatments. And so, his patients were doing really well. Well, that didn’t go over well.


So, even though he’s a giant, a giant in this field. But he can’t work in that hospital anymore and what happens is when people get discredited for something, nobody looks to see why they got discredited. His treatment worked. He was amazingly successful, but he got discredited. So, a lot of his work was kind of shoved aside. And it’s very sad because, again, this treatment protocol could save tens of thousands of lives. Yeah. So, to circle back around, sepsis can kill very quickly. Very quickly. I certainly can’t say from this weather I think, in my humble opinion, having him moved to the rehab hospital was a good idea or not. I’d have to really see his labs and how well he was doing and how things were changing.


So that’s a great question and it brings up a really critically important issue. Now, again, during COVID, it was impossible, in most cases, for friends, family, coworkers, whoever, to get into the hospital or even talk to the doctors. But in normal times, you have to have an advocate and or you need to be an advocate because you need to research these things yourself or go to someone that you trust outside of the hospital environment and see what’s really being done for these conditions. Then the advocate needs to go insist, go pound on the doors, insist that your doctors do that thing.


And I have many patients who’ve done that and have saved their partner’s lives. No doubt about it. No doubt about it. So, you always need an advocate and you need to be an advocate for anybody that you know that’s going to be hospitalized. Still the third leading cause of death in the United States. And this study was first published in 2016, but it has been repeated. The study found that a minimum of 200,000 people a year die from hospital and pharmaceutical misadventure.  For example, they came in for a heart attack and they died for something completely different because the treatment was inappropriate. So that’s been well proven.


So, you need to be there, you know. I’m not trying to put anybody down or the hospital system or anything. It’s just how it is. You need to be there as an advocate and always have an advocate. I recommend to my patients that they take someone with them whenever possible, even to their doctor’s visits. Because when someone’s talking to you about a condition, often we don’t hear everything. We’re nervous, it’s about us, we’re a little stressed. It’s nice to have someone else there that’s listening who can hear things a little bit differently.


Also, that second person often will add very, very useful information. This happens all the time with me. I’ll be interviewing someone and then the husband or wife goes, “Well, actually, remember, dear, this happened.” and the “Remember dear, this happens … ” Statement is often the thing that puts the whole case together. So, advocate.


Let’s see, what’s the next question here? Oh, yeah, this was a good question:
Could you touch on why someone would have the opposite response when they took melatonin? It caused them to wake up throughout the night and become almost hyper. This happened on a few occasions. I read it could be a mitochondria issue and they need to take niacin have you heard of anything like this? Thanks.


It’s a very complex question. I mean, the question is not complex. The answer is complex. So, melatonin can have a paradoxical effect, and I’ve seen that with my patients. I’ve read about it. And it seems to me with my patients, there’s this 80/10/10thing that happens. About 80% of the time melatonin works really well for what it’s supposed to do. Which is to help with sleep, but also to clear brain fog, because it may be the most important antioxidant in the body, but it’s almost certainly the most powerful antioxidant for the brain.


So about 80% of the time it works great. Sometimes it doesn’t work at all because it isn’t the problem. But about 10% of the time people will get paradoxical effects like the ones in your question. I am one of those 10%. So, if I take oral melatonin before bed, I will have crazy, crazy, crazy, wild, full technicolor dreams. Now, mostly my dreams are pretty quiet and mostly, I think in black and white. At least I don’t remember them in color. But when I do oral melatonin, it will just blast my dreams and often enough that I’ll get a cortisol rush that will then wake me up. And that’s probably what’s happening in this case.


Now, in terms of the mitochondria, there are lots of theories here, but bottom line, pretty much everything is about the mitochondria ultimately. And so, you can make linkages for almost any health condition from good health to bad health and look at the mitochondria. There are typically about 10,000 mitochondria in a cell in the body. Some don’t have any mitochondria, but there’re only a few of those types. The mitochondria are the energy factories. They are very complex, and they’ve got to have a constant supply of certain nutrients and certain enzyme conditions in order to produce the energy molecule called adenosine triphosphate, or ATP.


Now there are a whole bunch of reasons why the mitochondria can become damaged. We all have damaged mitochondria; in some cases, the mitochondria can purposely shut down to protect you from injury in particularly stressful illnesses and then not turn back on. Dr. Navio has written extensively and studied this phenomenon extensively and he said it’s one of the big problems with things that are colloquially called chronic fatigue.


However, in fibromyalgia for example, along with many other chronic conditions is that the mitochondria purposely turned off and purposely didn’t turn back on. So, you really need to get down to a mitochondrial level to get them turned on. And the Chinese have been treating mitochondrial dysfunction for over 2000 years. They didn’t call it mitochondrial dysfunction, but they call it Qi and Yang deficiency. They’ve got tons of formulas that we now know work on a mitochondrial level to get energy production increased.


Melatonin is very healing for the mitochondria, partially because melatonin is such a powerful antioxidant. You know, I don’t know when the original research was done on melatonin and sleep, but around that time they were looking at melatonin being released from the pineal gland, which helped us relax and go to sleep. So only in the last decade and really in the last few years, mostly that a lot of additional work has been done with melatonin. And we find that 40 times more melatonin is released into the body from other sources than is released by the pineal gland.


So, there’s massive amounts of research going on. You want to have a ball and go down the rabbit hole. Look at melatonin and mitochondria. For example, I have a study somewhere here. Proving that migraine headaches and cluster headaches are both primarily related to melatonin cortisol balance. They found that people with low melatonin, low systemic melatonin got cluster headaches and migraine headaches at a much higher rate, and that when they were having the cluster or migraine headaches, their melatonin levels were really bottomed out. They were very low, and the cortisol levels went up. So that balance of melatonin to cortisol is really critical in headache.


It’s also now being studied extensively. Melatonin, that is, as an anti-cancer supplement. I looked the other day and I think there were, well, dozens, I’ll say dozens of cancers that seem to be suppressed by melatonin usage. And this should be obvious because decades ago, studies started coming in for female shift workers, those who worked either irregular nighttime shifts or were just always working nighttime shifts had much higher breast cancer rates. And of course, that’s reasonable. Melatonin release causes the estrogen cycles to be balanced. So, you’d be getting, you know, too much or too little estrogen at different times which is going to stimulate future breast cancers.


Melatonin is massively anti-inflammatory. Typically, the most studied doses were very low for sleep 1 to 3mg. Most people actually now use about five. I use five when I use melatonin to sleep, which I do not often do because of those wild nightmares or dreams. But what I do is I use 200mg of melatonin nightly, massaged into my bad knee and using it as an as an anti-inflammatory. It doesn’t put me to sleep using it topically, but it does seem to give me a longer and better night’s sleep. So, I wouldn’t do that for sleep directly, but it really does seem to help. Now we are in love with melatonin.


There are several doctors that we think very highly of that use melatonin extensively, not for sleep, though they may. But I’m talking about inflammation treatment. We carry 200 milligram and 400 milligram suppositories, which is a very easy way to absorb the melatonin and you’ll absorb it a little better there than you will topically on the skin. But I like I like doing the lotion. Okay. So that’s kind of my gig on melatonin.


Next question:
Is this article about Nightshades completely accurate? It’s from the Cleveland Clinic, and I don’t know if it’s completely accurate. I looked at it. Um, I didn’t agree with it exactly. In that they seemed to indicate that nightshades are not as big a deal as a lot of people make them out to be. Well, that’s probably quite accurate. It’s like when people ask me, which they rarely do anymore, what’s the best diet? There is no best diet. We have some patients that we put on carnivore diets. That’s all they eat is meat. And it’s been magical in the patients that we’ve done that with. All of their symptoms went away. Why? Because each group of vegetables can have things in it that may be detrimental to your specific health. And sometimes, you know, by the time you cross-reference all of these different potential problems, you don’t have any much in the way of vegetables left anyway.


So, we just remove them. That’s going to remove most of the allergens. And again, it removes most of the lectins, which are one of the bigger poisonous kind of allergenic substances. We remove mostly carbohydrates for the same reason because you can have the same problem. Now, I’m not advocating that diet for any of you. Like I said, we put about maybe one patient a month on that because nothing else has worked. 


When it comes to vegetables, there are so many different potential problems that sometimes you really have to look very carefully. Do a little research on your body, keep a food diary if you’re having problems. But I will tell you this without a doubt. I’ve been licensed as an acupuncturist for about 25 years. I’ve seen over 60,000 patients in our clinic, and I’ll tell you, overwhelmingly, the biggest cause of hives, skin rashes and histamine problems is tomatoes. There’s nothing even close. In fact, people will come in, unable to understand why they have hives all over their body when they’ve never had hives before. Invariably, when I ask them how many tomatoes, they’ve eaten they’ll say something like, “Oh my God. I went out and got all these cherry tomatoes yesterday!” to which, of course I’ll respond with, “Yeah, you need to stop eating them.”


You don’t have to be allergic to tomatoes to have that response because tomatoes have such a high histamine level. They also have a high lectin level, largely because they’re picked too early before they’re ripe and then they’re not cooked. If you cook them, particularly if you pressure cook them, that lowers all of those problems, doesn’t get rid of it, but it will lower it significantly. But if you’re eating raw tomatoes, it’s going to kick your histamine up, you know, for, I don’t know, hundreds of years, I believe, but at least decades. Tomatoes were considered poisonous. I mean if you looked up the plant, they said don’t eat, these are poisonous. And I suspect it’s because so many people had histamine responses to them where they felt horrible, and they started developing these horrible rashes. So, this isn’t even a new thing.


So, nightshade, allergy symptoms, hives and skin rashes are the biggie. But itchiness goes along with that. But you can have nausea and vomiting. Typical allergy symptoms of excess mucus production, but achy muscles and joints, inflammation, and arthritis. So, when I was in my 20s, I had developed arthritis in my fingers. This is in my 20’s, and I played a lot of sports, played a lot of football, banged my hands a lot, was doing martial arts, but it got to the point where I could barely bend my fingers. I stopped eating nightshades and wheat and my arthritis went away 100%. Now I have some arthritis now in my wrist, but that’s a completely different issue. It completely resolved my arthritis. And in the Cleveland Clinic article, I think they downplayed that or underplayed it a little too much. I just see too many problems, particularly with tomatoes.


Now, there are other things that are nightshades, tomatoes, anything made with tomatoes, right? Marinara, ketchup et cetera. Though I haven’t seen as big of a big problem with ketchup because I think the way it’s  cooked, I think it may lower the lectin content. I’m not saying that’s true. I’m saying I’m suspicious that it may be accurate because I don’t see my patients having as much problem with ketchup. Also, European, primarily Italian in tomato products. I don’t see as much problem with either. It’s because of the cooking methods. They peel the skin off of them. They usually ripen the tomatoes on the vine, which is a huge issue, right? Vine ripened tomatoes. They take off the skin and they take out the seeds. And those are the most dense areas of histamine. So, you know, if you’re having trouble and you’re just desperate to try something marinara that’s actually made in Italy.


Tomatillos, eggplants, I would put next on the list and then I’d put peppers. So that’s bell peppers, jalapenos, chilies, all that pepper family. Spices, red spices that are made from those peppers those I find all really trigger this. Potatoes, which are definitely a nightshade plant. I just don’t. I don’t see as much of a problem. I do have patients that if they eat potatoes, they’re horribly inflamed the next day, but it’s much less, I would say 10% of what I see with tomatoes. But, you know, it just depends on how susceptible you are, because we’re all different.


Kathryn:  Um, let’s see here a couple of them about melatonin. Melatonin keeps me awake also. Can we take it in the morning?


John: Yeah, but if you’re not taking it for sleep. Yeah, I would. Well, I do a little bit in the morning, but. Again, with these paradoxical reactions, it might make you sleepy in the morning. It’s kind of interesting, but you’re probably going to be okay. But I would think about doing it as a topical also. 


Kathryn:  I find if I take it in the morning, I need to have the sun need to go outside and have the sun and then don’t have the grogginess. Really helps me.


John: Well, yeah, that’s going to overcome the melatonin for sure. Yeah. Mean the key. Like I like melatonin in people that are traveling across time zones. And the key there is to get sun exposure as early as you can in the day and as late as you can in the day because that resets the pineal gland and then to do melatonin with that. And that’s a very effective combination.


Kathryn: Yeah, yeah. That’s how I find to help with the melatonin grogginess. Are there any health conditions where you shouldn’t use melatonin?


John: I don’t like it in kids. I’ve had at least one kid that came to me. I didn’t prescribe this, who was given very high dose melatonin and developed Alice in Wonderland syndrome, literally. His fortunately, his mom is a therapist and she recognized that something was really wrong. And with Alice in Wonderland syndrome, you don’t have proper perspective. Big items look, small, small items look big. And so, it’s really, you know, if his mom wasn’t there, that could have been pretty dangerous. He would have thought he was losing his mind when he got off the melatonin that changed.


Any other condition that I would not want to give melatonin. I wouldn’t give it to someone who had narcolepsy or some sleeping disorder like that. And I wouldn’t give it if they were having these paradoxical symptoms. Now, melatonin and niacin do have an interactive quality, but I have not read about or seen it used in the way that the caller asked about.


Kathryn: It can also trigger detox symptoms. So, if you don’t detox well. That might not be a good time to take it. Until your detox pathways are open. … Those are the only big ones that I was thinking of.


John: The detox pathways are open. Yeah. Yeah. You think of anything else?

00:29:45:10 – 00:30:05:10

Kathryn:  And then what is the name of the product you use on your knee?

John: The company is called Zetpil. And it’s a topical melatonin.

Kathryn: Yeah, it’s pretty expensive.


John: It is expensive. That’s the same company that makes the suppositories. Okay. Um. And again, suppositories are generally a more effective way to deliver most things than is orally, because when it’s oral, it has to be broken down in the stomach, right? The stomach acid is going to work on it. You have to you’re going to digest it, et cetera. Where when it goes through the large intestine, through the through the walls of the large intestine, it really doesn’t have to be adulterated. That’s also mostly true with the topicals.

Kathryn:  And then someone’s wondering, should we take melatonin with or without food?


John: I would take it without food. I’m saying that because. I don’t know. Um, I haven’t seen any good studies on that. Um, but I wouldn’t want the food to in any way block the uptake of the melatonin since you’re using it for sleep. Also, if you’re using it for sleep, I don’t want you eating that close to bedtime. A lot of people will wake up in the time of the liver, between 1 and 3a.m. Part of that is if the blood sugar drops, which it often will at that time, because you’re switching over from one form of burning glucose to burning glucose from glycogen storage.


And some people, you know, because of certain deficiencies, will have a difficulty there. If the blood sugar drops even slightly while you’re asleep, the brain senses that as an impending emergency and it will want to wake you up around that time. In most people over 40, the melatonin levels also drop. So, if you get low blood sugar and low melatonin at the same time, it’ll just pop your eyes open. Okay, so in that case, I have people put a 25gram equivalent size of something to eat or drink beside their bed.


It could be rice milk; it could be a graham cracker. And before they even turn on lights or get out of bed or anything to eat the graham cracker. And often that’ll be enough to get their blood sugar up so they can get back to sleep. Also, I would have them do a sustained release or timed-release melatonin so that it’s kicking in a little bit later and some people have trouble falling asleep and also trouble staying asleep. I’ll have them do both an immediate release and a time release just to make sure we recover on the basis.


A great question that I don’t have an answer for directly, only an opinion. The topic of resistant starch and this person is saying, what about the frozen potato patties from Trader Joe’s that her husband likes so much? She says she thinks they’re processed in a manner that exposes them to a minimal amount of oil pressed into a mold in which they’re baked and partially browned, then frozen. They’re finished by being thawed, heated and crisped in our toaster. Um, I would guess, and this is a pretty fairly strong opinion that that would create a resistant starch, right? You’re getting freezing will cause even more resistant starch than will cooling in the refrigerator, for example, you can take a loaf of horrible white bread, throw it in your freezer, and if you leave it there for a month, it mostly is then resistant starch.


Now, please don’t do that. But that’s interesting to know. So, I would guess that eating those pancakes, I mean, the potatoes that have been precooked frozen and then you’re going to heat them up, I would guess that has that has a very high level of resistant starch. Anyway, I’m going to try it myself and see what I think.


Um, I think that’s about all the time I have. I want to thank you for tuning in. It’s been awesome. You know, as you know, I love doing this and contact us about the book. And think that’s about it, isn’t it? I think so. Okay, cool. Any of you interested out of, you know, curiosity or if you’re in a health field, I will be starting a cardiology course online on April 21st. It’s going to be way different than anything you’ve ever seen about cardiovascular conditions. That one is being sold through another company.


And so there is a small fee for it. But I promise you, you’ll learn stuff you never dreamed of because I wasn’t taught this in college. I wasn’t taught it in my master’s program, wasn’t taught in my doctoral program. And it’s really the most important things to know about cardiovascular health. So, if you’re interested, there’s a link in our newsletter. You can go check it out or sign up. Okay, So I’ll be back next bat Tuesday. Next bat time. 3:00.

Be well. Be happy. Thank you.

Dr. John Nieters L.Ac, DAOM, is an acupuncturist, Chinese herbalist, functional medicine, writer, teacher, and leader in the community. In this episode, John talks about his experience with the importance of finding your vision and purpose in life, in order to create the right goals for you.

Disclaimer: Dr. John Nieters received his Doctor of Oriental Medicine and Acupuncture degree from Five Branches. His use of “doctor” or “Dr.” in relation to himself solely refers to that degree. Dr. Nieters is a licensed acupuncturist in California. This video is for general informational purposes only. It should not be used to self-diagnose and it is not a substitute for a medical exam, cure, treatment, diagnosis, and prescription or recommendation. It does not create a doctor-patient relationship between Dr. Nieters and you. You should not make any change in your health regimen or diet before first consulting a physician and obtaining a medical exam, diagnosis, and recommendation. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. TheBalancingPoint.net, Alameda Acupuncture, and Dr. John Nieters L.Ac, DAOM are not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this video or site.

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