What are the types of metabolic disorders?
As I mentioned back in Toxic and Metabolic Disorders, metabolic disorders of the brain are caused by either deficiencies or excessive levels of nutrients: hence they are quite common. There are two types of metabolic disorders: acquired metabolic disorders and nutritional diseases.
What category does diabetes mellitus fall under?
Diabetes mellitus (types 1 and 2) is unfortunately a major contributor to acquired metabolic disorders. Type 1 diabetes is an autoimmune disease where the person’s own immune system attacks the pancreatic cells that produce insulin: this happens at a young age and the person has to have daily insulin injections in order to survive. Type 2, however, has to do with insulin resistance and often happens in late adolescence and adulthood. It is not always necessary for diabetics of this type to require insulin. Because of this, the extreme swings of glucose in the blood can seriously affect the brains’ capacity to function. As I mentioned in other pages, the brain is only able to use glucose and its storage form, glycogen, for energy unlike the rest of the body, which can rely on fat and protein stores in times of food shortage.
Acquired Metabolic Disorders
There are three separate types of acquired metabolic disorders. Two have to do with the level of glucose, and the other is hepatic encephalopathy.
Hypoglycaemia (low glucose levels)
Low glucose levels within the blood can lead to the brain exhibiting symptoms similar to that of lowered oxygen (hypoxic) levels in the brain, and if the levels of low glucose is long in duration, it can lead to brain injury. Unlike cases where low oxygen is seen, however, the Purkinje cells within the cerebellum are spared: this area is responsible for inhibition of motor reflexes.
Hyperglycaemia (high glucose levels)
High glucose levels in the blood can be associated with either coma or cases of diabetes mellitus that are either undiagnosed or uncontrolled. Symptoms associated with hyperglycaemia include dehydration, confusion, stupor (near unconsciousness) and eventually coma. If this condition is diagnosed, it must be treated in stages to bring the glucose down gradually in order to prevent swelling of the brain.
Hepatic or liver encephalopathy can affect the brain because of the increased amounts of ammonia (NH3) that build up within the blood. Normally, ammonia is converted to the safer product urea by the liver and is excreted in your urine as a waste product, but if the liver starts to fail, such as in cases of cirrhosis (scarring) that is shown by the picture alongside, this process can be interrupted. Hepatic encephalopathy lead to ‘flapping’ tremors in the early stages and may eventually lead to a coma.
There are two types of nutritional diseases which can lead to damage within the brain: Wernicke-Korsakoff syndrome and subacute combined degeneration of the spinal cord.
Wernicke-Korsakoff syndrome is a result of thiamine deficiency. Thiamine is also known as vitamin B1, and it is found in Vegemite, (or Marmite to you Americans out there), hummus, sunflower seeds pork chops, fish. herbs and spices such as coriander, sage, paprika, thyme, poppy seeds and mustard seeds and nuts such as pine, macadamia, pecan and pistachio.
Wernicke-Korsakoff syndrome is actually two stages of one disease: the acute stage is known as Wernicke encephalopathy and the irreversible condition is known as Korsakoff syndrome. Wernicke encephalopathy is characterized by confusion, ataxia (lack of control of body movements) and abnormalities in eye movements. At this stage, the disease is reversible if diagnosed by taking thiamine supplements or adding thiamine-rich sources to your diet. Korsakoff syndrome, conversely, involves disturbances in memory. There are several circumstances which can increase the risk of developing this condition: they include situations which prevent the intake of proper nutrition, such as chronic alcoholism, gastric disorders, chronic gastritis (stomach inflammation) and persistent vomiting.
Subacute Combined Degeneration of Spinal Cord
Subacute combined degeneration of the spinal cord (or SCDSC for short) is a condition which results from vitamin B12 deficiency. Vitamin B12 is also known as cobalamin, and can be found abundantly in meat and dairy sources. SCDSC involves a disorder of both the ascending and descending fibres within the spinal cord and the symptoms of this condition can evolve over a period of weeks. Such symptoms include ataxia, numbness, tingling in the lower limbs and spastic weakness in the legs. In the worse case scenario, a person with vitamin B12 deficiency can develop full-blown paraplegia (paralysis of the legs). The prognosis of a patient with vitamin B12 deficiency varies depending on the length of time between the condition developing and when the treatment is given: if it is quick, the condition can be reversed, however the condition worsens the longer it is allowed to go on.