An Ounce of Prevention: How to manage sickle cell disease

 "The greatest discovery of my generation is that a human being can alter his life by altering his attitudes." - William James

Since 2009, World Sickle Cell Disease Day has been observed in June. Thankfully, Sickle-cell disease is now being given the global attention it needs and deserves. Sickle-cell disease is an inherited disease in which haemoglobin, the oxygen carrying pigment found in our red blood cells, is abnormal. Haemoglobin is the substance that makes your blood red. The disease occurs primarily in people of African or Mediterranean origins and more than 10 per cent of Jamaicans have the sickle-cell gene.

Normal red blood cells, with normal haemoglobin, are disk-shaped and flexible, able to squeeze through the smallest blood vessels in the body. On the other hand, sickle cells, because of their abnormal sickle or crescent shape, can block small blood vessels and impede the flow of blood. This reduces the oxygen supply to tissues, may damage many organs and cause severe pain, in what doctors call 'painful crises'. While normal red blood cells live for about 120 days, sickle cells with their abnormal haemoglobin die after only 10 to 20 days, causing chronic anaemia. Other common problems include lung and breathing difficulties, chronic leg ulcers, jaundice, liver enlargement and an increased susceptibility to infections.

Sickle-cell anaemia and its many variants like sickle-cell trait are genetic disorders and cannot be 'cured' in the conventional sense. However, medical research and the emerging field of epigenetics clearly demonstrate that we are not helpless victims of our genes. Simple lifestyle modification involving things like good nutrition and nutritional supplements can help to moderate many of the problems of sickle-cell anaemia. This can mean fewer problems with anaemia and pain, and improvements in the general health of those with this illness.

Nutrition and Sickle-Cell Disease

Although many sufferers of sickle-cell disease are told that they can eat anything, I find that a healthy diet emphasising lots of water, water-rich foods like fresh fruit and vegetables, along with enough healthy protein is most valuable. I also suggest supplementing with the Cellular Nutrition Program, while several additional supplements may provide further special benefits.

Omega 3 fatty acids: The membranes of the red cells are made up mostly of fatty substances. Eating unhealthy fats like trans-fats makes the cell membranes more rigid and unhealthy and increases the tendency for the red cell membranes to rupture. Supplementing with omega 3 fats and eating healthy oils reduce the damage to the cell membranes and the frequency of problems like severe painful episodes. I recommend three grams daily of a high-quality omega 3 fatty acid-rich, fish oil supplement. In times of added stress or crisis, one may double this dosage.

Vitamin E: One of the most important nutrients for 'sicklers' may be vitamin E, a fat-soluble antioxidant that protects the membranes of red blood cells against free radicals. Red blood cells from people deficient in vitamin E, like those from people with sickle-cell anaemia, are more susceptible to free-radical damage.

Vitamin D: Researchers have found a very high level of vitamin D deficiency among sufferers of sickle-cell disease. The lower their levels of vitamin D the more painful the crises and bone pains suffered. I strongly recommend that sicklers have regular sunbaths, plus take 10,000 units or more of vitamin D3 daily. It is also a great idea for a sickler to check his/her vitamin D level with a simple blood test.

Herbal supplements: A study at the Philadelphia Biomedical Research Institute in the US examined the effects of green tea and garlic extracts on the hydration of sickle cells. Dehydration of the sickle cells worsens the damage to the cells and may increase the complications of the disease. An antioxidant found in green tea extract, almost completely prevented sickle cell dehydration. An extract of garlic reduced cellular dehydration by 30 per cent.

Research found that garlic, the amino acid arginine, Pycnogenol, green tea extract, black tea extract, and vitamin E improved the strength of the membranes in sickle cells. Ginseng, ginkgo, and coenzyme Q 10 were also found to be helpful. Other herbal antioxidants like schizandra and rosemary may also be useful in sickle-cell disease.

Multivitamins: In another study, it was found that a combination of several supplements in high doses greatly reduced symptoms of sickle-cell anaemia. Over six months, patients supplemented with six grams of vitamin C, vitamin E, six grams of garlic extract and one mg of folic acid. Meanwhile, the twins of those patients who also had sickle cell disease took only the folic acid. Those taking the multiple supplements had only one-third the number of painful sickle cell episodes and felt much more energetic than the other group.

Folic Acid and vitamin B 12: People with sickle-cell anaemia have elevated blood levels of a substance called homocysteine. This is a known risk factor for coronary artery disease, inflammation and circulatory disorders. Research at the University of Alabama, Birmingham, showed that this abnormal elevation of homocysteine in sickle-cell patients responded to a combination of folic acid, vitamin B12 and B complex vitamins, and not to just folic acid as is usually prescribed for these individuals.

Minerals: Supplementing with the minerals zinc and copper may help to prevent cell damage and accelerate the healing of leg ulcers associated with sickle-cell anaemia. Iron supplements are not usually needed in this kind of anaemia.

Rest and Stress Management: Get enough rest and learn to manage stress in a healthy way as part of your healthy lifestyle approach to sickle-cell disease.

My take-away message to sickle-cell patients is simple: Yes, you have an inherited genetic disorder, but there is a lot that you can do with a healthy diet and the appropriate nutritional supplements to prevent and control the problems associated with sickle-cell disease.

- You may email Dr Vendryes at tonyvendryes@gmail.com or listen to An Ounce of Prevention on POWER 106 FM on Fridays at 8:15 p.m. Details of his books and articles are available on his website www.tonyvendryes.com.