Individual Nutrition assessment – an example chart note

What is health care? What is included in an individualized health care appointment?

The answer varies with the type of specialist you are seeing – and what they are allowed to do within their facilities’, or the individual’s insurance plans protocols.

My nutrition counseling experience was in prenatal/early childhood, and residential (nursing home) facilities.

Chart notes would be written for high risk clients when working in either role. Occasionally the nutrition assessment and recommendations note would be sent to the physician directly if very high risk.

As a preventive health focused prenatal/early childhood counselor, or for residential facility chart review (nutrition assessments of all nursing home residents considered high risk nutritionally, occasionally would include an in person visit with the resident to visually observe and ask further questions about their health and diet symptoms.

Patients typically do not see a chart note. They might be given the ‘Problem’ and ‘Assessment’ sections as an action list of recommendations on a simpler handout. The medical chart has a Care Plan section where recommendations for a daily change in care might be added – such as adding a high protein snack in the evening.

I would typically spend a half hour to an hour per client and writing a good note might take an additional 15 minutes. Current insurance standards have been set which limit physicians to 15 minutes per patient appointment – and only scheduling/discussing one symptom per appointment. That would make a differential diagnosis fairly impossible.

  • The entirety of a person’s symptoms – and what makes the problems worse, and what seems to improve things – is what provides clues to the underlying issues that may have led to the increased inflammation and/or decreased function.
  • Health is a balance of not too much inflammatory response -> autoimmune or allergies – or too little -> rampant infection and catching every cold.
  • Health is also a balance of enough nutrients and not too many toxins to cope with, whether from air, water, food, or touch, or from internal production of stress chemicals caused by emotional or physical stress.

Autoimmune issues are particularly challenging because many odd symptoms can occur, and more than one type of autoimmune antibody may be involved – not just one ‘autoimmune disease’ – several. Low vitamin D makes autoimmune issues more likely to occur, and low magnesium can make low vitamin D more likely – even with supplements of vitamin D.

Low magnesium also increases inflammation symptoms, pain, and anxiety, depression or anger and irritability.

A physician might look at my example note (below) and think: ‘but this is not my field‘ — exactly — please refer to the specialist – a registered dietitian or clinically trained nutritionist. Caution, there are many ‘nutrition certification’ programs online which are not equivalent to a college education, internship, and the equivalent of a lawyer’s Board Exam.

The client gave permission to share the write-up for educational purposes or maybe to help someone. Patients know that pain hurts, and that health is better. Too often I hear from physicians something like ~ ‘we don’t know what is causing this, … so the patient will probably die‘ – but it is regarding symptoms that likely involve nutrient deficiency.

Even sick patients need to eat or be fed and their nutrient needs are likely increased, or decreased, due to the illness, for a few specific nutrients affecting or being used in excess by the underlying issue. Telling a patient there is no hope is providing a nocebo – a negative expectation. Saying “I don’t know,” – when that is the true situation – would at least not be setting up a roadblock for the patient to seek further information or a second opinion.

If in reading my example chart note*, as a physician, you think, ‘but this is not my field‘ — exactly — you are correct – but it is the patient’s whole health that matters, not just symptoms that may be temporarily controllable by medications.

SOAPE note

The SOAPE chart note* below, is an extended version compared to what would be likely to be written in a patient chart. SOAPE note: Subjective, what the client said; Objective, what the clinician observed; Assessment; what the clinician believes may be underlying issues; Problem/Plan, recommendations being made by the clinician; Evaluation – an opinion statement about the likelihood of positive change, based on the overall attitude or motivation the client is presenting and social factors that may impact the client positively or negatively.

I included extra information that might be in a report to the client, with the education they might need to understand the reasoning for the recommendation, or how to proceed. Complex strategies can take several weeks of a class like setting possibly with cooking and tasting demonstrations. My web pages and posts try to provide self care guidance so a motivated learner could just try things and see if they help.

I added some additional info links for the version in this post, to pages or posts that provide some next step guidance, Gluten Free diet? what is that? The products on the market are not ideal suppliers of nutrients in my personal and professional opinion and learning how to bake gluten free can be healthier and less expensive for the nutrient value. My websites are my file cabinet of patient handouts, some of it.

While working as a public health nutrition counselor I did occasionally write a very thorough note for someone with a complicated case, and send it to the client’s physician on their or their child’s behalf.

Nutrient deficiencies can lead to death (niacin/pellagra example) – and can turn around dramatically very shortly after the nutrients and any cofactors are provided (nutrients are a team – refeed gradually and in balance).

Sometimes nutrition care is a life or death situation. Continue the nutrient deficiencies and deterioration can be rapid, and death can be the result. Niacin deficiency, pellagra, has a nickname for symptoms – the four D’s: “Pellagra defines systemic disease as resulting from a marked cellular deficiency of niacin. It is characterized by 4 “D’s”: diarrhea, dermatitis, dementia, and death.” (1) If there is severe lower leg rash and edema – suspect a B vitamin deficiency.


Nutrition assessment

Subjective:

  1. CoV like symptoms, mild, ~ early outbreak mid 2020, left a new problem, 2. swollen throat, reflux like pain/not quite reflux though, flair up of CoV symptoms again later when family had it 2021, again not too bad. 
  2. Swollen throat symptoms – has had labs showing autoimmune thyroid condition.
  3. Thyroid symptoms had improved a year or so earlier after stopping use of wheat/gluten and dairy. Recently started using ginger tea for the throat problem and it sooths. Hasn’t used long term, recent addition. 
  4. Reading about eosinophilic esophagitis did not sound like the problem. 
  5. Reading about histamine/MCAS symptoms did sound like it might be a problem. Tomato/salsa particularly, chicken causes congestion. Likes to drink orange juice.

Objective:

  1. Pale complection, may suggest magnesium deficiency/low vitamin D, low level anemia of chronic inflammation possibly.
  2. Throat visibly enlarged in pattern of enlarged thyroid gland 

Assessment: 

  1. CoV, even with mild symptoms, may have increased autoimmune antibodies, or created new types. Pale complection may suggest magnesium deficiency/low vitamin D, low level anemia of chronic inflammation possibly.
  2. Enlarged thyroid gland would be likely to cause difficulty swallowing at times, particularly if a food flair of the underlying autoimmune antibody sensitivity. (The thyroid gland presses inwards also and can narrow the throat significantly – *personal experience from also being an autoimmune thyroid patient, swallowing a large supplement can be very painful, and may feel stuck even.)
    1. Eosinophilic esophagitis might also be adding to swallowing symptoms if early stages, wouldn’t be causing as severe reflux symptoms as a more advanced case which is more likely to be what is described in articles about the problem. Food sensitivities are the most frequent cause and include gluten, dairy, eggs, and other common food sensitivity foods.
  3. Autoimmune thyroiditis can be a gluten molecular mimicry problem – the thyroid hormone chemically is similar to the gluten molecule. 
  4. Autoimmune antibodies to other food chemicals might also flair up an underlying autoimmune overactive eosinophile problem, white blood cells. Ginger contains a chemical similar to albumin and an egg sensitivity might be triggered by a sudden increase in use of ginger – or chicken – or eggs, or any animal product containing albumin. *also learned from personal experience – this can be a significant problem – I developed sensitivity to eggs and gradually realized I needed to exclude all sources of albumin or my symptoms would flair up again (non healing rash, not quite eczema – more wounds, lack of skin regrowth).
    1. An apparent ‘wheat/gluten’ sensitivity might be an albumin sensitivity, see one of my early posts with the information about plant albumin in wheat and ginger: Wheat is rich in albumin – so are ginger and egg whites.
  5. Histamine sensitivity seems a problem worth working on by decreasing trigger foods. Orange juice could be an additive problem food. The total load is part of the problem but even small amounts can set off the allergy cells that increase inflammatory cytokines and pain/inflammation signals – swollen, itchy, sore throat, dry eyes, but it can also effect mood when a more severe problem – extreme anxiety and fear, or out of control, hyper-excitable.

Problem:

  1. Elevated iron and symptoms of anemia of chronic inflammation may be a lingering CoV effect or of autoimmune conditions – it can be common to have several types of autoimmune antibodies also, and there has been cases of LongCovid where autoimmune antibodies were found. The spike lodges in a receptor and antibodies are made against the receptor, instead of against spike.. 
    1. Iron chelators may help mitigate chronic inflammation damage, restore energy level if that is a problem. The quercetin is one, continue regularly, opposite the niacin protocol if following that., or eat more of the good plant sources of a few, EGCG, pomegranate peel, green tea, oregano, olive leaf extract, there are many see the Iron chelator section of this Resources & Iron Chelators list
    2. Epsom salt soaks for a topical source of magnesium, help immune function, energy level, fluid balance. Continue if already using or start 1-3 times a week.
    3. Sunshine or Full spectrum light 20-30 minutes per day and or a moderate dose vitamin D3 ~ 600-1000 IU. 
    4. Avoid glyphosate residue. Consider supplementing with DMG, dimethylglycine, bulk powder, 1/2 spoonful once or twice a day in water or with a little juice and water. (too much juice is not really good for us).
  2. Thyroid problems in the modern world are likely related to excess fluoride and bromide and too little iodine. Cautiously increasing iodine and 200 mcg selenium may be helpful. Higher dose for one month can help the body to dump fluoride, bromide and chloride. When there is a lack of iodine the body will build molecules with the other halides, but then the thyroid hormone or other chemical won’t work right. Lab tests may show ‘normal’ levels of thyroid hormone but symptoms of hypothyroidism may still be present.
    1. In autoimmune conditions, when possible, it is essential to identify the trigger foods and strictly avoid them. It can take 6 months for antibodies to fade away, at which point symptoms should improve, but memory B cells still exist so even little tastes of the problem foods can set off a new 6 month batch of autoimmune antibodies that will attack the thyroid gland, or esophagus, or wherever else the problem point is located. 
    2. In this case eggs/chicken/ animal products/ ginger/ albumin /*hemp kernels too then/, may be part of the problem foods – 
    3. Elimination type diets that start with the least risky foods and gradually reintroduce things one at a time can be the best way to individualize what is the problem for you the individual. 
  3. Gluten was definitely identified as a part of the thyroid problem by removing, it already had helped to stop that. Dairy has a variety of allergens, and also would have albumin. Removing food triggers strictly, can help a swollen thyroid gland reduce in size – versus get more swollen when trigger foods are eaten.
    1. Gluten free baking recipes and tips for converting recipes: effectivecare.info – G8. Cookies & Bean Soup. -> and it mentions that increasing corn or corn flour instead, is not ideal either. Corn or gluten can increase zonulin which also increases leaky membranes in the gut or blood brain barrier, and more open membranes can increase risk of allergens entering undigested from the diet. See: What is Zonulin? (2)
    2. A quick mix recipe that can be used for pancakes or muffins, a post: Pancakes in a Jiffy – Quick Bread Mix.
  4. Eosinophilic esophagitis may be related to food sensitivities, so as food elimination is attempted it would also be helpful to pay attention to the swallowing symptoms to see if change occurs other than the swollen pressure feeling of the enlarged thyroid gland.
    1. Research shows a strong connection between food allergies and eosinophilic esophagitis (EOE). These six foods are most commonly associated with this allergic response: dairy, wheat, soy, eggs, nuts, and seafood/shellfish. Unfortunately, there is no accurate test to identify food allergies* connected with EOE.” (3
    2. *The food sensitivity is not the same type as tested for people who get hives to peanut butter or eggs or are allergic to bee stings. It is food sensitivity that activates white blood cells though, called eosinophils. 
    3. During normal function eosinophils fight parasites for us. So …. Maybe they are doing something in ‘autoimmune disease’ that involves their normal function too fighting an unidentified parasite – or they are responding to chemicals of the six foods listed above in an allergy-like way. 
    4. Asthma and allergies involve increased eosinophil activity, which can lead to inflammation symptoms and tissue damage: “Eosinophils can consume foreign substances. For example, they fight substances related to parasitic infection that have been flagged for destruction by your immune system. Regulating inflammation. Eosinophils help promote inflammation, which plays a beneficial role in isolating and controlling a disease site.” […] “…eosinophils play a key role in the symptoms of asthma and allergies, such as hay fever. Other immune system disorders also can contribute to ongoing (chronic) inflammation.” (4
  5. Eliminating common histamine problem foods may help anxiety and inflammatory symptoms. Orange juice, tomatoes, fermented foods, or older leftovers, cranberries, others, it is a lengthy list but can make a huge difference *personal issue for me also.
    1. More info on page MCAS/Histamine, jenniferdepew.com: MCAS/HIstamine.
    2. Summary of foods to avoid, or a few helpful in an over-reaction: Histamine Food Lists. it is a document (6)

Evaluation:

Client seems motivated and capable of making positive changes for improving health, cheerful and confident amid a complex set of problems, and has support of family.


So does my disclaimer make more sense now?

  • Disclaimer: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

My professional and personal expectations of individualized health care guidance does not include a 15 minute appointment limited to discussing one symptom. In seeking a health care provider I recommend searching for ‘functional health’ or possibly holistic but that is less precisely used than ‘functional’. The orthomolecular approach is also whole body and restoring function oriented.

*am I taking clients? I am working in that direction but I am still in initial stages of having a system set up.


Change is easiest by just practicing the desired habit and the more often it is remembered, practiced, then the more that brain pathway will be strengthened and the old one is gradually deactivated, becomes harder for the nerve cells to fire instead of being an automatic habit like happens without even thinking consciously – to change that ingrained of a habit takes substituting a new pattern rather than trying to ‘attack’ with ‘will power’. Work with nature and it will work with you. Attack and it tends to have an undesired ripple effect.

Pain hurts, health is better.

We all die, the question is quality of life while living – and enjoying that life while living.

Namaste – the soul in me, sees the soul in you.

We are all children, under the care of Mother Nature and Father Sun.

Where there is light there is life, and there is hope.

Reference List

  1. Hegyi J, Schwartz RA, Hegyi V. Pellagra: dermatitis, dementia, and diarrhea. Int J Dermatol. 2004 Jan;43(1):1-5. doi: 10.1111/j.1365-4632.2004.01959.x. PMID: 14693013. https://pubmed.ncbi.nlm.nih.gov/14693013/
  2. What is Zonulin? https://www.creative-diagnostics.com/blog/index.php/what-is-zonulin/
  3. 6 Food Elimination Eosinophilic Esophagitis, oregonclinic.com, https://www.oregonclinic.com/6-Food-Elimination-Eosinophilic-Esophagitis-EOE 
  4. Eosinophilia, symptoms, mayoclinic.com, https://www.mayoclinic.org/symptoms/eosinophilia/basics/causes/sym-20050752

Documents, Posts & Pages

  1. Wheat is rich in albumin – so are ginger and egg whites, post transcendingsquare.com
  2. Resources & Iron Chelators list, document https://docs.google.com/document/d/1XiwJBPoFUnUTQKcRAW_8NMriQMt8b31zjeTY4zV0wJo/edit?usp=sharing
  3. effectivecare.info – G8. Cookies & Bean Soup, webpage
  4. Pancakes in a Jiffy – Quick Bread Mix. post transcendingsquare.com
  5. MCAS/Histamine. webpage, jenniferdepew.com
  6. Histamine Food Lists. document, https://docs.google.com/document/d/17iz9lsJyGqIUUjF0p-totXp4R2GhgRi2Na4gYueisTM/edit?usp=sharing

G3.6.1: “Calcium sparklets” and Oxidative Stress

G3.6.1.1: “Calcium sparklet” – a burst of energy from a TRP channel; can be measured but not seen.

Calcium and magnesium are both electrically active ions – ions are atoms of an individual element rather than being a more complex molecule that is made of a combination of several different elements. Water is made of one atom of oxygen and two atoms of hydrogen for example. Calcium and magnesium are both individual elements rather than being molecules. They are both considered to be essential trace minerals that we need in our diet on a regular basis or we would get sick and eventually die without enough of either one. They each have an ionic charge of +2 and can exchange one or two electrons.

Ions can typically donate or receive electricity by sharing or receiving one or two electrons. Sodium and potassium are essential trace minerals with a charge of +1, they can exchange one electron. the energy is in the form of electromagnetic radiation, which is also what make “light., (G3.105), so while our human eyes may be too big to detect the “light” of a microscopic burst of energy from the flow of calcium across a TRP channel – maybe a tiny spark might be visible to that microscopic world.

Magnesium sparklers – a spark of life.

Many people may be more familiar with holiday “magnesium sparklers” than with “calcium sparklets” as the mineral magnesium is flammable and can be used to make Fourth of July sparklers, which are a festive sight during celebrations of the U.S. Independence Day.

 

G3.6.1.2: Calcium sparklets can be caused by high blood sugar – hyperglycemia. (G3.108)

  • Calcium and diabetic vascular dysfunction, Focus on “Elevated Ca2+sparklet activity during acute hyperglycemia and diabetes in cerebral arterial smooth muscle cells: This report is also the first to describe a molecular mechanism by which hyperglycemia produces increased [Ca2+]i in VSM and suggests that this mechanism of Ca2+ sparklet activation may be uniquely initiated by hyperglycemia.” (G3.108)

Calcium sparklets are not a good thing, not in excess at least, they represent an open gate into the interior of the cell, allowing a crowd to enter instead of invited guests only. (G3.106, G3.107, G3.108) Too much energy or other types of chemicals suddenly being available on the interior of a cell can over activate it and even lead to the death of the cell.

Excitotoxins” refers to chemicals that can cause a cell to become overactive if the chemical is allowed to enter the interior of the cell. TRP channels are the gateway that selectively lets in some things and keeps out everything else. If TRP channels aren’t able to do their job properly, then too much of “everything else” is able to rush into the cell and that may be what happens for some people more than others. If the everything else includes MSG from a recent meal or the alternative sweetener aspartame then overactivity of the cell may result.

Calcium itself acts as a messenger chemical that can trigger action when it is on the interior of the cell and can act as an “excitotoxin” and lead to the death of cells. During normal health magnesium is in greater abundance inside of the cell and calcium is found in larger amounts than magnesium in the fluid surrounding the cells and within blood plasma.

The alternative sweetener aspartame, brand name Nutrasweet, or the more concentrated version Neotame may both act as excitotoxins. The food flavoring ingredient monosodium glutamate also may over excite cells. What they have in common is a free amino acid that can act as a signal to the brain cell to tell it to get busy doing whatever it usually does, “just get busy, go, keep going, there’s no “off” here, move it . . .” an excitotoxin is the worse drill sergeant ever, and eventually the cell runs out of nutrients and/or builds up waste products of metabolism, and may even die. That’s a dramatization, but roughly that is the story – “oxidative stress” equals “waste products of metabolism.”

G3.6.1.3: Oxidative Stress > metabolic waste products > “TRPA1 sparklets.”

To return to the excerpt and list from the previous section, the first list of chemicals known to activate TRPA1 channels included waste products of metabolism. Metabolism is the chemical deconstruction of a larger molecule into smaller parts. Enzymes are necessary that are specific to the exact type of chemical transformation. Toxins can collect without enough of the right type of enzyme to metabolize them into smaller chemicals that are safe or can be excreted more easily by the kidneys.

  • The summary and excerpt: The TRPA1 receptor is directly activated by calcium levels inside of the cell, and a variety of toxins or “noxious” (irritating) substances that are produced as a normal part of “oxidative stress” otherwise known as “inflammation” including, “4-hydroxy-2-nonenal, hydrogen peroxide, hypochloride, hydrogen sulphide, 15-delta prostaglandin J2 [2528].” and irritants from the environment or diet can also activate the TRPA1 receptor, *1.mustard oil (allyl isothiocyanate: AITC) [29], *2. cinnamaldehyde [30, 31], *3. allicin [32, 33] and *4. formalin [34]…”. (G3.25) Serotonin and other “Inflammatory mediators, such as bradykinin…[19, 35]” (G3.25) can make the receptors more sensitive which can lead to increased responsiveness of nerve endings – more pain (G3.25) or itch. (G3.24)
  • And a new excerpt about oxidative stress and metabolites that are produced within the body, some would activate TRPA1 channels: “Reactive oxygen species (ROS)”(G3.93) formed from oxidative stress were found to activate the TRPA1 channels in the cerebral arteries but not in other areas of the vascular system, “NOX-induced activation of TRPA1 sparklets and vasodilation required generation of hydrogen peroxide and lipid-peroxidizing hydroxyl radicals as intermediates. 4-Hydroxy-nonenal, a metabolite of lipid peroxidation, also increased TRPA1 sparklet frequency and dilated cerebral arteries.” (G3.93).

“Increased TRPA1 sparklet frequency” (G3.93) can be caused by chemicals that are produced during oxidative stress – which can be caused by emotional or physical reasons. The significance is that it means more calcium or other chemicals could be rushing through the open channel in the membrane wall. Calcium can also be an activating substance as was mentioned in the first summary and excerpt. This is complex chemistry and is just meant to be an introduction to the topic of oxidative stress in relation to conditions of chronic pain and itch. That second excerpt is from an additional list and is about chronic migraine – who are the people who might be more likely to have overactive TRPA1 channels? – quite a few besides those with sensitive skin or pain problems. A more complete list is in the next section but it is likely an incomplete list.

G3.6.1.4: “People with overactive TRPA1 channels” may include people with symptoms of:

  • chronic itch (G3.24);
  • chronic arthritis (G3.25);
  • inflammatory bowel diseases (IBD: ulcerative colitis, Crohn’s disease)” (G3.76);
  • people with an Irritable Bowel Syndrome (IBS) may also have had a history of child trauma, domestic violence or sexual abuse:  “As Leserman and Drossman (2007) note, patients with a history of physical or sexual abuse in childhood, or intimate partner violence, have 1.5 to 2 times the risk of reporting gastrointestinal symptoms or having a functional gastrointestinal disorder.,” (G3.94); and trauma survivors may also have comorbid chronic pain conditions such as fibromyalgia: “Van Houdenhove et al. (in press) found that 64% of patients in a group for FMS or Chronic Fatigue Syndrome had at least one type of either child or adult trauma. More concerning was that 39% of the group reported abuse during childhood and as adults, indicating a lifelong pattern of abuse. Although these findings are somewhat mixed,” (G3.94);
  • a medical hypothesis suggests TRPA1 channels may be involved in many chronic pain and airway conditions and also diabetes: “Furthermore, TRPA1 is also involved in persistent to chronic painful states such as inflammation, neuropathic pain, diabetes, fibromyalgia, bronchitis and emphysema.,” (G3.95);
  • symptoms of “diabetic hypersensitivity” (G3.96)  might feel or sound like: “Don’t touch me it hurts.” Symptoms of mechanical hypersensitivity may feel like being physically over sensitive to any sensation. Any touch may be experienced as “pain” or “itch” instead of being pleasant. Symptoms of hypersensitivity associated with diabetes have been found to respond to TRPA1 channel antagonists – chemical inhibitors – a medicine in other words. (G3.96) Reducing the over activity of the TRPA1 channels would help resolve the underlying problem but overmedicating would be a risk. Too much inhibition, too much of the medication could be dangerous to long-term health as the TRPA1 channels play important functions throughout the body.;
  • chronic migraine,” “cluster headache,” (G3.77); “Reactive oxygen species (ROS)”(G3.93) formed from oxidative stress were found to activate the TRPA1 channels in the cerebral arteries but not in other areas of the vascular system, “NOX-induced activation of TRPA1 sparklets and vasodilation required generation of hydrogen peroxide and lipid-peroxidizing hydroxyl radicals as intermediates. 4-Hydroxy-nonenal, a metabolite of lipid peroxidation, also increased TRPA1 sparklet frequency and dilated cerebral arteries.” (G3.93);
  • preeclampsia may involve overactivity of the TRPA1 channel, it also has mechanico-sensitive properties or other TRP channels  – more research is needed: (G3.78, G3.79, G3.80, G3.81, G3.82, G3.83);
  • chronic respiratory conditions involving “airway inflammation” such as “asthma” or “COPD,” overly dry airways may be a problem causing difficulty with completely emptying the lungs (G3.84);
  • cardiac issues such as Congestive Heart Failure may involve TRPC channels, (G3.85), which are not activated by the food type items on the list below but which are likely to be activated by cannabinoids which are #8 on the list below, (G3.89, G3.90);
  • male infertility due to motility issues in the sperm, (G3.87, G3.88). TRPC channels (G3.89) can be activated by Phospholipase C (G3.90) which suggests they can be activated by other phospholipids as well. So a deficiency or gene difference affecting their production endogenously may be involved in male infertility involving motility. More research is needed. In the meantime formaldehyde is definitely not beneficial for fertility in women or men. There is more research available regarding exposure risks for female reproductive health (G3.91) than for males.(G3.92)

G3.6.1.5: People with overactive TRPA1 channels may be sensitive to:

And now we return to the list from the section on the last page. It is greatly expanded now with more food items and other possible substances that can activate TRPA1 channels and TRPC channels, gathered from the research about the list of conditions that might be at increased risk for overactive TRP channels. The TRP channels are all membrane channels but there are many individual types and several categories. The basic form and function is similar however and is described and illustrated in an article about the TRPC channel and cardiohypertrophy associated with Congestive Heart Failure, which was included in the previous list.  (G3.85)

  1. Mustard:  “mustard oil”, (G3.25); “Isothiocyante derivatives constitute the main pungent ingredients in wasabi (allyl isothiocyanate), yellow mustard (benzyl isothiocyanate), Brussels sprouts (phenylethyl isothiocyanate), nasturtium seeds (isopropyl isothiocyanate) and capers (methyl isothiocyanate). Allyl isothiocyanate is the major active ingredient in mustard oil.” (G3.67); Yellow mustard is the condiment used in many ways in cooking. It is a spice made from a small seed that is dried and powdered. It has medicinal value for a variety of conditions. Mustard oil applied topically as a massage oil is reported to provide relief for pain due to arthritis. (G3.68) Wasabi is a type of horseradish like seasoning used in Japanese cooking.It is a root vegetable that also has many medicinal benefits. (G3.72) Brussel sprouts are a vegetable that look like tiny cabbages and are botanically related to cabbage. They are very healthy in many ways and might be worth trying in smaller quantities, steamed more thoroughly rather than raw or lightly steamed or sauteed.(G3.71) Nasturtium seeds can be pickled and used in cooking similarly to capers. (G3.69) Capers are a pickled product with a peppery taste which resemble peppercorns, however they are made of the springtime buds of the caper plant which are picked when they are the size of peppercorns, and are preserved in a pickling brine. Capers are used in salads or savory dishes. (G3.70)
  2. Cinnamon:  “cinnamaldehyde”, (G3.25); Cinnamon is a spice used in cooking which is made from the inner layer of bark from a plant. It is dried and powdered and used in baking or savory dishes. Medicinally a ½ teaspoon of cinnamon per day has been found helpful for improving blood sugar control. A half teaspoon is a large amount for a single serving but some people enjoy it at breakfast stirred into a bowl of hot cereal. (G3.43, G3.67))
  3. Onion or Garlic:allicin”, (G3.25); (G3.41) To be more precise – the raw garlic contains allicin; baked or roasted garlic would be less likely to still have allicin present. It would likely be similar for onion, raw or lightly sauteed might be a problem while caramelized, baked, or roasted might be tolerable. (G3.67)
  4. Formaldehyde:formalin“, (G3.25); chemically the two are very similar: (G3.42); and formaldehyde is found in the environment and as a metabolite of some alternative sweeteners and other dietary sources. (G3.56) See the next section (which was posted first on this site) for more information on sources and ways to avoid Formaldehyde.
  5. “(Winter-green),” (G3.67); Wintergreen is a natural flavoring herb in the mint family. It is typically used as an essential oil as a flavoring in many foods and other types of products. It has medicinal benefits related to it containing the chemical that acts as the pain killing ingredient of aspirin.(G3.73)
  6. “eugenol (Cloves)” (G3.67); Cloves are used in a traditional holiday decoration to make an aromatic dried ornament from an orange. The tack like cloves are poked into the rind of a fresh orange and then the fruit is allowed to dry and it shrinks and smells good for a long time without spoiling if it was allowed to dry thoroughly. Cloves for use in cooking or baking are ground into a powder and used in baking and also in savory dishes and chutneys. The spice and essential oil also have medicinal benefits. The essential oil has numbing properties and in traditional medicine is applied topically to the gums for relieving the pain of a toothache.(G3.74)
  7. “and gingerol (Ginger).” (G3.67); – a root with medicinal properties and commonly used in cooking as a minced or chopped vegetable and is used in dried and powdered form as a spice in savory and baked dishes and may be served dried and candied and used as a candy or chopped and used in baked goods or chutneys.Ginger has many medicinal benefits and has been found helpful for the relief of arthritis pain when used in a quantity that would be equal to about a half teaspoon of the dried powder. Pregnant women should avoid large quantities of the herb or vegetable or candy as miscarriage may be a risk. (G3.75)
  8. Δ9-tetrahydro-cannabinol (THC) and cannabinol (an oxidation product of THC).” (G3.67); The herb cannabis also known as marijuana has many medicinal benefits and  is the most significant source of THC but some foods also have some cannabinoid content. The topic of food sources of cannabinoids and risks and safe use warnings are discussed in the section I. Addiction or Starvation?. Medicinal benefits are discussed in detail in the textbook Endocannabinoids: The Brain and Body’s Marijuana and Beyond, editor and Chapter Three by Emmanuel S. Onaivi, et al., (CRC Press, 2006, Boca Raton, FL), which is available online as a pdf:  (I.Endocannabinoids: Full Text pdf)

See a healthcare provider for medical advice, diagnosis or treatment.

  • Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.
  • The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert)

References: