Biologisch Medisch Centrum        
Arts Paul van Meerendonk


Biologisch Medisch Centrum
ATP energie
Behandeling CVS/ME
Dr Myhill
Dr Teitelbaum
Dr Meirleir
Dr Cheney
Dr Chia
Arts Paul van Meerendonk

ADP-ATP efficiency
Mitochondrial dysfunction
Cvs en fibromyalgie
Video xmrv cvs
Virus gevonden
Virus en DNA
Viruses and mitochondria
Virussen en immuunsysteem
Zware metalen

CVS ME aantoonbaar
CVS legitiem
Research direction

Vitamine B12
Vitamine D
EPD Desensibilisatie
Meetresultaten 1

Meetresultaten 2
Meetresultaten 3
Meetresultaten 4





Lymfe vloeistof: We hebben ongeveer 11 liter lymfe vloeistof in ons lichaam. Het zit rond alle cellen en de voedings en afval stoffen gaan hier doorheen van en naar het bloed. Het voert grote eiwitten en witte bloedlichamen door een eigen systeem af omdat deze te groot zijn om door de capillaire membraan te gaan. Daarnaast heeft het nog een aantal functies voor het immuunsysteem.
Dr Perrin geloofd dat CFS/ME ontstaat door verstopping van het lymfe drainage systeem. Giftige stoffen blijven in de hersen met name de hypofyse en het ruggemerg en spieren zitten waardoor oa hormonale storingen ontstaan. Draineringsmassage veel bewegen, op en neer springen op een trampoline en supplementen moet helpen om de vloeistof beter door te laten stromen.

The Perrin Technique™ is based on Dr Perrin's theory that different stress factors whether physical, allergies, emotional or infections lead to an overstrain of the sympathetic nervous system.

Further investigation has led to a probable cause of this nervous system overload being a build up of toxins in the fluid around the brain and the spinal cord.

Some of the poisons caused by infection or inflammation in the head or spine flow through perforations in a bony plate (the cribriform plate) just above the nasal sinuses into the lymph ducts of the face and neck.

The toxins are also meant to drain down the spinal cord and out into the lymph ducts lying along the spine. In a CFS/ME sufferer these normal drainage points are congested.


Anatomy of the lymph system

The first thing to understand about your lymph system is its vast extent. Like the circulatory system that supplies blood, the network of lymph vessels serves almost every cell in your body.

Strung along the lymph vessels like pearls knotted on a string, the lymph nodes serve as a series of cleaning filters. Lymphatic fluid percolates through the nodes, being purified and immunologically boosted at every stage.

The lymph vessels and nodes are made of lymph tissue, but so are many other parts of the body. One crucial function of lymph tissue is generating and storing white blood cells, the blood cells that fight infection. Besides the lymph nodes, principal lymph organs include the bone marrow (where white blood cells called B-lymphocytes are made), the spleen, tonsils and the thymus gland (where T-lymphocytes are made). Lymphoma is a group of related cancers of the lymphocytes.

The largest concentration of lymph tissue in the body surrounds the intestines. Called gut-associated lymphatic tissue, or GALT, this tissue is the guardian of this largest gateway through the body’s defenses, and it actively separates desirable nutrients from undesirable pathogens, and helps mount a defense whenever needed



                                                                                                                                                                                                                   Lymph fluid entering a lymph capillary

























The flow of lymph fluid

The lymph system’s primary function is to isolate infection and cellular detritus from the rest of the body and deal with it. Imagine you are looking at a handful of living cells through a microscope. A capillary (the smallest blood vessel) delivers blood with its oxygen and nutrients. The local cells use these nutrients and excrete waste. There may be pathogens or antigens present that create an immune response, leaving dead cells and perhaps live infection. Some of the blood and waste products are picked up by tiny veins. But much of the vascular fluid and waste — and hopefully all of the live infection — is picked up by tiny lymph vessels. This process is happening all over the body all the time.

Like tributaries trickling into a stream that feeds a slow-moving river, the lymph system transports lymph fluid through ever-widening vessels, moving it through 500 filtration and collection points — your lymph nodes. At each successive node the lymph fluid is filtered and bacteria is removed. If lymph fluid is blocked in one lymph node it will usually take a detour, but when blockage is extreme it can cause the lymph fluid to back up and cause swelling in the surrounding tissue, a condition known as lymphedema.

The far-reaching lymph vessels merge at certain points to form lymphatic trunks. You have six major lymph trunks in your body, each responsible for draining filtered fluid from one region of the body.

The lumbar and intestinal trunks drain a large volume of purified lymph fluid upward from your lower extremities, pelvis and abdomen into the cisterna chyli, a widened collection pouch at the base of the thoracic duct.

Digestive fats from our food are meanwhile absorbed in the small intestine and then drawn into the lymphatic system for transport to the bloodstream via the cysterna chyli. This milky mixture of digestive fats and lymph is known as chyle.

The now enriched and purified lymph travels up your torso through the thoracic duct along the left side of your esophagus. It merges here with the lymph from your left trunk and arm, and finally returns to the bloodstream at its junction with the left subclavian vein, located above your heart and under your collarbone. A much smaller volume of filtered lymph fluid from nodes and trunks along the right side of your head, neck and arm is fed back into the bloodstream by the right lymphatic duct, on the right-hand side of your collarbone.

Amazingly, the lymphatic system has no central pump but depends on muscle contraction and manual manipulation to move fluid. Deep breathing is another essential way we can enhance movement of lymph through our bodies. And importantly, the organs of elimination (skin, kidney, liver, bladder, small and large intestines) need to be doing their jobs well so that the lymph does not get overwhelmed with waste products.

If the lymph system gets blocked or overrun (due to illness, surgery, toxic overload or lack of activity), lymph fluid backs up. This can cause swelling, joint pain, nausea and fatigue. Stagnant lymph may be stored within nodes for a long period of time but eventually becomes too toxic for the body to handle well.

Negative effects of chronic lymph blockages

All things in nature have a natural progression; when this motion is inhibited or jammed, concerns arise — and when it occurs in your lymph system, you feel it quickly.

Think again of a river: a healthy river runs clean and clear. A brackish river chugs along, thick with soot and silt that gets snagged, pocketing pollution in small pools along the way. Eventually, the sluggish river can become a breeding ground for bacteria and disease. The same is true for your lymph.

Because lymph cleanses nearly every cell in your body, symptoms of chronic lymph blockage are diverse but can include worsened allergies and food sensitivities, frequent cold and flu infections, joint pain, headaches and migraines, menstrual cramps, arthritis, fibrocystic breasts, breast tenderness, sinusitis, loss of appetite and GI issues, muscle cramping, tissue swelling, fatigue, mental fuzziness, mood irregularities, depression, parasites, skin breakouts, acne, and cellulite. In general, you may feel tired and toxic, with a heaviness in your abdomen. In Chinese medicine, practitioners call this “excessive damp” that undermines your whole health.

Stagnant lymph can also interfere with the system’s ability to cleanse more potentially hazardous concerns, such as bacteria and cancerous or diseased cells from organ tissue. Viral infections, bacteria, and cancerous or mutagenic cells move through the lymph fluid, where they are targeted and destroyed in the lymph nodes — when the system is adequate to the task.

Lymph nodes

The lymph nodes are small, bean-shaped pockets interspersed along the lymph network almost everywhere from your nose to your knees.

Lymph nodes counteract infection by filtering the lymph fluid, engulfing and removing any bacteria and foreign substances identified. Once a particular pathogen is detected, lymph nodes help customize antibodies to neutralize it. In a nutshell, immature lymphocytes mature in the bone marrow and thymus and are sent off to work in the lymph nodes and lymph tissue. There they wait until an offending substance happens along in the lymph fluid. Then, with the help of other defensive cells called APC’s (antigen-presenting cells), they target the invaders and create specific antibodies to get rid of them.

Swelling in certain node sites generally indicates an infection in the part of the body drained by those nodes. It’s a good sign when you develop swollen glands; it means your lymph system is doing its job.

The function of the spleen and immunity

The largest organ in your lymph system, your spleen is actually like a big lymph node, except that it filters your blood rather than your lymph fluid. The spleen houses a concentrated amount of immune cells and is designed to bring lymphocytes into contact with the blood, making it a major player in your ability to ward off blood-borne diseases and antigens. The spleen also removes worn-out red and white blood cells, platelets, and any other hazardous blood-borne debris.

An enlarged spleen, which can be a symptom of mononucleosis or the Epstein–Barr virus, is prone to injury and should be taken seriously. In our culture, the spleen is sometimes removed if its function declines or persistent swelling is a concern. A swollen spleen places a patient at a higher risk for hemorrhage (if it ruptures), so some doctors decide to remove a suboptimal spleen to avoid the risk.

In Eastern cultures, where the spleen and the lymph system are taken much more seriously, this is tantamount to clipping a bird’s wings. The bird will not die, but it will never fly very high again. In Chinese medicine the spleen governs the blood, the great nourisher of life. Without the guardianship of the spleen, the blood is weakened, can become either blocked or dilute, and has more difficulty supporting the rest of the organs.

I often hear my patients say, “You can live without your spleen.” My response is usually, “Yes, but how well?” Of course, if you must undergo spleen removal you should feel confident that your other organs can compensate for your lost immunity. But if you have a choice, you should make your decision knowing that the spleen exists for a reason. It does not operate in a void, and surgically removing it usually does have long-term immunological consequences. If you must do so, you must then support the rest of your immune system more carefully in response.

Most spleen concerns can be treated with an alternative protocol that includes a lot of rest, supplements, and supportive enzymes. As long as you are not endangering a swollen spleen with reckless activities, taking the time to heal it from the inside out is preferable to having it yanked. For a long time tonsils were treated with the same indifference (the lymph system just can’t get respect) — now it’s generally accepted that it’s healthier to keep them.

In fact, I don’t think any organ in the body should be treated as disposable. That kind of thinking is based on the fractured Western paradigm. But of course, all systems of the body are interconnected! Think of it this way: if you didn’t have a road map or welcome signs, would the landscape show any hint that you’d just crossed a state line? Nature respects few manmade boundaries, and when it comes to the map of your body, this is evident in the overreaching web that connects organ tissue to the lymph system and the lymph system to the immune, circulatory, endocrine, and digestive systems.

The lymphatic system, digestion and elimination

As you read above, so much of the lymph tissue is associated with the gut that it has its own acronym: GALT (gut-associated lymphoid tissue). Lymphatic tissue is where much of our immunity originates, and because the digestive tract is a main path of entry for offensive substances (bacteria, allergens, heavy metals, molds, fungi, chemicals, trans fats), many lines of defense permeate the gut.

The agents involved in digestion — enzymes, acids, and intestinal flora — do away with many of the pathogens that try to invade our systems. Those that make it through are taken up and acted upon by the GALT.

The GALT itself is a kind of tasting room for pathogens. The ones that survive the initial pass of digestion get sampled by receptors in the GALT, which coordinate an immune response (including mucus production). Anyone who lacks the enzymes to digest dairy is familiar with a GALT-dictated immune response.

So, the GALT receives information from the microenvironment of the intestines in the form of which pathogenic agents get through. It then decides which of these deserve an allergic response, calling upon the immune and endocrine systems to facilitate. In this way, the GALT tissue becomes its own command center, which is one reason many practitioners call the gut the “second brain.” (For more on this topic, read The Second Brain, by Michael Gershon).

Healthy GALT function generally inhibits allergic responses and decreases food sensitivity — but this is complicated and often relies on the status of the intestinal flora and other factors. Suffice it to say that the healthier your gut-associated lymph tissue, the less sensitive you are likely to be to food-borne bacteria and chemicals.

The mucosal tissue of the intestines (the villi and lacteals) are also classified as GALT tissue, playing an important role in the transportation of digested dietary fats (or chyle) into the blood (those LDL’s and HDL’s we hear so much about) via the cisterna chyli and the thoracic duct.

Constipation, diarrhea, and other GI issues compromise the lymphatic system’s ability to do its job. If the digestive tract is suboptimal due to food sensitivities, parasites or stress, the flow of lymph and chyle will also be diminished. This can cause nausea and toxicity, exacerbating the original GI concerns. It may also play a part in the appearance of cellulite.

The lymphatic system and cellulite

Cellulite and “saddle bags” along the thighs are partially the result of impaired lymph flow to certain areas, causing immobilized pockets of fat and trapping toxins. Over 90% of women have some form of cellulite resulting from weight gain, a genetic predisposition, or inactivity.

Cellulite begins when numerous fat cells collect in one area (generally the buttocks, thighs and upper arms in women), causing the skin to bulge. The dimpling effect occurs when the connective fibers in the skin pull down in areas where body fat is pushing up. Toxins and lymph fluid accumulate in the pockets of fat. Improving the circulation of lymph in areas prone to cellulite and reducing toxic burden are two successful ways to diminish cellulite from the inside out.

Liposuction, creams, and wraps on the other hand, may reduce the appearance of cellulite but do not keep it from coming back. Invasive procedures tend to increase inflammation in the area and strain the connective tissue, which can make the situation worse over time.

Lymphatic massage

Because lymph fluid moves slowly without aid of its own pump, inactivity can seriously restrict its flow. Muscular contraction through exercise and deep breathing is the primary means by which our lymph circulates, but lymphatic massage and drainage provide another helpful option.

In Europe, patients often receive a special massage called lymph therapy or lymph drainage before undergoing surgery. This method of treatment was popularized in the US by the Danish doctor, Dr. Emil Vodder, as an effective treatment for lymphedema. Practitioners believe that it significantly improves healing by readying the system for recovery. For more information, visit Dr. Vodder’s educational website.

On an everyday basis, regular lymph massage (particularly around the abdomen, axillary nodes, and breast) can be great preventive health maintenance. There are many ways to practice lymph massage, and I recommend that you visit a certified massage therapist to learn more. However, there are some techniques you can try at home, and for those of you who are ready to try it on your own we will be offering brief instruction on lymph massage in the near future, so check back with us again soon.

Rejuvenating your lymphatic system

As you can see, the lymphatic system works steadily to keep you clean and well. The nutritional and lifestyle guidelines we offer at Women to Women will go a long way toward reducing the overall “body sludge” your lymph system must sweep away. In addition, we recommend the following steps to ensure that your lymph remains clear and unimpeded. Whether you have symptoms or not, every woman will benefit from these techniques.

  • Clean up your diet. Reduce your body’s toxic burden by avoiding processed food, eating organic when possible, and eliminating simple sugars and carbohydrates. Get tested for heavy metal exposure (lead and mercury are very common in the US). The idea here is that the less waste your lymph has to deal with, the more easily it will flow.
  • A regular nutritional detox and colon cleanse, supported by liver enzymes, will ease your liver and kidney burden, which in turn will decrease pressure on your spleen. Even a two–week Quick-Cleanse can do wonders.
  • Investigate any food sensitivities or allergies that may be affecting your digestion. Take a medical-grade multivitamin to support your cellular function, digestion, and elimination. Look into probiotic supplements to help maintain a healthy ratio of intestinal flora. Experiment with a hypoallergenic diet for two weeks to cleanse your system of moderate food irritants. Deal with any troublesome GI issues, including parasites. Read our article on IBS and, if necessary, talk to your practitioner about relevant tests.
  • Drink plenty of purified or filtered water — at least six to eight 8–oz glasses per day. Your body needs hydration to keep the fluids running!
  • Consider regular visits to a lymph drainage massage therapist. This is a wonderful and healthy way to pamper yourself (and your internal organs). This is especially invaluable during a detox.
  • Practice deep breathing. Breathing deeply from the diaphragm, not shallowly from the chest, and through the nose rather than the mouth, is one of the best ways to move lymph fluid through your body.
  • Get regular physical exercise. Jumping on a rebounder, or mini-trampoline, just five minutes a day is a great way to get your lymph system pumping. Walking, stretching, t’ai chi, yoga, Pilates, and other moderate activities are helpful, too — especially if you do them every day. Or find an activity that suits you. Some women prefer ballroom dancing, others swimming. What’s important is that you make it a regular and joy-inducing part of your life.
  • Don’t be afraid to sweat! A weekly sauna or steam bath is a pleasant way to facilitate a healthy sweat, and sweating helps detoxify the body and so supports lymphatic function. Avoid aluminum-based antiperspirants (they block sweating and add to your toxic load) and choose natural deodorants instead.
  • Avoid restrictive clothing that press on your lymph nodes. Underwires and overtight bras, jeans, and skirts can impede lymph flow. Try to go bra-free for at least 12 hours a day, and don’t sleep in one. If this is uncomfortable for you, consider buying a stretchy camisole.
  • If you are concerned about cellulite, massaging those specific areas and the lymph nodes in the groin on a daily basis can be helpful.
  • Consider acupuncture. Chinese medical doctors are far ahead of their Western counterparts when it comes to “unsticking” the lymph system. As a treatment or preventative, acupuncture can be a great way to keep things moving. It can also help alleviate discomfort that may arise while you are detoxing.
  • Examine your emotional issues. Sometimes we get stuck in a particular pattern of stress that reduces our capacity to make positive changes. Your lymph can become blocked when you are feeling stuck or unable to express yourself. Remember that your life, too, is a progression, and “our biography becomes our biology.” If you find the same situations arising over and over, you may want to take a closer look. Discuss any areas that feel stagnant or obtrusive with a friend, partner, therapist or trusted religious advisor. You may find that as your lymph system unbinds, so does your spirit

 It is estimated that your body has more than 100 million different kinds of antibodies, each one custom-built to identify a particular pathogen. If your body is exposed a second time, no symptoms occur because the organism is destroyed quickly- you are now immune to that particular pathogen.


Oxidative Lymphopathy

Lymphopathy (lymph-au-pathy) is a term for formation of microscopic clots in lymph, the pale-white fluid that flows in lymphatic channels. Like circulating blood, circulating lymph also clots and unclots at all times. In CFS, lymph microclots cause blockage of lymph channels and stagnation of toxic fluid in tissues. Thus, oxidative lymphopathy adds to fatigue, muscle pain, brain fog, and other symptoms of CFS. (Ref: Ali M. Oxidative regression to primordial cellular ecology. The Journal of Integrative Medicine 1998;2:4-49.)


Water, fruit  en groenten voor de drainage.

Drink veel water. Zonder voldoende water kan lymfevocht niet goed stromen. Als je onvoldoende hoeveelheden water per dag drinkt, zal uw lymfesysteem vertragen.
De enzymen en zuren in rauwe groenten zijn krachtige lymfe reinigers, met name wanneer deze gegeten wordt op een lege maag. Voeg meer rauwe groenten, fruit, salades en verse sappen toe aan uw dieet en je lymfe zal het instrumenten worden wat je nodig hebt voor een diepe reiniging.

Flavonoïden, appelzuur, citroenzuur, chininezuur en enzymen in cranberries en cranberrysap helpen om hardnekkige vet in het lymfestelsel te emulgeren. Zorg dat je alleen pure, ongezoete cranberry sap vrij van zoetstoffen drinkt - gepasteuriseerde flessen cranberrysap hebeben niet dezelfde voordelen. Verdun het sap in een verhouding van ongeveer 4:1, water /cranberrysap. Als u liever een minder zure sap heeft, verdun 1 deel ongezoet cranberrysap met 2 delen puur appelsap en 2 delen water. Zorg ervoor dat u alleen puur appelsap drinkt zonder zoetstoffen of conserveringsmiddelen.

Eet veel groene groenten.Die voorzien u van chlorofyl (de groene kleur in planten) en tal van vitaminen en mineralen die helpen bij lymfe reiniging.

Voedingsmiddelen rijk aan essentiële vetzuren zijn essentieel om een goed functionerend lymfe-systeem te waarborgen. Sommige van deze voedingsmiddelen zijn lijnzaad en koud geperste lijnzaadolie, verse, rauwe noten en zaden, zoals walnoten, amandelen, hazelnoten, zonnebloempitten en pompoenpitten, avocado's en koudgeperste oliën, zoals walnoot en pompoenpitten. Zorg ervoor dat u verse, rauwe noten en zaden koopt van het gekoelde gedeelte van uw lokale gezondheids voedselwinkel of supermarkt. De essentiële vetzuren in noten en zaden worden snel ranzig.


versnelde pompwerking door te springen
There is a new medical perspective emerging in the world today: Disease and aging are intimately related to the acid/alkaline balance (pH) of the fluids in our bodies. Virtually every degenerative disease from cancer, osteoporosis, heart disease and arthritis, to skin problems, tooth decay and joint pain is associated with excess acidity in the body.


Calcium & mineral absorption is the ultimate alkalizer

Acid or Alkaline?

We are comprised of approximately 70% water. Water is comprised of hydrogen and oxygen [H2O]. When there is an equal proportion of oxygen (O-) and hydrogen (H+), then the pH [potential hydrogen] is said to be neutral and the pH is 7.0 as measured on the pH scale that ranges from 1 to 14. If there is more oxygen than hydrogen the water is alkaline and will measure between 7.1 and 14. If there is more hydrogen than oxygen the water is acidic and can range from 1.0 to 6.9 on the pH scale. Most importantly, the pH scale is logarithmic, which means that each step is ten times the previous one. Therefore, a pH of 7.0 means that there is ten times more oxygen available to the cells than a pH of 6.0 and 100 times more available oxygen than a pH of 5.0. A small variation in pH measures a rather large difference in the balance between oxygen and hydrogen.

Everyone knows we need to provide our lungs with adequate amounts of oxygen to sustain life. We now understand that the water in our bodies also needs adequate amounts of oxygen to resist disease and maintain health. The ONLY way to increase the amount of oxygen in our body “water” is to raise the pH level and provide the system with the optimum amount of oxygen. MMP Primary & Trace Minerals can raise your lymph pH to its naturally healthy level of 7.4 and create an environment for the body to heal itself and to attain that cherished condition called Super Health.

Now we’re getting somewhere. But how do you raise the lymph pH? How do you measure it? And what is lymph anyway?

Lymph & pH

To get a sense of how this works, it is important to understand more about our Lymphatic System. The Lymphatic System is a complex set of fluids, organs, cells, and lymph nodes positioned throughout the body forming a circulatory system that operates in close partnership with blood circulation. This system is the conduit for the lymph. The word “lymph” in Greek means a pure, clear stream. When you are Super Healthy, your lymph is indeed a pure clear stream with a pH of 7.4 flowing through the body quickly and efficiently, clearing infection, disease and acidic residue. The cells, organs and tissues of the body are bathed in this oxygen rich, slightly alkaline lymph fluid creating the BIO-ENVIRONMENT within which they exist. A 150 pound adult has approximately 22 pounds of lymph.

Lymph with a pH of 7.4 provides a nurturing, supportive environment, supplying all the oxygen required for vibrant heath. Just as we need oxygen available in our external environment to live, we also require oxygen available in our internal environment to thrive. Unfortunately, due to diet and the lack of nutrients in the foods we eat, the average American adult has a lymph pH of 6.2. Remember the pH scale is logarithmic. Therefore, a drop in pH from 7.4, which is where we start as children, to an adult average of 6.2, means there is a 94% decrease in the amount of available oxygen in the lymph. Imagine living in an environment that provides only 6% of the oxygen you need. Not a place where you would want to live. Well, that is exactly the kind of internal environment we have created inside our bodies. No wonder degenerative disease and premature aging are on the rise.

Sliding Down the pH Scale

At birth, most infants have a full supply of alkaline reserves. This is reflected in a lymph pH of 7.4. As the years go by, these reserves dwindle. And the system slowly becomes more and more acid. This is primarily due to our super sized, fast food/processed diet and our sedentary lifestyle. The staples of our diet – protein, carbohydrates and processed foods leave acidic residues that build up. Consider this – one cup of cola is so acidic that you need to drink 32 cups of water to neutralize the impact. With a diet that dumps acid residue into the system and the lack of exercise to move the lymph through the body the result is a body vulnerable to attack. Here’s how it works:

As the lymph becomes too acidic, fungi and bacteria spontaneously develop and grow. When they reach the lymph nodes they can clog the nodes, preventing proper function. As the accumulation of waste piles up in the lymph, a semi-opaque web of dark matter begins to form. At this point, not only is the lymph acidic, oxygen depleted and growing microorganisms, it also flows poorly. Unlike the heart, the lymph does not have a pumping mechanism that can force it to flow. It relies on bodily movements to advance the lymph in the Lymphatic System. As waste accumulates, the lymph becomes stagnant and the growing microorganisms are dumped into the blood stream, compromising our immune system. We become susceptible to external microbes and viruses and find ourselves “catching” every “bug” that floats by. With an acidic system and our immune system compromised we are also at risk of developing a degenerative disease.

Scary stuff, indeed. MMP Primary and Trace Minerals with the accompanying nutrients were designed to restore the lymph to its naturally alkaline state.

The Acid-alkaline Residue of Foods After Digestion

It is an easy matter to measure the pH of foods before eating it, either with pH strips or with a pH meter. However, once digested, foods do not always have the same pH. A healthy stomach digests food by first decomposing the food with the digestive enzymes. Then the stomach secretes a strong hydrochloric acid that continues to decompose the foods. After approximately 45 minutes, the food passes into the small intestine and there, an amount of bile is injected into the food by the gall bladder. This bile is strongly alkaline to neutralize the stomach acids. Next, the food travels slowly through the small intestine and various nutrients are extracted from the food and introduced into the blood stream. From there, the nutrients go into the cells and are processed to supply energy and building materials for repairs to the body. Over time, the cells release the residue of the consumed nutrients and this residue re-enters the blood stream. It is the pH of this residue that is the focus of the MMP regimen.

From the time the food grows, either as vegetable or animal, to the time its residue is released by our cells into the blood stream, the pH can fluctuate considerably. Generally, the fresher the food, the more alkaline it is, and it becomes acid as it ages. Beef is aged for several days before consumption and is the most acid food that we eat. By comparison, chicken can be eaten fresh and often has an alkaline residue depending on how the chicken was raised and how it is prepared. Organically raised chicken that haven’t been subjected to external stresses such as caging, generally have a more alkaline residue than mass produced chicken that are loaded with antibiotics.

Fermented foods, however, should not be considered as being aged, because they contain live bacteria that are continuously changing the structure of such foods during fermentation. As it happens, fermented foods will usually test very acid before eating but after processing by the cells will have a residue that is only weakly acid or even alkaline. This is the basis of the macro-biotic diet that promotes eating living foods of all kinds. Live foods usually have an alkaline residue, while the same foods after sitting for weeks in the vegetable bins of chain stores have a greater tendency to have an acid residue. The important point is: the more alkaline (or less acid) a food is, the more sensitive it is to aging. Therefore for maximum benefit it is best to consume fresh alkaline foods. The most accurate list of acid-alkaline residues of foods can be found in the book “The pH Miracle” by R.O. Young and S.R. Young.

Of course, our modern diet and lifestyle creates quite a challenge to consume fresh alkaline foods. Thus we see the national adult average lymph pH of 6.2. By Restoring Nature with MMP SOLUTIONS, you will be able to counter this dangerous trend and reestablish your alkaline balance (even if you don’t change your diet).


The MMP Solution

Our bodies are designed to absorb the minerals we need from the food we eat. Unfortunately, due to environmental pollutants and soil that is nutrient deficient this has become a huge challenge. Even if one is very strict and diligent about changing one’s diet and eating only high quality organic foods, you would have to eat enormous amounts in order to get sufficient minerals to support a slightly alkaline environment. The secret to re-alkalizing the lymph is mineral absorption. MMP is the SOLUTION! One serving of MMP Primary & Trace Minerals provides more Alkalizing potential than 4 pounds of high quality organic vegetables.


  • The fundamental alkalizing agents of calcium, magnesium, potassium and sodium as carbonates and bicarbonates.
  • Three times as much calcium as the most popular Coral Calcium capsule supplements.
  • The proper 2:1 ratio of Calcium : Magnesium.
  • Over 70 Trace minerals
  • Digestive Aids
  • Vitamin D which is essential for calcium absorption
  • Hydrochloric Acid - [HCl] is the only acid that our bodies produce. It is an active ingredient of our digestive system. Secondary to digestive enzymes HCl’s function is to break down food in the stomach. It is the first line of defense against various destructive microbes that enter the stomach. Many people have insufficient amounts of HCl which results in digestive problems such as acid reflux and poor absorption. Also, after the age of 40, HCl production begins to decline. Lack of HCl combined with lack of properly balanced minerals are the root cause of why the adult pH has declined to an average of 6.2.

pH is afgeleid van het Latijnse potentia hydrogenii en betekent: “werkzaamheid van de waterstof”.


Supplementing with minerals is a stronger way to balance body acidity. A study comparing calcium citrate and calcium carbonate supplementation in postmenopausal women found that calcium citrate decreased markers of bone breakdown both in blood and urine, whereas calcium carbonate did not. Otherwise, their performance was similar in improving bone health. Sodium bicarbonate has been studied extensively with mixed results.

Potassium citrate has shown positive results. In one study, women with osteoporosis given potassium citrate had increased bone density significantly after a year- something very difficult to achieve! It's important to follow the recommended doses on labels because it's possible to get too much potassium. If calcium is a concern because of kidney stones, potassium citrate is a great alternative.

Minerals reduce acidity and give your body's buffering systems a break. Systemic alkalization has been shown to help with osteoporosis, asthma symptoms, brain damage after stroke, preventing kidney stones, cancer , and other conditions. Much more research needs to be done.

Optimale pH waarde

- Bloed 7,35 - 7,45 (ideaal 7,41)
- Speeksel 7,20
- Cel 7,1
- Maag 1,35 - 3,50
- Urine 6,8 - 7,2
- Ontlasting 6,00 - 6,80

Al onze cellen baden in het extracellulaire vocht dat net zoals het bloed licht basisch is (pH 7,35-7,45). De uiterste pH-waardes waarbinnen nog leven mogelijk is liggen voor het bloed en het extracellulaire vocht tussen 6,8 en 7,8. Te lage pH-waardes (zuur) leiden sneller tot levensbedreigende situaties dan te hoge waardes (basisch). Zo ontdekte dr. Berthold Kern dat een verlaagde pH waarde (meer zuur) tot een verdikking van het bloed leidde

Oorzaken van verzuring

- slechte voeding
- overmatig alcohol- en suikergebruik
- slechte eetgewoonten
- stressbelasting
- milieu invloeden
- verminderde functie van lever, nieren of longen
- weinig beweging
- roken
- crash diëten
- overmatige sportactiviteiten
- veroudering

Het lichaam gebruikt pH buffers in het bloed om zich te weer te stellen tegen te snelle grote veranderingen in het zuurgraadniveau. De meest belangrijke pH buffer in het bloed is bicarbonaat. Bicarbonaat is een basische stof en moet in het bloed in evenwicht zijn met koolzuur. Als er meer zure stoffen het bloed binnenstromen wordt er meer bicarbonaat geproduceerd. Als er meer basische stoffen de bloedstroom bereiken wordt er meer koolzuur aangemaakt. In beide gevallen wordt het effect op de pH geminimaliseerd. Ook kan het lichaam mineralen gebruiken om het bloed te alkaliseren. Zoals men landbouwkalk gebruikt om verzuurde grond weer alkalisch te maken, zo gaat ons lichaam calcium, magnesium, ijzer en andere mineralen roven om het bloed te alkaliseren.
Ruwweg kan onze voeding onderverdeeld worden in twee groepen:

1. Waterrijke voedingsmiddelen.

Deze zijn meestal volumineus, rijk aan vitamines, mineralen en fytonutrienten en ze bevatten weinig calorieën. Over het algemeen hebben deze voedingsstoffen een basen-overschot. Voorbeelden zijn: fruit, groente, thee en melk.

2. Geconcentreerde voedingsmiddelen.

Deze zijn vast van structuur, rijk aan vet, eiwit en calorieën. Ze hebben over het algemeen een zuren-overschot. Voorbeelden: vlees, vis, ei, kaas, peulvruchten, noten, zaden en granen. Suiker, koffie en alcohol zijn uitzonderingen op de regel en zijn zuurvormend.
bloem, bonen, erwten en vetten

Acidity-in the body rising foods Score*
Fish 14.6
Meat 12.4
Poultry 7.8
Eggs 7.3
Shellfish 7.3
Cheese 3.3
Milk 1.3
Cereal Grains 1.1
Neutral foods Score*
Beans -0.4
Base-producing foods Score*
Nuts -1.1
Fresh fruit -5.2
Potatoes -5.4
Mushrooms -11.2
Carrots -17.1
Vegetable fruits(vruchtvormige groenten) -17.5
Leafy greens(blad groenten) -23.4
Plant stalks (planten stam) -24.9

ph dranken:

Zeewater 8,5
Thee, naturel 7,1
Zuiver water 7,0
Melk, halfvol 6,8
Kruidenthee <6,0
Karnemelk 4,4
Bier 4,3
Yoghurt (drank) 3,8
Sportdrank 3,4
Rode/witte wijn 3,4
Kinder-Cola 3,3
7up 3,2
Sinaasappelsap 3,2
Limonadesiroop 3,0
Azijn 3,0
Cassis 3,0
Cola Light 2,9
Appelsap 2,8
Cola 2,7
Citroensap 2,0
Maagzuur 2,0


Cesium: pH 14
Potassium: pH 14
Sodium: pH 14
Calcium: pH 12
Magnesium: pH 9

Rauwe groente sap ph 8.9

FOOD CATEGORY High Acid Acid Low Acid Low Alkaline Alkaline High Alkaline
BEANS, VEGETABLES, LEGUMES Pickled Vegetables Pinto Beans, Navy Beans Sweet Potato, Cooked Spinach, Kidney Beans Squash, Asparagus, Rhubarb, Fresh Corn, Mushrooms, Onions, Cabbage, Peas, Cauliflower, Turnip, Beetroot, Potato, Olives, Soybeans, Tofu Carrots, Green Beans, Lima Beans, Beets, Lettuce, Zucchini, Carob Vegetable Juices, Parsley, Raw Spinach, Broccoli, Celery, Garlic, Barley Grass
FRUIT   Canned Fruit Blueberries, Cranberries, Bananas, Plums, Processed Fruit Juices Coconut, Sour Cherries, Tomatos, Oranges, Cherries, Pineapple, Peaches, Avocados, Grapefruit, Mangoes, Strawberries, Papayas, Lemons, Watermelon, Limes Dates, Blackcurrant, Grapes, Papaya, Kiwi, Berries, Apples, Pears Dried Figs, Raisins
GRAINS, CEREALS   White Rice, White Bread, Pastries, Biscuits, Pasta Rye Bread, Whole Grain Bread, Oats, Brown Rice Amaranth, Lentils, Sweetcorn, Wild Rice, Quinoa, Millet, Buckwheat        
MEAT Beef, Pork, Veal, Shellfish, Canned Tuna & Sardines Fish, Turkey, Chicken, Lamb Liver, Oysters, Organ Meat            
EGGS & DAIRY Parmasan, Processed Cheese Eggs, Camembert, Hard Cheese Whole Milk, Butter, Yogurt, Cottage Cheese, Cream, Ice Cream Soy Cheese, Soy Milk, Goat Milk, Goat Cheese, Buttermilk, Whey Breast Milk    
NUTS & SEEDS Peanuts, Walnuts Pecans, Cashews, Pistachios Pumpkin, Sesame, Sunflower Seeds Chestnuts, Brazils, Coconut Hazelnuts, Almonds    
OILS         Corn Oil, Sunflower Oil, Margarine, Lard Flax Seed Oil, Olive Oil, Canola Oil    
BEVERAGES Tea (black), Coffee, Beer, Liquor Wine, Soda/Pop Cocoa Ginger Tea Green Tea Herb Teas, Lemon Water
SWEETENERS, CONDIMENTS Artificial Sweeteners
Milk Chocolate, Brown Sugar, Molasses, Jam, Ketchup, Mayonnaise, Mustard, Vinegar White Sugar, Processed Honey Raw Honey, Raw Sugar Maple Syrup, Rice Syrup Stevia


Werking op het lichaam:

zeer verzurend: verzurend: licht verzurend: licht alkalisch: alkalisch: zeer alkalisch:
groenten, peul-
vruchten en wortels:
ingelegde (in
zuur of pekel) groenten
blikgroenten, diepvries-
groenten, champignons, zuurkool
gekookte groenten (alle soorten),
zoete aardappelen, kidney beans
aardappels, paprika, sla, ui, prei, div. kool, rabarber, aubergine, courgette, asperges, spruitjes, erwten (vers), wortels, maïs (vers), mierikswortel, koolrabi, koolraap, pompoen, pepers, zeewier tomaten, witlof, spinazie, sperciebonen, snijbonen, rode biet, selderie, radijs, knoflook,
div. kruiden, alfalfa, gember
komkommer, boerenkool, broccoli, groentesap, kiemen, grassen
fruit:   banaan (rijp), ananas, rozebottels, granaatappel aardbeien, appel, peer, grapefruit, sinaasappel, man-
darijn, pruimen, nectarine, mango, abrikoos, perzik, bessen, meloen, cranberry, druiven, acai vrucht, papaya, zoete kersen, dadels, frambozen
citroen, limoen, watermeloen, banaan (onrijp), zure kersen, kokosnoot (vers)
brood, granen
en rijst:
gebak, pasta tarwe, bruine rijst, tarwepitmeel, witbrood, mais tortillas, haver, zuurdesembrood,
witte rijst, bruine rijst, cornflakes
gist, gerst, basmati rijst, couscous, haver, rogge, volkomen brood, witmeel cracker, tempeh tofu, soja meel/bloem, amarant, linzen, boekweit, spelt, wilde rijst
soja granulaat, witte bonen, lima bonen, soja bonen soja noten
noten en zaden:   pinda's, pindakaas,
pistache noten

hazelnoten, paranoten, macadamia noten, walnoten, cashews, lijnzaad, pompoenpitten, zonnebloempitten pijnboompitten, sesamzaad, karwijzaad, kastanjes amandelen  
zuivel: kaas, gehomo-
geniseerde melk, ijs
kwark, eieren, kaas, melk (gepasteuriseerd) gehomogeniseerde melk, (slag)room, yoghurt, melk (niet gepasteuriseerd), boter, rijstmelk, sojamelk,
cottage cheese
karnemelk, geitemelk, geitekaas, wei borstvoeding  
dranken: koffie, thee, bier, frisdrank, vruchtensap (gezoet), sterke drank spa rood, wijn kokosmelk, vruchtensap (ongezoet), surrogaatkoffie gedisilleerd water, mineraalwater,
bronwater, kokosnoot water
groene thee, rooibosthee citroenwater, kruidenthee
oliën:   margarine boter, maïsolie, zonnebloemolie olijfolie, lijnzaadolie, visolie, kokosolie, sesamolie    
en vis:
varkensvlees, rundvlees, kalfsvlees,
vis in blik
oceaanvis, kip, kalkoen, lam, schaaldieren zoetwatervis, orgaanvlees,
zoet: zoetstoffen chocola,
melasse, stroop,
witte suiker,
bruine suiker, rietsuiker, bietsuiker,
bewerkte honing, rijst siroop, gerstemout siroop, melksuiker, fructose, suikerrietsap, ahornsiroop,
agave diksap
ruwe honing   stevia
diversen: sojasaus, azijn ketchup, mayonaise, mosterd, miso, blikvoedsel, magnetronvoedsel appelwijnazijn, hummus, popcorn Royal Jelly, bijenpollen zuiveringszout  


Acid-Alkali balance

From DoctorMyhill


Maintaining the correct acidity/alkalinity (or pH) of the blood is an essential part of good health. Acidity and alkalinity is determined by the concentration of hydrogen ions - the lower the pH, the greater the acidity and the greater the concentration of hydrogen ions. It is important to realise the pH scale is a logarithmic one. This means that the difference between a pH of 7 and 4 means a thousand fold increase in hydrogen ions. Such a shift would have a massive effect on biochemical processes, most of which are exquisitely sensitive to pH changes. For normal metabolism, the pH of the blood is tightly controlled by the lungs and the kidneys. In the short term the lungs compensate where there is a tendency to acidosis by slowing breathing so retaining carbon dioxide and increasing bicarbonate, and with that pH. In the medium term the kidneys compensate - where there is acidosis, we pee out acid.

This works fine when we have enough acid or bicarbonate to play with. We run into problems when we don't. Where there is poor mitochondrial function, we slip into anaerobic metabolism and produce lactic acid. This chronic overproduction puts us into a permanently acidic state. This means that any person with a tendency to fatigue and anaerobic metabolism is likely to be chronically acidotic. We try to correct this by peeing out acid, but there is only so much we can do! The possible effects of being acidic are:

  • Hypoglycaemia

An acidic body means we cannot release glucose from the liver, nor can we make use of sugar in blood and muscle (glycolysis is inhibited). So mitochondria are further starved of energy and the sufferer craves carbs, feeling ghastly when he does not eat.

  • Muscles contract less strongly (see below)
  • Acid urine strips out minerals so we lose minerals too easily. Acidic urine is a risk factor for osteoporosis.
  • Plasma potassium levels may rise.

Hyperventilation will worsen any tendency to acidosis because it washes out carbon dioxide, and therefore bicarbonate, from the blood.

Muscles and acidity

I suspect there is another effect on muscles. To understand this, think how muscles work. There are two important protein components, namely actin and myosin. They interact like little men rowing a boat. The actin oars are dipped in the myosin water and pull, so shortening the muscle fibre. The oars are lifted out and take another bite of water so the muscle filament is ratcheted shorter. This process depends on the oars being alternately sticky and then letting go. This is depended on electrical forces. One moment there is attraction and stickiness, next repulsion to let go. These electrical forces are controlled by electrons and protons, i.e. pH is vital! If the pH is wrong, the oars are too sticky, do not let go of the myosin and there is muscle damage. I suspect this acidic tendency clinically is associated with sore muscles, muscle cramps, spasms, tics and restless legs.

Once started on magnesium carbonate, many people comment that their early morning stiff muscles are much improved!

Calcium and acidity

One of the biochemical problems that John McLaren-Howard has identified is a tendency for calcium to build up inside cells. The cells try to tuck it out the way by sticking it on to calcium containing proteins, such as calmodulin, calcium-actin or CaATPase. This is OK in the short term, but eventually these mechanisms become saturated, free ionised calcium rises and inhibits many of the mechanisms for energy production in the cell. This calcium is not responsive to magnesium administration, so what to do about it? We honestly do not know! BUT calcium and hydrogen ions are intimately related and the optimist in me is hoping that an alkaline environment will help correct the biochemical abnormalities. Watch this space!


Easy and cheap. You simply measure urine pH with litmus paper. The idea is to get the pH between 6.5 and 7.0. Water has a neutral pH of 7.0. Adjust the body's pH with judicious doses of magnesium bicarbonate starting with 1-2 grams at night, but see below! You do not want to upset normal stomach acidity at the wrong time!

Acid and alkali in the gut

This is a vital part of sterilising the gut, providing the correct pH for digestion and absorption of food and minerals. We need an acid stomach (pH 4 or below) to kill off the acid sensitive bugs. This acidity also digests protein and controls the emptying of the stomach. Food remains in the stomach for 1-2 hours, then empties into the duodenum. Here we need an alkali environment (pH 8, i.e. a 10,000 fold decrease in hydrogen ions) to kill the alkali sensitive bugs, and allow pancreatic enzymes and bile salts to work to digest fats, carbohydrates and some proteins. Normally, the liver produces this bicarbonate but can only do so if it has the raw materials to play with.

Thus by manipulating the pH in the gut we protect ourselves from infections - something which many CFSs are not good at! Many are helped by taking acid with meals, such as ascorbic acid or betaine hydrochloride. We can help the body further by taking magnesium carbonate to neutralise this acid 1-2 hours after eating food. It is important not to take the magnesium bicarbonate with food or the gut function will be upset. You can check that you are somewhere near by measuring urinary pH. Do not overdose with magnesium carbonate or you will run into problems of being too alkali. You do not have to be too accurate as the body is very good at compensating so long as it has the basic raw materials to do so.

A traditional remedy is sodium bicarbonate. The problem is this produces a sodium load which, with Western diets, we are already overloaded with. Magnesium carbonate is a good option because magnesium deficiency is common, and magnesium is all too easily excreted. Often people report improved bowel function as a result of the additional magnesium.

Alkaline Mineral Supplementation Decreases Pain in Rheumatoid Arthritis

Patients: A Pilot Study

Regina Maria Cseuz1, Istvan Barna2, Tamas Bender3 and Jürgen Vormann*,4

1Revita Klinik, Budapest, Hungary; 2Institute of Experimental Medicine of the Hungarian Academy of Sciences,

Budapest, Hungary; 3Hospital Brothers of St. John of God, Budapest, Hungary, 4Institute for Prevention and Nutrition,

Ismaning, Germany

Abstract: The aim of this pilot study was to investigate the efficacy of an alkaline mineral supplement as a means of suppressing

disease activity in rheumatoid arthritis (RA) patients, and to check whether any change occurs in the circulating

beta-endorphin concentration. Thirty-seven patients with moderately active RA of at least two years duration, who were

receiving stable pharmacological treatment, participated in a 12-week study. All patients were randomly allocated to a

supplemented group (30g of an alkaline mineral supplement daily) or to an unsupplemented group. Their usual diet and

medication was maintained. Disease activity, pain, and health-associated status were recorded (DAS 28 - Disease Activity

Score 28, VAS - visual analogue scale for pain, HAQ - Health Assessment Questionnaire). Plasma immunoreactive endorphin

(ir-EP) was measured in the study groups and also in healthy subjects. DAS 28 and VAS decreased in the supplemented

group, whereas there was no change in these parameters during the trial in the control group. The functions

(HAQ) of the supplemented patients improved. The ir-EP levels increased in both groups but to a higher degree in the

supplemented group. During the trial, medication (NSAIDs and steroids) could be reduced in the supplemented group

only. Conclusion: This study suggests that an alkaline supplement may improve function and pain in rheumatoid arthritis

and may represent an easy and safe addition to the usual treatment of RA patients.

Keywords: Pain, rheumatoid arthritis, acid-base balance, beta-endorphin.


A large body of epidemiological and experimental studies

has demonstrated that nutrition has an important impact

on the occurrence and severity of various chronic diseases

[1]. The level of disease-associated pain may also be dietrelated.

For example, patients with rheumatoid arthritis (RA)

frequently experience a positive effect of a change in diet on

the activity of their disease. The hypothesis of our present

study was that patients with RA, consuming an ordinary

Western diet as most of the population of the world's developed

countries, develop a diet-induced low-grade systemic

metabolic acidosis [2]. There is strong evidence that a diet

rich in fruit and vegetables acts protectively against a wide

variety of human diseases. However, such a diet usually also

supplies excess alkalinity, and part of its beneficial effects

might be associated with a reduction of the chronic acid load

[3]. The chronic inflammatory process in RA patients leads

to a local increase in acidity; the pH in synovial fluids from

patients with RA is significantly lower than that in patients

with osteoarthritis or controls [4]. This change in local acidity

might aggravate pain symptoms, especially in connective

tissues. Therefore, alkaline supplementation might lead to an

improvement of the clinical outcome in RA patients. In patients

with chronic low back pain, alkaline supplementa-

*Address correspondence to this author at the Institute for Prevention and

Nutrition, Adalperostr. 37, D-85737 Ismaning, Germany; Tel: +49 (0)89

55267989; Fax: +49 (0)89 55267990; E-mail:

tion significantly reduces pain and disability [5]. Our own

observations of some RA patients also suggest the positive

effect of a complementary treatment with alkalines. We have

therefore conducted a pilot study to investigate, in more detail,

the effects of an alkaline supplement on pain symptoms

in patients with RA. In addition to subjective indicators of

pain, disability, and quality of life, the change of the concentration

of beta-endorphin (ir-EP) has been determined in the

plasma of patients as a more objective parameter of pain

problems. Significantly lower ir-EP levels have been reported

in RA patients than in controls, and an inverse correlation

has been found between the rheumatoid disease activity

score and plasma ir-EP concentration [6].


Patients and Study Design

Prior to commencing the study, approval by the local

ethical committee (Scientific Committee of St John’s Hospital,

Budapest) was obtained, and the ethical principles of the

Helsinki Declaration were followed. All patients were informed

orally and in writing about the study design and the

underlying hypothesis and of the participant’s right to withdraw

at any time. The study design was a single-center randomized

parallel trial over a period of three months.


Out of 76 outpatient candidates who were screened for

the trial and were willing to participate, 37 patients fulfilled

all the inclusion criteria according to Table 1. These patients

were randomly selected into a supplemented group or an

unsupplemented control group. Baseline characteristics of

patients in both groups are shown in Table 2.


After a 4-week wash-out period (other supplements),

patients in the supplemented group started to take, on a twice

daily basis, 30 g (2 x 15 g) of a lactose-based alkaline multimineral

supplement (Basica Vital®, Protina Pharmaceuticals,

Germany) for a 12-week period in addition to their

usual medication. The mineral composition was as follows

(mg/daily dose): Ca (400), K (250), Na (250), Mg (100), Fe

(5), Cu (1) all as citrates, Zn (5) as gluconate, I (0.1) as potassium

iodide, Mo (0.08) as sodium molybdate, Cr (0.06) as

chromium chloride, Se (0.03) as sodium selenite. The alkaline

mineral supplement was taken twice daily in the form of

a powder mixed in one of the following: soup, yoghurt, tea,

or cereal. A suitable inert placebo in a similar daily dose was

not available, and the use of sugar as a placebo seemed not

to be appropriate. Therefore, a placebo was omitted in this

pilot trial. During the trial, patients were not allowed to take

any dietary supplements except for the alkaline mineral supplementation

in the supplemented group. The individual dose

of non-steroidal anti-inflammatory drugs (NSAID) could be

adjusted but had to be recorded.

Determinations and Measurements

All patients were evaluated by the same investigator in

accordance with a written protocol that included medical

history, ACR criteria [7], complete evaluation, articular

evaluation, and extra articular evaluation of RA (history of

rheumatoid nodules, Reynard’s phenomenon, or pulmonary,

cardiac, dermal, ocular, and nervous system involvement).

Disease activity was assessed by determination of the number

of swollen joints, the score of tender and swollen joints,

and the duration of morning stiffness (in minutes). A composite

disease activity score (DAS 28) [8], a physical function

index Health Assessment Questionnaire (HAQ) [9], Creactive

protein (CRP), and rheumatoid factor were measured

at baseline and 4, 8, and 12 weeks after starting the

trial. DAS28 is a composite disease activity index and also a

response index with good discriminatory validity. It includes

28 joint counts for tenderness (tender joint count) and swelling

(swollen joint count), the erythrocyte sedimentation rate

(ESR), and the patient's global assessment of disease activity

on a horizontal visual analog scale (patient global VAS, 0-

100mm). As a parameter connected to pain, the level of ir-

EP was determined in blood samples of both patient groups

and from healthy subjects (6 females, 6 males; mean age: 45

years). Blood samples were collected into K2-EDTAcontaining

plastic tubes and then centrifuged, after which

plasma aliquots were stored at –20 °C until assayed. Details

of the EP radioimmune assay (RIA) including the percental

cross-reaction data were as described earlier [10]. In short,

synthetic human EP (Sigma) was used both for the standard

and 125I-labeled tracer, and a second antibody was used to

separate the bound and free fractions.


Compliance of supplemented patients was monitored by

the weekly determination and recording of the pH of the first

morning urine with pH paper strips by the patients themselves.

Supplementation induced a significant increase in

urinary pH by at least one pH unit after one week in all supplemented

patients and remained high throughout the supplementation

period thus indicating adherence to the supplement.

Statistical Methods

Determined parameters were normally distributed and

variations were compared between time 0 and 4, 8, and 12

weeks, respectively, and between the supplemented and unsupplemented

groups by using Student’s t-test. Frequencies

of reduction of medication were compared between groups

by means of the Fisher exact test. All reported P values are



A total of 37 patients were enrolled of whom 19 were

randomly allocated to the supplemented group and 18 to the

unsupplemented control group. In one control patient, an

intra-articular injection with triamcinolone hexacetonide was

reported what expectedly influenced the disease acitivity,

and this patient was excluded from the study. Hence, 19 supplemented

and 17 control patients completed the trial. At the

start of the experiment, the two groups were equal in all respects,

except for disease activity score (DAS28). At baseline,

the control patients showed a score of 4.5 (range: 2.8-

6.0) versus the supplemented group with a score of 5.2

(range: 3.6-6.9); this difference is statistically significant (ttest).

At the end of the observation period, the supplemented

group, in which members had started with significantly

higher disease activity score, showed significantly lower

DAS28 compared with control patients (Fig. 1). DAS28 decreased

in the supplemented group, whereas there was no

significant change in disease activity score during the trial in

the control patients. There were also significant differences

between supplemented and unsupplemented groups at 4, 8,

and 12 weeks. The level of pain (according to the patient's

visual analog scale (VAS)) decreased to a considerable extent

in the supplemented group (Fig. 2). In the control patients,

the pain increased between week 0 and week 4. Be-

Fig. (1). DAS28 in supplemented (first column) and unsupplemented

(second column) RA patients at 0, 4, 8, and 12 weeks. Significant

difference in comparisons with time 0 of the respective

group; a: p = 0.049; b: p = 0.011, c: p = 0.004. Significant differences

between groups; A: p = 0.006; B: p = 0.016, C: p = 0.028;

mean ± SEM.

Fig. (2). Pain level according to a visual analog scale in supplemented

(first column) and unsupplemented (second column) RA

patients at 0, 4, 8, and 12 weeks. Significant difference in comparisons

with time 0 of the respective group; a: p = 0.045; b: p = 0.004,

c: p = 0.048. Significant differences between groups; A: p = 0.003;

B: p = 0.001, C: p = 0.037; mean ± SEM.

tween groups, significant differences were detected after 4,

8, and 12 weeks. HAQ results showed a significant improvement

in supplemented patients by the end of the trial,

whereas no change was seen in the control patients (Fig. 3).

At the end of the trial, the difference between groups also

became significant.

Fig. (3). Physical function index (HAQ) in supplemented (first

column) and unsupplemented (second column) RA patients at 0, 4,

8, and 12 weeks. Significant difference in comparisons with time 0

of the respective group; a: p = 0.009. Significant differences between

groups; A: p = 0.049; mean ± SEM.

ESR, CRP, and the level of rheumatoid factor showed no

significant change during the trial in either of the groups (not


In healthy subjects, the plasma ir-EP levels were significantly

higher than in RA patients: (plasma ir-EP in fmol/ml,

mean ± SEM) healthy subjects, 12.6 ± 3.9 (n = 12); RA patients,

4.1 ± 0.5 (n = 37). Plasma ir-EP levels significantly

increased in the supplemented and control group; however,

the increase in the supplemented group occurred earlier and

was higher than in the control patients (Fig. 4); at the end of

the supplementation period, there was also a significant difference

between both groups.

Fig. (4). Plasma endorphin concentration in supplemented (first

column) and unsupplemented (second column) RA patients at 0, 4,

8, and 12 weeks. Significant difference in comparison with time 0

of the respective group; a: p = 0.016; b: p = 0.018, c: p = 0.045.

Significant differences between groups; A: p = 0.043; mean ± SEM.

At the end of the study, the medication of 6 out of 19

supplemented patients was reduced: in 3 patients, the daily

steroid dose was decreased by 2-4 mg, and three other pa


no longer needed to take NSAIDs. In the control

group, one patient had to be put on medication because of

hypertension during the trial, and one patient's steroid dosage

had to be increased, in the other patients medication was

unchanged. The reduction in medication in the supplemented

compared with the control group was statistically significant

according to the Fisher´s exact test (p=0.014).


The cause of RA is still unknown, but it is likely to involve

both genetic susceptibility and environmental factors

such as diet [11]. The role of nutrition should be clarified

with respect to two fundamental aspects: 1) Does it have any

effect in the clinical expression of the disease or in susceptibility

to RA? 2) Could any diet or nutrient supplementation

play a role in the management of RA by alleviating symptoms

such as pain, by decreasing the progression of the disease,

or by reducing the reliance on or combating the sideeffects

of NSAIDs ? [12].

Case-controlled studies indicate that the lifelong consumption

of fish, olive oil, and cooked vegetables may have

protective effects on the development or severity of RA [13,

14]. Patients with RA have been reported to consume too

much total fat and too little polyunsaturated folic acid

(PUFA) and fibre [15]. The so-called Western diet (which is

also ingested by most of the population in Hungary) is well

known to lead to the development of latent metabolic acidosis

[16]. Compensation of this acidosis is possible by increasing

the intake of organic mineral salts either from the

diet (increased intake of vegetables and fruits) or from supplements.

The main alkaline substances in our diet are citrates;

a useful supplement therefore should contain a mixture

of various citrate salts of sodium, potassium, calcium, and

magnesium. The used supplement contains all these salts,

together with trace elements and lactose, which increases the

bioavailability of minerals. The used dose of the supplement

provides a total of 45 mEq base per day. The usual daily

surplus of acid in the Western diet is 60 mEq in an elderly

population [17], and so a significant reduction in acid load is

achieved with the supplementation. There is to date no indication

that single constituents of the supplement alone work

in improving the symptoms in RA patients.

Supplementation of the usual diet with alkaline minerals

improved the DAS28 in this study. Of the contributory factors

of DAS, the level of pain changed most remarkably in

the supplemented group; however, laboratory parameters

indicating the degree of inflammation (ESR, CRP) did not

change in either of the groups, indicating that the severity of

the disease by itself was not influenced by the supplementation.

One might argue that plasma parameters of acid-base

status (pH and bicarbonate values) should have been determined

in this study; however, these parameters are extremely

well buffered, and changes in these parameters are much

smaller than the probable pH or buffer changes in the interstitium


The reduced pain sensation can be explained by the significant

elevation of plasma ir-EP levels following alkaline

supplementation. The exact physiological role of circulating

ir-EP is still obscure. What is clear from biochemical studies

is that ir-EP binds predominantly to the mu opioid receptors

[19] that are present in several peripheral tissues including

immune cells [20, 21] and the synovial membrane [22]. Sporadic

experimental data suggest that peripheral ir-EP and its

opioid receptor system play a role in the physio-pathology of

local inflammatory processes. The above experimental results

and the reported negative correlation between RA activity

and plasma ir-EP levels [23], together with the general

opinion that relative ir-EP deficiency may play a part in the

manifestation of autoimmune diseases [24, 25], all suggest a

causality between the circulating ir-EP levels and the arthritis-

induced pain.

In addition to a pain-reducing direct effect of endorphins,

an alternative explanation might be the more alkaline environment

in the local surrounding of the joints, as pain receptors

are sensitive to small pH changes. Significant changes in

pH have been shown to occur in the interstitium without detectable

changes in blood pH [18].

The finding that 6 out of 19 patients taking an alkaline

supplement could reduce their daily steroid or NSAID dosage

also supports the view that a reduction in latent metabolic

acidosis has a positive effect on pain sensation. As the

chronic need for pain medication is connected to potential

side-effects, it is of great importance to find safe adjuvant

therapies for these patients, such as supplementation with

alkaline minerals, even though the supplementation does not

influence the severity of the disease itself.

The limitations of this study include its small sample size

and the lack of an active control group. However, the results

of this pilot trial should encourage further randomized placebo-

controlled studies to investigate the effects of alkali



Studies of the effects of dietary habits and nutrient supplementation

on RA are, to quote Ollier et al. [26], "hampered

by the inherent variability in the clinical course of the

disease and the wide spectrum of clinical phenotypes." Patients

frequently self-prescribe complementary medicines

including diet modifications. This leads to considerable difficulties

in selecting an appropriate group of patients for

study. Improvement in symptoms may be dependent on the

severity of the disease and on the underlying inflammatory

status. An important finding of this study is the significant

decrease in pain and DAS28 level and elevation in plasma ir-

EP levels following several weeks of alkaline supplementation.

Our study is the first to demonstrate the effect of the

metabolic acid-base balance on plasma ir-EP levels. The

results of our study suggest that an alkaline supplement may

improve function and pain in rheumatoid arthritis and represents

an easy and safe addition to the usual treatment of RA