Houston Chronicle

Immune disorder’s symptoms mimic two mental illnesses.

- DRS. MICHAEL ROIZEN AND MEHMET OZ Contact the You Docs at realage.com.

When singer/songwriter/ actor Demi Lovato was diagnosed with bipolar disorder at age 22, it came as a relief, and allowed her to deal with her condition. “When I focus on my treatment plan with my team and my support system, I’m able to not only maintain a healthy mind, but … to maintain my sobriety.”

Imagine, however, if you were diagnosed with that mental illness — for which there is no cure — when in fact you had a treatable immune disorder!

Back in 2007, researcher­s discovered that there was a form of immune encephalit­is that affects specific brain receptor functions and triggers symptoms, such as paranoia and hearing voices, that are associated with bipolar disorder and with schizophre­nia as well.

Researcher­s at Houston Methodist Hospital became curious about the potential for misdiagnos­is: “We suspect … a significan­t number of people believed to have schizophre­nia or bipolar disorder actually have an immune system disorder that affects the brain’s receptors,” said Dr. Joseph Masdeu, the study’s principal investigat­or. “If true, those people have diseases that are completely reversible.”

So, the researcher­s are launching a study in which they’ll collect cerebral spinal fluid from those diagnosed with the mental illnesses. If samples contains antibodies known to attack certain brain receptors, researcher­s will notify the participan­ts so that they can ask their doctor about using existing drugs to suppress production of the attacking antibodies!

Stay tuned for results, and if you or a loved one has been diagnosed with either condition, ask your doc about ruling out anti-NMDA receptor encephalit­is as a cause of symptoms.

Triclosan still in use

For a long time, triclosan was thought to eliminate unwanted bacteria in consumer and hospital products. It’s been used in everything from cleaning supplies to toothpaste — in fact, it’s a good bet that any product that says “antimicrob­ial” or “antibacter­ial” on the label contains triclosan or its cousin triclocarb­on.

Unfortunat­ely, triclosan’s antiseptic properties are toxic to the liver, thyroid and lungs. It’s also a hormone disruptor and promotes antibiotic resistance. So the Food and Drug Administra­tion has banned it for use in over-thecounter health care antiseptic products, labeling it nonGRAS (“not generally regarded as safe”). Previously it was banned from use in soaps, but even with this new ban, it’s still in use until December 2018 (that’s when it, along with 23 other chemicals, has to be out of products).

For a complete list of consumer products (215) that contain triclosan, go to the Environmen­tal Working Group’s website (EWG.org) and look for Skin Deep Cosmetics Database.

The good news is that triclosan is in a lot fewer products than it used to be. The FDA proposed this ban in 2015, but we and the EWG have been sounding the triclosan alarm for almost 15 years.

Q: My doctor suggested that I get a liquid biopsy to determine what therapy will be most effective for treating my prostate cancer, even though my insurance won’t pay for it. Is it more accurate, less risky? What’s the deal?

Jack H., Orlando, Florida A: The concept of a liquid biopsy is a great one: It uses a simple blood draw to see what DNA mutations related to prostate cancer are present in your circulatio­n. No incisions, no risk of infection nor complicati­ons from the biopsy itself. Identifyin­g those mutations is supposed to help doctors predict a patient’s response to immunother­apy, and if it turns out that the DNA mutations are not responsive, then the doctor can select another therapy that may be more effective.

Sounds perfect. And one day it might be, but not now. A new Johns Hopkins study took blood draws to obtain DNA samples from 40 study participan­ts, and then divided each one so that identical samples could be sent to two separate, well-accredited labs for analysis. Unfortunat­ely, the lab results matched only 7.5 percent of the time (that’s three of the 40 participan­ts), and only 15 percent of the time did the two companies’ results match for at least one mutation.

These results come on the heels of an earlier study published this year in JAMA Oncology that found that mutations identified in tumor tissue samples and in liquid biopsy results from the same patients had what Johns Hopkins calls “a similar lack of congruence.” That means doctors looking at differing results may come to different conclusion­s about which treatments will be most effective for you.

Ask your doctor about the Johns Hopkins findings, and offer this quote from the researcher­s: “Liquid biopsy is a promising technology, with an exceptiona­l potential to impact our ability to treat patients, but it is a new technology that may need more time and experience to improve.”

 ?? Houston Methodist Hospital ?? Dr. Joseph Masdeu, of Houston Methodist Hospital, is leading a study to help determine whether people diagnosed with bipolar disorder or schizophre­nia may in fact have a treatable immune system disorder.
Houston Methodist Hospital Dr. Joseph Masdeu, of Houston Methodist Hospital, is leading a study to help determine whether people diagnosed with bipolar disorder or schizophre­nia may in fact have a treatable immune system disorder.
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