ROSACEA AND ARTHRITIS

Two faces of the same coin

In this narrative, I reveal all the difficulties I came across during the time it took to recover from Rosacea and muscle damage associated with this condition. Moreover I give my opinion about what has happened, based on all the research I did. I hope my experience defeating Rosacea/arthritis inspires other people suffering from the same condition, into believing they too can beat this disorder. I wish my success will be the beginning for others to understand what is troubling them, and that many mysteries hidden under the mask of Rosacea will finally be unraveled.

At the age of 35 an inflammation in my face, with persistent redness and pimples, developed, little by little, until it covered my face completely. This annoying and constant inflammation persisted for years, no matter what I did. In the winter, the cold air made my symptoms worse. Anything I tried to deal with this disease had only temporary results. With time, I realized I had inherited a chronic skin inflammation – ROSACEA. Anybody ‘cursed’ with this skin problem is confronted with the fact that this is a disease for life.

Other symptoms, in particular muscle stiffness and tiredness, started to bother me as time went by. Little by little, my energy levels dropped to the point that anything I did made me feel tired very quickly. In the morning, when I woke up, it took me at least one hour until my muscles became more flexible and I could go on doing my daily chores. A few years later, one morning late in autumn, I woke up with inflammation in my shoulder, I felt pain I had never had in my entire life. It lasted for two whole weeks. Anything that touched my arm or any attempt to move it, induced an immediate dull ache. When finally the pain diminished, a process of calcification began and all muscles in the right side of my back became stiff. I couldn’t use my arm anymore, my shoulder was ‘frozen’!  After two months of painful sessions of physiotherapy I decided to quit, the pain was unbearable! However, as I had already booked a session I decided to go one last time. As usual, before physiotherapy,  I did the exercises I was told to do at home but, this time, I tried something that had already helped me in the past to relieve pain in my back. I took a couple of the hottest chilies from my garden, chopped and macerated them in alcohol. With a cotton ball I applied the lotion on muscles and, to my surprise, the heat and burning from  capsaicin in chilies, reduced the pain, facilitating exercises. But the greatest surprise of all was that muscles responded more quickly. I felt smaller muscles in the injured area recover easier, one by one, without forcing, I just had to insist on moving them slowly. The best of all, next day physiotherapy session was less painful and I needed less effort to recover damaged muscles. This allowed me to continue physiotherapy until I could completely raise my arm.

I wondered why chili had helped me so much! My curiosity made me look for an answer which I found by doing some research.

Capsaicin (the main chemical in chilies) potentiates the role of exercise in stimulating circulation so that muscles get the nutrients they need to recover. Moreover, when the lotion is applied repeatedly, capsaicin activates the pain receptors in the body till they lose sensitivity, this reduces pain and allows to exercise muscles with less effort. Reference (1)

Before I could celebrate my success, a few months later, I caught a viral infection. This time, muscles of my legs were the most affected. To walk only a few steps required a great effort. Climbing the stairs in my home, to get into the bedroom, was out of the question. I slept on the couch for the period during which inflammation was worse.

At first, I faced this situation a bit by intuition using the information I gathered during the time I was treating my shoulder. Exercising my legs everyday made me recover strength although it took over a year until I could walk without help. But along with all these muscle disorders, I also had symptoms of dizziness, blurred vision and lack of balance, not to mention a pressure in the right side of my skull that made it difficult to sleep at night. My life was completely disturbed! I had to sleep in a sitting position or else, my head wouldn’t stop spinning. It became so severe I fell to the side several times, when I tried to get up in the morning.

Things got worse at night with darkness to the point I began to fear night fall! Many times I woke up in the middle of the night gasping for air. I had to breathe slowly for my rib cage lifted with difficulty. In addition, I felt a suffocating sensation as if something was tied very hard to the right side of my neck. These symptoms made me avoid going out, besides, the irregular walk and a red face didn’t allow me to go unnoticed. I felt like a drunk not being able to walk on a straight line.

My social life was deeply affected. I couldn’t help but feel embarrassed! 

After doing medical exams that showed nothing was wrong in my head, I wondered if these symptoms of dizziness and lack of balance were connected with the injury I had in my back. Although I felt no pain, the upper right side of my back, next to the neck, had been injured very badly and was very stiff.

A visit to my physiotherapist confirmed that lack of balance could be connected with the shoulder injury. Again, I began a long process of physiotherapy that lasted for two and a half years. Luckily I found a physiotherapist with great skills and knowledge, who helped me deal with all the difficulties that followed. He probably thought I was crazy: in the very first session, I told him I needed his help to cure my arthritis and rosacea at the age of 55. But with time, he saw the results and how committed I was in achieving this goal, and he too, considered that recovering full function of my muscles could be a reality. Without his dedication I wouldn’t have succeeded in overcoming this situation. According to his diagnosis I had a condition called myositis ossificans, a disease that causes calcification of muscles, what explains all the symptoms I had of muscle stiffness and rigidity.

The possibility that rosacea was connected with arthritis made me search for information about this inflammation, with the hope that unraveling its causes would help reduce calcification, the very first step to regenerate muscles.

Many recent studies show that Rosacea is connected with a Staphylococcus aureus infection. This bacteria usually lives in our body, as part of our microbiota, without causing major problems except when it assumes a virulent form. Slowly, in a process that takes years, the bacteria colonizes many parts of the body, in particular muscles and the skin, causing severe damage. This would justify my suspicion that rosacea is connected to arthritis.

Determined to beat this bacteria, I had to know more about it so that, maybe, I could find a way to help my immune system destroy S. aureus. 

STAPHYLOCOCCUS AUREUS A bacteria with many strategies S. aureus, a member of the firmicute bacteria, is part of the flora in the upper airways were it does no harm to the body until it finds an opportunity to become virulent and invade other parts of the body. In situations of stress, injury or a viral infection,  when the immune system is either down or busy fighting a disease, S. aureus finds the right conditions to overgrow. With that purpose the bacteria  escapes and aims to the intestines, its first target.  There it attaches to tissues and initiates the formation of a bio-film: a protection against the immune system and a tool to interact with other bacteria in the gut. Symptoms of enteritis, diarrhea and abdominal pain are the first signs of S. aureus infection. In order to colonize the body, S. aureus follows several steps: In a first phase, it attaches to tissues, just like a limpet clings tightly to rocks. Then, it covers itself with a bio-film, feeding it until it gets thicker and stronger and finally, it is ready to detach and disseminate into other parts of the human body.  In order to follow all these steps it produces virulent factors allowing the bacteria to escape the immune system and gain strength. VIRULENT FACTORS Most of the damage caused by S. aureus is due to exoproteins, nucleases, proteases, lipases, hyaluronidases and collagenases, enzymes produced by the bacteria with a destructive effect. They breakdown tissues in the body with the purpose of releasing their nutrients as a food supply or, as a means to disseminate into other tissues of the body. Nevertheless, the main weapon S. aureus uses to escape the immune system is the adenosine producing enzyme, Adenosine synthase. In excess, adenosine keeps A2A adenosine receptors inhibited, a condition that hinders  the work of the immune system into killing bacteria. Reference (2)

As if this wasn’t enough S. aureus also works together with other gut bacteria in synergy reinforcing its destructive action in the body.

COMPLICITY AMONG BACTERIA Quorum sensing In its virulent form, Staphylococcus aureus interacts with other bacteria in the body using a communicating system called quorum sensing – ‘cell-to-cell communication’. This system allows bacteria to  communicate and interconnect with each other, working as a community, sharing nutrients and strategies to escape the immune system and fight their common competitors, a necessary cooperation to guarantee their survival. Among the many bacteria that benefit with the presence of S. aureus in the gut, klebsiella pneumoniae and Pseudomonas aeruginosa are likely ‘partners in crime’. Working in synergy with S. aureus, they further inhibit the action of the immune system by reducing the activity of A2A receptors, as a consequence the mitochondria is severely damaged. With time infection becomes chronic and evolves to autoimmune diseases. – klebsiella is connected to diseases such as Ankylosing spondylitis, Crohn’s disease, Ulcerative colitis, fatty liver and IBS (Inflammatory Bowel Disease). As if this weren’t enough, this bacteria produces hydrogen, which circulates in the bloodstream and creates the perfect conditions for another bacteria, H. pylori to colonize the stomach. – Pseudomonas, in its turn, is the cause of many health issues including bone and joint damage, and when working in synergy with S. aureus it aggravates chronic wound infections. This bacteria aggravates the damage caused by S. aureus by using T3SS (type III secretion apparatus) a virulent factor that causes mitochondrial dysfunction. Reference (3)

I still needed  to learn more about the complicity among these bacteria in order to better understand what was happening to me. My purpose was to help the immune system fight back, to achieve complete recovery. I already knew that exercising muscles slowly helped in reducing inflammation and healing damaged muscles, but I still had a lot to learn.  I never stopped believing I could recover and that gave me the motivation I needed to continue. 

OTHER CONDITIONS BESIDES MUSCLE DAMAGE RELATED TO ROSACEA

HYPOGLICEMIA

A few years before my muscles were injured I had symptoms of panic attacks, a frightening feeling that happened all of a sudden without any warning. Because it happened mostly an hour or two after a meal, I wondered if it had something to do with a drop in blood sugar. Since then I started monitoring my glucose level in blood and noticed that, especially in the morning, blood sugar was much lower, making me feel tired, with low energy. But panic attacks happened mostly after a meal rich in carbs, blood sugar raised very quickly and after a while it dropped to very low levels. A sudden drop in glucose stimulates adrenaline, as a means to raise blood sugar. The adrenaline rush was the probable cause of my panic attacks, which I learned to prevent by eating less carbohydrates.

The presence of S. aureus explains hypoglicemia

Studies show that the antimicrobial peptide  Cathelicidin LL-37 is overactive in Rosacea. Cathelicidin has a role in fighting bacteria, but when the mitochondria are damaged (by bacteria), instead, it causes inflammation in the body. If vitamin D is deficient the enzyme S1P (sphingosine-1-phosphate) is activated to produce cathelicidin.  Among its many functions in the body, this enzyme  stimulates the pancreas into producing both insulin and glucagon. Insulin lowers blood sugar in the presence of glucose and glucagon does the opposite when blood sugar levels are down. S. aureus uses the strategy of stimulating S1P enzyme to cause chronic inflammation in the body. The over activity of this enzyme, induces the excess production of insulin after a meal rich in carbohydrates, causing a sudden drop in blood sugar. With adenosine A2A receptors inhibited by bacteria, glucagon is not produced and the body has difficulties into raising blood sugar. As an alternative it produces adrenaline. Cathelicidin is also stimulated by red wine and tobacco, two factors that exacerbate rosacea inflammation. Reference (4)

Ever since I can remember I have been sensitive to tobacco smoke. I avoided going to cafes because of the smoke that caused a feeling of itching and burning in my eyes and, somehow, for a reason I couldn’t explain, even when there was only one person with a cigarette, smoke always came into my direction.

OCULAR INFLAMMATION

Eye inflammation is a symptom many people with rosacea have to face. Styes, sensitivity to light, blurred vision and itchy gritty eyes bothered me very often. In sunshiny days I couldn’t forget my sunglasses or else I had problems keeping my eyes open. In the garden, wearing a hat was more important than wearing gloves. In addition to eyesight problems I also developed food sensitivities. Eating pineapple, avocados or shrimps always made me feel sick with bowel pain, that sometimes evolved to diarrhea and vomiting, forcing me to stay in bed for a couple of days. I only made the connection between these two conditions when I found out that foods that made me feel sick had in common the carotene astaxanthin. Only then I realized some of the symptoms I had were caused by a deficiency in absorbing carotene, a nutrient essential for eye health.

Astaxanthin as well as other carotenes like lutein and zeaxanthin are carried to be absorbed in the bowel by SR-B1 transporter, which is activated by the action of A2A adenosine receptors. As S. aureus inhibits these receptors carotenes cannot be properly absorbed in the intestines. As a consequence the body handles these substances as noxious components and reacts accordingly, speeding their elimination by inducing vomiting and diarrhea. In addition, lutein and zeaxanthin become deficient, disturbing eye function. However there are certain carotenes, such as cryptoxanthin in orange peel, that don’t need this transporter in order to be absorbed. Herbal teas, and other drinks with lemon also made me feel sick maybe because  citral (in lemons) and geranial (the oil of roses) are aldehydes which inhibit SR-B1 transporter and further intensify indigestion. This also explains why tobacco smoke made me feel nauseated. Acrolein in cigarettes damages this same transporter. References (5)

FOOD CRAVINGS

Eating fat rich foods, such as pork meat, gave me relief from feeling nervous or anxious and raised my energy levels. On the other side, drinking alcohol exacerbated inflammation of rosacea and made me feel intoxicated very quickly. However, I could drink Portuguese green wine without any of the symptoms I felt with other wines. Studying the components in foods I craved, or had aversion to, helped me to understand what nutrients were deficient in my body and which exacerbated inflammation. Many of the food disturbances I had were caused by the action of S. aureus in repressing adenosine A2A receptors. The fact I was cravings for fat foods helped me raise the levels of succinic acid (succinate), an important nutrient for mitochondria to produce energy, and it is deficient when adenosine A2A receptors are suppressed. When succinate levels are low, fat accumulates in the body, instead of being used for energy. Actually, succinate is proven to help in reducing body weight. 

In cases of hipoxia (low oxygen), or when mitochondria is disturbed by the inhibition of adenosine A2A receptors, the enzyme succinic semialdehyde (ALDH5A1) is inactivated. This is the enzyme that produces succinic acid (from GABA neurotransmitter), a nutrient important to reduce stress and anxiety. If ALDH5A1 is inhibited, GABA is transformed into GHB (gamma-hydroxybutyrate) instead, which disturbs the neurological system and, in the long term, causes serious brain disturbances. A diet rich in fat (ketogenic diet) restores the action of GABA into producing succinic acid. In addition, it calms an overactive brain, and also helps to detoxify alcohol, because succinic acid is needed for ADH (aldehyde dehydrogenase) activity, an enzyme that detoxifies alcohol. This explains why I reacted badly to alcohol. The fact that green wine was a drink that made me feel good, in opposition to other wines, can be explained by the evidence that green wine has a high content in malonic acid which inhibits the oxidation of succinic acid, raising its levels in the body. Reference (6)

STRATEGIES TO LOWER INFLAMMATION AND RECOVER MUSCLE STRENGTH

When inflammation was very high I felt strong symptoms of intoxication due to the accumulation of toxins in my body. I noticed that some foods that stimulate detoxifying enzymes in the body gave me immediate relief from inflammation. Raw carrots, garlic butter spread on a piece of bread, apples and oranges were my foods of choice every time I felt inflammation was getting worse.

The excessive growth of gut bacteria (SIBO– small intestinal bacterial overgrowth) causes dysbiosis, a condition where the normal function of the digestive system is compromised. Bacteria toxins induce Beta-glucuronidase an enzyme that  inhibits glucuronidation (a pathway to eliminates toxins, hormones, bile acids, thyroid hormones and drugs), causing chronic inflammation and symptoms of intoxication. Foods rich in calcium D-glucarate inhibit beta glucuronidase and restore the elimination of toxins. Carrots, oranges, apples are good sources of this nutrient and indeed, they were my SOS remedy when nothing else worked. Allicin in garlic and  butyric acid in butter both reduce the growth and virulence of bacteria. In addition to reducing the symptoms of intoxication, oranges have many other properties that were vital to recover muscle flexibility. They are rich in vitamin C, a nutrient that stimulates the collagen producing enzyme, prolyl oxidase. Moreover, it prevents the destruction of BH4 (tetrahydrobiopterin), a vitamin important for many functions in the body (including the production of neurotransmitters) in particular, to raise nitric oxide levels which lowers inflammation induced by S. aureus. The characteristic smell of oranges is due to Limonene, an oil well known for its many medicinal properties. It has a strong anti-inflammatory action against all these three bacteria and in addition it activates adenosine A2A receptors restoring the work of the immune system into killing bacteria and other pathogens. This receptor is also needed for the body to produce collagen type I, to strengthen muscles and make them recover flexibility. Limonene’s anti-inflammatory properties are not exclusive to the digestive system and muscles. In the brain, it induces oxytocin by activating  5-HT-1A receptors.  This action helps to deal with stress and protects the brain from inflammation caused by bacterial toxins. In addition it acts as a prokinetic medicine which means it enhances gastrointestinal motility speeding the elimination of bacterial toxins from the bowel. Reference (7)

Eating a piece of orange peel every time inflammation was worse always helped to make me feel better. Now, I strongly believe that our body tells us all the time what foods we need to fulfill nutritional deficiencies. It’s not by chance that for a long period of time oranges were my favorite fruits.

EXERCISING

orange zest lotion

With time, and all I had learned in my physiotherapy sessions, I could identify what were the symptoms I was feeling, a skill vital to respond adequately. Feeling that a muscle was kind of twisted made me react, it meant that it was inflamed, the first phase before it lost rigidity. I had to exercise that particular muscle otherwise I would be in trouble. Immediately after they lose stiffness, muscles that were inactive for a prolonged period of time become lax and need exercise. If I skipped this step, things could get complicated. A lax muscle easily causes injury. It happened to me a few times and made me rush to my physiotherapist. I had to exercise muscles until they completely lost stiffness, and then again until they gained full flexibility. Only then inflammation stopped and I could go on with my normal daily tasks. However, this happened repeatedly every day, muscles were recovering one after the other and as soon as one had recovered it sort of stimulated the other next to it, I had to start over and over again. All together, I spent three to four hours a day doing exercises. It became part of my daily routine. Exercising muscles was the most important part but I wouldn’t have achieved complete recovery if it weren’t for another strategy I adopted to fight the bacteria that were already in joints and muscles. I figured that if orange peel had helped me reduce inflammation, maybe it could do the same in damaged muscles. To find out if it would work I applied a lotion made with orange zest macerated in alcohol, every time before exercises. It worked better than I expected, muscles started to lose calcification much easier and quicker, without pain, or soreness and no need to force them to move. I just had to exercise my arm slowly, but repeatedly, to stimulate a natural recover. In addition to limonene I used menthol alternatively, because this oil potentiates the action of exercise. Besides the anti-inflammatory properties, both oils stimulate the transport of nutrients into muscles so that the healing and recovering flexibility is made easier. Otherwise I would have to face an almost impossible job, not to mention that it would take forever or much longer to accomplish this effect if I exercised muscles only. Reference (8)

NIGHT FALL WAS THE WORSE TIME OF THE DAY

In the evening, and in particular at night, with darkness inflammation always got much worse. It got to the point – before I knew how to deal with it – I feared night fall. Any situation that involved darkness bothered me very much. Driving through tunnels is something people living on the island of Madeira cannot escape. Darkness made me feel confused, with a great difficulty focusing on the road. As inflammation got worse, there were a few episodes that made me decide not to drive anymore. At night, adenosine levels rise naturally and of course more adenosine helps the bacteria to cause more damage. However, while dealing with inflammation I noticed that this was also the time of the day muscles responded more easily to exercises and recovered quicker. To deal with the exacerbation of inflammation in the middle of the night I spent many hours exercising muscles every time I felt they were starting to lose calcification. Inflammation was just part of the process. To recover the hours of sleep I had lost, I had to go to bed earlier or slept a few hours during the day.

The connection between muscle and skin inflammation was very easy to establish. Every time new pimples appeared on my face I expected to feel inflammation in another muscle, a sign I had to exercise again. As soon as that muscle recovered, inflammation in my face was also reduced. Depending on the intensity of muscle inflammation, it would accordingly exacerbate symptoms of rosacea. Prior to the time I started treating muscles, I noticed that pimples on my face had no pus and took a long time to disappear but, as soon as muscles were recovering, inflammation was different, pimples, this time, were filled with pus and dried quickly after muscles had recovered. In my opinion, that meant that the immune system was finally reaching and attacking the bacteria.

THE MANY WEAPONS OF S. AUREUS

One of the most virulent factors produced by S. aureus is alpha toxin, with great power in inhibiting the action of the immune system, but inducing massive inflammation. It seems like a paradox, that the same inflammation our immune system uses to fight S. aureus, is identical to the inflammation the bacteria causes. However this is a very clever strategy developed by S. aureus to misguide the immune system Our mitochondria are the main energy ‘factory’  our body uses, through a complicated system called citric acid cycle, that uses glucose as fuel to produce energy. In addition, mitochondria also have a relevant role in protecting our body from invading pathogens, they kill them in a process that involves NLRP3 (NOD-like receptors) and caspase-1. In addition NLRP3 also stimulates the repair of damaged tissues by inducing MMP-9 enzymes.   S. aureus  Alpha toxin stimulates the same receptors and enzymes while, at the same time, inhibiting the action of the mitochondria (by inhibiting A2A adenosine receptors). As a result inflammation is the same, however it follows another direction. This inflammation damages different parts of the body with a relevant action in the cornea and wet mucosal areas of the oesophagus, pharynx, bladder, kidneys and the colon. MMP-9 enzyme destroys collagen type IV, in  tissues affected by the bacteria, allowing it to colonize more easily muscles and other parts of the body. In addition, S. aureus produces another enzyme, hyalluronidase which destroys hyaluronic acid (important to give flexibility and protect joints and skin) potentiating the virulence and destruction of S. aureus infection. As if all the damage S. aureus does to the mitochondria weren’t enough it also carries another weapon to escape the immune system.  Staphyloxanthin is a yellow pigment  that acts as an antioxidant annulling inflammation, H2O2 and hydroxyl radicals,   produced by the immune system in an attempt to fight bacteria. The damage S. aureus does has no limits, in addition to colonizing muscles and skin this bacteria disrupts the lymphatic system, affects the flow of lymph fluid disturbing the good functioning of this important organ compromising the immune system. MMP-9 enzymes induced by S. aureus damages severely the lymphatic system and has an important role in the development of cancer of several types. Beating S. aureus and disrupting its interaction with other bacteria is what must be done to prevent the growth of tumors. Reference (9)

SYNERGY AMONG BACTERIA

S. aureus and other associated bacteria cause severe damage to the body and are in many cases in the origin of nutrient deficiencies which trigger cravings for foods rich in those nutrients.  For a long time I frequently had cravings for cakes with egg filling, eggs in general, pork and other foods rich in choline. I strongly believe my need to eat those foods was due to a deficiency in this important vitamin, probably caused by the presence of Klebsiella aerogenes, a bacteria that depletes choline from the body.

Klebsiella degrades choline from the body to use it to produce TMAO (trymethylamine N-oxide)  as a food source for carbon.  The deficiency in choline causes several health problems including muscle weakness, memory loss (due to acetylcholine deficiency), mood swings, brain fog and fatty liver. Choline is necessary to prevent elevated creatine phosphokinase, a condition that causes muscle fatigue and loss of muscle energy. Low levels of choline facilitate S. aureus infection especially in muscles and joints, for choline inhibits MMP-9, the enzyme that degrades collagen in the skin and muscles and the main cause of muscle damage due to S. aureus infection. Reference (10)

Succinate deficiency combined with low levels of choline affected my brain to the extreme, many times it made me feel frustrated, confused and suspicious, I couldn’t order my thoughts: one day I took a decision the next day I changed my mind. I had problems trusting people, which made me avoid socializing.  My brain seemed like a roller coaster of thoughts coming and going.  All this changed after I got rid of S. aureus inflammation. Now I can think clearly again, I have  positive thoughts and I can drive my car in the free road, tunnels are not a problem any more. Muscles at the bottom of my neck, from the back till the right side were damaged severely and caused the choking sensation I felt so often. Connected to those muscles, the joints in my shoulder and armpit were very much affected. The hard work exercising for hours every day, together with physiotherapy sessions, allowed me to recover completely. Rosacea inflammation little by little was decreasing, but it was gone for good only after all damaged muscles in my neck and shoulder were healed completely.

MISTAKES WERE PART OF THE PROCESS

Although I was succeeding in healing  muscles I knew, from previous experience, that I had to be very careful the way I was dealing with this situation. I had always in mind the day I accidentally fell asleep turned to the right side, with my body weight on the injured shoulder. I woke up a few hours later feeling something was wrong, although I felt no pain,  I noticed that my shoulder was too close to my nose. That couldn’t be normal! By touching my shoulder it felt like it was dislocated and I could move it easily with my hand. Again I had to rush to see my physiotherapist. Since that day I promised myself I wouldn’t sleep turned to the right before all inflammation had stopped completely.

However, one day, feeling very tired I rested for a while in bed, lying on my stomach with my arms under my breast. By accident I fell asleep and woke up a couple of hours later with my right arm numb and a sensation some muscles in my shoulder were loose. My body weight had made pressure on muscles that were still stiff and forced them to loosen, of course they had no flexibility and it felt like the shoulder muscles had no action. With patience, I exercised muscles very slowly and carefully and, to my relief, one by one they gained flexibility although they were still kind of twisted. Another injury that needed the work of my physiotherapist. On the bright side, this situation speeded up the process and it didn’t take much longer until all other stiff muscles also recovered. Very soon, all inflammation stopped. I felt no more twisted muscles and with it rosacea was gone. I hope forever!

After all I’ve been through, and the fact that I managed to achieve almost complete recovery from a disease that is supposed to be chronic, I strongly believe that rosacea/arthritis is not an autoimmune disease. It is the work of bacteria that developed the capacity of mimicking the action of the immune system and induce massive inflammation while, at the same time, blocking the immune system’s defense inhibiting its reaction. In my opinion, the key to succeed in defeating this bacteria is to stimulate adenosine A2A receptors, which I did using limonene, menthol and exercising muscles. If this receptor is obstructed, mitochondria are blocked from producing energy and fight bacteria, moreover the production of collagen is obstructed. As a consequence, muscles weaken due to the lack of collagen, facilitating the invasion of pathogens which, without mercy, cause extensive destruction.

Finding the strength to surpass and beat this condition was made easier thanks to the support of my family. My son and daughter, who held my arm and helped me walk when I was weak and my husband who supported me all the time, woke up many times in the middle of the night to help me face inflammation, when things were getting too difficult, kept me company all the time and calmed me down when I was about to panic. Without his patience and support I wouldn’t have the strength to keep going, working every day to recover completely.

I was also very lucky to be treated by the physiotherapist, Marco Gonçalves, who accepted this challenge, but not without expressing his concerns of the risks I was taking, because he knew how severely damaged my back muscles were.

References

(1) https://www.sciencedirect.com/science/article/pii/S0006291X13013533 https://articles.mercola.com/sites/articles/archive/2014/07/14/chili-peppers-pain-relief.aspx

(2) https://bmcbiochem.biomedcentral.com/articles/10.1186/1471-2091-12-56 https://www.hindawi.com/journals/jpath/2011/601905/

(3) https://www.ncbi.nlm.nih.gov/pubmed/25700738 https://www.researchgate.net/publication/273327058_Chronic_wound_infections_The_role_of_Pseudomonas_aeruginosa_and_Staphylococcus_aureus

(4) https://diabetes.diabetesjournals.org/content/diabetes/64/12/4135.full.pdf https://www.sciencedirect.com/science/article/pii/S0022202X15363545

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