Gut Health

Understanding Leaky Gut

Leaky Gut: Can This Be Destroying Your Health?

Ronald Grisanti D.C., D.A.B.C.O., D.A.C.B.N., M.S.

Leaky Gut Syndrome (LGS) is a major cause of disease and dysfunction in modern society, accounts for at least 50% of chronic complaints, as confirmed by laboratory tests.

In LGS, the epithelium on the villi of the small intestine becomes inflamed and irritated, which allows metabolic and microbial toxins of the small intestines to flood into the blood stream. This event compromises the liver, the lymphatic system, and the immune response including the endocrine system.

Some of the most incurable diseases are caused by this exact mechanism, where the body attacks its own tissues.

This is commonly called auto-immune disease.

It is often the primary cause of the following common conditions: asthma, food allergies, chronic sinusitis, eczema, urticaria, migraine, irritable bowel, fungal disorders, fibromyalgia, and inflammatory joint disorders including rheumatoid arthritis are just a few of the diseases that can originate with leaky gut. It also contributes to PMS, uterine fibroid, and breast fibroid.

Leaky Gut Syndrome is often the real basis for chronic fatigue syndrome and pediatric immune deficiencies.

Leaky Gut Syndrome is reaching epidemic proportions within the population. Historically, the only way bowel toxins entered the blood stream was through trauma, for example by sword or spear.

This quickly led to septicemia that might be treatable, or more probably, ended in death. Outside of trauma, the body maintained a wonderfully effective selective barrier in the small intestine, one that allowed nutrients to enter, but kept out metabolic wastes and microbial toxins rampant in the intestines.

What Modern Event Allowed Such A Break-Down?

Primarily it has been antibiotics, secondarily non-steroidal anti-inflammatory drugs (NSAIDs, Motrin, Aleve and Advil) with NSAIDs being the major cause of leaky gut because they so viciously inflame the intestinal lining, causing a widening of the spaces between cells and sometimes hemorrhaging.

Other common causes are chemotherapy, ingested alcohol, inhaled formaldehyde from a new carpet, food allergens, stress emotions, lactase deficiency, gluten/gliaden allergy, abnormal gut flora (bacteria, parasites, yeasts).

The first antibiotic, penicillin, did not enter mainstream health care until 1939. Since the 50s and 60s, antibiotic use has been frantically prescribed for every infection and inflammation, particularly pediatric ear infection, bronchitis, and sore throat.

It is sadly ironic that most of these infections are viral in nature, and not only are the antibiotics damaging, but they are ultimately unnecessary. Antibiotics should be considered a hospitalization level medicine, when bacteria have entered the blood, bone, or organ.

Antibiotics Destroy Beneficial Bacteria

Antibiotics create their damage in two ways. The first is by destroying beneficial bacteria. The small intestine and large intestine host over five hundred different kinds of beneficial bacteria. These bacteria perform hundreds of functions required for healthy metabolism and immune response.

Through enzyme secretions, bacteria transform metabolic and microbial wastes before they are discharged by the body. These wastes include cellular debris, hormones, chemical wastes, bile, pus accumulations, viral toxins, bacterial toxins, etc.

For example, the body creates bile not only as a lubricant to flush wastes out of the liver, but also, to detoxify many of the poisons accumulating in the liver. Bile however is extremely damaging to large intestine epithelium.

When bile enters the small intestine via the common bile duct, beneficial bacteria break the bile salts down into a less toxic compound, making it non-dangerous by the time it reaches the large intestine.

When you take antibiotics you destroy these bacteria and the bile salts freely enter and damage the large intestine. I believe this contributes significantly to the high incidence of colon cancer plaguing today's society.

Beneficial bacteria also break down hormone secretions that are discharged from the liver to the small intestine. If you lack the bacteria to break down estrogen and the intestinal permeability has been altered, the patient is now reabsorbing estrogens in their original state.

The body will deposit these in estrogen sensitive areas such as the breast, uterus, or ovaries, contributing, if not causing, fibroids and tumors. The same scenario is responsible for premenstrual syndrome as well.

Healthy mucosa allows nutrients to pass the barrier while blocking the entry of toxins.



With leaky gut, the barrier is dysfunctional, blocking nutrients at the damaged villi while permitting toxins to enter the blood stream.



Antibiotics Promote the Growth of Fungus

The second way antibiotics damage the intestines is by fostering the growth of Candida albicans and other pathogenic fungi and yeast. This event, more than any other, precipitates Leaky Gut Syndrome. In a healthy situation the small intestine epithelium maintains tight cell junctions, which contributes to the physical barrier involved in intestinal absorption. In addition to the physical barrier, there is an important chemical barrier within the mucus that contains immune agents, which neutralize any toxin that comes in contact.

Candida exudes an aldehyde secretion, which causes small intestine epithelial cells to shrink. This allows intestinal toxins to infiltrate through the epithelium and into the blood. The secondary barrier - immune agents in the epithelial mucus - remain the sole agent for neutralization.

Eventually, the immune system becomes exhausted rising to this challenge.

The damage done by Candida is to the intestinal epithelial barrier, allowing the absorption of serious toxic agents and chemicals, which then enter the blood and affect numerous organs, including the brain.

Food Allergies: The Complicating Factor

When the integrity of the intestinal barrier has been compromised, intestinal toxins are not the only pathogens to be absorbed. The barrier, in a healthy state, selectively allows digested nutrients to enter the small intestine when all is ready.

With leaky gut, nutrients can be absorbed before they are fully digested. The body's immune response, through specific antigen-antibody markers, will tag some of these foods as foreign irritants.

Every time that particular food touches the epithelia, an inflammatory immune response is mounted which further damages the epithelial lining. What started as a Candida irritation with shrinking of the cells has now been complicated with active inflammation every time a particular food is eaten.

Food allergies are a common secondary problem to Candida, and if present, will maintain the leaky gut continuously, even if the Candida is eradicated.

The most common food allergies are dairy, eggs, gluten grains (wheat, oats, rye), corn, beans (especially soy), and nuts. There are seldom real allergies to meat, rice, millet, vegetables, or fruit, although an allergy to garlic is not uncommon.

We have to distinguish a real allergy - that which causes a histamine inflammatory reaction at the site of the small intestine (SI) epithelia - from sensitivity, which may cause uncomfortable symptoms, but seldom is damaging.

Sensitivities are usually due to low stomach acid or pancreatic enzyme secretion, that is, poor digestion.

In the healing of the intestinal lining, exposure to a significant allergy can sabotage the treatment. For example, one may be very good at restricting wheat, dairy and eggs, but then compromises the treatment by taking garlic tablets.

The Role of the Liver and Lymphatic System

The metabolic and microbial toxins that enter the bloodstream during leaky gut end up in the liver, which has the job of detoxifying and discharging the poisons. Under normal conditions, the liver is taxed just by processing the daily metabolic wastes created by cell and organ activity.

Imagine the further load created by dumping serious intestinal toxins on a regular basis. There is a point when the liver becomes saturated; it cannot further detoxify the poisons, and they are returned to the blood circulation.

The blood has sophisticated mechanisms for preserving chemical homeostasis, and will diffuse as much of the toxic chemicals and physical debris into the interstitial fluids as is possible. From here the lymphatic system will attempt to collect and neutralize the toxins, but unable to send the toxins to the liver, the body essentially becomes toxic.

Microbes grow and develop, hence there can be chronic lymphatic swelling, especially in children. Over a period of time, toxins will be forced into distal connective tissue around muscles and joints, causing fibromyalgia, or into the cells, which can precipitate genetic mutation and ultimately cancer.

Stress to the Immune and Endocrine Systems

The immune system is stressed in three major ways. First is at the site of the intestinal mucosa. As toxins and food antigens brush up against the mucosa, the immune system mobilizes to neutralize the toxins. Normally, much of this work would have been done by beneficial bacteria, which have been destroyed by antibiotics.

For toxins that make it to the mucosa, the body will tag them with a chemical secretory IgA (SIgA), which attracts macrophages and other white blood cells to consume the toxins. It is not long before this immune response is overwhelmed and depleted.

This can be measured directly with a stool or saliva test for the intestinal SIgA level.

The second stressor happens in the liver and lymphatic system, which, also overwhelmed, puts demands on the immune system. The third stressor is a consequence: as the immune response diminishes, more microbes (viruses, bacteria, and fungi) multiply, allowing for a chronic state of infection.

The most important organ in the production of immune agents seems to be the adrenal gland, and Leaky Gut Syndrome slowly diminishes adrenal function. In the early and middle stages, there is actually an adrenal excess, as measured by excess cortisol output. Eventually, cortisol levels drop, and one now has exhaustion.

The Role of the Digestive Tract

Candida flourishes when the terrain in the intestines favors it. Just killing Candida is usually not successful, because the chemistry and vitality of the terrain has not been normalized, and Candida returns.

Antibiotics are the original cause of the change on the terrain. By killing acid forming bacteria (Lactobacillus bacteria produce lactic acid, for example), the environment becomes alkaline, which promotes Candida.

Antibiotics and chronic illness reduce stomach acid production, contributing to the alkalinity, and also allowing poor digestive absorption. In fact, many people with LGS are malnourished and will lose excessive weight, no matter how healthy the food is that they eat.

The idea that lactobacillus supplementation is all that is required after antibiotics is somewhat delusional; in fact most of the lactobacillus from supplementation does not survive in the intestine, due to poor terrain. Just to make sure you have a full understanding of the seriousness of Leaky Gut, the following is a summary:

  • When the gut is inflamed it does not secrete digestive enzymes to digest foods properly or absorb nutrients and foods properly. The result can indigestion with gas and bloating, called irritable bowel syndrome (IBS).

  • When large food particles are absorbed, food allergies and new symptoms are created (e.g., IBS, gallbladder disease, arthritis or fibromyalgia).

  • When the gut is inflamed, carrier proteins are damaged, so malabsorption and nutrient deficiencies occur.These deficiencies slow down the ability of the gut to heal and can cause any number of other symptoms (e.g., magnesium deficiency induced angina or gut spasms, chromium deficiency induced high cholesterol or sugar cravings, zinc deficiency induced prostatitis or lack acid formation)

  • When the detoxification pathways that line the gut are compromised, chemical sensitivity can arise. Furthermore, the leakage of toxins overburderns the liver so that the body is less to handle everyday chemicals in foods, water and air.

    Now many foods can cause symptoms that never did before, because the gut's detoxification (liver) system is unable to cope with the hundreds of chemical additives, dyes, colorings, preservatives and pesticides common in our foods.

  • When the gut lining is inflamed, the protective coating of the gut antibodies can be lost. With loss of the secretory immunoglobulin A (SigA), the body becomes more vulnerable to infections in the intestines from bacteria, viruses, parasites and yeast and they become resistant to treatment.

  • Ironically, the more resistant the bugs become, the more-high powered antibiotics doctor prescribe, resulting in more overgrowth of resistant fungi (Candida). As the unwanted bugs grow, the gut gets more inflamed and leaky initiating a vicious cycle of worsening condition and major cause of so many incurable diseases.

  • When the intestinal lining is inflamed, bacteria and yeast can translocate. In other words, they can pass from the gut cavity into the blood stream and set up infection anywhere else in the body, including the brain. This is often the mysterious and undiagnosed cause of infections in the teeth and gums, bones, prostate, bladder and sinuses.

  • With the formation of antibodies, the food antigens that leak across the gut wall can sometimes resemble the natural antigens on tissues. Protective antibodies will then attack the antigens, as they should and the tissues, causing further damage.

    It is the very reason why auto-immune diseases begin. Lupus, multiple sclerosis, rheumatoid arthritis, myocarditis, iritis and thyroiditis are some of the members of this ever-growing category of mysteriously incurable auto-immune diseases.

compliments of Functional Medicine University

www.functionalmedicineuniversity.com

Insomnia....possible underlying causes

Insomnia Solution

Ronald Grisanti D.C., D.A.B.C.O., D.A.C.B.N., M.S.

If you suffer from insomnia then you understand the seriousness of simply not getting a good night's sleep. Your whole world around you appears to crumble when you can't get a good 6-8 hours of quality deep REM sleep. Your work life, your family life all suffer.

Today's article will touch on a few "key" things to consider to solve insomnia.

 

To begin remember that the awakening after a few hours of sleep and not being able to get back to sleep is often rebound from what you ate or drank hours before. High sugar, alcohol, highly spiced foods and of course, caffeinated drinks are often the culprits.

If you are unknowingly deficient in chromium, vanadium, manganese and other nutrients you can experience hypoglycemic rebound in a few hours where you abruptly wake-up and are unable to drift back to sleep.

Let's now consider something called the “happy hormones” that lead to a restful sleep.

One of these hormones is serotonin, which anti-depressants like Prozac work on.

We make serotonin from the amino acid tryptophan.

Unfortunately as we age or faced with an overload of stress the level of serotonin suffers.

Dozens of studies show that low tryptophan levels lead to insomnia, awakening feeling unrested, inability to stay asleep after getting there, and just lying there all night watching the clock.

For over a quarter of a century literally dozens of studies have proven this amino produces a great sleep in many, and with no side effects or hangover. In fact, folks have better mental clarity during the day. Furthermore, it improves daytime depression, PMS, fibromyalgia, and anxiety as well as carbohydrate cravings, binge-eating and even alcohol recovery.

Now from a functional medicine position it is important to know that a simple B6 or zinc deficiency can contribute to insomnia. A common vitamin B6 deficiency can keep you awake all night, or low zinc causing impaired conversion of B6, which is needed to make tryptophan work.

If you have an elevated organic acid, kynurenate acid, for example, and a low tryptophan, the correction of B6 may be all you need.

Now don't forget plasticizers in our bodies lower zinc which is needed in the enzyme to convert B6 to its active form so it can then transform tryptophan to a serotonin.

I am disappointed with the number of people suffering with insomnia who could be helped if only their physician understood the significance of nutritional biochemistry.

It comes down to finding the cause of the cause.

Remember that as important as serotonin is for sleep and moods, most of serotonin is not made in the brain.

Ninety five percent of serotonin is made in the gut.

If the gut isn't healthy, then you are going nowhere. If you have gas, bloating, alternating diarrhea or constipation or other gut issues than your chances of solving your insomnia problem may be futile until you fix your gut.

The secret is to find a doctor who understands the probable underlying causes of insomnia and knows how to do the proper testing to discover what needs to be fixed.

It really can be as simple as that.

References

Schmidt HS, L-tryptophan in the treatment of impaired respiration in sleep, Bull Eur Physiopathol Respir, 19; 6:625-9, 1983

Demisch K, et al, Treatment of severe chronic insomnia with Ltryptophan: results of a double-blind cross-over study, Pharmocopsychiatry, 20; 6:242-4, 1987

Hartmann E, Effects of L-tryptophan on sleepiness and on sleep, J Psychiatr Res, 17; 2:1-7-13, 1982

Ashley DV, et al, Evidence for diminished brain 5-hydroxytrptamine biosynthesis in obese diabetic and non-diabetic humans, Am J Clin Nutr, 42; 6:1240-5, 1985

Riemann D, et al, The tryptophan depletion test: impact on sleep in primary insomnia - a pilot study, Psychiatry Res, 109; 2:129-35, 2002

Schneider-Helmert D, et al, Evaluation of L-tryptophan for treatment of insomnia: a review, Psychopharmacol (Berl), 89; 1:1-7, 1986

COMPLIMENTS OF FUNCTIONAL MEDICINE UNIVERSITY

www.functionalmedicineuniversity.com

Link Between the Gut and Brain and Inflammation

The Gut-Brain Axis in Health and Disease

Robert G. Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, SASTM

 

The brain is the most nutrient-dependent, energy-dependent and toxin- and stress-vulnerable organ in the body. The gut and the brain are very tightly linked. In the gut-brain axis, damage to one is often damage to the other.

 

 

Concussion is a good example. When a blow to the head or severe jolt causes a concussion, the damage to the neurons has a parallel in damage to the gut lining. The tight junctions of the lining almost immediately open up and become permeable. This produces inflammatory cytokines that can penetrate the blood-brain barrier, leading to additional brain inflammation. In other words, when the gut is on fire, so is the brain.

If the sudden intestinal permeability caused by a concussion goes untreated, the concussion symptoms will be worse, due to the additional inflammation. The gut permeability may not resolve by itself, which could contribute to making the concussion symptoms linger on for weeks instead of days. Intestinal permeability may also play a role in those patients who go on to develop post-concussion syndrome by causing ongoing brain inflammation.

So, in addition to treating the concussion itself with nutrition, the intestinal permeability, particularly the release of occludin and zonulin, needs to be immediately addressed.

The intercellular permeability of the gut lining can be treated through repair and regeneration with xanthohumol. A natural phenol derivative of hops, xanthohumol has a very extensive (more than 250 publications in preclinical science) record of efficacy and safety. In the brain, xanthohumol acts as an antioxidant and anti-inflammatory; it also helps with the biogenesis of mitochondria in damaged neurons. In the gut, the polyphenols are strongly anti-inflammatory. They modify the inflammatory kinases in favor of antioxidant pathways and, just as important, block the kinases in the cell-damaging inflammatory pathways for tumor necrosis factor, COX-2, and others.

On a chronic level, we know that neurodegenerative diseases such as Alzheimer's, depression, and anxiety may not be exclusively triggered within the brain. When the intestinal barrier is breached, so is the blood-brain barrier. Inflammation from circulating gut-derived lipopolysaccharides (LPS) pass through the blood-brain barrier and have been linked to a number of neurodegenerative disorders. In particular, LPS stimulates the production of IgA, IgG, and IgM antibodies that can cross-react with tissues and induce autoimmune disease and neurodegeneration. 

Treating brain inflammation caused by gut inflammation starts with removing the cause through a modified elimination food plan and the removal of pathogens. Anti-inflammatory supplements, such as berberine, and digestive enzymes, such as lipase and amylase, help restore the gut lining. The next step is to reinoculate and regenerate the gut with a powdered nutritional supplement if needed, continuation of the modified elimination diet, and the addition of probiotics, vitamin D, alpha-lipoic acid, and specialized pro-resolving mediators (SPMs). Xanthohumol is also very helpful for regenerating intestinal mucosa.

Once the process is underway, retesting is important to see the gains and make any necessary adjustments to the treatment plan. As healing progresses, retaining the gains with a better diet and appropriate supplements becomes the focus of treatment.

Healing the intestinal barrier is only half the equation. The brain inflammation needs to be treated as well. Low-level laser therapy (LLLT) is a valuable tool for improving neurological function. In concussion patients, it has been shown to help reduce inflammation, modulate oxidative stress and nitric oxide production, and down-regulate pro-inflammatory microglial cytokine expression.

LLLT is also valuable for reducing inflammation of the vagus nerve. The longest of the cranial nerves, the vagus is often called the great wanderer for the way is wanders through the visceral organs. A major function of the vagus nerve is preventing inflammation. In the gut, the vagus nerve endings sense the chemical signals of inflammation, such as cytokines and tumor necrosis factor, and send messages to the brain telling it to release anti-inflammatory neurotransmitters via the cholinergic anti-inflammatory pathway. When the brain-gut axis is disrupted, the vagus nerve is affected and the messages back and forth are garbled or don't get through at all. Decreased vagal nerve activity has some serious effects on the gut. Hydrochloric acid and pancreatic enzyme secretion is reduced, as is bile secretion. The parietal cells in the stomach, which are responsible for producing intrinsic factor, don't work as well, leading to reduced absorption of B vitamins. 

We know that post-injury vagal nerve stimulation (VNS) after a concussion can help prevent the breakdown of epithelial cells in the gut and keep the tight junctions from opening. This only works when administered within 90 minutes of the injury, however. Later on, stimulation of the vagus nerve with LLLT using 405 nm violet lightcan help to restore communications and reduce inflammation.

Treatment modalities such as those discussed here help repair the integrity of the gut lining and the blood-brain barrier. They're a hopeful new approach to restoring the functionality of the gut-brain axis and returning the body to harmony.  

Compliments of Functional Medicine University

www.functionalmedicineuniversity.com