Back In Action

Health Solutions (703) 356-6284


Leave a comment

Gut bacteria play a role in anorexia; eating disorders

837 anorexia and gut microbiome

People with eating disorders such as anorexia simply do not experience hunger and satiety in the same way people who have a healthy relationship with food do. New research suggests that the composition of gut bacteria, or the gut microbiome, may play a role in the behavioral aspects of anorexia and eating disorders. For instance, previous research shows a connection between mood disorders such as depression and poor gut microbiome diversity. Less than half of people with eating disorders fully recover, showing that conventional treatments are failing untold numbers of people, the vast majority of them women.

The study showed that patients with anorexia had lower diversity of gut bacteria than healthy individuals. They also found that the less diverse the gut microbiome was the more depression and anxiety patients suffered. The researchers also found that as a patient with anorexia began eating again their gut bacteria diversity was partially restored, which in itself aided in recovery.

Alterations in the gut microbiome can affect how a person’s body functions, how they think, feel, and behave, and how they interact with others.

The gut microbiome is critical not only to regulating mood and behavior, it also plays a vital role in regulating metabolic function, appetite control, and weight.

A better understanding of the role of the gut microbiome in anorexia can help researchers forge new directions in treatment around determining target weight goals, how fast the anorexic patient should gain weight, and what type of diet the anorexic patient should follow to best support the brain’s role in eating disorder behaviors.

The researchers are now investigating whether targeted probiotics could ease the renourishment and refeeding phase of anorexia recovery — many patients struggle with gastric and abdominal distress when reintroducing foods. Customized probiotic therapy could also support the mental and emotional aspects of recovery from an eating disorder.

Gut bacteria targeted in eating disorders

Past research has also shown a link between the gut microbiome and eating disorders, which affect an estimated 5 to 10 percent of the population. A 2015 study from France showed gut bacteria plays a role in eating disorders.

The study looked at mice who had an inflammatory reaction to a protein made by gut bacteria. In essence, the mice responded to these bacteria as if it were an allergy or sensitivity. This immune response caused eating disorders in the mice.

The gut bacteria that triggered this reaction is very similar in structure to a hormone called alpha-Melanocyte-stimulating hormone (a-MSH). a-MSH is a satiety hormone that tells you when to feel full. When the immune system attacks the gut bacteria similar to a-MSH, it also attacks the a-MSH due to their structural similarity. This immune reaction can then dysregulate signals around feeding, energy usage, and anxiety.

When the immune system mistakenly attacks the body

This study is evidence of a “cross-reactive” immune reaction, in which the immune system confuses something in the body with something infectious and attacks both. This is a very common mechanism in autoimmune reactions, such as with Hashimoto’s hypothyroidism, type 1 diabetes, or multiple sclerosis.

The research suggests that some eating disorders may have an immune reaction driving the psychological disorder.

Tips on addressing eating disorders nutritionally

Although eating disorders are highly complicated and require intensive, sometimes multi-faceted therapeutic approaches, it’s still important to be mindful of nutritional strategies to support the brain and the gut microbiome:

Eliminate processed carbs and sugars as they trigger addictive tendencies metabolically.

Keep blood sugar stable to curbing cravings, food obsession, and relentless hunger. You may need to eat small, frequent meals that include protein initially.

Base your diet on plenty of vegetables and a wide, ever changing diversity of vegetables. This will increase the diversity of your gut microbiome, which promotes psychological health and stability.

Supporting your brain chemicals, or neurotransmitters. Neurotransmitters affect your mood, thoughts about yourself, behavior, energy levels, and other aspects of how you feel and function. For instance, you may need serotonin or dopamine support. Serotonin is the neurotransmitter that allows us to feel joy and stave off depression. Dopamine, on the other hand, is necessary to feel self-worth, motivation, and to not experience constant cravings. Both serotonin and dopamine have been shown to play a role in eating disorders. If you have been starving yourself, binging and purging, undereating, or affecting your diet in other ways due to an eating disorder, there is a strong possibility you may be deficient in either one or both of these important neurotransmitters.

Ask my office for more advice on how to support a healthier approach to balanced approach to recovering from eating disorders.

Advertisements


Leave a comment

How to support your brain’s “happiness” chemical

836 serotonin basics

Many people take SSRI antidepressants for depression. However, it’s important to ask why you are feeling depression in the first place.

Many important research strides have been made linking chronic inflammation, poor gut health, gut bacteria, and general brain health with depression.

However, we still need healthy serotonin activity, the target of SSRIs, to feel good.

Do you have these symptoms of low serotonin?

  • No longer finding joy, pleasure, or enthusiasm in life
  • Rage and anger
  • Depression
  • Depression related to lack of sunlight
  • No longer enjoy hobbies, favorite foods, friendships, or relationships
  • Unable to sleep deeply or feel rested from sleep
  • Life looks good on paper but doesn’t feel good

Light. The brain depends on sufficient light to manufacture serotonin, so being indoors all the time or in chronically dark or grey weather can affect serotonin activity.

Estrogen. In women an estrogen deficiency can lead to poor serotonin activity. This can explain why some women who are perimenopausal or post-menopausal experience depression.

Although it’s important to use functional medicine to address the cause of low estrogen, such as blood sugar or adrenal imbalances, some perimenopausal or post-menopausal women may still need bioidentical hormone replacement. In these situations, estrogen therapy can deplete the methyl donors necessary for serotonin synthesis, making it important to supplement with them: methyl B-12, SAMe, or MSM (methylsulfonylmethane).

Diet. Some nutritional advice will tell you to address low serotonin activity with foods high in tryptophan, a precursor amino acid to serotonin. However, clinically we really don’t see this work.

Better nutritional advice is to eat a diet that keeps blood sugar stable and does not inflame the gut or the body. This means avoiding sugar and processed carbohydrates, avoiding foods that trigger an immune response, and eating lots of diverse vegetables to foster healthy and diverse gut bacteria.

Blood sugar and gut inflammation. Unstable blood sugar — blood sugar that is either too low or too high — can significantly impact serotonin activity, leading to depression. The same goes for a diet that inflames the gut and the body.

Iron. Additionally, an iron is deficiency can cause low serotonin production. Things that can cause iron deficiency include iron anemia, celiac disease, leaky gut, heavy periods, parasites, over exercising, low stomach acid, hypothyroidism, and uterine fibroids.

Nutritional cofactors for serotonin activity

In addition to iron, nutrients serotonin synthesis requires include P-5-P (pyridoxal-5-phosphate), an active form of B-6, niacin, methyl B-12, folic acid, and magnesium.

Deficiencies in these cofactors are widespread due to how poorly most Americans eat.

Additionally, magnesium deficiencies can arise in those taking diuretics or athletes who over train.

Methyl donors such as methyl B-12 are important for the conversion of the amino acid 5-HTP to serotonin; people who take SSRI antidepressants for long periods of time deplete their methyl donors and P-5-P.

Those considering weaning off SSRIs may need to supplement with these cofactors to cover deficiencies acquired during use of the medication.

Supplements that support serotonin activity

The amino acids 5-HTP or tryptophan are precursors to serotonin. Tryptophan has been shown to more easily cross the blood-brain barrier than 5-HTP. Others prefer 5-HTP because it is only one step away from being converted to serotonin, whereas tryptophan is two steps away. Therefore, 5-HTP has more potential to boost serotonin levels. However, both work and taking both can cover your bases.

Both 5-HTP and tryptophan have been shown to be helpful in addressing depression, persistent nightmares, fibromyalgia, chronic headaches, migraines, and mood disorders.

Botanicals that increase receptor site sensitivity, ensure the breakdown of used serotonin, and provide necessary cofactors for serotonin production include St. John’s wort, SAMe, P-5-P (a form of B-6), niacinamide, magnesium citrate, methyl B-12, and folic acid.

Ask my office how we can help you support your brain serotonin activity so it can help you feel happier and enjoy life more.


Leave a comment

Is chronic stress damaging you? Take an adrenal test

835 adrenal salivary test

Many of us are too stressed out these days and this can have negative consequences on our bodies and brains, promoting chronic disease and rapid brain degeneration. If you’re concerned about the effects of stress on your body and how to manage it, an adrenal salivary test is an important ally. It can show you whether your stress hormone cortisol is too high or too low and whether this has affected your sleep-wake cycle, or circadian rhythm.

Symptoms of low adrenal hormones

  • Fatigue
  • Slow starter in the mornings
  • Crash in the afternoon
  • Crave sweets, caffeine, or nicotine to keep going
  • Prone to moodiness
  • Become shaky, light-headed, or irritable if go too long without eating
  • Wake up at 3 or 4 a.m.; inability to stay asleep
  • Become dizzy when move from sitting to standing

Symptoms of high adrenal hormones

  • Excess belly fat
  • Insulin resistance (high blood sugar)
  • Trouble falling asleep
  • Wake up not feeling rested
  • Women grow facial hair; men grow breasts
  • Polycystic ovarian syndrome (PCOS).

How to do an adrenal salivary test

To perform the adrenal salivary test, simply collect a small vial of saliva several times throughout the day using the vials in your test kit. The lab will then analyze your saliva for cortisol levels and how much cortisol you produce in the morning, afternoon, and evening. Do not something unusual or stressful on the day of your test.

It’s important to understand that low or high adrenal hormones usually don’t reflect a problem solely with the adrenal glands, two glands that sit atop each kidney and secrete adrenal hormones. Instead, chronic stress affects stress pathways in the brain, which start to dysfunction when stress is chronic.

It isn’t just being too busy, a bad job, a bad relationship, and so forth that cause chronic stress. Lesser known factors of chronic stress can include unstable blood sugar (usually from too many carbs), a chronic infection, leaky gut, or an autoimmune disease. Using second and third adrenal salivary tests allow you to track whether you’re successfully managing your condition; adrenal health should improve as these conditions resolve. If adrenal health does not improve, it means you must keep investigating to find out what is causing the body stress.

Measuring the sleep-wake cycle, or circadian rhythm

A sleep-wake cycle, or circadian rhythm, that is out of whack is one symptom of adrenal stress. If the circadian rhythm is normal, then cortisol is highest in the morning and lowest at night. This is what allows us to feel alert when we wake up and sleepy before bed. Many people with altered circadian rhythms notice they are more awake at night. Or they may notice an energy crash in the afternoon and being wide awake in the middle of the night.

The stages of stress

The adrenal salivary test measures circadian rhythm, the cortisol precursor hormones DHEA and 17 hydroxyprogesterone, and cortisol levels. It can tell you where you fall on the spectrum of adrenal fatigue to high adrenal hormones. People don’t necessarily progress from high adrenal hormone to low; adrenal function can jump back and forth between phases or stay stuck in one phase.

The adrenal salivary test also measures total secretory Ig antibodies, or (SIgA). Low SIgA levels reflect poor and dysfunctional immunity. If your SIgA levels are low, you are more prone to food intolerances, chemical sensitivities, autoimmune disease, infections, and other assaults on the immune system.

Ask my office about functional medicine protocols that can profoundly influence your adrenal health. We will also search for and manage the root causes of your adrenal stress.


Leave a comment

Test for gluten intolerance if you have Hashimoto’s

834 hashimotos and gluten

Numerous studies show a strong link between gluten intolerance and Hashimoto’s disease, an autoimmune disease that attacks the thyroid gland, causing hypothyroidism. This is because gluten has a molecular structure that closely resembles thyroid tissue — gluten sensitivity triggers an attack on the thyroid gland. Gluten (technically, the correct term is gliadin), is the protein found in wheat and wheat-like grains, such as spelt, kamut, rye, barley, triticale, and oats.

One of the immune system’s primary jobs is to protect the body from foreign invaders. Sometimes it may recognize a common food as a dangerous invader. When you eat that food throughout each day this can keep your immune system engaged in constant battle, making it hyper zealous, overly sensitive, and thus prone towards food sensitivities and autoimmunity.

Some people also have celiac disease, disease in which gluten triggers an autoimmune attack against the gut, the skin, or neurological tissue. Gluten sensitivity is more common than celiac disease, however, both show up in higher numbers in people with Hashimoto’s hypothyroidism.

If you have been diagnosed with hypothyroidism you should first test for Hashimoto’s by screening for TPO and TGB antibodies — the majority of hypothyroidism cases are caused by Hashimoto’s.

You should also screen for gluten intolerance or celiac disease given how common these conditions are in patients with Hashimoto’s. Likewise, people who discover they are gluten intolerant or have celiac disease should screen for Hashimoto’s.

It’s important to give up gluten completely if you have Hashimoto’s and gluten intolerance. Cheats and little bites are not ok as they trigger an immune response that ultimately destroys thyroid tissue. Also, it’s important to avoid foods that have been contaminated by gluten. Be careful when in a kitchen where gluten is used, with restaurant food, or with questionable packaged foods.

Cyrex Labs offers testing to identify gluten intolerance. However, sometimes the immune system can be so depleted that it produces too few antibodies to produce a positive test, even though you react to gluten. You can screen for this with a total immunoglobulin test.

However, given the evidence establishing a link between gluten intolerance and Hashimoto’s disease, you may be surprised how much better you feel by simply removing gluten from your diet as a start.

Many people have to remove other foods as well, such as dairy, eggs, or other grains. Following the autoimmune paleo diet for about a month and then reintroducing restricted foods one at a time every 72 hours can help you determine which foods trigger an inflammatory reaction in you.

Many people are able to put their hypothyroid symptoms into remission simply by following a diet that eliminates gluten and other trigger foods. Although autoimmune diseases such as Hashimoto’s can be successfully managed through diet and lifestyle strategies, it’s important to understand they can’t be cured. It’s just a matter of taming the immune system.

Ask my office for ways to manage your autoimmune Hashimoto’s hypothyroid condition.


Leave a comment

Viruses trigger celiac disease and other autoimmunities

833 virus triggers celiac

Autoimmune disease is a modern epidemic in which your body’s immune system, which normally helps defend you from pathogens, mistakenly attacks your own organs and tissues. Current research tells us multiple factors can play a role in causing autoimmunity, including viruses. More recently, a virus has been linked with celiac disease, an autoimmune disease in which symptoms are triggered by eating gluten.

Celiac disease linked with normally harmless virus in humans

Celiac disease affects one in 133 people in the United States, however only 17 percent have been diagnosed.

While former research has focused on genetic factors underlying celiac disease, a recent study found a link between celiac disease and reovirus, a normally harmless virus in humans.

The study found that mouse subjects with celiac-like disease have higher levels of reovirus antibodies than those without the disease. Those with reovirus antibodies also had high levels of a gene regulator that plays a role in loss of oral tolerance to gluten protein.

In the study, researchers took two different reovirus strains that infect humans (T1L and T3D), and tested them on mice. Both types triggered a protective immune response, but only the T1L caused the mice’s immune systems to act against gluten. This triggered a celiac-like condition in the mice.

The immune response triggered by the T1L virus was dependent on a molecule called interferon regulatory factor 1 (IRF1), which has been found in higher than normal levels in the small intestine of human children with celiac disease.

This suggests that early reovirus infection might raise the risk for developing gluten-related autoimmunity.

According to lead researcher author Bana Jabri, MD, PhD, director of research at the University of Chicago Celiac Disease Center, “During the first year of life, the immune system is still maturing, so for a child with a particular genetic background, getting a particular virus at that time can leave a kind of scar that then has long term consequences.”

Along with other researchers, Jabri is investigating the possibility that other viruses can play a similar role in autoimmunity.

Chronic viral infection makes the short list for autoimmune factors

Research increasingly indicates viruses and bacteria may play a role in the development of autoimmunity.

Viruses and bacteria trigger an immune response in the body. Some researchers suggest that the antibodies we produce in response may also attack our body’s cells. This may be because they resemble the virus or bacteria, confusing the immune system into the attack.

If you already experience lifestyle-induced chronic inflammation, this makes the immune system hyper zealous and thus more likely to erroneously attack self-tissue.

The viruses suspected in connection with autoimmunity are varied, and some are linked to multiple conditions:

  • Hashimoto’s autoimmune thyroiditis is associated with Epstein Barr virus (EBV), herpes simplex 1 and 2, hepatitis C, and cytomegalovirus (CMV).
  • Multiple Sclerosis is associated with EBV and measles virus.
  • Rheumatoid arthritis is associated with EBV, hepatitis C, E-coli bacteria, and mycobacteria.
  • Lupus is associated with EBV.
  • Type 1 diabetes is associated with coxsackievirus B4, cytomegalovirus, mumps virus, and rubella virus.
  • Guillain-Barré syndrome is associated with EBV, CMV, and campylobacter bacteria.

Know your viral exposure

Having a viral or bacterial infection is not a guarantee of developing autoimmunity, because other factors must come together for it to occur. However, it’s a good idea to take viral exposure into account when looking for the root causes and treatment of your autoimmune condition.

Some practitioners say regardless of other medical protocols, patients with autoimmunity do not go into remission unless they also address their chronic viral and bacterial infections.

Because viral infections usually occur well before any autoimmune symptoms develop, it can be difficult to make a definitive link between a specific infection and a your autoimmune disorder.

Therefore, if you are seeing your doctor about your autoimmune condition, remember to mention any infections you know you’ve had, even back in your childhood; some viruses such as Epstein Barr can persist in the body for decades without obvious symptoms. Lastly, if you don’t seem to be able to heal, ask about testing for hidden chronic viral infections as well as bacterial gut infections.

Other autoimmunity risk factors

Although there is a genetic component to autoimmunity, the following factors are linked to an increased risk of develop an autoimmune condition:

  • Females. Women represent about 75 percent of autoimmune cases. Researchers speculate women’s hormones or their active immune systems make them more vulnerable to developing autoimmunity.
  • Young to middle-aged. While the elderly can develop autoimmunity such as rheumatoid arthritis, autoimmune conditions more frequently show up in youth or middle age.
  • African American, Native American, or Latinx heritage. These ethic groups represent higher rates of autoimmunity than others.
  • Family history of autoimmunity. If your family members have had autoimmunity, you are at higher risk.
  • Environmental exposure to toxins or heavy metals. There is evidence relating toxic exposure to higher rates of autoimmunity.
  • Intestinal hyper-permeability (leaky gut). Leaky gut is present not only in all autoimmune diseases, but in other chronic illnesses such as heart disease, depression, and more.


Leave a comment

Don’t overlook the necessity of vitamin D cofactors

832 Vitamin D cofactors

Sufficient vitamin D levels requires more than a healthy diet and taking supplements—good vitamin D levels need the right cofactors too. A shocking three-quarters of the US population has too little vitamin D, even in sunny locales. Vitamin D is necessary to dampen inflammation and tame autoimmune diseases. Some people with autoimmunity may even need extra vitamin D due to a genetic variation that affects the ability of their cells to absorb adequate vitamin D.

In addition to supplementing with fat-soluble vitamin D (cholecalciferol), make sure you are getting the right cofactors, or “helper molecules” that assist in the biochemical transformations required by vitamin D.

These include fat-soluble vitamin A, magnesium, and K2, which make vitamin D more bioavailable and help prevent D overload.

Vitamin A and vitamin D work together to make sure your genetic code functions appropriately. There are two main types of vitamin A:

  • Beta-carotene, found in brightly colored fruits and vegetables, apricots, mango, and leafy greens.
  • Retinol, found in organ meats and dairy products.

You can take vitamin A in supplement form as both beta-carotene and retinol, however retinol is the more active form. Although it’s also possible to take too much retinol. Your body can’t get rid of it easily, which can be harmful.

Magnesium. You can obtain sufficient magnesium through food, but high doses of vitamin D3 deplete magnesium. If you are already low in magnesium and supplement with vitamin D, supplementing with magnesium may avoid headaches, cramping, nausea, numbness and more that may accompany high doses of D3.

The Vitamin D Council recommends 500–700mg of magnesium per day. Supplement sources include magnesium glycinate, magnesium citrate, and magnesium malate. Each has unique effects, so consult with my office to learn which is right for your needs.

Magnesium-rich foods include dark leafy greens, potato, beans, lentils, avocado, bananas, figs, strawberries, blackberries, nuts, seeds, brown rice, and dark chocolate.

Vitamin K2. Vitamin D toxicity can cause soft tissue to accumulate calcium and calcify like bone. In contrast, sufficient vitamin D i may even protect against calcium deposits in arteries.

Vitamin K2 is an important cofactor for vitamin D to help the body deposit calcium in appropriate locations such as the bones and teeth, and to prevent calcium from depositing where it doesn’t belong, such as the soft tissues, arterial walls, joints and organs.

Healthy gut bacteria are necessary to convert vitamin K1 to the more active form K2. However, we can supply our K1 needs through eating cabbage, kale, spinach, chard, green leafy vegetables, broccoli, cauliflower, Brussels’ sprouts, and sauerkraut. These foods will also promote healthy gut bacteria.

The National Academy of Sciences recommends 90mcg of K2 for women and 120mcg for men.

However, Osteoporosis International recommends 180 mcg a day of K2 as MK-7.

If you take blood thinning medicines such as Warfarin or Coumadin, vitamin K supplements can affect how well your blood clots, so please talk to your doctor.

Testing

Checking your vitamin D level periodically can help you improve your health if you suffer from chronic illness.

In functional medicine we measure vitamin D levels with a serum 25-hydroxy vitamin D test. Optimal levels are between 50 and 80 ng/mL.

If you suffer from leaky gut or autoimmunity, you may be more prone to a genetic vitamin D deficiency, so make sure to pay attention to this vital vitamin.


Bad gut bacteria big risk in heart disease

832 gut bacteria and the heart

Unhealthy gut bacteria are a bigger risk for atherosclerosis, or hardening of the arteries than smoking, cholesterol levels, obesity, or diabetes. Atherosclerosis is the leading cause of heart disease.

That’s because the root cause of heart disease is inflammation. In fact, most modern health disorders are rooted in inflammation, including arthritis, diabetes, obesity, dementia, depression, and inflammatory bowel disease. Cardiovascular disease is no exception.

So where do gut bacteria come in? Researchers have discovered an unhealthy microbiome — the term given to our inner garden of gut bacteria — is pro-inflammatory while a healthy gut microbiome is anti-inflammatory. Unfortunately, Americans have the unhealthiest gut microbiomes studied thus far.

A recent study found that women experiencing hardening of the arteries also showed less gut bacteria diversity while women with healthy arteries showed healthier gut bacteria. A diverse array of gut bacteria is linked with better health.

The study also found that in healthy subjects, diverse and healthy gut bacteria produced more indolepropionic acid (IPA), a neuroprotective antioxidant that also has been shown to lower the risk of diabetes.

The gut microbiome and high blood pressure

It turns out there is more to high blood pressure than reducing your salt intake. Researchers have found high blood pressure, which increases your risk of heart disease and stroke, can also be linked to the gut microbiome.

The key is in a compound called propionate, one of several short-chain fatty acids (SCFAs) produced by healthy gut bacteria. Scientists are learning that SCFAs such as propionate and butyrate are instrumental to the health of the brain and body in many ways, with propionate being specific to the cardiovascular system.

How to foster a heart-healthy gut microbiome

Although taking propionate may help, it won’t do much good if it’s battling a minefield of infectious and inflammatory gut bacteria. Just as healthy gut bacteria produce SCFAs that are good for us, bad bacteria produce the highly inflammatory compound lipopolysaccharide (LPS).

The key to a heart-healthy gut microbiome is to eat about 25–30 grams of fiber a day via a very diverse array of vegetables and modest amounts of fruit (fruits are high in sugar and too much sugar is inflammatory).

It’s the diversity of vegetables that matters most, with research increasingly confirming that a diverse gut microbiome is what lies behind good health and a lower risk of disease.

Switch up the vegetables you eat regularly and shop at world markets unfamiliar to you to try new types of produce. Even a teaspoon of different new veggies each day is enough to help colonize the friendly bacteria that will work to keep your heart healthy.

In this fiber-rich environment, supplementing with SCFAs such as butyrate and propionate can help boost your gut bacteria to produce even more of their own SCFAs.

Additionally, make sure to keep your blood sugar stable by eliminating sugars, sweeteners, and processed carbohydrates, avoid foods that cause an immune reaction in you (for example, gluten and dairy do for many people), avoid toxin chemicals in your foods and body products that can kill good bacteria, and exercise daily — exercise has been shown to positively influence your gut microbiome.

Ask my office for more advice on how to cultivate an optimal gut microbiome and detoxify bad bacteria.