The brain is the organ responsible for our higher functioning in day to day life. The nervous system is obviously a highly complex unit that requires the coordination of many components. In order for the stimuli that we encounter to be incorporated into a functional signal we must ABSORB and translate that information into a language we can use. Well, the brain is not the only organ that functions in this manner. In fact, the body has another nervous system called the enteric nervous system. This is basically the brain of our guts.
In basic biology, physiology, etc. we all learn about this so called gut brain. This is essentially a system of neurons (long wires that transmit signals through chemicals). This system is the basis for digestion but also makes use of more than 30neurotransmitters. A few of these familiar neurotransmitters are serotonin and dopamine which are also found in the central nervous system.
These principles are basic facts that provide the background for the rest of this topic. I have been fortunate to spend time in the office of an integrative internist/cardiologist over the last few months and have learned a tremendous amount about how the function, or malfunction, of our digestive system plays a huge role in our daily lives.
The "leaky gut" is a theory that I had never heard much about in my traditional medicine training but I think it will start getting more attention. The hypothesis is that dysfunction in the barrier that lines the intestinal cells of the gastrointestinal tract creates a leaky gut (hyperpermeable) which can cause a widespread array of consequences. A few of the hypothesized consequences include irritable bowel syndrome, type 1 diabetes, asthma, and autism.
The million dollar question is, why would my gut be leaky? Possible infectious etiologies include viruses, bacteria and parasites (basically anything possible). Infectious sources appear to disrupt the tight junctions of the cells that form the intestinal barrier, specifically by altering the cytoskeleton. Many of us may not remember having this kind of infection but most of us have had some kind of "stomach bug." Also, the NY times editorial by Thomas Friedman this weekend illustrated the excessive amount of antibiotics used in our food supply due to the set-up for infections based on factory farming (another reason to consider eating organic when possible).
Alcohol consumption also induces a leaky gut which results in an inflammatory cascade (cytokines) and reactive oxygen species that can result in chronic diseases such as cancer. The majority of alcohol is yeast which I have learned is probably one of the largest causes for this phenomenon. Many of us may actually be allergic to the foods we eat in some way or another which successfully feeds this process. Symptoms such as blotting, gas, loose stools, etc. may indicate a yeast problem or food allergy such as gluten.
The common end point for most of these factors is that the gut is not able to absorb and function at its optimal level because of flattened villi. The main results that the doctor I was working with focused on were Vitamin D deficiency, low levels of serotonin and the resulting high epinephrine/low dopamine/low GABA. We have previously discussed the widespread Vitamin D deficiency in our society today and this may be a common reason. We simply are not able to absorb the Vitamin D that we are consuming in our diet.
Additionally, as I mentioned above, serotonin (the happy hormone) is produced by the intestines. If the intestines are not functioning at a high level, then clearly serotonin deficiency may exist. The result of low serotonin is a reflex elevation in epinephrine which may produce an anxiety state at baseline. A low level of dopamine may make it difficult to concentrate and a low GABA level will likely influence our sleep patterns. These are symptoms that many of us have and it would be nice to find out not only why, but also how we can improve them through lifestyle changes.
The current problem is that not many doctors are aware of this phenomenon and if they are not many evaluate for food allergies. The intestinal permeability blood test evaluates for up to 120 different possible food allergies (IgG mediated). Upon receiving the results, the doctor I was working with would go over it with the patient and advise the necessary dietary changes. The initial blood test also included a Vitamin D level (almost always deficient) and Homocysteine level (measures the amount of green vegetables consumed, also a marker for inflammation). Most doctors will screen for celiac disease (gluten allergy) so if you have any of these symptoms you should request this blood test.
The second million dollar question, how can I make my gut less leaky? Probiotics have hit the mainstream in foods such as yogurt (Activa) and are certainly available in most supplement shops. While the verdict had previously been out on the use of probiotics I think there may be more benefit then harm. Look for probiotics with colony forming units (CFU's) in the billions and that contain Lactobacillus GG and/or Bacillus Coagulans. I have started putting a 1/4 teaspoon in my protein shake in the morning. Also supplement your GI tract with L-glutamine which has both anti-inflammatory and anti-oxidative properties. Lastly, if your Vitamin D level is not increasing with oral Vitamin D (2000 units/day) then you may need to supplement with Vitamin D drops.
While this is certainly not a concept that we hear discussed frequently the results I witnessed in patients were simply astounding. The patients stated that their moods and energy levels were improved and the majority of them lost a significant amount of weight. One women in her late 60's had lost about 100 pounds in 1 year just by diet and people had thought she had undergone bariatric surgery.
I hope you all are continuing to learn from this blog. I am trying to provide a mix of more traditional information as well as things that we may find new and interesting. Thank you for reading and please pass the blog onto your friends and family. As always, you can subscribe by email at the top right corner.
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