gut dysbiosis treatment
TRANSCRIPT
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Peter Bennett NDMeditrine Clinic,
Langley, BC
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Card
iology
Oncology
Neu
rology
Rheu
matology
Gastro
enterology
Clinical Application
Gut Dysbiosis And The Brain
Case History: Tyler
Intestinal Permeability
Gut Ecology
Cleaning The Blood
Nutritional and Lifestyle Factors That Damage Circulation
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Associations Between IntestinalProblems & Systemic Illness
! Malnutrition (Malabsorption/maldigestion)
! Skin disease (endotoxin, infection)
! Allergies (protein)
! Neurological/behavioral problems (fungal
or bacterial organic acids)
! Joint disease (antigenic cross-reactivity)
Gut Ecology
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If gut ecology is unhealthy, itaffects every other system in
the body.To heal gut dysbiosis, usedetoxification plans offasting, diet modificationand supplementation.
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!Bacteria exceed the total number of cells inthe body.
!Total of 3 pounds of bacteria in the gut.
!
A complex interdependent ecosystem
system.
!Four hundred species of bacteria in our GItract.
!Bacteria are beneficial and dangerous; bothcompete for dominance.
!Good bacteria outnumber the bad and makenatural antibiotics.
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Acute and Chronic Diseases FromAltered Gut Ecology
!rheumatoid arthritis
!colitis
!diabetes
!meningitis
!myasthenia gravis
!Graves disease
!Hashimotos thyroiditis
!bowel cancer
!food allergies
!eczema
!psoriasis!acne
!urticaria
!migraine headache
!ankylosing spondylitis
!systemic lupus erthematosis
!Crohns disease
!otitis media
!sinusitis
!asthma
!premature labor
!peptic ulcers
!premenstrual syndrome
!cystitis.
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Gut Romp
A bacterial imbalance:
!allows harmful bacteria and yeast to multiply
uncontrollably.!injures the membranes that line the intestines,
allowing undigested food products and othercontaminants to leak into the bloodstream
!Alters local detoxification ability
!leads to the production of dangerous chemicals.
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Gut Romp500 to 1,000 kinds of bacteria reside in thegastrointestinal (GI) tract
Bacteriodes thetaiotaomicron: more than 1,000 times asabundant as Escherichia coli.
!breaks down indigestible complex carbohydrates intoeasily absorbed sugars
!produces vitamins
!can turn on specific intestinal genes to promote thegrowth of blood vessels necessary for the gut's function
!trigger production of a chemicals that kill competing
bacteria
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Gut Romp
Germfree rodent:
!
must consume about 30 percent morecalories to maintain its body weight
!unusually susceptible to infections
Hooper, L.V., and J.I. Gordon. 2001. Commensal host-bacterialrelationships in the gut. Science292(May 11):1115-1118.
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the hosts physiology is the result ofinnumerable interactions that should notbe considered as the autonomous piecesof a puzzle but rather like the result ofsubtle equilibria between changingcomponents:species, age, physiologicalstate, gender, diet, environment, intestinalbacterial populations and even stress.Simopuolos AP, et al.(eds) Intestinal Flora, Immmunity, Nutritionand Health. World Rev Nutr Diet. Basel, Kerger, 1193, vol74,123-148.
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Autointoxication resurfaces from the 19th centuryhealth culturists as endotoxins. Endotoxemia has now
gained favor as an explanation for the multiple organfailure with severe trauma and sepsis.
Editorial. Intestinal endotoxins as mediators of hepatic injury-an idea whose time has come again. Hepatology 1989:10(5) :881-891.
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Endotoxin:
!occurs in the cell walls of of gramnegative bacteria.
!lipopolysaccaride (LPS) is a sugar and fatmolecule.
!cause cell membrane peroxidation.!unchecked, lipid peroxidation results in
massive cellular damage.
!lipid peroxidation causes aging,mutagenisis, carcinogenisis, changes influidity of membranes, necrosis, oxidativehemolysis of red blood cells.
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.systemictranslocation of theseenteric bacteria andendotoxin plays a majorrole in the developmentof multiple organ
failure.
Gut Ecology
Deitch EA, et al. Bacterial translocation from the gut impairs systemic immunity. Surgery;109(3):269-276, 1991
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!Endotoxins(LPS) can transit the gut.
!involved in multiple organ failure with severe trauma and
sepsis.
!has been clearly associated with Crohns and neonatal
enterocolitis.
!LPS is scavenged by Kupffer cells, then depresses p450, and
impairs mitochondrial function.
!LPS induces complications in chronic liver disease.
!alcohol aggravates LPS toxicity.
!the Indican teat and microclot generation test determine
endotoxin load.
!selenium and vitamin E deficient diet cause enhanced lipid
peroxidation.
!patients with food sensitivities and environmental
sensitivities suffer from endotoxemia..
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Cardiology
On
cology
Neu
rology
Rheu
matology
Gastroenterology
Clinical Application
Gut Dysbiosis And The Brain
Case History: Tyler
Intestinal Permeability
Gut Ecology
Cleaning The Blood
Nutritional and Lifestyle Factors That Damage Circulation
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Intestinal Permeability
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Intestinal Permeability
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nProlonged Fasting
nLow dietary fiber
nChemotherapy
nNutritional insufficienciesszincsvitamin Asfolate
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Roles in The GI Tract
! Mouth
!
Stomach- HCL, mucus production! Small Intestine- secretion of
pancreatic enzymes triggered byvagus nerve and duodenalhormones (secretin/cholecystokinin)
! Large Intestine- water absorption,
anaerobic fermentation of SCFA
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Roles of HCL
! Rate limiting step in digestion
!
Activates pancreatic enzymes! Prevents bacterial overgrowth
in SI
! Activates mineral absorption
! Sets the tone for gut ecology
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Typical HypochlorhydriaPicture
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Roony PJ, et al. A short review of the relationshipbetween intestinal permeability and inflammatory
joint disease. Clin Exp Rheum 8:75-83, 1990
the gut is likely thesource of the antigenscausing inflammatoryarthritis.
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Carini C, et al. Immune complexes in food inducedarthralgia. Ann Allergy (59) Dec, 422-428
IgG and IgE antibodieswere high in patients witharthralgia, in the serum andthe synovial fluid ascompared to normals.
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Carini C, et al. Immune complexes in food induced arthralgia. Ann Allergy (59) Dec, 422-428, 1991
Intestinal permeabilitytesting is a successfulmethod to determine truefood allergy.
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Car
diology
On
cology
Neurology
Rheumatology
Gastr
oenterology
Clinical Application
Gut Dysbiosis And The Brain
Case History: Tyler
Intestinal Permeability
Gut Ecology
Cleaning The Blood
Nutritional and Lifestyle Factors That Damage Circulation
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The Gut/Liver-Detoxification
First pass breakdown
Gut-hepatic circulation
Filters blood and sewage
Removal of bacterial toxin
Cleaning The Blood
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Body FatBurden
(Stored toxins)
xxLeaky Gut
Alteration of Organ SystemFunction and/or Structure
4R Program Remove Replace Reinoculate Repair
Liver Detoxificationand Ongoing HepaticNutritional Support
Nutritional SupportResults in Organ SystemDysfunction
Possible Causes
oxidantstress
Liver Burden and AlteredHepatic Detoxification
Genetic State
Nutritional History
Current Nutritional Status
Toxin Burden
MitochondrialDamage
Toxins
Toxins
Eliminated inurine and feces
Body Fat Reduction
Program(Released of stored
toxins)
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Specific food residues arebroken down by thecolonic microrflora with theproduction of chemicals,which, in susceptibleindividuals with low
concentrations of relativehepatic enzymes, pass intosystemic circulation toproduce distantsymptoms.
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Western Diet And DiseaseCleaning The Blood
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+++ Beta-Glucuronidase
Cleaning The Blood
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+++ Beta-Glucuronidase
Cleaning The Blood
Study links antibioticsand breast cancer
Women who took themost antibiotics (morethan 25 prescriptions)
faced double the risk ofdeveloping breastcancer over 17 years,
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Cardiology
On
cology
Neurology
Rheumatology
Gastroenterology
Clinical Application
Gut Dysbiosis And The Brain
Case History: Tyler
Intestinal Permeability
Gut Ecology
Cleaning The Blood
Nutritional and Lifestyle Factors That Damage Circulation
C Hi t T l
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06/06/02Tyler21yo WM
Dx with autismMEDS:
after seizuresto prevent multiple seizures. On Ativan for 6 years. Tried notgiving him the Ativan in Dec/01 and he had 3 seizures within 24 hrs.
(valproic acid) anti seizureTested for fragile X, neg. Hx of family of other kids with learning disabilities.A lot of anxiety disorders on mothers side.Seizures onset age 1.5. Step-mother has known him since age 10. Put on tegretol justbefore seizures. Parents separated at age 10. Last seizure was 1 week ago. Now,seizures 1-2 weeks apart. Typical time is as he is going to sleep or waking, usually itis in the morning. After seizure, he is incontinent at noon for about 24 hrs. Bothbowel and bladder.Seizure early in the morning after getting up to urinate, dropping off to sleep. Whenhe perseverates on something. When he was kneeling watching a CD go around.Used to scrape the letters off yogurt containers for hours. So active throughout theday now, more interactive now.He did his own program at high school. He has also done the Sunrise program whenhe was 16. His seizures were down to 56 weeks apart.Interaction was better, less anxiety. Total attention.
He talks about his seizures, likes the dramatics.
Case History: Tyler
C Hi t T l
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06/06/02TylerDARK SIDE: major aggression in high school, at home. He tried to push her down thestairs. Hit Gail over the head. His mother used to hit him. He slammed his cup of teadown on the counter. Told him to calm down. He looked like he would throw thingswhich he has done. He does not like to be told what to do.1 week ago was verbally abusive, he has a good memory. He started to yell at us. Ihave learned to leave. He threw a can at father.Has a new Neurologist, told to increase the tegratol, he became more aggressive.Especially with the young woman who works with him after work, did not want to go
for a walk. He actually hit co-worker in the van, it was the medication. Took him offthe medication and he is fine.O/ 100/65Heart rrrT: redNo cerv nodesP: deep
PRESEIZURE: tired, irritable. Like to repeat things you say to irritate you. Step-mother has watched his diet after she read about autism and sugar. He tested highon sugar and given a mineral supplement. Once he tested high on all the things heate. Always high in corn and sugar.
Case History: Tyler
Case Histor T ler
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06/06/02Tyler
8:30-6. No bad dreams.he is quite shaky. Hand tremor.on a good diet. Off wheat corn, sugar.
well, no dreams.Seizures last 30 seconds, then he goes through snoring, then he sleeps. Can't talk for10 min. His head will turn sideways and he won't answer. Parents take his glasses offand puts him on the ground. Thrashing, full tonic/clonic, Grande Mal.Possible autism from immunization. First seizure when he was in Courtney.Grandmother remembered that he had just had his immunization. Since birth cried alot. Had a difficult birth, forceps. Treated with cranial.Has scoliosis (typical with autism).
His hair changed when stopped sugar.FHXFather 53 good healthMother 50 low thyroid.Sister good health
Tyler talks to all the secretaries.
P/ Organic acids, amino acids, food allergy
Case History: Tyler
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GI Diagnostic Testing
! Fatty acid analyis
! Food allergy testing
! B12 levels
! CDSA
! Candida testing
! Breath hydrogen
! O+P
! Urine amino acids
! Cortisol and DHEA
! Gastric pH
! Intestinal permeability
! Hair analysis
! Organic acid analysis
! Stool Culture
! Helicobacter
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Ethylmalonate 18.7-drug inducedcarnitine might be helpful
Ineffecient energy producingpathways. Succinate is very high,rare, especailly with fumarate andmalate, this is the heart of citric acidcycle. Indicates CoQ10 inadequateto accept electrons, not makingenough CO Q10. Possible
mitochondrial genetic flaw. Also addB complex.
Low alphaketoglutarate: keymetabolic nutrient, can be drawnaway from mitochondria.
High methylmalonate, very high:(B12) methylcobalamin.
High beta-betahydroxyisovalerate.
Case History: Tyler
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Bacteria and yeast overgrowth,toxins in the body, could befrom giardiacould be yeast.
Case History: Tyler
Intestinal dysbiosis.Case History: Tyler
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Intestinal dysbiosis.Needs B's, folic acid.
Beta-alanaine competes for theretention of taurine. Producedfrom abnormnal bacteria andbreakdown of yeast. Also
Taurine is high. When it is thishigh, it is taurine wasting.Taurine is critical for maintainingintracellular magnesium.
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Case History: Tyler
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Case History: Tyler
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Cardiology
Oncology
Ne
urology
Rhe
umatology
Gast
roenterology
Clinical Application
Gut Dysbiosis And The Brain
Case History: Tyler
Intestinal Permeability
Gut Ecology
Cleaning The Blood
Nutritional and Lifestyle Factors That Damage Circulation
Gut Dysbiosis And The Brain
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GI Function And The Mind
If you talk to God, you arepraying;
If God talks to you, you
have schizophrenia.Thomas Szasz , The Second Sin
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Irritable bowel syndrome, found in 4% to 10% ofthe population, has been associated withpsychiatric illness.
Researchers evaluated 20 patients with IBS andcompared to a control group found 18 of 20patients with irritable bowel syndrome had some
history of psychiatric illness.
One half of the patients with irritable bowelsyndrome met the criteria for panic disorder, whileanother half had social phobia. Major depression,somatization disorder and substance abuse werealso seen frequently in those with irritable bowelsyndrome.
"IBS Patients' Family Has More Mental Illness", Jancin, Bruce,
Family Practice News, May 15, 1994;2.
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Nutrition And The Mind
# Amino Acids From Protein
# Fats From Fish, Seeds and Nuts
# Carbohydrates From Vegetables, Fruitand Whole Grains
# Cofactors From Diet and Supplements
Building Blocks Of Our Thinking
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GI Function And The Mind
! Behavior and Learning Disorders
! Depression, Anxiety and Stress
! Memory and Cognitive Disorders
Gut Dysbiosis And The Brain
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GI Function And The Mind
Neurological
# Neuritis
# Migraineheadaches
# Epilepsy
# Multiple sclerosis
# Alzheimersdisease
# Parkinsons
disease
Behavioral
# ADD/ADHD
# Affective disorders
# Mental illness
# Autism
# Insomnia
# PMS
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Happy Heart=Healthy Intestines
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Adaptation To Chronic Stress InMilitary Trainees
Stress alters the levels of progesterone,estrogen, and thyroxin. In this study it caused:
!increased free salivary cortisol levels!decreased testosterone levels to hypogonadal
levels
!increased salivary DHEA
!insulin insensitivity
!increased gut permeabilityBernton, E., D. Hoover, R. Galloway, and K. Popp. Adaptation to Chronic Stress in Military
Trainees, Ann NY Acad Sci 774 (1995): 21731
y
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Our Intestines Change As We Age:Parietal cells atrophy
HCL secretion decreases
Increased delivery of undigested food to bacterial populations
Altered nutrient absorption
Bacterial populationschange
Increased Clostridia
Decrease in Bifidobacteria
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Gut Ecology
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Ca
rdiology
O
ncology
Ne
urology
Rhe
umatology
Gastroenterology
Clinical Application
Gut Dysbiosis And The Brain
Case History: Tyler
Intestinal Permeability
Gut Ecology
Cleaning The Blood
Nutritional and Lifestyle Factors That Damage Circulation
Clinical Application
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If you eat the wrong food..
Clinical Application
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ABCs of Gut Health
Enzymes
Soluble fiber
Probiotics
Membrane promoters
No sugar, healthy diet
No food allergies
Healthy heart
M b D l tClinical Application
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Membranes Degranulate
VasoconstrictionBronchoconstrictionVascular permeabilityPlatelet aggregation
Chemotaxis
Clinical Application
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Fats On FireCauseCell Membranes To In-flame
VasoconstrictionBronchoconstrictionVascular permeabilityPlatelet aggregation
Clinical Application
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Cell Membrane
Arachidonic Acid
(AA)
cyclooxygenase lipooxygenase
Phospholipase A2Quercetin
Quercetin
Curcuma longa
Curcuma longa
potentiatesCortisol
Ginger
Curcuma longa
Quercetin (weak)
Prostaglandins
Series 2
Thromboxane
A2 Leukotrienes
Series 4
Hesperidin/quercetin
Cell membrane stabilizing
Aspirin
Ibuprofen
Clinical Application
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Clinical Application
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Boswellia
Myrrh
blocks lipoxygenase to shut down
inflammation in cell membranes
Clinical Application
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Boswellia serrata!Invigorates Blood
!Promotes Qi circulation
!Relieves pain from BloodStasis
!Relaxes sinews, activateschannels
!Reduces swelling
!Promotes healing as avulnerary
Clinical Application
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Applications:
!
Trauma!Pain
!Inflammation
!Open sores
!Topical infections
Boswellia serrata
Clinical Application
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nActive ingredients: boswellic acidsnInhibits 5-lipoxygenasen82% of patients with ulcerativecolitis went into remission (350mgtid for 6 weeks) compared tosulfsalazine 75%.
Gupta I, Parihar A, et al. Effects of Boswellia serrata gum resin inpatients with ulcerative colitis. Eur J Med Res, Jan,2(1):37-43, 1997.
Boswellia serrataPharmacological Research
Clinical Application
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Boswellia serrataPharmacological Research
!70% of patients bronchial asthma dramatically
improved (300mg tid for 6 weeks). Gupta I, Gupta V, et al.Effects of Boswellia serrata gum resin in patients with bronchial asthma:results of a double blind, placebo controlled 6 week study. Eur J Med ResNov 17;3(11):211-514, 1998
!40 patients with Crohns disease were comparedin treatment with mesalazine and it was concludedto be superior in terms or risk vs benefitevaluation. Gerhardt H, et al. Therapy of active Crohns disease withboswellia serrata extract H15. Z Gastroenterol. Ja;39(1):11-17,2001.