Gut problems can have different root causes

In the world of functional medicine, it has long been known that gut health is paramount to the health of the rest of the body. For decades we didn’t fully understand why, although we knew the gut was the seat of the immune system and chronic inflammation. Now with the gut microbiome renaissance underway, we also understand how integral gut bacteria is to health.

As such, addressing gut health has always been one and continues to be one of the first steps in managing a chronic inflammatory or autoimmune condition. However, people tend to fall into the trap of thinking everyone needs to follow the same gut healing protocol, wondering why it works for some and not others.

As it turns out, repairing gut health is not a one-size-fits-all approach. There is not just one diet, one type of probiotic, or one gut healing powder that works for everyone. Although there are some basic foundations to gut healing — remove immune reactive foods, keep blood sugar stable, and create a healthy gut microbiome — the truth is you still need to know why your gut health deteriorated in order to address the root cause.

Examples of root causes of poor gut health

For example, a number of patients can come in with a complaint of constipation. While laxatives may help the patient, it is nevertheless important to understand why they are constipated in the first place. This goes for any digestive complaint and not just constipation.

Here are some different reasons why a person can develop a digestive complaint such as constipation:

• A past brain injury has dampened activity of the vagus nerve, which carries communication back and forth between the gut and the brain. This slows down motility of the intestines and causes constipation.
• The gut’s nervous system, called the enteric nervous system, has degenerated significantly due to chronic gut inflammation from immune reactive foods, too many sugars and junk foods, chronic stress, gut infections, or brain degeneration. Intestinal motility depends on a healthy enteric nervous system, and constipation develops.
• Small intestinal bacterial overgrowth (SIBO) releases gases that shut down motility.
• Medications impact intestinal motility and cause constipation.
• Dysautonomia, a dysregulation of the central nervous system, prevents the body from getting into the “rest and digest” state that allows for healthy bowel function.

A one-size-fits-all gut protocol can completely heal one person, create improvement in another, do nothing at all for a third, and perhaps make another even worse.

It’s also important to screen for more serious conditions. These can include gastric ulcers from an h. pylori infection, intestinal permeability — or leaky gut — from damage to the microvilli of the small intestine, inflammatory bowel disease, ulcerative colitis, or Crohn’s disease. Knowing whether these conditions are an issue also impacts how you manage gut health.

Also vital is knowing whether gut autoimmunity is the root cause of your gut issues. You can test for this through Cryex Labs. If so, this changes your expectations of your outcomes and how you evaluate your progress. Autoimmune disease occurs when the immune system erroneously attacks and destroys tissue in the body. Eventually this leads to symptoms and breakdown of function.

Although autoimmune disease cannot be cured, it often can be dampened or driven into remission for long periods of time. However, unpredictable flare ups also happen, and the person with gut autoimmunity must have realistic expectations in order not to feel demoralized if their symptoms flare and recede. Also, there is still much we don’t know about autoimmunity. For some people it’s easy to manage and for others it’s a constant battle. In these cases, the goal can be as simple as “more good days.”

This is an overview of why common gut-healing protocols work gangbusters for some people and little to not at all for others. Our digestive system is one of the most fascinating, complex, and influential systems in the body. The more scientists learn about it, the more apparent it becomes that gut health largely determines the health of the rest of the body, including the brain.

This is why we are seeing so many chronic health conditions in modernized societies that subsist largely on industrialized agriculture and food processing. The commercialization of cheap, processed, chemically laden, and highly sweetened “foods” largely void of produce has inflamed and damaged the digestive tract, decimated the gut microbiome (some researchers call it an extinction event), and ravaged the brain in today’s modern populations.

Fortunately, functional medicine excels when it comes to repairing and maintaining gut health. Ask our office how we can help you.

“Lazy” and no motivation can be due to inflammation

Many of us are pretty good at beating ourselves up when we have lost our motivation, calling ourselves lazy or worthless. But research shows laziness, or lack of motivation, can actually be a symptom of chronic inflammation.

A natural state of health is to want to engage in life. If you don’t want to and don’t care, this is a red flag to look for an underlying health condition.

New research shows that chronic low-grade inflammation hinders the activity of areas in the brain responsible for motivation.

Called the dopaminergic signaling system, these parts of the brain rely on sufficient dopamine, a brain chemical responsible for motivation, drive, and a sense of self-worth — hence the feelings of worthlessness that often accompany low motivation or “laziness.”

The hypothesis is that when the body is suffering from chronic inflammation, this means it has an injury or illness it must heal. In order to meet the demands for healing, the brain lowers drive and motivation so that energy is freed up for healing.

Our everyday tasks and chores, or working toward our goals and dreams suddenly no longer feel worth it.

That’s because inflammation has down regulated areas of the brain that link a sense of reward to effort and work.

We can especially feel this when we are laid up with the flu or a bad injury that can make watching Netflix tiring.

However, low-grade chronic inflammation is not just about the flu or an injury anymore. It is an epidemic problem these days, as evidenced by the mushrooming incidences of chronic inflammatory disorders, such as heart disease, obesity, diabetes, autoimmune disease, and cancer.

In fact, many brain-based disorders are often a consequence of inflammation, including depression, anxiety, fatigue, memory loss, brain development disorders in children, and even acute psychiatric conditions.

Understanding the cause of no motivation can lift shame and stigma

Because chronic illness and inflammation causes lack of motivation and fatigue, sufferers are often stigmatized for their condition.

The majority of people with chronic illness are women, and they are commonly dismissed or disbelieved by doctors in the standard health care model or even by their own families.

What’s worse, many internalize the stigmatization and suffer in isolation and with shame around their low energy and lack of motivation.

That’s why it’s important to understand “laziness” and lack of motivation can be symptoms of a larger, underlying problem and not character flaws.

Why is modern life so inflammatory?

Compared to our ancestors and many people on the planet today, many Americans have it pretty easy in terms of ease and convenience.

Yet why are we so inflamed and chronically ill?

Here are just a few factors driving epidemic levels of chronic inflammation and illness:

Blood sugar is too high. Advertising, restaurants, grocery store aisles — everything about modern life is hellbent on making us gorge on sugar and processed carbohydrates. However, science shows high blood sugar is one of the most common and relentless sources of chronic inflammation.

Modern foods are pro-inflammatory. Gluten intolerance is responsible for more inflammation than people realize, thanks to modern hybridization, storing, and pesticide use of gluten grains and other grains. Industrialized fats such as canola oil, soybean oil, and hydrogenated fats are recognized as inflammatory and are ubiquitous in the food supply.

People eat too little produce. Americans eat about half the amount of fiber they should to be healthy. A diet rich in plant fibers creates a gut microbiome rich in healthy gut bacteria. Bad gut bacteria and an unhealthy microbiome are pro-inflammatory and pro-disease.

Modern life is sedentary. Except for workers whose jobs are physical, our ultra-convenient, screen-based lives are extremely sedentary. Lack of regular physical activity and “sitting disease” are sources of chronic inflammation.

Modern life is toxic. Numerous studies link numerous toxins to inflammatory-based conditions. Plastics, pesticides, car exhaust, scented cleaning products, chemically laden body products and foods — we live in a sea of environmental toxins and heavy metals the body was not designed to manage. We are also exposed to too much artificial light, which confuses our biological rhythms and triggers inflammation.

People are stressed out. Despite our many comforts and conveniences, rates of depression, anxiety, and stress are high and afflicting younger and younger people. These negative emotions are known triggers of inflammation. When you experience them all the time, it can lead to inflammatory-based health disorders.

How functional medicine can help you restore your natural motivation

Although we are up against many daunting assaults on our physiology, functional medicine recognizes this and has strategies and protocols to help you.

One of the most common rewards of a functional medicine dietary, lifestyle, and nutritional game plan is the return of energy, motivation, and ambition.

“Laziness” and lack of motivation are red flags. Ask us how we can help you remedy them.

What kind of brain inflammation do you have?

If you have a chronic health or autoimmune condition, chances are you also suffer from brain inflammation. Brain inflammation causes symptoms such as brain fog, fatigue, lack of motivation, and depression. We all have some degree of brain inflammation, but it can range from barely perceptible to debilitating depending on how advanced it is.

What kind of brain inflammation do you have? We can look at brain inflammation as either subtle, moderate, or severe, and as transient or chronic. Brain autoimmunity is another cause of brain inflammation and brain-based symptoms.

Subtle brain inflammation:

• Brain fog
• Slower mental speed
• Reduced brain endurance (can’t read, work, or drive as long you used to)
• Brain fatigue after exposure to specific foods or chemicals
• Comes and goes with exposure to triggers

Moderate brain inflammation:

• Fatigue
• Depression
• Lack of motivation
• Inability to focus and concentrate for long periods
• Sleepiness
• Need to sleep more than 8 hours
• Lethargy
• Loss of appetite
• Unable to be physically active

Severe brain inflammation:

• Disorientation or confusion
• Dementia
• Delirium
• Coma
• Seizures
• Difficulty speaking
• Tremors or trembling
• Involuntary twitching

Transient neuroinflammation:

• Symptoms are activated by exposure to a trigger but subside. Person has more good days than bad.

Chronic neuroinflammation:

• Symptoms are persistent symptoms and the person has more bad days than good.

Brain autoimmunity:

• Autoimmunity is a condition in which the immune system attacks tissue in the body, mistaking it for a foreign invader. Neuroautoimmunity is more common than people realize and can cause a wide range of neurological symptoms, depending on the area of the nervous system being attacked. Symptoms are caused by flares of the autoimmune condition, which can be whatever triggers the body’s immune system. These people also have symptoms of brain inflammation.

Why the brain becomes inflamed

Most people think the brain is made up mainly of neurons and that neurons run the show. But in recent years, research shows neurons only make up about 10 percent of the brain. The rest is made up of the brain’s immune cells, called glial cells. Glial cells outnumber neurons 10 to 1.

Although the glial cells are the brain’s immune system, scientists have discovered they do much more than defend the brain. When the brain is not battling inflammation, glial cells support healthy neuron function, clear away plaque and debris that can lead to brain degenerative diseases such as Alzheimer’s or Parkinson’s, and they help facilitate efficient pathways of communication in the brain.

Factors that cause brain inflammation include a brain injury, unmanaged autoimmune disease, high blood sugar, eating inflammatory foods, undiagnosed food intolerances, excess alcohol consumption, a chronic viral or bacterial infection, leaky gut, leaky blood-brain barrier, hormonal imbalances or deficiencies, or other chronic health conditions and imbalances.

When the brain is in a chronic state of inflammation, this takes glial cells away from their job of supporting neuron health, debris clearing, and neuronal communication. This not only causes symptoms like fatigue and depression but also raises your risk of more serious brain disorders down the road.

If your symptoms are in the mild category, following functional medicine protocols (finding and addressing the root causes of your brain inflammation) can help restore your brain health. As long as you follow a healthy diet and lifestyle, you can keep brain inflammation at bay.

These strategies include:

• Balancing blood sugar; lowering blood sugar if it’s too high.
• Removing foods that cause an immune reaction from your diet, gluten in particular.
• Repairing leaky gut and leaky blood-brain barrier.
• Improving microbiome diversity.
• Addressing autoimmune conditions.
• Addressing chronic infections.
• Taking high-quality glutathione and other supplements to dampen inflammation.
• Daily exercise, especially high-intensity interval training (HIIT).
• Hormonal balance if necessary.

If your brain inflammation symptoms are in the moderate to severe category, you still need to follow these steps, but you may need pursue one or more of them very aggressively, as well as adjust your expectations. Unlike the immune system in the body, the brain’s immune system does not have an off switch and inflammation can move through the brain like a slow-moving forest fire for months, years, or even decades. If you have not been the same since a brain injury or other brain insult, this may apply to you.

Additionally, if glial cells undergo a severe inflammatory event, such as a brain injury, they can become “primed.” A primed glial cell permanently changes its physical structure to function less as a neuron helper and more as an immune soldier. This also shortens its lifespan. As with neurons, we only have so many glial cells — their numbers dwindle as we age, and unmanaged brain insults and injuries and unhealthy diet and lifestyle habits can accelerate their demise.

Once glial cells are primed, acute inflammatory events can trigger your brain inflammation symptoms, even if you are following a healthy diet and lifestyle. Also, symptoms from triggering events will be much more severe once your glial cells have been primed. Whereas someone with mild to moderate neuroinflammation may suffer from some brain fog or fatigue if triggered, a person with primed glial cells may see loss of brain function, depending on the area of the brain most affected. This could mean bouts of memory loss, inability to speak properly, loss of muscle function, fatigue so severe they are bed ridden, and more. Once your glial cells are primed, it becomes necessary to structure your life around preventing flares.

Note: One scenario that can occur with primed glial cells is that anti-inflammatory functional medicine protocols may work great for a few weeks and then the person has a rebound crash with severe symptoms. This does not mean the protocols aren’t working, it just means you need to slow down with your protocols and keep systematically working through the various mechanisms until you find your primary triggers, whether its blood sugar, hormonal imbalances, or a dietary or chemical trigger. They will be different for everyone.

Trigger-happy neurons

Outside of brain inflammation lies another mechanism of brain-based symptoms called “neurons close to threshold.” This means that a triggering neurological event, such as smelling perfumes for the chemically sensitive person, eating gluten for the gluten intolerant person, pushing your brain past what it can handle (with reading, working, studying, driving, etc.), too much noise for someone who is sound sensitive, etc. can fatigue fragile neurons and trigger symptoms.

For instance, a scent-sensitive person may develop migraines and fatigue walking past a perfume counter, or a gluten sensitive person may suffer from brain fog and fatigue after eating gluten. Or a day-long drive may take three days to recover from for the person whose neurons have lost endurance.

Poor health and chronic inflammation sabotage neuronal mitochondria, the energy factory in each cell. This causes a neuron to fire too easily, and then to fatigue. A classic example is tinnitus — auditory neurons are too close to threshold and “hear” noise that isn’t there, which causes ringing in the ears.

In these cases, rehabilitation includes anti-inflammatory strategies for the brain, but also gently exercising the neurons back to better health. This may mean a gradual introduction of essential oils for the scent-sensitive person, using hearing aids to gently stimulate the auditory neurons for the person with tinnitus (there are other causes of tinnitus, this is just one), or gradually increasing reading time each day to build endurance.

This is a broad overview of neuroinflammatory concepts. Ask my office how we can help you manage your brain inflammation.

New study links PPIs to earlier death, chronic disease

If you struggle with heartburn or acid reflux, you just pop some pills for that, right? Turns out regular use of drugs to treat heartburn, acid reflux, and ulcers can lead to an earlier death. These disorders are some of the easier to manage using functional medicine protocols, so it’s unnecessary to risk shortening your lifespan through chronic disease when you can enjoy improved health instead.

A recent study found that chronic use of proton pump inhibitors (PPIs) is linked to an increased risk of death from cardiovascular disease, kidney disease, and upper gastrointestinal cancer. The degree of risk increases with duration of use, even if you take low doses. Other studies have linked PPIs to dementia, bone fractures, and pneumonia.

Common brands of PPIs include Prevacid, Prilosec, Nexium and Protonix.

The study looked through the medical records of more than 200,000 people over 10 years. They found those who took PPIs had an almost 20 percent increased rate of death over people who took other types of acid-suppressing drugs (unfortunately, they did not compare death rates to people who took no acid-suppressing drugs). This applied to both prescription and over-the-counter PPIs.

What’s even more alarming is that researchers found more than half the people taking PP!s had no medical need for the drugs and PPI-related deaths were more common in this group.

Why you should address the root cause of your acid reflux or heartburn instead of taking acid-suppressing drugs

It’s assumed overly high stomach acid causes heartburn and acid reflux, but in most cases it’s due to low stomach acid. Stomach acid is vital to the health of the body in its role of digesting foods, in particular meats. When stomach acid is too low your stomach is unable to properly digest foods. Your small intestine does not want to accept improperly undigested food — this will damage its lining and contribute to intestinal permeability, or leaky gut. The low pH of the stomach acid prevents the valve to the small intestine from opening and, as a result, the contents of the stomach shoot back up into the esophagus.

Although the food is not acidic enough to gain entry into the small intestine in a timely manner, it is too acidic for the delicate tissue of the esophagus, which it burns as it shoots back up toward your throat. The extra time the food spends in your stomach also causes it to putrefy, causing that acid stomach sensation, or the feeling of having a brick in your stomach. Some people quit eating meat not because they want to be vegetarians, but because eating meat makes them feel sick.

Low stomach acid contributes to digestive issues throughout the rest of the digestive tract. As undigested food travels into the intestines, it causes inflammation and damages the lining of the intestines. This leads to intestinal permeability, or leaky gut, a condition in which the lining of the small intestine becomes inflamed and leaky. Leaky gut allows undigested foods into the bloodstream, yet prevents micronutrients from passing through because of the inflammation. Undigested foods in the bloodstream trigger inflammation throughout the body.

Stomach acid serves another useful purpose in that it kills bacteria, fungi, and other pathogens that may be in your food, preventing them from getting into the digestive tract and the bloodstream. When stomach acid is low, you lose this additional layer of protection.

Sufficient stomach acid also prevents food sensitivities. Undigested food particles trigger the gut’s immune system to become over burdened and over reactive. This causes the immune system to start reacting to more of the foods you eat, creating immune reactions that become food sensitivities. This is called losing oral tolerance, and it can be a primary cause of food sensitivities and other health issues.

Symptoms of low stomach acid

• Heartburn
• Acid reflux
• Indigestion
• Stomach ulcers (low stomach acid raises the risk of an pylori infection, which causes stomach ulcers)
• Nausea
• Belching after meals
• Hiccups after eating
• Constipation
• Diarrhea
• Undigested food in stools

What to do for low stomach acid

You can help support your stomach acid by taking betaine hydrochloric acid (HCl) capsules. Take HCL after you begin eating a meal with meat or protein. How much do you take? Keep increasing your dose until you feel warmth in your stomach, then cut back down to the previous dose. You may need quite a bit in the beginning but then find you need to gradually lower your dose over time.

If you feel intense gastric burning with even one capsule, it means you may have ulcers and an H. pylori infection that can be treated with nutritional compounds.

Ask my office for more advice on how to manage your heartburn, indigestion, or acid reflux, and how to improve your overall health by improving your digestive health.