With Forward by

RAZI BERRY
All disease be-

gins in the gut.

― Hippocrates

Copyright © 2018 Naturopathic Doctor News & The Naturopathic Guide to a Healthier Gut
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i
TABLE OF CONTENTS

Page iii - Forward Page 48 - Small Intestine Bacterial Overgrowth

(SIBO): The Most Common Cause of Irritable
Page 7 - Gut Health, Emotional Health and
Bowel Syndrome
Chronic Disease
Page 52 - Good Digestive Health Starts in the
Page 10 - Constipation: Causes and Cures from
Mouth
a Naturopathic Perspective
Page 56 - Cannabis for Inflammatory Bowel Dis-
Page 15 - Exercise and the Gut Microbiome
eases: Crohn’s and Ulcerative Colitis
Page 19 - Spirituality for Gut Health: An Unmet
Page 59 - Rethinking Reflux and PPI Use
Need
Page 63 - What do Stress and Trauma Have to
Page 25 - Meet the Major Players of the Gut Mi-
do with your Gut? A Lot!
crobiome and Learn How to Keep Them Healthy
Page 67 - Are you losing Sleep? Sleep, Stress
Page 30 - Gut Health and its Relation to Autism
and the Gut
Spectrum Disorder (ASD)
Page 71 - Individual Responses to Phytoestro-
Page 35 - The Gut, Anxiety & Depression: Be-
gens and the Microbiome Connection
yond Probiotics, The Effect of Gut Permeability &
Inflammation on Your Emotional Well-being

Page 40 - Gut Health, Emotional Health and

Chronic Disease

Page 43 - What about Bile?!? A Vital, but Often

Ignored Aspect of Digestion

ii
 FORWARD

“BUTTERFLIES” IN THE STOMACH -

HOW RELATIONSHIPS AND STRESS
AFFECT DIGESTIVE HEALTH
“Butterflies” in the stomach is a metaphor similar Revolutionary neuroscientist and pharmacolo-
to a broken heart where we anthropomorphize gist, Candace Pert, was possibly the first scien-
emotions with a physical state tist to truly show this in a way that would please
die-hards of Descartes and the scientific
This has been done for centuries, and lends it-
method.
self to the idea that the human experience can-
not be separate from our environment, and that When she discovered the opiate receptor, she
separating our mind and body is not really possi- revealed that these peptides influence both psy-
ble. chological response and cognition. She coined
the term “molecules of emotion†and said
Our emotions certainly affect our physical health
they were a bridge between our body and our
and our physical health affects our emotions
consciousness.

iii
What does this have to do with digestion? Gastro-
intestinal disease? Everything!
WHAT DOES THIS HAVE TO
DO WITH DIGESTIVE
With the recent publicity about the intestinal mi- HEALTH?
crobiome, the consumer has become more
aware that the majority of the body’s immune
This reduced blood flow and motility slows down
function resides in the gut.
the digestion, alters the release and absorption
For instance, let's take the term “fight or flight” to of gastric juices while inhibiting the assimilation
discuss stress of nutrients.

• Flight mode: blood flow moves to the This is how stress can lead to dysbiosis. Intesti-
legs, so you can escape nal permeability, or ”leaky gut” SIBO (small intes-
tinal bacterial overgrowth), can all lead to food
allergies and even autoimmune conditions.
• Fight mode: blood flow goes to your
arms, so you can fight, defend and protect Our intestines are the gateway between our-
selves and our world

• When a lover or possible mate is near, We take in our environment and it embodies us.
the blood flow goes to your sex organs The intestine is both a barrier and a gatekeeper.
The role of emotion is to help us navigate our sur-
This shunting of blood to other areas is partly re- roundings and guarantee survival. Now, while
sponsible for the feeling known as “butterflies” in there are no negative emotions...they all are help-
your stomach because the adrenaline that is re- ful to survival, chronic negative emotions defi-
leased in times of stress opposes the “rest and nitely impact our health.
digest“ state.
In 2000, the journal GUT reported that as much
While adrenaline contracts most of the gut wall to as 60% of gastrointestinal diseases are associ-
slow digestion, it relaxes a specific gut muscle ated with stress.
called the “external anal sphincter,” which is why
some people report a pressing need to visit the Where emotions are manufactured and why you
bathroom when they’re nervous. This reduction want to digest your emotions just as you want to
of blood flow through the gut produces the oddly digest your food
characteristic “butterflies” feeling in the pit of
The beginning of our digestion is our olfactory
your stomach.
sense. When we smell food, it signals to our nerv-
ous system to begin salivating, producing bile
and other gastric juices for digestion. It is impor-
tant that we preserve our olfactory sense by
avoiding artificial fragrances. Our sense of smell
tells us a lot about the world around us...and is

iv
involved with emotions.Think of something that System...which is why the gut is called the sec-
doesn't smell right, or if something unpleasant ond brain. Neurons, or nerve cells, transmit elec-
happens, we say “it stink” or may feel suspi- trochemical signals and those signals can be
cious. transmitted over long distances.

Our throat is the doorway to the digestive tract. It

is where we speak our truth, where we take in the
NEURONAL NETWORKS
food that will become our very cells. It is the en- OF THE ENTERIC NERVOUS
trance to who we become and it also speaks SYSTEM (ENS)
what we call forth into our environment. This is
why we get a lump in our throat when we’re One function of neurons in the Enteric Nervous
upset about something, or say we stuffed our System (ENS) is to take information from your in-
feelings down our throat and stifled something. testinal microflora, or microbiota. Your brain and
Repressing emotions begins in the throat and gut work together to adjust peristalsis, or transit
subsequently affects digestion. time, of the food you are digesting while control-
ling mucous production and secretion.
The stomach, as we know, is an emotional cen-
ter. It produces bile to be stored in the gallblad- Further, these microbes impact the neurotransmit-
der. The liver has been traditionally associated ters that are produced in the gut, such as
with emotions like fear, anger and envy. Think of serotonin, dopamine, norepinephrine and more.
calling someone ‘yellow’ because they are
fearful, or ‘green’ with envy. It is said that In fact, 90 percent of serotonin is produced in
these negative emotions affect the liver and gall- the gut...and research has found that it is pro-
bladder to over and/or under produce bile and duced in an intricate communication between
impair digestion. the neurons of the host cells and the microbiota.
Irritable Bowel Syndrome (IBS) is now being
The liver is the organ treated in depressive disor- thought of a”mental illness” of the gut.
ders. In Traditional Chinese Medicine, liver qi
(pronounced chi) stagnation is considered a pri- For example, a link between antibiotic exposure
mary cause of emotional distress. New research and altered brain function is well evidenced by
indicates that bile, produced in the liver, is a ma- the psychiatric side-effects of antibiotics, which
jor regulator of the gut microbiome.That’s range from anxiety and panic to major depres-
huge considering how the microbiome impacts sion, psychosis and delirium.1 Journal of Clinical
immunity and neurotransmitter function. Psychology reported that treatment with a single
antibiotic course was associated with an in-
The gut contains more neurons than the spinal creased risk for depression and anxiety, rising
cord with multiple exposures.27

The brain and spinal cord combined have 100

million neurons and the gut itself has another 100
million neurons...making up the Enteric Nervous

v
MANY FACTORS INFLUENCE
References:

GUT HEALTH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1774304/

Moody microbes or fecal phrenology: what do we know

about the microbiota-gut-brain axis?
Chlorinated water can affect gut microbiota while
lack of adequate sleep affects the regulation of From gut dysbiosis to altered brain function and mental ill-
ness: mechanisms and pathways
hormones produced by the microbiota.
Reframing things in the positive can influence https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121944/
the gut for the better. Abdominal massage can
The Excitations and Suppressions of the Times: Locating the
aid the peristalsis process. Take your time when Emotions in the Liver in Modern Chinese Medicine
eating - relax, don't rush, enjoy the experience of
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2555412/
ingestion with all of your senses. Try the “Yes
meditation”--say the word yes! while breathing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4275100/
deeply. Be good to your gut and your gut will be
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1927328/?pa
good to you. ge=4

vi
GUT HEALTH, Your digestive system is the seat of your health, and keeping it
EMOTIONAL healthy prevents many chronic diseases. Your intestines have a

HEALTH AND lining that acts as a semi permeable barrier, controlling what is

CHRONIC DISEASE absorbed into your body from the food you eat. Numerous tiny
blood vessels surround your intestines and absorb nutrients that
Dr. Ameet Aggarwal is a naturopathic doctor
pass through this semi permeable barrier, later transporting
and psychotherapist (Gestalt, Family Con-
stellations, EMDR) with years of experience these nutrients to your entire body through your bloodstream.
treating physical issues, anxiety, stress, de-
pression, abuse, relationship issues and
Poor diet, antibiotic use, and lifestyle choices destroy the lining
also working with UNICEF, UN Staff, and
other large organizations. Dr. Aggarwal fo- of your intestines, exposing your entire bloodstream to improp-
cuses on healing the gut, liver, adrenal sys-
erly digested food particles and toxins. These absorbed toxins
tem and emotions together to optimize
health and happiness. His online course and food particles cause unhealthy chemical reactions and in-
(free videos on health.drameet.com/p/intro)
flammation throughout your body, compromising the health of
has been approved in the highest category
for continuing education for naturopathic every organ and altering your entire balance of hormones and
doctors. Dr. Aggarwal was voted as one of
brain chemicals.
the top 5 speakers on 2 world summits,
which earned him recognition as one of the
top 43 naturopaths to follow. He practices in
Kenya and lectures around the world, teach-
PROBIOTICS AND LEAKY GUT SYNDROME
ing students how to treat anxiety and depres-
sion holistically. His book “Feel Good” (free Your intestines have naturally occurring good bacteria known as
videos on drameet.com/p/mindbodybook is
probiotics that keep harmful bacteria and harmful yeast (also
considered to be one of the most compre-
hensive guides to anxiety and depression. known as Candida) in your digestive system to a minimum. Probi-

7
otics also produce chemicals that protect the cell healthy cells and neurotransmitters, causing
lining of your intestines. Antibiotic use, stress, im- physical and mental health issues.
proper diet, poor lifestyle, and other factors kill
Due to its contribution to chronic and excessive
off your probiotics, allowing yeasts and harmful
inflammation in your body, leaky gut syndrome
bacteria to increase in numbers. The harmful bac-
also causes damage and plaque formation in
teria and yeasts release toxins in your intestines,
your blood vessels, including those in your heart,
which cause your intestinal cells to become in-
kidneys, and genital organs, creating an in-
flamed and die off, leaving gaps in your intesti-
creased risk of heart disease, kidney disease,
nal barrier, a condition commonly known as
poor erections, and reduced sexual stimulation.
leaky gut syndrome.
Chronic inflammation is also a leading cause of
Behind the lining of your intestines resides a skin issues such as eczema and psoriasis, in-
large part of your immune system, also known as creased food sensitivities, asthma, premenstrual
gut associated lymphoid tissue (GALT). GALT is syndrome, endometriosis, chronic sinusitis, arthri-
exposed to toxins and undigested food particles tis, and other chronic diseases.
when the lining of your intestines is damaged,
causing a huge immune reaction. This immune TREATING YOUR INTESTINES
response triggers excessive inflammation in
your body, which produces more toxins and in- Replenish the probiotics in your gut
creased cortisol levels. It also changes the chem-
istry of your blood and balance of hormones and
neurotransmitters, causing chronic diseases and High-strength probiotics are found in health-food
mood disorders. stores (under different strains, such as lactobacil-
lus acidophilus, lactobacillus rhamnosus, saccha-
The added toxicity from leaky gut syndrome also romyces boulardii, etc.). Certain foods such as
harms organs such as your liver, pancreas, adre- yogurt, fermented cabbage, and some raw vege-
nal glands, and thyroid gland, all crucial for emo- tables also contain probiotics but not at thera-
tional stability. If your liver becomes burdened peutic levels. Replenishing your probiotics to ade-
with toxins, its ability to clean your blood de- quate amounts might take up to 3 months, so be
creases, causing even more inflammation and patient with yourself. The effort is worth it,
toxins to build up in your body - worsening dis- though, because you are building a strong foun-
ease and emotional issues. dation for long-term health.

Your intestinal cells, pancreas, and liver are also Increase your digestive enzymes and stom-
producing digestive juices and enzymes to di- ach- acid levels
gest and absorb your food completely. If they be-
come unhealthy, digestion and, therefore, absorp- Stomach acid (hydrochloric acid, or HCL) and di-
tion of important nutrients into your body, are gestive enzymes break food down properly so
reduced. When nutrients aren’t being absorbed that your intestines better absorb nutrients. Stom-
properly, it affects your body’s ability to produce ach acid also helps kill harmful bacteria that
might be in your food. Stress, improper eating

8
 Replenishing your probiotics to can be added to your cooking. Herbs such as
adequate amounts might take up to 3 licorice and slippery elm are soothing and help
months, so be patient with yourself. The heal your inflamed intestines. In addition to probi-
effort is worth it, though, because you otics and healthy foods, I always use a nutritional
supplement called L-glutamine. L-glutamine is
habits, and digestive damage will sometimes
an amino acid that provides a rich energy source
cause levels of stomach acid and digestive en-
to intestinal cells and helps to heal your intesti-
zymes to be lower than normal, even though
nal wall. L-glutamine brings far better healing to
most stressed people tend toward higher
your intestines than using probiotics alone. L-
stomach-acid levels. Low stomach acid levels
glutamine also helps make important brain
can also be due to low thyroid activity.
chemicals, such as GABA, which reduces anxi-
Low stomach acid and low levels of enzymes al- ety. Other nutrients that help to repair your intes-
low poorly digested food and harmful bacteria to tines include vitamin A, vitamin B5, folate, sele-
reach your lower intestines and cause further nium, zinc, vitamin D and calcium.
damage and inflammation, worsening leaky gut
If you use antibiotics frequently, talk with your
syndrome. Increasing stomach acid and diges-
doctor on how to reduce the amount of antibiot-
tive enzymes can be achieved using HCL cap-
ics you take. Part of the reason children develop
sules and digestive-enzyme supplements avail-
chronic infections is because they are given anti-
able through health-food stores. Use them with
biotics too many times at an early age. It be-
caution and under supervision because exces-
comes a vicious cycle because the more antibiot-
sive stomach acid can damage your intestines.
ics they take, the worse their immunity gets, and
the sicker they become. Hence you see a lot of
REDUCE AND CORRECT THE
children with chronic infections or needing their
DAMAGE DONE TO YOUR
tonsils removed.
INTESTINES
Removing inflammatory foods from your diet and
eating healthy foods reduces damage to your
probiotics and to your intestines. Different foods
affect different people. The most common inflam-
matory foods seem to be wheat (gluten), dairy,
sugar, excessive coffee, alcohol and soy. You
can get yourself tested for food allergies by a
health practitioner.

Omega-3 oils found in foods such as fish, nuts,

and seeds also reduce inflammation in your
body, unless you are allergic to these foods. Cer-
tain spices such as cumin and turmeric, used
in Indian cuisines, also reduce inflammation and

9
CONSTIPATION: Constipation is a common condition worldwide. It makes you feel
awful and decreases your quality of life. Read on to find out what
CAUSES AND constipation is, the most common causes, and what naturopathic
CURES FROM A medicine can do to fix it.
NATUROPATHIC
PERSPECTIVE WHAT IS CONSTIPATION?
Dr. Candace Mathers received her doctorate
in naturopathic medicine from the National
Constipation is usually defined as reduced stool frequency, spe-
University of Health Sciences in 2016. Al- cifically 3 or fewer bowel movements per week. The Rome Foun-
though she works with various conditions,
Dr. Mathers has a special interest in illness
dation, a not-for-profit organization whose goal is to better the
prevention, wellness, and health optimiza- lives of people with functional gastrointestinal disorders, has a
tion for children with Down Syndrome, endo-
crine disorders, autoimmune conditions,
set criterion for a constipation diagnosis.
weight loss and hydrotherapy. Dr. Mathers is
the owner of Life Blossom Wellness, a tele- The Rome criteria for constipation is defined as 2 or more of the
medicine natural health consultation service
located in the northwest Chicago suburbs.
following symptoms: straining, lumpy or hard stools, sensation of
Dr. Mathers has been featured on the Practi- incomplete evacuation, sensation of a blockage, manual maneu-
cally Healthy Life Show Podcast. Since Illi-
nois is a pre-licensed state, she holds her
vers to bring about defecation, and the absence of loose stools
naturopathic physician license in the state of with insufficient criteria to diagnose IBS (Irritable Bowel Syn-
Vermont.
drome).

10
According to the Rome criteria, these symptoms the need to defecate but you may have abdomi-
have to present for at least 6 months. nal bloating and pain.

TYPES OF CONSTIPATION Defecation disorders, like dyssynergia, are

caused by poor toilet training, painful defecation,
back injuries, and gut-brain dysfunction. Dyssyn-
Constipation is divided into two separate catego- ergia is diagnosed after a number of tests are
ries: primary and secondary. performed like anorectal manometry and the bal-
loon expulsion test.
Primary constipation usually arises from defects
of the colonic function or malfunction of the defe- Secondary constipation comes as a result of an-
cation process. Primary constipation includes al- other disorder like Hirschsprung’s disease, Park-
tered bowel transit times and anorectal structural inson’s, colorectal cancer, strictures from chronic
abnormalities.1 inflammation, hypothyroidism, or pregnancy.

Primary constipation is broken down into 3 differ- Medication related constipation is also classified
ent categories: normal-transit time, slow transit as secondary.
time, and defecation disorders.

Normal-transit time constipation is also called

WHO GETS
functional constipation because no abnormalities CONSTIPATION?
with colonic transit time can be found. You may
have functional constipation if you experience Constipation is extremely common. The majority
bloating, abdominal pain, and difficulty with hav- of us have experienced it at one time or another.
ing a bowl movement. In fact, constipation is so common that it is esti-
mated that 16% of adults worldwide suffer from
Functional constipation is the most common form
the condition.2 While constipation is common in
of constipation seen by clinicians.
adults, studies suggest that women tend to suffer
Slow-transit time constipation causes infrequent from constipation more than men. Those who are
bowel movements which occur less than once a over 65 are also prone to constipation as well as
week. This type of constipation is found in young young children who are toilet training.
women. It is due to less frequent coordinated
Since constipation is so prevalent, it helps to
contractions of the colon, called high-amplitude
know some of the most common causes.
propagated contractions.

High amplitude propagated contractions push

stool throughout the colon until it reaches the rec-
tum. When this happens, you receive a signal
that you need to have a bowel movement. With
slow-transit time constipation, you may not feel

11
THE MOST COMMON 4. Lack of Exercise

CAUSES OF CONSTIPATION How we choose to live has a great impact on

whether we have constipation or not. Lack of
Unfortunately, the list of factors that contribute to physical activity is a huge contributor to constipa-
constipation is quite long. Some causes include: tion. Exercise helps to induce contractions of the
large intestines to help move waste.
1. Inadequate Fiber Intake
5. Stress
Fiber is an indigestible carbohydrate that bulks
up stool making it easier to pass through the di- Stress is a major contributor to constipation.
gestive tract. You need approximately 30 grams When we experience psychological stress, the
of fiber a day to prevent constipation. According HPA (hypothalamus-pituitary-adrenal) axis is
to Harvard health, the standard American diet stimulated. This causes the release of hormones
(SAD) contains less than half of that.3 like cortisol and ACTH which directly affect gut
function through altering the cells of the gut mu-
2. Inadequate Fluid Intake
cosa and altering the gut microbiome.5
The colon receives approximately 1.5L of fluid
6. Compromised Gut Microbiome
from the small intestines daily. 200mL to 400mL
of this fluid is excreted in stool. Without proper It is now widely recognized that we have more
fluid intake, the large intestine absorbs more fluid bacteria living within us than cells of the human
to prevent fluid loss. This makes stool drier and body! Clearly our gut flora plays a huge role in
harder to pass. our health, or the lack of it, and this is no different
with constipation. The lack of helpful bacteria like
3. Food Sensitivities
Lactobacillus, Bifidobacterium, and Bacteroides
Food sensitivities, especially dairy, are a known species with the simultaneous arise of harmful
contributor to constipation. Cow’s milk and dairy bacteria like P. aeruginosa and C. jejuni is linked
products contain a high amount of a protein to chronic constipation. Possibly due to a de-
called casein. A variation of this casein found in crease in intestinal motility.6
dairy products, ß-casein A1, when acted on enzy-
7. Altered Serotonin Levels
matically during digestion, becomes ß casomor-
phin 7. ß casomorphin 7 delays bowel transit Serotonin is a neurotransmitter that stabilizes
time.4 The ideal bowel transit time is anywhere mood and contributes to feelings of wellbeing.
from 12-24 hours. Delayed bowel transit time The majority of serotonin, up to 95%, is produced
means that it takes longer for stool to move in the gut. Decreased levels of serotonin have
through the bowels and be eliminated contribut- been linked to constipation.7
ing to constipation. Gluten has also been linked
to constipation.

12
8. Medications and Supplements 2. Lifestyle Modification

The list of medications causing constipation is One of the most effective ways to combat consti-
immense. Pain medications like opiates and non- pation is increasing exercise. Studies show that
steroidal anti-inflammatory drugs (NSAIDs), cal- increasing your physical activity to 60 minutes a
cium channel blockers for high blood pressure, day, 3 times a week, improves constipation.8 In-
diuretics like hydrocholorothiazide and fu- creasing fluid intake will also help to prevent con-
rosemide, antidepressants, and even antacids stipation. It is recommended that you drink half
are known to cause constipation. The most com- of your body weight in ounces of water a day. For
mon supplement linked with constipation is iron. example, if you weigh 120 lbs, then you would
drink 60 ounces of water a day. Increase your fi-
Now that we have an idea of what constipation is
ber intake through fresh vegetables like carrots
and what causes it. How do we treat it?
and broccoli and fresh fruits like apples and
strawberries. A healthy diet helps to increase the
NATUROPATHIC TREATMENT amount of serotonin in the gut as well as provid-
OF CONSTIPATION ing your daily fiber requirements. Eliminating
food sensitivities will also decrease constipation.
Although the causes of constipation are many, It is helpful to work with a naturopathic physician
the naturopathic physician has even more tools to identify any food sensitivities.
to combat it.
3. Start Taking Probiotics
1. Proper Toilet Training
Probiotics help to normalize the gut microbiome
When trying to eliminate constipation, proper toi- which in turn helps decrease constipation. Tak-
let usage cannot be overlooked. When you feel ing a probiotic with Bifidobacterium lactis has
the need to have a bowel movement, listen to been shown to decrease bowel transit time by up
your body. Don’t ignore the urge to defecate. If to 12 hours and increase bowel movement
you aren’t having regular bowel movements, frequency.9 Probiotics also improve stool consis-
make sure to schedule about 10-12 minutes a tency making it easier to pass.
day to use the toilet. This will train your body to
start having bowel movements regularly. Also 4. Natural Laxatives
consider using a device that helps you to squat
Natural laxatives like vitamin C and magnesium
on the toilet instead of sitting. Squatting is the
help to eliminate constipation by increasing the
original way that people used to defecate before
water content in the colon. If your stools are hard
the invention of toilets. Squatting helps align the
to pass, consider these options. Be wary of tak-
rectum in such a way that makes stool easier to
ing too much of either vitamin C or magnesium
pass.
because they can cause loose stools. Senna tea
is also another alternative for easing constipa-
tion. Be wary because it can cause abdominal
cramping if taken frequently. Always consult with

13
your naturopathic physician before starting any 6.Zhao Y, Yu Y-B. Intestinal microbiota and chronic constipa-
tion. SpringerPlus. 2016;5(1):1130.
supplement regimen.
doi:10.1186/s40064-016-2821-1.

5. Homeopathic Remedies 7.Camilleri M. Serotonin in the Gastrointestinal Tract. Current

opinion in endocrinology, diabetes, and obesity.
The most often used homeopathic remedies for 2009;16(1):53-59.
constipation are silica, which is indicated when
8.Tantawy SA, Kamel DM, Abdelbasset WK, Elgohary HM.
there is a lot of straining to have a bowel move- Effects of a proposed physical activity and diet control to
ment, nux vomica, which is indicated when there manage constipation in middle-aged obese women. Diabe-
is a desire to pass stool but the stool can’t pass, tes, Metabolic Syndrome and Obesity: Targets and Therapy.
2017;10:513-519. doi:10.2147/DMSO.S140250.
bryonia, which is indicated when there are large
dry stools that are accompanied with tearing 9.Dimidi E, Christodoulides S, Fragkos K, Scott S, Whelan K.
pain, and natrum muriaticum, which is indicated The effect of probiotics on functional constipation in adults: a
systematic review and meta-analysis of randomized con-
with dry stools with a desire for salty foods and
trolled trials. Am J Clin Nutr. 2014;100(4):1075-1084.
no desire to drink. doi:10.3945/ajcn.114.089151

Almost everyone has suffered from constipation

at least once in their life. Although it is a common
condition, there can be relief. Naturopathic medi-
cine offers an array of tools to help eliminate con-
stipation and help you feel your best. If you are
suffering from constipation, contact your naturo-
pathic physician and find the relief you deserve.

References

1.Andrews CN, Storr M. The pathophysiology of chronic con-

stipation. Canadian Journal of Gastroenterology.
2011;25(Suppl B):16B-21B.

2. Forootan M, Bagheri N, Darvishi M. Chronic constipation: A

review of literature. Abenavoli. L, ed. Medicine.
2018;97(20):e10631. doi:10.1097/MD.0000000000010631.

3.
https://www.health.harvard.edu/digestive-health/constipation-
and-impaction

4.Pinto Sanchez MI, Bercik P. Epidemiology and burden of

chronic constipation. Canadian Journal of Gastroenterology.
2011;25(Suppl B):11B-15B.

5.Qin H-Y, Cheng C-W, Tang X-D, Bian Z-X. Impact of psycho-
logical stress on irritable bowel syndrome. World Journal of
Gastroenterology: WJG. 2014;20(39):14126-14131.
doi:10.3748/wjg.v20.i39.14126.

14
EXERCISE AND We all know that exercise is great for our health, strengthening
both the muscles and the cardiovascular system. Now new re-
THE GUT search sheds light on another reason why exercise is so benefi-
MICROBIOME cial. The benefit of exercise goes beyond just our muscles and
Catherine Clinton ND, is a graduate of the National cardiovascular system. Exercise also has dramatic impacts on
College of Natural Medicine (NCNM) in Portland,
the gut microbiome which, in turn, has a dramatic impact on over-
Oregon. She is a board licensed naturopathic doc-
tor currently practicing at her private clinic in all health.
Eugene, Oregon.

Dr. Clinton is a speaker on integrative medicine and

gut health and has authored several publications in
EXERCISE CHANGES THE
those areas. She is founder of WellFuture, a line of
nutritional supplements for infants and children that
MICROBIOME
uses organic, whole food ingredients and the green-
est, bioavailable nutrients.
It is amazing to see the myriad ways our bodies, gut, and our life-
When in medical school Catherine was diagnosed style interconnect. Recent research found that the gut micro-
with an autoimmune disease that effects the gastro-
intestinal tract, leaving her with a special interest in biome of people who exercise have a much more diverse and
autoimmune diseases and gastrointestinal condi-
dense population of gut bacteria which is ideal compared to their
tions. Accessing how the multiple systems of the
body are working together is a vital piece of Dr. seden-tary counterparts. (1) Research from earlier this year ex-
Clinton’s practice. With a practice focused on gas-
trointestinal and immune health Dr. Clinton utilizes plored the impact of exercise with a variety of diets on the gut mi-
the latest in functional medicine combined with crobiome. Both lean and obese exercisers displayed a de-
nutrition, herbal medicine and lifestyle interventions
to treat a variety of digestive complaints, autoim- creased COX-2, an enzyme that promotes inflammation, as well
mune diseases and pediatric conditions.
as increased gut integrity. (2) Just this year researchers found
www.wellfuture.com/blog

15
that exercise created metabolites which pre- ness of health-promoting interventions that target
vented inflammatory changes in the gut and the microbial ecosystem. We have recently re-
throughout the body. (3) ported that exercise initiated in early life in-
creases gut bacterial species involved in promot-
‘The PlanHab wash-out period corresponded to
ing psychological and metabolic health. In this
a profound life-style change (i.e., reintroduction
review, we emphasize the ability of exercise dur-
of exercise) that resulted in stepwise ameliora-
ing this developmentally receptive time to pro-
tion of the negative physiological symptoms, indi-
mote optimal brain and metabolic function
cating that exercise apparently prevented the
across the lifespan through microbial signals.”
crosstalk between the microbial physiology, mu-
cin degradation and proinflammatory immune ac-
tivities in the host.”
WHAT EXERCISE IS DOING
TO THE GUT MICROBIOME?
EARLIER THE BETTER Bile acids

Exercise at an early age also has a profound im- One of the factors by which exercise causes
pact on the gut microbiome. Researchers found changes in gut microbiota is the modification of
that exercise in early life can alter the gut micro- bile acids. Bile acids help break down fats so the
biome for the better, supporting healthier brain body can absorb the necessary lipids from our
and metabolic activity. (3) They weren’t able to diets. They also act as anti-microbial agents in-
pinpoint a certain age, but the research showed hibiting the growth of some bacteria while favor-
that the microbiome was more plastic when ing the growth of others. Several studies have
young and exercise has the most long-term bene- found an inverse relation between the amount of
ficial impact on the microbiome during this time. fecal bile acids and physical activity, with the
This study seems to show the younger the better more exercise you get, the less bile acids you
when it comes to exercise benefitting the gut mi- have. (4) Rats whose diets were supplemented
crobiome over a lifetime. with bile acid had a change in the microbiota in
both diversity and composition. The diet high in
“Microbial colonization of the gut shortly after
bile acids resulted in an increase of the Fir-
birth is vital for the proper development of im-
micutes phylum of bacteria that is associated
mune, neural and metabolic systems, while sus-
with obesity and decrease of the Bacteroidetes
taining a balanced, diverse gut flora populated
phylum associated with lean metabolic function.
with beneficial bacteria is necessary for maintain-
(5) This beneficial modification of the bile acids
ing optimal function of these systems. Although
by exercise has a powerful impact on our micro-
symbiotic host–microbial interactions are impor-
biome for the better.
tant throughout the lifespan, these interactions
can have greater and longer lasting impacts dur- Short-chain fatty acids
ing certain critical developmental periods. A bet-
ter understanding of these sensitive periods is In animal models, it has been observed that exer-
necessary to improve the impact and effective- cise increases fecal butyrate levels as well as in-

16
creasing butyrate-producing bacteria groups (6). animals that performed long-term moderate exer-
More recent research has also found an increase cise compared to sedentary mice. (8) The in-
in short chain fatty acids from exercise. (7) Re- creased levels of intestinal IgA caused by exer-
searchers found that moderate exercise in- cise may augment the resistance of exercised
creased short chain fatty acids in the gut as mice to intestinal pathogen infections, as well as
much as fiber intake did. This increase in short the resistance to colonization by commensal mi-
chain fatty acids fuels the microbiome and shifts crobiota, ultimately influencing the composition
the ratio of harmful/beneficial fiber in a positive of the microbiota (9). This increased IgA from ex-
direction. ercise positively impacts the gut microbiome.

Ig-A-mediated mucosal immunity Gut transit time

IgA is a mucousal immunoglobulin that helps Moderate exercise reduces intestinal transit time
fend off pathogens as well keep the gut inflamma- which can impact the microbiome. (10) We know
tion in check. An increase of immunoglobulin A that there are microbiota differences between
(IgA) production and a reduced number of B and constipated individuals and those that had regu-
CD4 + T cells have been observed in the gut of lar bowel movements. Normalizing transit time is

17
just another way that exercise can impact the gut References:

microbiome for the better. (1) Clarke SF, Murphy EF, O'Sullivan. Exercise and associ-
ated dietary extremes impact on gut microbial diversity. Gut.
Exercise positively influences the diversity and 2014 Dec;63(12):1913-20
density of the gut
(2) Campbell SC, Wisniewski PJ, Noji M. The Effect of Diet
Exercise has powerful actions throughout the and Exercise on Intestinal Integrity and Microbial Diversity in
Mice. PLoS One. 2016 Mar 8;11(3):e0150502
body, and as we’ve seen, powerful actions on
the gut microbiome. Exercise positively influ- (3) Robert Šket, Tadej Debevec, Susanne Kublik, et al. Intesti-
nal Metagenomes and Metabolomes in Healthy Young Males:
ences the diversity and density of the gut micro-
Inactivity and Hypoxia Generated Negative Physiological
biome as well as increasing the integrity of the Symptoms Precede Microbial Dysbiosis. Front Physiol. 2018;
gut and decreasing gut inflammation. Exercise 9: 198.
early in life even has the power to influence the
(4) Mika A, Fleshner M. Early-life exercise may promote last-
make-up of the gut microbiota, influencing health ing brain and metabolic health through gut bacterial metabo-
throughout a lifetime. So, get those little ones ex- lites. Immunology and Cell Biology volume 94, pages 151–
ercising early, and often, and do yourself a favor 157 (2016)

and exercise with them! (5) Wertheim BC, Martínez ME, Ashbeck EL, Roe DJ, Jacobs
ET, Alberts DS, Thompson PA. Physical activity as a determi-
nant of fecal bile acid levels. Cancer Epidemiol Biomarkers
Prev. 2009 May; 18(5):1591-8.

(6) Islam KB, Fukiya S, Hagio M, Fujii N, Ishizuka S, Ooka T,

Ogura Y, Hayashi T, Yokota A. Bile acid is a host factor that
regulates the composition of the cecal microbiota in rats. Gas-
troenterology. 2011 Nov; 141(5):1773-81.

(7) Matsumoto M, Inoue R, Tsukahara T, Ushida K, Chiji H,

Matsubara N, Hara H. Voluntary running exercise alters micro-
biota composition and increases n-butyrate concentration in
the rat cecum. Biosci Biotechnol Biochem. 2008 Feb;
72(2):572-6.

(8)
http://www.fasebj.org/content/30/1_Supplement/1287.5.short

(9) Viloria M, Lara-Padilla E, Campos-Rodríguez R, Jarillo-

Luna A, Reyna-Garfias H, López-Sánchez P, Rivera-Aguilar V,
Salas-Casas A, Berral de la Rosa FJ, García-Latorre E. Effect
of moderate exercise on IgA levels and lymphocyte count in
mouse intestine. Immunol Invest. 2011; 40(6):640-56.

(10) Macpherson AJ, Köller Y, McCoy KD. The bilateral re-

sponsiveness between intestinal microbes and IgA. Trends
Immunol. 2015 Aug; 36(8):460-70.

(11) Oettlé GJ. Effect of moderate exercise on bowel habit.

Gut. 1991 Aug; 32(8):941-4.

18
SPIRITUALITY FOR Spirituality is the practice of self-care and self-care is honoring
yourself and taking time to simply, be. Aboriginal cultures all over
GUT HEALTH: AN the world believed that spirit flows through all living things and
UNMET NEED that a disconnect, or amnesia of spirit, caused physical illness.
Many of my patients who suffered from impaired gut health were
Dr. Cresencia Felty is a naturopathic doctor
dedicated to improving people’s health and in what I call, survival mode, a state of constant doing. The
self-healing abilities. Her goal is to encour- thought, “I need to survive,” creates mental distress that slowly
age and empower others to wholeness and
well-being. Along with her medical educa- destroys the integrity of the gut and the mind. North-American
tion, she is trained in holistic counseling and Aboriginals considered it more important to develop our being,
somatic experiencing. She has received
extensive training in digestive disorders than to grow in our capacity for doing or having. According to
such as Ulcerative Colitis and Irritable Bowel Ojibway healer, Calvin Morrisseau, the purpose of spirituality is,
Syndrome. She has effectively managed
and healed her own ulcerative colitis with “the process and relationship we have with the great spirit that
natural health. She is currently studying flows through all living things…the part of which, helps you see
earth medicine and shamanic healing
practices. She is accepting new patients at the beauty along the way and the goodness in others.” I have
Natural Advancement Primary Care at two seen spirituality do this for my patients and strengthen their gut
Chicagoland locations and via telemedicine
beginning October 2018. In her spare time, health. In this article, I will discuss the latest management strate-
she is in nature, with loved ones, and learn- gies for gut health, what gut health entails, how spirituality can
ing.
help strengthen the gut, and some ways to increase spirituality.

19
A simplified algorithm for diagnosing and manag- the ability to digest food with ease; gut health is
ing functional gastrointestinal disorders the ability to digest emotions, life situations, the
external environment, and other people with
ease. Increasing spirituality can increase one’s
A simplified algorithm was created and pub- emotional digestion. The gut, also known as the
lished September 2017, in The United European second brain, is constantly processing every-
Gastroenterology Journal, for diagnosing and thing we feel and sending it to the brain through
managing functional gastrointestinal disorders bi-directional communication known as the gut-
such as Irritable Bowel Syndrome (IBS). It was brain axis. Research has proven that brain devel-
created by a group of doctors from all over the opment is dependent on gut health, more specifi-
world who focused on treating symptoms for gut cally, the bacteria in the gut.
problems using medication, traditional psycho-
therapy, and minor diet modifications. Specific
recommendations include: various medications We are 90 percent bacteria with an ecosystem of
based on symptoms; advice to eat a low fodmap microbes living on us and in us. This ecosystem,
diet; and psychological therapy that includes containing more biodiversity than a rainforest, is
cognitive behavioral therapy, relaxation therapy, called the microbiome. Many of these single
dynamic psychotherapy, and hypnotherapy. For celled organisms make their home in the gut and
IBS, anti-depressants and anti-anxiety prescrip- are essential for the body to function effectively.
tions are provided. For celiac patients, go gluten These bacteria need us to practice self-care in
free and take an anti-inflammatory. For Inflamma- order to function properly such as eating enough
tory Bowel Disease (IBD), if drug and talk ther- dietary plant fiber and slowing down. Good bac-
apy fails to help, then surgery is the next step. teria are called commensal bacteria which
These treatments are shown to alleviate symp- means “to feed together.” New research shows
toms but only address the body, mind, and emo- that when these microbes are starved of fiber,
tions. Many of my patients have gone down this they begin to munch on the natural layer of mu-
conventional route with little to no success and cus that lines the gut which opens the gut up to
realized they were missing something. infection and inflammation. When people and
their bacteria don't feed together in harmony, the
bacteria feed on the body and begin a process
of autoimmunity, a destruction of the self. This de-
BI-DIRECTIONAL COMMUNI- struction of self occurs in the intestinal barrier
CATION KNOWN AS THE commonly known as “leaky gut.” Since most hor-
GUT-BRAIN AXIS mones that make people happy are produced in
the gut, this is the proposed mechanism for ma-
jor depressive disorder.
Gut health is having proper digestion and absorp-
tion of food, a functionally diverse intestinal micro-
biome, and an intact intestinal barrier to block
the entry of harmful substances. It is more than

20
POWER OF PERCEPTION: moment. It is a state of being in appreciation for
yourself, your ability to be alive, and everything
HOW PEOPLE PERCEIVE that surrounds you.
THEIR WORLD IMPACTS
THEIR GUT HEALTH AND I encourage my patients to go within and re-

VICE VERSA
connect with their inner voice:

1) This process begins with self-examination.

The solar plexus chakra is where we store our Notice your behavior, your likes, dislikes, pat-
stress energy. The solar plexus controls the en- terns, sleep schedules, hygiene, how messy
ergy flow to the stomach, spleen, small intestine, things are or how clean they are, time manage-
gall bladder, and liver. Therefore, too much ment or lack of, finances, relationships, thoughts,
stress affects a large portion of the digestive reactions, etc. Then ask yourself why you’re like
tract. We know that not all stress is bad, some that. Learning who you are and why you are the
stress is good and important for evolution and to way you are is the first step to improving your
accomplish great things. However, it is bad when health. What you do in one area of your life is
it overburdens the body so much that it cannot how you do everything. Your gut might be warn-
heal itself and then begins to break down. In an ing you that what you’re doing or how you’re
article published by the Canadian Psychological thinking doesn’t serve you anymore. Elkhart Tolle
Association in May 2005, Dr. Terry Gall proposed says in his book, A New Earth that recognizing
that spirituality is the best stress coping mecha- one’s own insanity is the first step to sanity. Self-
nism that could be used. Recent research shows examination can be done through journaling, ask-
that individual spirituality can be a predictor of ing friends and family what you need to work on,
better health, lower levels of stress, and benefi- and taking time in silence.
cial to chronic diseases. 2) Next, is self-acceptance. Once you learn
about why you are the way you are, it’s time to ac-
cept that you have good and bad traits. Instead

SPIRITUALITY HAS DIFFER- of denying this fact, accept your lower self so
that you can choose to live as your higher self. In
ENT MEANINGS FOR EVERY- any moment, your lower self can emerge so it is
ONE important to recognize what your lower self-
qualities are so you can prepare to be resilient in
It is a way of being, that respects oneself through times where you may be triggered, or in more
a lifelong process of self-examination, self- stress.
acceptance, and self-love. It is learning about
3) Third, is self-love. Self-love is removing re-
your true nature and rooting yourself into the
sentment toward others, including yourself. Self-
earth. Spirituality is tapping into your infinite po-
love is realizing where you self-sabotage and to
tential. It is reclaiming who you are and your
stop doing it. Self-love is slowing down, going to
health. Self-care can begin anywhere and at any
bed early, listening to your body, and being gen-

21
tle with yourself. Self-love is focusing on the 10. Let go of expectations. Appreciate the mo-
beautiful parts of you while letting go of the parts ment: gratitude decreases inflammation.
you don’t like as much.
11. Journal as much as possible; it decreases
There are numerous ways to practice spirituality inflammation.
to enhance gut health
12. Create a vision board; mindfulness de-
Here are a few other ways to increase creases inflammation and purpose decreases de-
spirituality: pression.

1. Eat vegetables; gut health is maintained 13. Write a to do list and cross things out one
with dietary fiber. by one; focus on one thing at a time. It’s not a
race, you are on your own journey.
2. Clean your bedroom and home; a clean
space clears the mind and lightens the spirit. 14. Practice being kind to yourself.

3. Daily prayer/meditation/chanting. People 15. Enjoy the journey and the relationships you
who do these types of activities live longer and have. In some cultures, success is measured by
die less from heart disease. the strength of their relationships. I love this. Re-
search proves that people who live longer, have
4. Practice gratitude for being alive, for all,
friends or a support system. Friendships are heal-
and for reading this.
ing.
5. Practice lying in silence for 5 minutes every
16. Psilocybin with a professional. Psilocybin is
day to listen to your breath and heartbeat.
proven to heal amnesia of oneness and regrow
6. Holistic Counseling to get to the root belief the brain. It is exercise for the brain and healing
systems that do not serve you anymore. to the spirit or soul.

7. Yoga, known for numerous benefits. SUMMARY

8. Spend time in nature daily. Observe the
In summary, healing the gut must be a holistic en-
birds, the leaves, the wind. Notice how alive the
deavor that is unique to each individual. Learn-
earth is. Nature scenes decrease stress in many
ing to honor that, and each of our own paths is
studies. In Japan, they prescribe forest bathing. I
part of the process. I have learned this through
highly recommend it to all because nature is
my own gut healing. In various cultures, gut
more healing than we can imagine.
health is the foundation for wellness and well-
9. Practice breathing and moving with being. Wellness refers to physical health and
Qigong. Close your eyes, sync your arms with function while, well-being refers to a holistic life
your breath, and slow down. Do qigong barefoot experience, an interconnection to everything. For
as much as possible. optimal gut health, the whole person needs to be
considered: mentally, physically, emotionally, and

22
spiritually. Research shows that spirituality re- 5. The Impact of Spirituality in Mental Health:
https://www.mentalhealth.org.uk/sites/default/files/impact-spir
duces psychological stress, strengthens mental
ituality.pdf.
health and immunity, decreases inflammation,
and increases the body’s ability to heal itself. 6. Understanding the Nature and Role of Spirituality in
Relation to Coping and Health:A Conceptual Framework:
Take a moment to think, when was the last time
http://www.chaplaincyacademy.com/files/Understanding%20t
you looked around and noticed how beautiful na- he%20Nature%20and%20Role%20of%20Spirituality%20in%2
ture was? When was the last time you stopped 0Relation%20to%20Coping%20and%20Health%20pdf.pdf.
and smelled the flowers you always pass by?
7. Use of Dietary Management in Irritable Bowel Syn-
When was the last time you looked at yourself drome: Results of a Survey of Over 1500 United States Gas-
and noticed how beautiful you were, on the in- troenterologists:
https://www.ncbi.nlm.nih.gov/pubmed/29886578.
side? When was the last time you were in survival
mode? I suggest stopping to smell the roses as 8. Irritable bowel syndrome in children: Current knowl-
much as you can because it is not about where edge, challenges and opportunities:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989237/.
you are going, it is about where you are. For an
individualized self-care plan to improve gut 9. Irritable Bowel Syndrome Treatment & Management:
health and spirituality, contact me at Natural Ad- https://emedicine.medscape.com/article/180389-treatment.

vancement Primary Care. 10. Gastritis:

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024957/.

11. New psychological therapies for irritable bowel syn-

Gut Health and Inner Peace, drome: mindfulness, acceptance and commitment therapy
(ACT): https://www.ncbi.nlm.nih.gov/pubmed/28724306.
Dr. Cresencia Felty
12. Adenosine A2B Receptors: An Optional Target for the
Management of Irritable Bowel Syndrome with Diarrhea?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704121/.
References
13. Irritable Bowel Syndrome:
1. Risk of Serious and Opportunistic Infections Associ- https://journals.lww.com/ajnonline/Fulltext/2017/06000/Irritabl
ated with Treatment of Inflammatory Bowel Diseases: e_Bowel_Syndrome.26.aspx.
https://www.gastrojournal.org/article/S0016-5085(18)30445-1/
14. The Effectiveness of Emotional Schema Therapy on
abstract.
the Emotional Schemas and Emotional Regulation in Irritable
2. Traditional Chinese Medicine and Kampo: A Review Bowel Syndrome: Single Subject Design:
from the Distant past for the Future: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952533/#ref
http://journals.sagepub.com/doi/10.1177/1473230006034003 43.
01.
15. Home-Based Hypnotherapy Self-exercises vs Individ-
3. A New Objective in Medicine: ual Hypnotherapy with a Therapist for Treatment of Pediatric
www.researchgate.net/publication/ Irritable Bowel Syndrome, Functional Abdominal Pain, or
50394128_’Gut_health'_A_new_objective_in_medicine. Functional Abdominal Pain Syndrome: A Randomized Clinical
Trial: https://www.ncbi.nlm.nih.gov/pubmed/2834658.
4. Irritable bowel syndrome diagnosis and management:
A simplified algorithm for clinical practice: 16. The Gut Microbiota and Host Health: A New Clinical
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625880/. Frontier:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4752653/.

23
17. Significance of Microbiota in Obesity and Metabolic 29. Gut Microbiota Modulation and Its Relationship with
Diseases and the Modulatory Potential by Medicinal Plant Obesity Using Prebiotic Fibers and Probiotics: A Review:
and Food Ingredients: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378938/.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5493053/.
30. Bodily Maps of Emotions:
18. Cognitive-behavioral therapy for patients with irritable http://www.pnas.org/content/111/2/646.full.
bowel syndrome: current insights:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5530860/. 31. The Wellness Wheel: An Aboriginal Contribution to So-
cial Work:
19. Mind/Body Psychological Treatments for Irritable http://www.reseaudialog.qc.ca/Docspdf/LoiselleMcKenzie.pd
Bowel Syndrome: f.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2249749/.
32. Spiritual Wellness as a Treatment for Irritable Bowel
20. Advances in Diagnosis and Management of Celiac Dis- Syndrome (IBS):
ease: https://www.sallyfstjohn.com/articles/2017/12/6/spiritual-welln
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409570/. ess-as-a-treatment-for-irritable-bowel-syndrome-ibs.

21. Undiagnosed pancreatic exocrine insufficiency and 33. Vis Medicatrix naturae: does nature "minister to the
chronic pancreatitis in functional GI disorder patients with di- mind?”:
arrhea or abdominal pain: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353853/.
https://onlinelibrary.wiley.com/doi/pdf/10.1111/jgh.13791.
34. Does a Multi-Dimensional Concept of Health Include
22. Some patients with irritable bowel syndrome may have Spirituality? Analysis of Japan Health Science Council’s Dis-
exocrine pancreatic insufficiency: cussionson WHO’s ‘Definition of Health’ (1998):
https://www.ncbi.nlm.nih.gov/pubmed/19835990. http://article.sapub.org/10.5923.j.ijas.20120206.03.html.

23. Endometriosis and Irritable Bowel Syndrome: A Di- 35. The Cultivation of Pure Altruism via Gratitude: A Func-
lemma for the Gynecologist and Gastroenterologist: tional MRI Study of Change with Gratitude Practice:
https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/tog.122 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770643/.
41.

24. The Role of Carrageenan and Carboxymethylcellulose

in the Development of Intestinal Inflammation:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410598/.

25. The Shikimic Acid Pathway:

https://www.researchgate.net/figure/The-shikimic-acid-pathw
ay-shown-in-green-and-selected-metabolites-Chorismate-is-t
he_fig1_284722314.

26. The Shikimic Acid Pathway:

https://www.ncbi.nlm.nih.gov/pubmed/27880063.

27. Interactions between phytochemicals from fruits and

vegetables: Effects on bioactivities and bioavailability:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5750943/.

28. Does a low FODMAPs diet reduce symptoms of func-

tional abdominal pain disorders? A systematic review in adult
and pediatric population, on behalf of Italian Society of Pedi-
atrics:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952847/.

24
MEET THE MAJOR An abundance of research has been published about the bene-
PLAYERS OF THE GUT fits of a healthy gut microbiome. Most of this research focuses on
MICROBIOME AND the bacterial biome within the gastrointestinal tract. While the
LEARN HOW TO beneficial bacteria that line the GI tract have a profound impact
KEEP THEM HEALTHY on our gut microbiome composition and health, the relationship
between the bacteria, fungi, protists, archaea and viruses lead to
Catherine Clinton ND, is a graduate of the National
College of Natural Medicine (NCNM) in Portland, the balance needed for gut health. With more than 100 trillion mi-
Oregon. She is a board licensed naturopathic doc-
tor currently practicing at her private clinic in
crobes lining our gut, let’s explore each player of the microbiome
Eugene, Oregon. and learn how to keep them healthy.
Dr. Clinton is a speaker on integrative medicine and
gut health and has authored several publications in
those areas. She is founder of WellFuture, a line of
THE BACTERIAL BIOME
nutritional supplements for infants and children that
uses organic, whole food ingredients and the green-
est, bioavailable nutrients. There are over a thousand different bacteria that line our gut,
making the bacterial biome the biggest player, accounting for
When in medical school Catherine was diagnosed
with an autoimmune disease that effects the gastro- 95% of the entire gut microbiome. These bacteria ferment fiber
intestinal tract, leaving her with a special interest in
autoimmune diseases and gastrointestinal condi-
from food into short chain fatty acids and other metabolites that
tions. Accessing how the multiple systems of the fuel so many of our cells and hormone pathways. Lower bacterial
body are working together is a vital piece of Dr.
Clinton’s practice. With a practice focused on gas- diversity has been associated with inflammatory bowel disease,
trointestinal and immune health Dr. Clinton utilizes
the latest in functional medicine combined with
psoriatic arthritis, type 1 diabetes, atopic eczema, coeliac dis-
nutrition, herbal medicine and lifestyle interventions ease, obesity, type 2 diabetes, and arterial stiffness.1-8 The asso-
to treat a variety of digestive complaints, autoim-
mune diseases and pediatric conditions. ciation between lower bacterial diversity and disease conditions
www.wellfuture.com/blog
25
 Feeding the gut microbiome a diet rich in a course of antibiotics.13 Amazingly, the norovirus
variety of fiber is the first step to cultivating a helped to rebalance the gut microbiome, both
healthy gut microbiome. A diet lacking in fiber the viral and bacterial components of the biome.
from fruits, vegetables, grains, legumes, even This balancing influence has never been ob-
animal fiber alters the microbiome in the gut. served with viruses and it is an exciting discov-
ery. This has been replicated in other studies that
highlights the need for a diverse gut microbiome show the same balancing of the microbiome by
as this is usually an indicator of good health.9-10 adding a virus to the gut of mice.14 Recent re-
While the impacts of this dominant part of the gut search has also shown that viruses present in sa-
microbiome are huge, the bacterial microbiome liva can target harmful bacteria, acting as a line
lives in close relation to the other members of the of defense in the immune system.15
microbiome. Viruses, fungi, yeast, archaea and
protists all crosstalk with the bacteria to create MYCOBIOME
an environment of inflammation and damage, or
one that is anti-inflammatory and health promot- It was not until 2010 that we started to research
ing. the role fungi and yeast play in the gut micro-
biome. Researchers found that bacteria and
THE VIROME fungi work together to build plaques against the
gut lining.16 These plaques protect the microbes
Viruses are the second player in the gut micro- living within, and can be beneficial to our health,
biome. There are a few types of viruses- the ones or quite detrimental to our health. Researchers
we’re familiar with are classified as either RNA saw that when fungus Candida tropicalis and the
and DNA and can infect our cells, the more ob- bacteria Escherichia coli and Serratia marces-
scure viruses like the viral elements that are em- cens grow together, they can form robust
bedded in our own DNA and the bacteriophages plaques that worsen the intestinal inflammation
that infect the bacteria in our microbiome. seen in inflammatory bowel disease. Other fungi,
like Saccharomyces cerevisiae, have been
Bacteriophages are viruses that infect and kill
shown to illicit a beneficial effect as well as keep
the bacteria in our individual microbiomes. They
harmful fungal species in check.17 It is this
do not infect us, but do a wonderful job fighting
unique relationship we see between ourselves,
the bacterial infections that plague us. Each bac-
our microbiome and the outside world that
teriophage is specific to a certain type of bacte-
shapes our health.
ria, making them a precise antibiotic agent with-

ARCHAEA AND PROTISTS

out any of the myriad side effects that modern
day antibiotics cause.11 Research has consis-
tently shown that bacteriophages play a role in
As with other members of the gut microbiome,
the regulation of the gut microbiome.12
archaea and protists were looked at as parasites
In one 2014 study mice were infected with a cer- with pathogenic effects in the gut, only causing
tain strain of the norovirus after completing a damage and inflammation. Recent research has

26
shown that these species might be more than probiotics from fermented foods and/or probiotic
transient residents of the Gi tract and have a supplements helps keep the field of your gut
strong impact on the diversity of the gut packed with beneficial bacteria.
microbiome.18-19
Short chain fatty acids are the fuel source of the

HOW TO KEEP THEM cells that line the gut and make a great addition
to a healthy gut microbiome diet.21 Short chain
HEALTHY fatty acids can be found in ghee and butter but it
is also produced in the colon when you consume
Now that we’ve met the key players in our gut mi-
a high fiber diet.
crobiome, let’s explore how to keep them healthy.
We know that diet has a huge impact on the
Feeding the gut microbiome a diet rich in a vari-
health of our gut microbiome but exercise, sleep,
ety of fiber is the first step to cultivating a healthy
less antibiotic use and stress also directly impact
gut microbiome. Gut bacteria thrive on the fiber
the gut microbiome. Exercise has been shown to
we eat. Bacteria ferment the resistant starches in
improve the diversity and health of the gut
the fiber and create butyrate for fuel. A diet lack-
microbiome.22-25 New research shows how the
ing in fiber from fruits, vegetables, grains, leg-
gut microbiome has its own diurnal fluctuations
umes, even animal fiber alters the microbiome in
in tune with the diurnal rhythm of the sun.26,27
the gut. A recent study found that a 2 week
Disturbances to this rhythm can cause a dysbio-
change in diet from processed foods to whole
sis, making a good night’s sleep essential for a
foods loaded with fiber resulted in a dramatic
healthy gut biome. This effect was even more pro-
shift in the microbiota. The whole food diet rich in
nounced in people under the influence of a poor
fiber shifted the balance to a more anti-
diet.28 Lastly, avoiding processed foods that can
inflammatory state.20 The beneficial bacteria
damage our players in the microbiome is key to
that line the gut need fiber to thrive. Fiber not
maintaining a healthy gut.29 Antibiotics have an
only feeds the beneficial bacteria in the gut, it
enormous impact on the gut microbiome, killing
also prevents the damage to the lining of the gut
off beneficial bacteria and deranging the biome
that occurs when the gut bacteria are deprived
for an entire year. Stress also has a negative influ-
of fiber. The resistant starches in fiber arrive in
ence on our gut biome decreasing the diversity
the large intestine relatively undigested, ready to
of microbes in the gut.30 While the relations be-
be consumed by our microbiota. These starches
tween the microbes in the gut microbiome are
are fermented into butyrate for fuel and are es-
complex and still unfolding, we see simple natu-
sential to feed your gut bacteria.
ropathic treatments upholding the integrity and
Fermented foods and probiotic supplements can health of the gut microbiome.
also help maintain the balance of the gut micro-
biome. One limiting factor that plays a role in a
balanced gut microbiome is the real estate. Bac-
teria compete for a spot in the mucin layer of the
References:
digestive tract. Making sure your diet is rich in

27
1. Manichanh C, Rigottier-Gois L, Bonnaud E, et al. Reduced 14. Cadwell, Ken. The virome in host health and disease. Im-
diversity of faecal microbiota in Crohn’s disease revealed by munity. 2015 May 19; 42(5): 805–813.
a metagenomic approach. Gut2006;55:205-11.
15. David T Pride, Julia Salzman, Matthew Haynes, Forest
2. Scher JU, Ubeda C, Artacho A, et al. Decreased bacterial Rohwer, Clara Davis-Long, Richard A White, III, Peter
diversity characterizes the altered gut microbiota in patients Loomer, Gary C Armitage, and David A Relman. Evidence of
with psoriatic arthritis, resembling dysbiosis in inflammatory a robust resident bacteriophage population revealed through
bowel disease. Arthritis Rheumatol2015;67:128-39. analysis of the human salivary virome. ISME J. 2012 May;
6(5): 915–926.
3. de Goffau MC, Luopajärvi K, Knip M, et al. Fecal microbi-
ota composition differs between children with β-cell autoim- 16. Hager, Christopher L., Ghannoum, Mahmoud A. The my-
munity and those without. Diabetes2013;62:1238-44. cobiome: Role in health and disease, and as a potential probi-
otic target in gastrointestinal disease. Digestive and Liver Dis-
4. Wang M, Karlsson C, Olsson C, et al. Reduced diversity in ease , Nov 2017, Volume 49 , Issue 11 , 1171 – 1176.
the early fecal microbiota of infants with atopic eczema. J Al-
lergy Clin Immunol2008;121:129-34. 17. Kelesidis T, Pothoulakis C. Efficacy and safety of the pro-
biotic Saccharomyces boulardii for the prevention and ther-
5. Schippa S, Iebba V, Barbato M, et al. A distinctive ‘micro- apy of gastrointestinal disorders. Therapeutic Advances in
bial signature’ in celiac pediatric patients. BMC Gastroenterology. 2012;5(2):111-125.
Microbiol2010;10:175.
18. Lukeš J, Stensvold CR, Jirků-Pomajbíková K, Wegener
6. Turnbaugh PJ, Hamady M, Yatsunenko T, et al. A core gut Parfrey L. Are Human Intestinal Eukaryotes Beneficial or Com-
microbiome in obese and lean twins. Nature2009;457:480-4. mensals? Knoll LJ, ed. PLoS Pathogens.
2015;11(8):e1005039.
7. Lambeth SM, Carson T, Lowe J, et al. Composition, diver-
sity and abundance of gut microbiome in prediabetes and 19. Audebert, C. et al. Colonization with the enteric protozoa
type 2 diabetes. J Diabetes Obes2015;2:1-7. Blastocystis is associated with increased diversity of human
gut bacterial microbiota. Sci. Rep. 6, 25255 (2016).
8. Menni C, Lin C, Cecelja M, et al. Gut microbial diversity is
associated with lower arterial stiffness in women. Eur Heart 20. O’Keefe, S. J. D. et al. Fat, fiber and cancer risk in African
J2018. Americans and rural Africans. Nat. Commun. 6:6342.

9. Sommer F, Rühlemann MC, Bang C, et al. Microbiomarkers 21. Canani RB, Costanzo MD, Leone L, Pedata M, Meli R,
in inflammatory bowel diseases: caveats come with caviar. Calignano A. Potential beneficial effects of butyrate in intesti-
Gut2017;66:1734-8. nal and extraintestinal diseases. World Journal of Gastroenter-
ology: WJG. 2011;17(12):1519-1528.
10. Sommer F, Anderson JM, Bharti R, Raes J, Rosenstiel P.
The resilience of the intestinal microbiota influences health 22. Clarke SF, Murphy EF, O'Sullivan. Exercise and associ-
and disease. Nat Rev Microbiol2017;15:630-8. ated dietary extremes impact on gut microbial diversity. Gut.
2014 Dec;63(12):1913-20
11. Xavier Wittebole, Sophie De Roock, and Steven M Opal.
A historical overview of bacteriophage therapy as an alterna- 23. Campbell SC, Wisniewski PJ, Noji M. The Effect of Diet
tive to antibiotics for the treatment of bacterial pathogens. and Exercise on Intestinal Integrity and Microbial Diversity in
Virulence. 2014 Jan 1; 5(1): 226–235. Mice. PLoS One. 2016 Mar 8;11(3):e0150502

12. Janka Babickova and Roman Gardlik. Pathological and 24. Robert Šket, Tadej Debevec, Susanne Kublik, et al. Intesti-
therapeutic interactions between bacteriophages, microbes nal Metagenomes and Metabolomes in Healthy Young Males:
and the host in inflammatory bowel disease. World J Gastro- Inactivity and Hypoxia Generated Negative Physiological
enterol. 2015 Oct 28; 21(40): 11321–11330. Symptoms Precede Microbial Dysbiosis. Front Physiol. 2018;
9: 198.
13. Cadwell, Ken. Expanding the Role of the Virome: Com-
mensalism in the Gut. Journal of Virology. 10 December
2014.

28
25. Mika A, Fleshner M. Early-life exercise may promote last-
ing brain and metabolic health through gut bacterial metabo-
lites. Immunology and Cell Biology volume 94, pages 151–
157 (2016)

26. Thaiss CA, Zeevi D, Levy M, Segal E, Elinav E. A day in

the life of the meta-organism: diurnal rhythms of the intestinal
microbiome and its host. Gut Microbes. 2015;6(2):137-142.

27. Rosselot AE, Hong CI, Moore SR. Rhythm and bugs: Cir-
cadian clocks, gut microbiota, and enteric infections. Current
opinion in gastroenterology. 2016;32(1):7-11.

28. Voigt RM, Forsyth CB, Green SJ, et al. Circadian Disor-
ganization Alters Intestinal Microbiota. Cermakian N, ed.
PLoS ONE. 2014;9(5):e97500.

29. Chassaing B, Koren O, Goodrich J, et al. Dietary emulsifi-

ers impact the mouse gut microbiota promoting colitis and
metabolic syndrome. Nature. 2015;519(7541):92-96.
doi:10.1038/nature14232.

30. Jane A. Fostera, Linda Rinamanb,, John F. Cryanc,da.

Stress & the gut-brain axis: Regulation by the microbiome.
Department of Psychiatry & Behavioural Neurosciences,
McMaster University. doi.org/10.1016/j.ynstr.2017.03.001

29
GUT HEALTH AND Welcome to the new normal. The new normal is a world where 1 in
6 children suffer from some form of developmental disorder.1 An
ITS RELATION TO estimated 9.6 million of today’s children under the age of 18 suffer
AUTISM SPECTRUM with asthma.2 Today, upwards of 20% of children are affected by
DISORDER (ASD) atopic dermatitis also known as eczema.3 8% of children have
food allergies; milk and peanuts top the list.4 Obsessive compul-
Dr. Jill Skurnowicz graduated with her doctorate in
sive disorder occurs in 1-3% of today’s children.5
Naturopathic Medicine in December 2017 as Vale-
dictorian of her class at National University of
Health Sciences(NUHS)in Lombard, IL. After 17
years in Anesthesia, Dr. Skurnowicz became inter-
THE NEW NORMAL WORLD
ested in treating the large iatrogenic epidemic of
Autism and other neurodevelopmental disorders.
WE LIVE IN
Dr. Skurnowicz received additional training in Fun-
damentals of Functional Blood Chemistry, Func- The new normal consists of a world where chronic disease and
tional Endocrinology, and Mastering Brain Chemis-
try. She completed 100 hours in Acupuncture train- disability plague America’s youth. For example, according to esti-
ing as well as receiving certification to provide mates from CDC’s Autism and Developmental Disabilities Monitor-
Ozone & Oxidative Therapy. She is an active mem-
ber in the American Association of Nurse Anesthe- ing (ADDM) Network in 2014, about 1 in 59 children has autism
tists and the Naturopathic Medicine Institute. Dr. spectrum disorder.6 Each year the numbers climb.
Skurnowicz practices in Franklin, Michigan and
provides affordable, progressive, naturopathic
care with particular emphasis on pediatrics and There is much speculation as to why the number of individuals af-
family medicine. fected with autism has increased so significantly. The science of
epigenetics tells us that changes in organisms are caused by
modification of gene expression rather than by alteration of the ge-
netic code itself. This alteration of gene expression is influenced
by the environmental factors the organism encounters. Today’s

30
youth are subjected to a flood of environmental vaccine schedule.10 So now, not only are Ameri-
factors that are toxic when consumed, breathed cas’ children consuming glyphosate, they are
or injected. also having it directly injected. This highly toxic
contaminant contributes to the increasing ill
Increasing usage of Glyphosate, introduced into
health of our population.
the food supply in 1974, and declared (a) “prob-
able carcinogen”
CHILDREN WITH AUTISM
One such environmental hazard children are ex- SUFFER FROM GI PROBLEMS
posed to is the increasing usage of Glyphosate.
Glyphosate is a toxic chemical found in the herbi-
It is commonly seen in the scientific literature and
cide Roundup. It was introduced into the food
in clinical practice that children with autism suffer
supply in 1974. Today, the U.S. uses some 125.4
from GI problems. Studies suggest different
million kilograms of glyphosate. Crops have
prevalence depending on the cohort studied, but
been genetically modified to resist Roundup.
the consensus is that GI disorders are common
Some GMO Roundup-ready crops common in
in autism. Tissue samples observed in Autism
the U.S. are: corn, soy, canola, sugar beets, cot-
Spectrum Disorders include findings of ileo-
ton, tobacco and alfalfa. Roundup is also used
colonic lymphoid nodular hyperplasia, enterocoli-
as a desiccant/ripener in: wheat, oats, barley,
tis, gastritis, and esophagitis. Gastrointestinal
rye, sugar cane, beans, lentils, peas, flax, sun-
symptoms have been strongly correlated with the
flowers and chick peas. Glyphosate inhibits the
severity of autism. 11,12,13,14,15,16
Shikimate Pathway involved in the synthesis of
tyrosine, tryptophan and phenylalanine, also
known as the 3 aromatic amino acids. In 2015,
WHAT ARE THE SOLUTIONS
the World Health Organization declared glypho- TO THE CRISIS?
sate a “probable carcinogen.”7
I have found in my practice that limiting biotoxins
Glyphosate disrupts the human gut microbiome
such as glyphosate and heavy metals has an ex-
and alters folate metabolism. In her research, Dr.
tremely positive effect on the gut. Glyphosate is
Stephanie Seneff from MIT noted that glyphosate
found in the products listed above. Eating a
caused “disruption of mucosal folds and disarray
gluten-free/dairy-free, organic and non-
of microvilli structure” in the intestinal wall, along
genetically modified diet eliminates much of the
with an exaggerated secretion of mucin through-
Glyphosate present. Heavy metals are found in
out the alimentary tract.8 The increase in glypho-
the foods we eat, like Mercury in tuna and Alumi-
sate usage has mirrored the increase in autism
num from cans, cookware and aluminum foil
with a statistical significance that can’t be
among other places. There is also heavy metal
avoided.9
contamination that results from injection of vac-
Recent research has concluded that glyphosate cines on the current childhood vaccine sched-
has not only contaminated the soil but is also ule. Mercury in thimerosal, and aluminum in vary-
found in certain vaccinations on the childhood ing forms, are employed as preservatives and im-

31
 The intestine is the most highly regenerative accounts for the potentially addictive quality of
organ in the human body and in a healthy these foods, and the associated withdrawal
human the intestinal lining can be entirely when they are taken out of the diet. They are
replaced every 2-3 weeks, longer for those common food intolerances, especially in children
with gut signs and symptoms. and adults with autism.

Certain peptides from gluten and casein can

mune stimulants in the current vaccine schedule.
bind to opioid-receptors in the brain, and can
Wherever the contamination is sourced, it is sig-
have a potent effect on behavior (like heroin or
nificant for human biochemistry and must be miti-
morphine), causing problems including sleepi-
gated. Heavy metal toxicity has many deleterious
ness, giddiness, inattention/”zoning out”, and ag-
effects on human biochemistry.17
gressive and self-abusive behavior.

GFCF (GLUTEN-FREE/ These problems appear to be due to the fol-

CASEIN-FREE) DIET lowing:

1) A failure of the digestive tract to fully digest

A gluten-free/dairy-free diet has been found to the gluten and casein peptides into the smallest
produce great benefit over other interventions in absorbable component, single amino acids.
a poll conducted for autism parents who treat
their children biomedically. Gluten is a general 2) Inflammation of the gut, allowing the gluten
name for the proteins found in wheat: wheatber- and casein peptides to enter the bloodstream
ries, durum, emmer, semolina, spelt, farina, faro, and reach opioid receptors in the brain.18
graham, KAMUT®, Khorasan wheat and einkorn,
Cade Nyland, associate professor of pediatrics
rye, barley and triticale. Gluten helps foods main-
at the Uniformed Services University of the
tain their shape, acting as a glue that holds food
Health Sciences in Bethesda, Maryland per-
together. Gluten has become an increasing
formed a large study of children with autism and
health threat due to its hybridized protein and the
found that 87% had IgG antibodies (allergy) to
glyphosate sprayed on it.
gluten versus 1% of the age and gender-
Dairy is a type of food produced from, or contain- matched controls, and 90% had IgG antibodies
ing the milk of mammals, primarily cattle, water to casein versus 7% of the controls. He also stud-
buffaloes, goats, sheep, camels, and ied 70 autistic children who followed a GFCF
humans. Dairy products include food items such (gluten-free/casein-free) diet for 1-8 years, and
as yogurt, cheese, and butter. Gluten in wheat found that 81% improved significantly by the
and casein, the protein in dairy, should be re- third month, with improvements continuing over
moved from the diet simultaneously due to gly- the next 12 months. Large improvements were
phosate contamination and the molecular similar- observed in the areas of social isolation, eye con-
ity between gluten and casein. Digested proteins tact, mutism, learning skills, hyperactivity, stereo-
from cow dairy and gluten, termed exorphins, in- typic activity and panic attacks. Among the 19%
teract with opiate receptors in the brain, which who did not improve, about 1/3 of them were not

32
following the GFCF diet and had significant glu- 70-80% of the immune system lies in the gut. For
ten and casein peptides still in their blood.18 proper immune function, the gut must be func-
tioning normally and not be “leaky”.22 90% of
Glyphosate also has another ominous effect on
our neurotransmitters are made in our gut.23 The
the gut. It paralyzes the gut by debilitating my-
gut is now being considered as the first brain.
osin decreasing the ability of the gut to contract
This is especially important in the autism commu-
and propel food through the large intestine.19,20
nity where small changes in the neurotransmitter
When the large intestine does not contract and
concentration in the brain can lead to big
propel food forward, it backs up into the small in-
changes in behavior. We know the gut and the
testine. The small intestine has a relatively low
brain are connected and where there is inflamma-
concentration of bacteria normally, but when the
tion in one, there is inflammation in the other.
motility of the large intestine is compromised, the
bacteria back up into the small intestine causing
small intestinal bacterial overgrowth (SIBO).
IT IS NECESSARY TO FIX THE
SIBO leads to additional abdominal symptoms or GUT LINING SO THAT FUNC-
exacerbation of those already present. It is nec- TION IMPROVES
essary to eliminate glyphosate from the GI tract
with the help of binders such as humic or fulvic After removing the inflammatory foods and
acid (among others) that bind and help to elimi- chemicals from the gut, it is necessary to fix the
nate it from the GI tract. It is much easier to avoid gut lining so that function improves. In humans,
these toxins than trying to remove them once the gut microbiome provides many functions.
they have paralyzed the gut. Keep in mind that The gut bacteria produce folate, biotransform
you are what you eat and what your food eats. To our food and produce Vitamin K to name a few
this end, it is necessary when avoiding Glypho- functions. In populations with a neurodevelop-
sate to eat meat that is grass fed and eggs that mental disorder, it is even more important to
are free range. have a functioning GI tract. Fixing the gut can be
accomplished by detoxifying the gut, promoting
CORN enterocyte proliferation and providing protection
to the lining until it can be reformed. The intes-
Corn is another food that should be avoided due tine is the most highly regenerative organ in the
to BT toxin in the corn kernels. BT toxin was intro- human body and in a healthy human the intesti-
duced into the food supply in the 1990’s. BT nal lining can be entirely replaced every 2-3
toxin is a soil probiotic that acts as a pesticide. weeks, longer for those with gut signs and
When consumed by a pest, BT toxin causes the symptoms.24
pest’s stomach to explode. Unfortunately, when
humans consume BT toxin it causes death to our
gut microbiome. Corn, if consumed, must be or-
ganic and NON-GMO.21

33
21 DAYS TO DETOX GLUTEN
FROM THE BODY
It is estimated that it takes approximately 21
days to detox gluten from the body. Repair takes
at least 2-3 weeks after the offending foods have
been removed. For complete gut repair it can
take a few months if the diet and removal proc-
ess is followed strictly. If there are lapses in the
diet even for a day, the microbiome is again dam-
aged, and the process will need to start over.25

BEGIN TO HEAL BY LIVING

BY HIPPOCRATES’ WISE
WORDS

As Hippocrates once stated, “Let food be thy

medicine and medicine be thy food.” This is
never truer than in the world we live in today. It is
time we heed the warning signs regarding the ill
health of our youth and begin to heal by living by
Hippocrates’ wise words.

34
THE GUT, ANXIETY & The health of the microbiome may be a key underlying issue for
DEPRESSION: BEYOND those individuals with anxiety and depressive disorders. The mi-
PROBIOTICS crobiome refers to the array of microorganisms living in us and
THE EFFECT OF GUT on us. The study of the microbiome has led to investigations into
PERMEABILITY & what effect microorganisms exert on health versus disease. This
INFLAMMATION ON area has been a hot topic of research for the past decade or
YOUR EMOTIONAL more, with numerous researchers looking into how different re-
WELL-BEING gions of the microbiome affect the human host. More recently re-
search has provided some interesting connections between the
Dr. Maggie Luther works with women experi- health of the microbiome and mental illness, including anxiety
encing hormone, gut and adrenal issues
who are ready to be free of their symptoms
and depression. In particular, the health of the microbiome in the
and have their life back. She specializes in gut, the gut microbiota, seems to have a clear implication in emo-
the restoration of health by supporting the
physical, mental, and emotional parts of us
tional and mental wellness.1
to heal. As a medical intuitive, Dr. Luther is
able to tap into her clients’ ability to heal
allowing them to move past their own self- THE ROLE OF A HEALTHY GUT
imposed limitations, guiding them to the
core of their health issues. Dr. Luther
MICROBIOTA
teaches that healing happens in the journey,
every day is an opportunity to feel like your
The gut microbiota is a major contributor to the intestinal barrier.
best self.
Web-site: https://yourwellnessexpert.com/ It is involved in the maturation of our immune system by stimulat-
ing the innate immune system in the early stages of life (non-

35
specific immunity). This leads to the maturity of immune system, through the lens of inflamma-
intestinal-related lymphoid tissue, which inspires tion, may be implicated in your symptoms.5
the acquired immunity (specific immunity). The
gut microbiota is responsible for intestinal synthe- PROBIOTICS AS TREATMENT
sis and metabolism of certain nutrients, hor- FOR ANXIETY
mones and vitamins. It plays an important role in
drug and poison removal. Under normal condi-
& DEPRESSION
tions, the gut microbiota continuously stimulates
Emerging studies have shown varying results on
the human immune system, which leads to a con-
supplementation with probiotic strains, and their
stant state of “low degree of physiological inflam-
viability as a treatment option providing sympto-
mation.” This allows for a rapid and effective
matic relief, for anxiety and depression. A study
mechanism for defending against pathogenic mi-
involving pregnant women who were given a spe-
croorganisms. The gut microbiota also supports
cific Lactobacillus rhamnosus species while preg-
the continuous existence of itself, stimulates in-
nant, experienced significantly less anxiety and
testinal epithelial cell regeneration, produces mu-
depressive symptoms in the postpartum period.6
cus and nourishes our mucosa by producing
short-chain fatty acids (SCFAs) used by our intes- A pilot study looked at the use of a single strain
tinal cells. Really, the right gut microbiota creates Bifidobacterium longum on people who suffered
a mutually beneficial relationship with the from Irritable Bowel Syndrome (IBS) and depres-
human.2,3,4 sive type symptoms, as anxiety and depression
are much more common in IBS sufferers. In this
PREVALENCE OF ANXIETY study, imaging of the brain was performed along
AND DEPRESSION with routine depression intakes used in these
types of studies. After 10 weeks of taking the pro-
Anxiety disorders are the most common mental biotic daily, the treatment group experienced de-
illness, affecting more than 40 million adults in creased depression scores, and interestingly,
the United States. Roughly 7%, or 16 million these changes showed up on functional MRI as
adults, have experienced a major depressive beneficial changes to the mood centers of the
event in the last year, and depressive disorders brain.7
are the leading cause of disability amongst
A review of 10 studies looking at the effective-
adults ages 18-44. Nearly one half of those diag-
ness of probiotics on anxiety and depression
nosed with a depressive disorder will also re-
summarized their findings as some trials effec-
ceive an anxiety disorder diagnosis. Many
tively reducing symptoms of agitation, anxiety,
women I see in practice have varying degrees of
and depression, and others not having strong
anxiety or depression. You don’t have to have a
enough efficacy power for the probiotic to be
diagnosed disorder to want to find relief from the
seen as a standalone treatment. Authors who
symptoms of anxiety and depression. If you do
had done sub-group analysis of various studies,
have a diagnosed mental illness, even more rea-
included in this review, often found significant re-
son to look at how the health of the gut and the
duction in symptoms when comparing mild to

36
moderate depression versus no depression, In addition to the gut releasing these molecules,
meaning that probiotics may not exert a strong various gut microbes have been shown to synthe-
enough effect on their own to be recommended size neurotransmitter-like molecules, using the
as a standalone treatment, but their use may same substrates our body uses from food. These
benefit a subset of people enough to make it neurotransmitters include gamma-amino butyric
worth recommending as an adjunctive acid (GABA), serotonin (5-HT), dopamine, norepi-
treatment.8 nephrine, and acetylcholine.10

While some studies have demonstrated a poten- Neurotransmitter imbalances are commonly impli-
tial benefit in symptomatic relief solely using pro- cated in anxiety and depressive disorders. Many
biotics, is symptomatic relief enough? While the pharmaceutical medications for anxiety and de-
health of the gut microbiota has spurred much pressive disorders target neurotransmitter path-
interest in treating anxiety and depression natu- ways, in addition to a few which target the cen-
rally, it may be time to look beyond the micro- tral nervous system. While the gut communicates
biome of the gut and whether just a single probi- with the brain in what is termed the “gut-brain”
otic will have enough influence on your mental axis, further research demonstrates there is a
well-being, and instead turn more of our attention “gut-microbiota balance” that is just as key in its
to the health of the gut itself, including gut perme- ability to influence the brain’s state of emotional
ability and inflammation. This may be the next wellness. Interestingly, in regards to serotonin,
step in finding long-term symptom resolution for early studies have demonstrated how specific
anxiety and depression. gut microbes may be able to modulate human
serotonin production in the colonic enterochro-
BEYOND THE GUT: THE maffin cells of the digestive tract.11,12
ROLE OF THE GUT MICROBI-
OTA IN ANXIETY & DEPRES- MICROBIAL IMBALANCE IN
SIVE SYMPTOMS THE GUT MICROBIOTA AND
INTESTINAL PERMEABILITY
The gut releases a number of hormones, neuro-
transmitters and immunological factors, which Dysbiosis, or a microbial imbalance, in the gut
send signals to the brain either directly through can lead to increased inflammation and intestinal
the blood or through the autonomic nervous sys- (gut) permeability, allowing bacterial metabolites
tem via the vagus nerve. The gut has, in recent to move through the submucosa and into the sys-
years, been dubbed “the second brain,” as the temic circulation. The term “leaky gut” has been
more common molecules we’ve always associ- used to describe this process. The actual mecha-
ated with the brain, including serotonin and dopa- nism of this “leaking” involves multiple mecha-
mine, have been found to be more prevalently nisms still being uncovered. One mechanism in-
released from the gut. For instance, we now cludes the manipulation of the tight junctions, the
know that more than 90% of the body’s serotonin area between the cells of the digestive system
is synthesized in the gut, not the brain.9 contributing to the barrier, by dysbiotic bacteria.

37
Other mechanisms involve cytokine signaling by 2. They themselves may create gut permeabil-
the environment of the digestive system, which ity and inflammation, independent of their effect
can be both from an imbalance of microbes as on the gut microbiota.
well as a number of factors listed below. This in-
On-going inflammation in the digestive system
crease in gut permeability is what leads to im-
places stress on the microbiome whereby the re-
mune dysregulation and increased
lease of cytokines and neurotransmitters occurs.
inflammation.6 Intestinal permeability seems to
Coupled with an increase in intestinal permeabil-
be a real concern for multiple conditions, includ-
ity these molecules then travel systemically. Ele-
ing anxiety and depression, Irritable Bowel Dis-
vated blood levels of cytokines TNF-a and MCP
ease (IBD), asthma, autism, diabetes and
(monocyte chemoattractant protein) increase the
more.13
permeability of the blood-brain barrier, enhanc-

MICROBIAL IMBALANCE, IN- ing the effects of rogue molecules, such as cyto-
kines and neurotransmitters from the permeable
TESTINAL PERMEABILITY inflamed gut. The subsequent absorption of
AND INFLAMMATION these rogue cytokines and neurotransmitters
across the blood-brain barrier and influence
Gut inflammation and microbial imbalance may brain function, leading to anxiety, depression,
occur from a number of factors, including: lack of and memory loss.9
breastfeeding; early nutritional deficiencies; poor
dietary choices as a teenager and adult includ- A study conducted with healthy subjects and no
ing insufficient plant nutrients, non-digestible fi- history of depressive disorders has led to a
bers and healthy fats; environmental toxicity in- clearer understanding of how inflammation leads
cluding plastics and pesticides exposure; ciga- to depression. Participants were administered an
rette smoke; overconsumption of caffeine, alco- endotoxin infusion, and the infusions triggered
hol, and sugar; regular use of acid blockers and the release of cytokines and subsequent emer-
other over the counter medications designed to gence of classical depressive symptoms. This
alter normal digestive processes. Obviously, the study helped establish a direct correlation be-
factors you have control over are the ones you tween increased levels of IL-6 and TNF-a with
should focus on to correct any underlying intesti- symptoms of depression and anxiety, supporting
nal permeability and inflammation contributing to that pro-inflammatory cytokines play a role in the
your anxiety and depression.14 development of anxiety and depression.15

These factors can do 2 things: CONCLUSION:

1. They can lead to an imbalance in the micro-
While it is entirely possible for you to find sympto-
biota itself, causing dysbiosis, making it easier
matic relief of anxiety and depressive symptom
for non-beneficial species to grow in the gut,
with the use of a probiotic, it is also in your best
which will in itself contribute to increased gut per-
interest to rule out gut dysbiosis, intestinal perme-
meability and inflammation.
ability and digestive inflammation as a cause of

38
your symptoms. Yes, probiotics have the ability 5. The Anxiety & Depression Association of America.
https://adaa.org/about-adaa/press-room/facts-statistics. Re-
to bring back some balance to the microbiota in
trieved August 11, 2018.
the gut, but most probiotics are transient, mean-
ing their effects may wear off once you stop tak- 6. Slykerman RF, et al. Effect of Lactobacillus rhamnosus
HN001 in Pregnancy on Postpartum Symptoms of Depres-
ing them. Using probiotic supplements exclu-
sion and Anxiety: A Randomised Double-blind Placebo-
sively as a means to reduce symptoms in the controlled Trial. EBioMedicine. 2017 Oct; 24: 159–165
short-term can be extremely beneficial for those
7. Pinto-Sanchez MI, et al. Probiotic Bifidobacterium longum
with anxiety or depressive disorders.
NCC3001 Reduces Depression Scores and Alters Brain Activ-
ity: A Pilot Study in Patients With Irritable Bowel Syndrome.
Addressing the health of the gut, whether you Gastroenterology. August 2017 Volume 153, Issue 2, Pages
have digestive symptoms or not, may be just the 448–459.e8
treatment you need to reduce anxiety and de-
8. Wallace CJK and Miley R. The effects of probiotics on de-
pressive symptoms. This is in no way to dis- pressive symptoms in humans: a systematic review. Ann Gen
suade you from getting on a quality probiotic. It Psychiatry. 2017; 16: 14.
is to motivate you to look deeper at the root
9. Clapp M, Aurora N, Herrera L, Bhatia M. Gut microbiota’s
cause of your anxiety and depression in hope effect on mental health: The gut-brain axis. Clinics and Prac-
that you can find the long-term relief you desire, tice 2017; volume 7:987
and deserve. The long-term approach lends it-
10. Galland L. The Gut Microbiome and the Brain. J Med
self to uncovering whether your anxiety and/or Food. 2014 Dec 1; 17(12): 1261–1272.
depressive symptoms stem from your digestive
11. Wang HX and Wang YP. Gut Microbiota-brain Axis. Chin
system, and encourages you to take a good look
Med J (Engl). 2016 Oct 5; 129(19): 2373–2380.
at the digestive environment you are currently
supporting! 12. Yano JM, Yu K, Donaldson GP, Shastri GG, Ann P, Ma L,
Nagler CR, Ismagilov RF, Mazmanian SK, and Hsiao EY. In-
References: digenous bacteria from the gut microbiota regulate host sero-
tonin biosynthesis. Cell. 2015 Apr 9; 161(2): 264–276.
1. Ursell LK, Metcalf JL, Parfrey LW, and Knight R. Defining
the Human Microbiome. Nutr Rev. 2012 Aug; 70(Suppl 1): 13. Arneth BM. Gut-brain axis biochemical signalling from the
S38–S44. gastrointestinal tract to the central nervous system: gut dys-
biosis and altered brain function. Postgrad Med J. 2018 Jul
2. Sekirov I, Russell SL, Antunes LC, Finlay BB. Gut microbi- 19. pii: postgradmedj-2017-135424.
ota in health and disease. Physiol Rev. 2010
Jul;90(3):859-904. 14. Conlon MA and Bird AR. The Impact of Diet and Lifestyle
on Gut Microbiota and Human Health. Nutrients. 2015 Jan;
3. Rakoff-Nahoum S, Paglino J, Eslami-Varzaneh F, Edberg S, 7(1): 17–44.
Medzhitov R. Recognition of commensal microflora by toll-like
receptors is required for intestinal homeostasis. Cell. 2004 Jul 15. Benson S, et al. Effects of acute systemic inflammation on
23;118(2):229-41. the interplay between sad mood and affective cognition.
Translational Psychiatryvolume 7, Article number: 1281
4. Burger-van Paassen N, Vincent A, Puiman PJ, van der (2017)
Sluis M, Bouma J, Boehm G, van Goudoever JB, van Seunin-
gen I, Renes IB. The regulation of intestinal mucin MUC2 ex-
pression by short-chain fatty acids: implications for epithelial
protection. Biochem J. 2009 May 13;420(2):211-9.

39
GUT HEALTH, Your digestive system is the seat of your health, and keeping it
healthy prevents many chronic diseases. Your intestines have a
EMOTIONAL lining that acts as a semi permeable barrier, controlling what is
HEALTH AND absorbed into your body from the food you eat. Numerous tiny
CHRONIC DISEASE blood vessels surround your intestines and absorb nutrients that
pass through this semi permeable barrier, later transporting
Dr. Ameet Aggarwal is a naturopathic doctor
and psychotherapist (Gestalt, Family Constel- these nutrients to your entire body through your bloodstream.
lations, EMDR) with years of experience treat-
ing physical issues, anxiety, stress, depres- Poor diet, antibiotic use, and lifestyle choices destroy the lining
sion, abuse, relationship issues and also
working with UNICEF, UN Staff, and other of your intestines, exposing your entire bloodstream to improp-
large organizations. Dr. Aggarwal focuses on erly digested food particles and toxins. These absorbed toxins
healing the gut, liver, adrenal system and
emotions together to optimize health and hap- and food particles cause unhealthy chemical reactions and in-
piness. His online course (free videos on flammation throughout your body, compromising the health of
health.drameet.com/p/intro) has been ap-
proved in the highest category for continuing every organ and altering your entire balance of hormones and
education for naturopathic doctors. Dr. Aggar- brain chemicals.
wal was voted as one of the top 5 speakers
on 2 world summits, which earned him recog-
nition as one of the top 43 naturopaths to fol-
low. He practices in Kenya and lectures
PROBIOTICS AND LEAKY
around the world, teaching students how to
treat anxiety and depression holistically. His
GUT SYNDROME
book “Feel Good” (free videos on
drameet.com/p/mindbodybook is considered Your intestines have naturally occurring good bacteria known as
to be one of the most comprehensive guides
to anxiety and depression.
probiotics that keep harmful bacteria and harmful yeast (also

40
known as Candida) in your digestive system to a Your intestinal cells, pancreas, and liver are also
minimum. Probiotics also produce chemicals that producing digestive juices and enzymes to di-
protect the cell lining of your intestines. Antibiotic gest and absorb your food completely. If they be-
use, stress, improper diet, poor lifestyle, and come unhealthy, digestion and, therefore, absorp-
other factors kill off your probiotics, allowing tion of important nutrients into your body, are re-
yeasts and harmful bacteria to increase in num- duced. When nutrients aren’t being absorbed
bers. The harmful bacteria and yeasts release properly, it affects your body’s ability to produce
toxins in your intestines, which cause your intesti- healthy cells and neurotransmitters, causing
nal cells to become inflamed and die off, leaving physical and mental health issues.
gaps in your intestinal barrier, a condition com-
Due to its contribution to chronic and excessive
monly known as leaky gut syndrome.
inflammation in your body, leaky gut syndrome
Behind the lining of your intestines resides a also causes damage and plaque formation in
large part of your immune system, also known as your blood vessels, including those in your heart,
gut associated lymphoid tissue (GALT). GALT is kidneys, and genital organs, creating an in-
exposed to toxins and undigested food particles creased risk of heart disease, kidney disease,
when the lining of your intestines is damaged, poor erections, and reduced sexual stimulation.
causing a huge immune reaction. This immune Chronic inflammation is also a leading cause of
response triggers excessive inflammation in your skin issues such as eczema and psoriasis, in-
body, which produces more toxins and in- creased food sensitivities, asthma, premenstrual
creased cortisol levels. It also changes the chem- syndrome, endometriosis, chronic sinusitis, arthri-
istry of your blood and balance of hormones and tis, and other chronic diseases.
neurotransmitters, causing chronic diseases and
mood disorders. TREATING YOUR
The added toxicity from leaky gut syndrome also INTESTINES
harms organs such as your liver, pancreas, adre-
nal glands, and thyroid gland, all crucial for emo- Replenish the probiotics in your gut
tional stability. If your liver becomes burdened
with toxins, its ability to clean your blood de- High-strength probiotics are found in health-food
creases, causing even more inflammation and stores (under different strains, such as lactobacil-
toxins to build up in your body - worsening dis- lus acidophilus, lactobacillus rhamnosus, saccha-
ease and emotional issues. romyces boulardii, etc.). Certain foods such as
yogurt, fermented cabbage, and some raw vege-
Replenishing your probiotics to tables also contain probiotics but not at therapeu-
adequate amounts might take up to 3 tic levels. Replenishing your probiotics to ade-
months, so be patient with yourself. The quate amounts might take up to 3 months, so be
effort is worth it, though, because you patient with yourself. The effort is worth it,
are building a strong foundation for though, because you are building a strong foun-
long-term health. dation for long-term health.

41
Increase your digestive enzymes and stom- tain spices such as cumin and turmeric, used in
ach- acid levels Indian cuisines, also reduce inflammation and
can be added to your cooking. Herbs such as
Stomach acid (hydrochloric acid, or HCL) and
licorice and slippery elm are soothing and help
digestive enzymes break food down properly so
heal your inflamed intestines. In addition to probi-
that your intestines better absorb nutrients. Stom-
otics and healthy foods, I always use a nutritional
ach acid also helps kill harmful bacteria that
supplement called L-glutamine. L-glutamine is
might be in your food. Stress, improper eating
an amino acid that provides a rich energy source
habits, and digestive damage will sometimes
to intestinal cells and helps to heal your intestinal
cause levels of stomach acid and digestive en-
wall. L-glutamine brings far better healing to your
zymes to be lower than normal, even though
intestines than using probiotics alone. L-
most stressed people tend toward higher
glutamine also helps make important brain
stomach-acid levels. Low stomach acid levels
chemicals, such as GABA, which reduces anxi-
can also be due to low thyroid activity.
ety. Other nutrients that help to repair your intes-
Low stomach acid and low levels of enzymes al- tines include vitamin A, vitamin B5, folate, sele-
low poorly digested food and harmful bacteria to nium, zinc, vitamin D and calcium.
reach your lower intestines and cause further
If you use antibiotics frequently, talk with your
damage and inflammation, worsening leaky gut
doctor on how to reduce the amount of antibiot-
syndrome. Increasing stomach acid and diges-
ics you take. Part of the reason children develop
tive enzymes can be achieved using HCL cap-
chronic infections is because they are given anti-
sules and digestive-enzyme supplements avail-
biotics too many times at an early age. It be-
able through health-food stores. Use them with
comes a vicious cycle because the more antibiot-
caution and under supervision because exces-
ics they take, the worse their immunity gets, and
sive stomach acid can damage your intestines.
the sicker they become. Hence you see a lot of
Reduce and correct the damage done to your children with chronic infections or needing their
intestines tonsils removed.

Removing inflammatory foods from your diet and

eating healthy foods reduces damage to your
probiotics and to your intestines. Different foods
affect different people. The most common inflam-
matory foods seem to be wheat (gluten), dairy,
sugar, excessive coffee, alcohol and soy. You
can get yourself tested for food allergies by a
health practitioner.

Omega-3 oils found in foods such as fish, nuts,

and seeds also reduce inflammation in your
body, unless you are allergic to these foods. Cer-

42
WHAT ABOUT WHAT COMES TO MIND WHEN YOU
BILE?!? A VITAL, THINK ABOUT BILE?
BUT OFTEN
IGNORED Do you know what it’s for? Where it comes from? If you’re like
most of my patients, you probably haven’t given it much thought,
ASPECT OF and only have a vague idea about the function of bile. I’m on a
DIGESTION mission to change that. In my clinical opinion, bile is THE most
important aspect of our digestion, and ultimately has an impact
Dr. Matt Reddy runs Reddy Natural Medi-
cine in Lafayette Colorado. He is a Colorado on nearly all aspects of your health. That might sound dramatic,
native, graduate of the University of Colo- but I have a feeling that by the time you finish this article, you
rado, and proud alumnus of the National
University of Natural Medicine in Portland, may find yourself nodding your head in agreement.
Oregon where he graduated in 2002. While

BASIC FACTS ABOUT BILE

Dr. Reddy works with all sorts of health con-
cerns, he specializes in digestive issues
(gas, bloating, candida, diarrhea, etc), liver
and gallbladder disease, hormone imbal-
ances and immune system issues. Dr. It is estimated that each day, your liver creates approximately
Reddy can be reached at one liter of this greenish brown fluid. It flows from the liver into the
drmattreddy@gmail.com.
gallbladder, where it’s concentrated and stored. Every time you
eat, your gallbladder releases some bile into your intestine,
where it helps with both digestion and detoxification. It enters
your small intestine immediately after food leaves your stomach.

43
Here, it’s joined by enzymes from your pancreas. food dyes or pharmaceutical medication. They
Once the food is mixed with bile and enzymes, it can also be waste products from normal physiol-
makes its way down the small intestine (all 20+ ogy. For example, estrogen is processed by the
feet of it) where further digestion, absorption, liver and cleared from the body through the bile.
and assimilation occur. Not enough bile or poor bile flow can mean too
much estrogen. So keeping hormone balanced
SO, WHY DO WE EVEN must include the bile too.
NEED BILE? The final function of bile is its ability to support
3 MAIN REASONS the immune system by acting as a kind of deter-
gent in the small intestine. When the flow of bile
First, bile is in charge of digesting fats - and is adequate and strong, it acts to sweep up and
proper digestion and absorption of fats is vital to move out potential pathogens that could cause
our health. We use fats for many functions includ- health issues. The process of clearing bacteria,
ing energy storage and production, hormone mold toxins, viruses, and more can be supported
building, temperature regulation, and managing by proper bile flow.
inflammation. Also, every single cell of your body
is made of fat. Specifically, the membrane that SEE HOW IMPORTANT BILE
surrounds each cell is built by phospholipids - a
type of fat. So, in order to produce enough en-
IS FOR DIGESTIVE HEALTH?!
ergy, create adequate hormones like estrogen,
Now you’re likely beginning to see how important
testosterone, and cortisol, keep your body warm,
bile is for digestive health. And don’t forget,
and repair your cell membranes, you must be
since your digestive system is in charge of break-
able to digest and absorb fat. Also don’t forget
ing down the food you eat, assimilating those nu-
about the fat soluble vitamins like Vitamins A and
trients into your body, and keeping out the things
E. Bile is how you get those into your body too.
that it doesn’t need, the gut truly is the gateway
Another vital function of bile has to do with the to health. Here’s the problem, though: bile pro-
elimination of toxins. Most people have a general duction is difficult. Most of us have poor bile flow.
understanding that the liver is a big filter, but Why? Some of the building blocks of bile are diffi-
what does it do with the toxins that it removes cult for us to get on a daily basis, no matter how
from the blood? These toxins are put into the healthy a diet we eat. This creates weak and
bile. The body then carries the bile to the intes- scanty bile. And bile tends not to flow well be-
tine so that the toxins can be excreted from the cause the liver ducts can get plugged up.
body via bowel movements. Without proper bile
Diseases of bile production and flow are surpris-
flow, toxins that the liver is trying to filter out of
ingly common
the body are not cleared properly. What are
these toxins? Well, we live in a world FULL of tox- So, you won’t be surprised to hear that diseases
ins. They can be chemicals in our environment, of bile production and flow are surprisingly com-
like benzene. They can be things we ingest like mon. The most common condition is called cho-

44
lestasis, or stagnant/sluggish bile flow. Symp- by ultrasound; however, in my practice, I’ve seen
toms of cholestasis include floating stools, nau- that many people have gallbladder dysfunction
sea, bloating, and fullness after meals, espe- and/or gallstone production that hasn’t reached
cially meals high in fat. The next level of concern the level where it would be detected with ultra-
is the formation of gallstones, also called sound. While digestive distress and abdominal
cholelithiasis. Gallstones range from extremely pain are the most obvious symptoms with bile
small sandy particles (called sludge), to large flow issues, other symptoms are often present as
stones that can block ducts and cause signifi- well. Migraines, painful periods, fatigue, and anxi-
cant problems. An inflamed gallbladder, a condi- ety are common symptoms that I’ve seen with
tion called cholecystitis, is a medical emergency sluggish bile and they almost always improve
with symptoms of intense pain and nausea. In with improved bile flow.
the US, over 300,000 people have their gallblad-
Supporting bile creation and bile flow requires a
der removed each year and it’s estimated that 20
few specific (scarce) nutrients
million have gallstones.1 Diagnosis of gallblad-
der dysfunction and gallstones is typically done

45
Supporting bile creation and bile flow requires a “bouncers” of the cell, ensuring only the good
few specific nutrients that are unfortunately stuff enters and keeping the not so good stuff
scarce in our modern diet. When we supplement out. Phospholipids also support the nervous sys-
small amounts of these nutrients every day, we tem and brain function.
start to build better quality bile. Once we have
Bitter herbs better the body for bile production
quality bile, we can then support it to flow more
easily and effectively. The two supplements I rec- Bitter herbs or cholagogues, have been used for
ommend to improve the quality of bile are liver, gallbladder, and digestive complaints for
Taurine and Phosphotidylcholine. Once those are centuries. Their therapeutic action is due to their
in place, stimulation of bile flow can be accom- ability to increase the amount of bile that’s made
plished with cholagogue herbs, AKA bitters. by the liver and increasing the speed for bile
movement into the intestine. Common bitter
TALKIN’ BOUT TAURINE herbs are chamomile (Chamomilla recutita), ele-
campain (Inula helenium), dandelion (Taraxacum
Taurine is an amino acid, is a key ingredient in officinalis), St. John’s wort (Hypericum perfora-
the formation of bile. It is found in high amounts tum), Artemisia sp, yarrow (Achillea millefolium),
in raw eggs, raw milk, and raw meat. We don't rosemary (Rosmarinus officinalis), chelidonia
eat these foods raw typically, so we have a hard (Chelidonium majus), and Gentian (Gentiana
time making quality bile. The liver binds taurine lutea).
to cholesterol to create something called a bile
acid. Bile acids keep the cholesterol, which is a Digestive complaints are often complex and mul-
fat, dissolved in the bile, and assists in the bind- tifaceted. Addressing bile production and flow
ing or emulsification of fats in the intestine. With- provides a strong foundation upon which all
out enough taurine, cholesterol will form sludge other contributing factors can be properly as-
and stones which block bile flow and impede sessed and addressed. So don’t forget about the
proper digestion and elimination. As a bonus, bile!
Taurine also plays a major role in stabilizing the
heart beat and electrical activity of nerves. CASE STUDY
PHOSPHATIDYLCHOLINE A 38-year-old male patient came in to my office
THE EMULSIFIER with severe fatigue and digestive trouble. His
symptoms started in 2013 after what he reported
is a one of the most important phospholipids was a bad case of food poisoning; over the fol-
(fats) in our body. In the bile, phosphatidylcho- lowing six months, he lost around 30 pounds. His
line acts as an emulsifier of the fats, allowing symptoms included gas, bloating, diarrhea,
them to be absorbed into the body and utilized. brain fog, poor sleep, fatigue and trouble regulat-
Our body needs these essential phospholipids ing his body temperature. He eventually was di-
for building cell membranes (remember you agnosed with IBS and prescribed a probiotic. In
have around 100 trillion cells!), which act like the the five years since his symptoms began, he

46
found some relief from acupuncture and Chinese Reference:
herbs, but was never able to heal completely. In
1 - https://www.ncbi.nlm.nih.gov/books/NBK448145/; Ken-
the last two years, my patient had identified cer- neth R. Hassler; Mark W. Jones. Gallbladder, Cholecystec-
tain foods made his symptoms worse, as well as tomy, Laparoscopic. Last updated October 217
foods that he tolerated. This gave him some re-
lief, but the list of tolerated foods was getting
smaller and smaller. He was extremely sensitive
to any changes to his diet, and lifestyle stressors
impacted his symptoms greatly. His extreme fa-
tigue meant that it took him days to recover from
any exertion, so his life revolved around manag-
ing his tasks in order to account for his recovery
time. As you can imagine, he was frustrated and
miserable.

As with most of my patients with digestive is-

sues, I started him on a treatment plan to im-
prove his overall digestive function, with special
emphasis on his bile production. We ran a SIBO
(Small Intestinal Bacterial Overgrowth) test.
Within two weeks of being on my initial recom-
mendations, my patient reported feeling better
than he had in years. His uncomfortable bloating
started to subside, and he noticed more energy
and better sleep. He was ecstatic! We hadn’t
even received the SIBO test results at that point.
He did end up testing positive for SIBO, so we
are currently addressing that; however, nothing
we’ve done in the SIBO protocol has had the
same impact as our initial protocol. At this point
he and I have been working with for six months
and I’m convinced that poor bile production and
flow are the root causes of his SIBO and other di-
gestive issues. As his liver, bile production, and
bile flow continue to improve, he’s getting his life
back. The foods he can tolerate continue to ex-
pand, his bloating is non-existent, his energy
and motivation have significantly improved, and
he is able to exert himself and recover normally.
Amazing what a little bile can do.

47
SMALL INTESTINE Developed countries have the highest incidence of irritable
BACTERIAL bowel syndrome (IBS) in the world. This common digestive disor-
OVERGROWTH (SIBO) der is mostly characterized by digestive symptoms such as; fre-
THE MOST COMMON quent bloating, constipation or diarrhea, abdominal pain, gas
CAUSE OF IRRITABLE and acid reflux. Previously thought to be caused by stress and
BOWEL SYNDROME poor diet, more recent research suggests that the majority of IBS
sufferers actually have a bacterial infection in the small intestines,
Dr. Nirala Jacobi, ND has been a naturopathic
known as SIBO.
physician for over 20 years.She is considered
one of Australia’s leading expert in the treat-
ment of small intestine bacterial overgrowth(SI-
BO),a common cause of IBS.
WHAT IS SIBO?
Nirala is the medical director for SIBOtest, an
online breath testing service, as well It is common knowledge that the digestive tract is home to our
as“TheSIBO Doctorâ€, an online profes-
sional education platform. She lectures inter-
gut microbiome—the incredibly important bacterial ecosystem
nationally about the assessment and treat- that performs such vital functions as immune regulation, nutrient
ment of SIBO and is the host of the SIBO
Doctor podcast for practitioners.
absorption, dampening inflammation, and the removal of waste.
She is the medical director and senior naturo-
pathic physician at The Biome Clinic, center Most of these interactions occur in the large intestine. However,
for functional digestive disorders in Mullum-
bimby, Australia
the small intestine, with its massive absorptive surface, usually
contains much smaller numbers of bacteria to prevent the fermen-
tation of food as it passes. The human body has several mecha-
nisms to keep the small intestines relatively free from bacteria.

48
 Besides digestive symptoms, emerging causes scarring and adhesions and alters the
research into SIBO is finding this common normal anatomy of the small intestines
disorder to be at the root of many systemic
inflammatory conditions. When food stays in the small intestines it acts as
fuel for bacterial growth via fermentation. Foods
Natural defenses include stomach acid, bile ac- that are particularly easy to ferment are simple
ids, and the normal cleansing wave through the sugars, fiber, and other fermentable carbohy-
small intestines. This cleansing wave, also called drates which are found in higher amounts in a va-
the migrating motor complex (which is separate riety of foods, including garlic, onion, pear, apple
from peristalsis in the large intestine), occurs and grains such as spelt and rye.
every 90 minutes between meals and ensures
A good treatment plan for SIBO will invariably in-
food contents are propelled downwards toward
clude a diet that restricts these fermentable
the colon.
foods for a period of time. In addition to SIBO,
When these defenses are damaged, bacteria are small intestine fungal overgrowth (SIFO) is com-
allowed to flourish in the wrong area of the intes- monly seen as a co-infection and would also re-
tines. quire food elimination.

THE MOST COMMON

Bacterial fermentation produces hydrogen gas,
methane gas, and hydrogen sulfide gas. Meth-
CAUSES OF SIBO ARE: ane gas is highly associated with chronic consti-
• Damage to the cleansing wave which
pation, while the over-production of hydrogen
means food is allowed to remain in the small in-
gas usually causes diarrhea or an alternating pat-
testine, encouraging bacterial overgrowth. This is
tern. Hydrogen sulphide gas cannot yet be meas-
most often caused by an autoimmune reaction
ured on the breath test.
after a case of bacterial food poisoning. This is

SYMPTOMS OF SIBO
known as “post-infectious IBS.”
• Medications such as proton pump inhibi-
tors, morphine and other opiates, narcotics, pos- BACTERIAL OVERGROWTH
sibly beta agonists and calcium channel block- CAN CAUSE:
ers
• Chronic stress can decrease stomach acid • Bloating, especially after meals
output (hypochlorhydria) and affect the nervous • Gas
system of the gut (enteric nervous system). Nor- • Diarrhea or constipation
mal stomach acid levels are required to kill bacte- • Reflux
ria. • Burping
• Stress also causes changes in the motility • Abdominal pain
of the small intestines, causing a pooling and • Food intolerances, including histamine
stagnation which allows for bacterial overgrowth intolerance
• Altered anatomy such as malformation of • A host of systemic symptoms including fa-
the ileocecal valve following surgical intervention tigue, rashes, headaches, and anxiety

49
DAMAGE CAUSED BY •
•
Restless leg syndrome
Fibromyalgia and Chronic Fatigue Syn-
BACTERIAL OVERGROWTH drome – especially associated with diarrhea -
dominant SIBO
SIBO causes damage to the absorptive surface • Acne rosacea
of the small intestine – and therefore the ability of • Interstitial cystitis (chronic bladder inflam-
the body to absorb nutrients from food. mation)

The absorptive surface of the small intestine is

likened to a shaggy carpet, with finger-like protru-
TESTING FOR SIBO
sions called villi. The surface of the villi is cov- Testing for SIBO can be done through a hydro-
ered with microvilli that act as the interface for ab- gen or glucose breath test which can conven-
sorption. Microvilli secrete enzymes called iently be done at home. The test measures the
“brush border enzymes” which break down gases of bacterial fermentation. In the US and
starches into single molecules, and proteins into Europe, these tests are mostly ordered through
single amino acids so these can be absorbed. your physician, but some labs offer them without
a prescription and can be ordered online.
Bacterial gas production damages these sensi-
tive microvilli, therefore allowing larger carbohy-
drate molecules to remain in the small intestine
TREATMENT OF SIBO
and thus be fermented by bacteria. The pres-
Due to the frequent relapsing nature of this condi-
ence of bacteria in the small intestines also dam-
tion, the treatment of SIBO is best done under
ages bile acids.
the care of a trained medical professional such
Bile is important in the break down and absorp- as a Naturopathic Physician.
tion of fatty acids. Exposure to bacterial gases
often renders bile acids useless resulting in the TREATMENT INVOLVES:
malabsorption of essential fatty acids and fat-
Diet- I have created the SIBO Bi-phasic diet
soluble vitamins.
which guides you through 2 phases of foods to
Lastly, the continued presence of bacteria in the minimize bacterial fermentation. Click here to
small intestines causes the gut lining to become download a copy of the SIBO Bi-phasic diet.
leaky, allowing for the absorption of bacterial tox-
ins and undigested food particles. Leaky gut is a KILLING BACTERIA:
potent trigger for inflammation and immune acti-
vation involved in other systemic symptoms often • Specific antibiotics, such as Xifaxan
associated with SIBO. • Herbal antimicrobials such as Berberine
containing herbs, oregano oil and specific garlic
Besides leaky gut, SIBO is also commonly as- extract
sociated with conditions such as: • Motility agents (prokinetics) these aim to re-
set the normal motility of the small intestines

50
• Digestive aids are sometimes helpful.

These include:

• hydrochloric acid, enzymes, or bile

stimulants

• healing agents for the small intestine

replacement of nutrients which are defi-
cient as a result of poor absorption

CONCLUSION
If you’ve been diagnosed with Irritable
Bowel Syndrome (IBS), your digestive
symptoms may actually be due to a bac-
terial overgrowth. A simple breath test
can help to confirm this diagnosis and
get you on the road to recovery. Treat-
ment of this condition is best done un-
der the care of a medical professional. It
involves a specific diet, antibacterial
treatments, and often motility agents to
prevent relapse.

Besides digestive symptoms, emerging

research into SIBO is finding this com-
mon disorder to be at the root of many
systemic inflammatory conditions.

You can find more information on this

condition and the SIBO Bi-phasic Diet
on www.TheSIBODoctor.com

51
GOOD Probiotics are “good” microbes which help tune the immune sys-
tem and keep harmful microbes out of the body. Although the
DIGESTIVE claims surrounding the growing collection of probiotic supple-
HEALTH STARTS ments may sound too good to be true, in reality, probiotic re-
IN THE MOUTH search is growing rapidly and many great products are available
to help people with their digestive health. This is the area with the
Dr. Sean X. Hesler received the 2018 AANP most study, as the probiotic strains commercially available are
President’s Award and the 2011 SCNM
Alumni Award for Community Service for his
mostly taken by mouth in pill or powder form, or as food.
commitment to global and community health
throughout his career. Alongside his wife, Dr. First, let’s discuss some basic facts from the research on taking
Sarah Preston Hesler, he co-founded the
MamaBaby Haiti birth center in 2010, and
probiotics
he currently serves as Executive Director of
Naturopaths Without Borders (NWB), a not- Because they are generally aerobes, meaning they need oxygen
for-profit organization operating in Haiti, Mex-
ico, Thailand and Phoenix. In addition to
to thrive, most probiotic supplements and foods do not actually
presenting at conferences and universities colonize the gut. They may stick around for a few weeks, but gen-
around the US, Dr. Sean also see patients
privately at Phoenix Natural Family Medicine
erally we need to consume them for weeks to months to see ef-
in Tempe, AZ and Regenerative Health fects and possibly continue long-term.
Group in Mesa, AZ.

Probiotics are best taken with food to increase their survival

through your acidic stomach juices. Think about them as
naturally-occurring nutrient-producers in foods which grow from
the earth.

52
We now have enough research to be able to 3. Wash hands, and massage the cabbage
make recommendations for specific probiotic for ~10 minutes.
strains for specific health concerns. Strains of
4. Place cabbage into a clean 1-liter jar and
these microbes can have very different effects in
press with wooden spoon.
the body, even when they are from the same spe-
cies! For example, Lactobacillus plantarum is a 5. The pressed liquid must completely cover
well-known species of probiotic, but there are cabbage. If it doesn’t, add brine (4 cups non-
over a dozen different strains. Of 13 strains of chlorinated water, 1 Tbsp salt). Ideally leave ~1
Lactobacillus plantarum in a 2010 study, 5 did inch of air space between liquid and lid.
not stick to the intestinal wall and therefore would
not have an effect1. Likewise, E.coli has many 6. Let sit for at least 1 week at room tempera-
known strains, from normal flora in the gut to En- ture and away from direct sunlight.
terohemorrhagic E.coli which causes fatal infec-
7. Taste and refrigerate if tangy enough. If not,
tious diarrhea, to a beneficial strain called E.coli
test again daily.
Nissle 1917 which can help with Irritable Bowel
Syndrome, Ulcerative Colitis, and constipation!
This is why it is important when you read ingredi-
ent labels for probiotic supplements and yogurt PROBIOTICS SUPPORT ORAL
to look for the specific strains of the species HEALTH
name, which are indicated by letters or numbers
after the name. Without those letters or numbers, Good digestive health starts in the mouth. Help-
you can’t know for sure what that specific strain ful strains to prevent bacteria from damaging
is. teeth and gums include Bifidobacterium lactis
Bb12, Lactobacillus rhamnosus GG, Lactobacil-
Still, there are many digestive health benefits to lus casei Shirota, Lactobacillus acidophilus La5,
consuming foods fermented with naturally- and Streptococcus salivarius M18.
occurring probiotics. In commercial foods, look
for some of the specific strains from this article – Notably, Lactobacillus rhamnosus GG in a 2001
yogurts and kombuchas are available at your gro- randomized controlled trial reduced the risk of
cery store. Sauerkraut, kombucha and yogurt are dental cavities in children by 44%.2 This is proba-
easy to make so everyone can work these foods bly because it reduced harmful Streptococcus
into the diet. mutans.

1. Wash 1 head of cabbage. Remove outer CONSTIPATION

leaves, cut into quarters, remove the core and
then shred into thin slices. Daily elimination of waste is essential to health,
and chronic constipation is not only a painful con-
2. Add 1 Tbsp salt (kosher, pickling, sea or Hi-
dition, it is also an obstacle to improving other
malayan).
health issues. Good strains for chronic constipa-
tion are Bifidobacterium animalis lactis DN-173

53
010, Bifidobacterium lactis Bb12, Lactobacillus
casei Shirota, Lactobacillus rhamnosus Lcr35,
INFECTIOUS/TRAVELER’S
Lactobacillus acidophilus NCFM and Bifidobacte- DIARRHEA
rium lactis HN019.
Food recalls and outbreaks of food poisoning are
A 2008 study showed after only 2 weeks of sup- often in the news, and my patients and volun-
plementing a fermented milk with Bifidobacte- teers frequently ask me what they can do to pre-
rium lactis DN-173 010, constipated women had vent getting sick when traveling. I generally rec-
59% more stools and softer consistency.3 ommend they find at least 2 of these strains: Lac-
tobacillus casei DN-114 001, Lactobacillus
H.PYLORI reuteri DSM 17938, Lactobacillus rhamnosus
GG, Bifidobacterium lactis Bb12, and Saccharo-
This bacteria can cause stomach ulcers, chronic myces boulardii.
gastritis and acid reflux. The conventional treat-
Children hospitalized for food poisoning were
ment is a combination of antibiotics and acid-
given Lactobacillus reuteri DSM 17938 in a 2014
blocking medication, with varying levels of suc-
study – 50% of treated children had no diarrhea
cess and side effects. Probiotic treatment, even
after 24-48 hours vs. 5% of the placebo group7.
as regular yogurt, can increase the effectiveness
Lactobacillus rhamnosus GG reduces the risk of
of the medications while decreasing their side ef-
traveler’s diarrhea by 47%, and even better news
fects. The best strains based on research are
for people who have had traveler’s diarrhea be-
Lactobacillus casei DN-114 001, lactobacillus
fore: their risk is reduced by 58%!8
reuteri DSM 17938, Lactobacillus casei Shirota,
Saccharomyces boulardii, Lactobacillus acido-
philus La5, and Bifidobacterium lactis Bb12. SMALL INTESTINAL
BACTERIAL OVERGROWTH/
Alongside medications, separate studies
IBS
showed Lactobacillus casei DN-114 001 in-
creased the success rate from 85% to 92%4, SIBO is becoming increasingly recognized as a
and Lactobacillus casei Shirota from 76% to distinct disorder causing chronic diarrhea and/or
94%5. Surprisingly, Lactobacillus reuteri DSM constipation, and it’s closely associated with Irri-
17938 taken with the acid-blocker Omeprazole table Bowel Syndrome. Because there is an over-
eliminated H.Pylori in 30 days in 60% of pa- growth of bacteria in the small intestine, some
tients6. probiotics can actually aggravate the condition.
For methane-dominant SIBO, Lactobacillus
Lactobacillus rhamnosus GG reduces the risk of reuteri DSM 17938 eliminates methane produc-
traveler’s diarrhea by 47%, and even better tion in 55% of people9. For hydrogen-dominant
news for people who have had traveler’s SIBO, Saccharomyces boulardii10 and Lactoba-
diarrhea before: their risk is reduced by 58% cillus casei Shirota11 are the strains of choice.

54
SUPER STRAINS
References

1. Gross G, Snel J, Boekhorst J, Smits M, Kleerebezem M. Biodiver-

sity of mannose-specific adhesion in Lactobacillus plantarum revisited:
You may notice some of these strains come up strain-specific domain composition of the mannose-adhesin. Beneficial
Microbes. 2010;1(1):61-66. doi:10.3920/bm2008.1006.
repeatedly for multiple conditions – I call these
“super strains.” They are the answer to the ques- 2. Näse L, Hatakka K, Savilahti E, et al. Effect of Long–Term Con-
sumption of a Probiotic Bacterium, Lactobacillus rhamnosus GG, in Milk
tion, “which probiotic should I take for general
on Dental Caries and Caries Risk in Children. Caries Research.
health?” 2001;35(6):412-420. doi:10.1159/000047484.

3. Yang Y-X, He M, Hu G, et al. Effect of a fermented milk containing

The most versatile and well-researched strains
Bifidobacterium lactis DN-173010 on Chinese constipated women. World
for GI health available in supplements and food Journal of Gastroenterology. 2008;14(40):6237. doi:10.3748/wjg.14.6237.

products are: 4. Sykora J, Valeckova K, Amlerova J, et al. Effects of a Specially

Designed Fermented Milk Product Containing Probiotic Lactobacillus ca-
1. Lactobacillus rhamnosus GG – immune sei DN-114 001 and the Eradication of H. pylori in Children. Journal of
Clinical Gastroenterology. 2005;39(8):692-698.
booster and inflammation/allergy reducer
doi:10.1097/01.mcg.0000173855.77191.44.

2. Lactobacillus acidophilus La5 and Bifido- 5. Sahagún-Flores JE, López-Peña LS, de la Cruz-Ramírez Jaimes
J, García-Bravo MS, et al. Eradication of Helicobacter pylori: triple treat-
bacterium Lactis Bb12 – usually paired in supple-
ment scheme plus Lactobacillus vs. triple treatment alone. Cirugia y ciru-
ments and foods janos. 2007;75(5):333-336.

6. Saggioro A. Helicobacter pylori eradication with Lactobacillus

3. Lactobacillus reuteri DSM 17938 – also
reuteri. A double-blind placebo-controlled trial. Dig Liver Dis.
helpful for acid reflux, infant colic, enhancing the 2005;(37):S88.

immune system and bad breath 7. Dinleyici EC, Vandenplas Y. Lactobacillus reuteri DSM 17938 ef-
fectively reduces the duration of acute diarrhoea in hospitalised
4. Lactobacillus casei Shirota – helps with children. Acta Paediatrica. 2014. doi:10.1111/apa.12617.

stress, low immunity and even improving lab val- 8. Hilton E, Kolakowski P, Singer C, Smith M. Efficacy of Lactobacil-
ues in cirrhosis of the liver lus GG as a Diarrheal Preventive in Travelers. Journal of Travel Medicine.
1997;4(1):41-43. doi:10.1111/j.1708-8305.1997.tb00772.x.

5. Saccharomyces boulardii – especially for 9. Ojetti V, Petruzziello C, Migneco A, Gasbarrini A, Franceschi F.

preventing and controlling bad microbes The Effect of Lactobacillus Reuteri (DSM 17938) on Methane Production
in Patients Affected by Functional Constipation: A Retrospective
Study. Gastroenterology. 2017;152(5).
Look for them in your probiotic products and
doi:10.1016/s0016-5085(17)33419-4.
when you browse fermented foods at your gro-
10. Goulet O, Joly F. Intestinal microbiota in short bowel
cery and health food store! syndrome. Gastroentérologie Clinique et Biologique. 2010;34.
doi:10.1016/s0399-8320(10)70019-1.

11. Barrett JS, Canale KE, Gearry RB, Irving PM, Gibson PR. Probi-
otic effects on intestinal fermentation patterns in patients with irritable
Notably, Lactobacillus rhamnosus GG in a bowel syndrome. World Journal of Gastroenterology. 2008;14(32):5020.

2001 randomized controlled trial reduced doi:10.3748/wjg.14.5020.

the risk of dental cavities in children by 44%.

2 This is probably because it reduced harmful
Streptococcus mutans.

55
CANNABIS FOR Over 1 million people in the United States suffer from inflamma-
tory bowel disease (IBD), an inflammatory condition of the gastro-
INFLAMMATORY intestinal tract. IBD should not be confused with IBS- irritable
BOWEL bowel syndrome, which is not caused by inflammation and does
DISEASES: not damage gastrointestinal tract tissue. Inflammatory bowel dis-
CROHN’S AND eases are chronic, debilitating conditions that can lead to serious

ULCERATIVE complications. Cannabis offers hope as a treatment option for

those suffering from these gastrointestinal disorders. There may
COLITIS not be a cure right now, but we can definitely help to give people
back their comfort, happiness, and life with the use of cannabis
Dr. Shaon Hines is a licensed Naturopathic
Doctor and an U.S. Air Force veteran. She is
for inflammatory bowel diseases.
originally from Wisconsin, did tours of duty in
Saudi Arabia and Qatar and served as Flight
Sergeant for the MacDill AFB Honor Guard. CROHN’S DISEASE AND ULCERATIVE
Dr. Hines earned her Doctor of Naturopathic
Medicine degree from National University of
COLITIS
Health Sciences.

As a Naturopathic Doctor, Dr. Hines believes

Crohn’s disease and ulcerative colitis are the two most common
in the healing power of nature. Cannabis forms of inflammatory bowel disease. Crohn’s disease affects
possesses natural healing properties and
balances the endocannabinoid system. Her
any part of the GI tract from the mouth to the anus while ulcera-
passion for cannabis as a natural healer tive colitis occurs in the large intestine and rectum. The cause of
started over 15 years ago. Today, she en-
joys educating others on the wonderful prop-
these conditions is still unknown but it is possible that stress, die-
erties of this plant.

56
tary factors and pathogens may play a role. Ge- Recently, the first ever controlled trial on canna-
netics and immune system health are also fac- bis use for Crohn’s and ulcerative colitis was pub-
tors. Some of the most common symptoms in- lished in the Journal of Crohn’s and Colitis. The
clude: persistent diarrhea, abdominal pain, rectal study was a randomized placebo-controlled trial
bleeding/bloody stools, weight loss and fatigue. and aimed to assess the effectiveness for canna-
These conditions can also cause malnutrition, de- bis use in moderately active ulcerative colitis. In
pression, anxiety and an increased cancer risk. this study, patients were given medical marijuana
Unfortunately, these conditions do not have a to smoke. The patients were assessed before
one-size fits all approach when it comes to treat- and after the 8 weeks of treatment for disease ac-
ment options. Many patients have to try different tivity, endoscopic findings and laboratory tests.
medications and often times receive no relief. The study found improvement in all areas in the
Some treatment options include: nutritional sup- patients that received cannabis treatment. There
plements, surgery, non-steroidal anti- were also no side effects observed in anyone.
inflammatories, corticosteroids, immune system Some patients receiving treatment for these con-
suppressors, antibiotics, anti-diarrheals, and ditions often times do not respond to the medica-
fluid replacements. Cannabis offers a treatment tions prescribed and/or have terrible side effects
option for inflammatory bowel diseases that is from the medications. Some side effects include
both safe and effective. Research is compound- but are not limited to: nausea, stomach cramps,
ing regarding cannabis benefits for those particu- flare ups, diarrhea, gas, fever, sore throat, flu like
larly suffering from ulcerative colitis and Crohn’s symptoms, constipation, headache, dizziness,
disease. lethargy, or skin rash.

The first ever controlled trial on cannabis use for Another study showed that CBD (cannabidiol) tar-
Crohn’s and ulcerative colitis was recently pub- geted intestinal reactive gliosis (a change to glial
lished in the Journal of Crohn’s and Colitis cells as a result of central nervous system dam-
age), counteracted the inflammatory environ-
ment in mice and in human colonic cultures de-

57
rived from ulcerative colitis patients. Intestinal surprising that cannabis does, in-fact, play a role
glial cells are responsible for mediating inflamma- in benefiting inflammatory conditions such as ul-
tion in the gut, proliferating and releasing neuro- cerative colitis and Crohn’s disease. Some of the
trophins, growth factors and pro-inflammatory cy- benefits noted with cannabis use for inflamma-
tokines. This, in turn, may amplify the immune re- tory bowel conditions include slowing of motility,
sponse, representing a very important link be- lowering the frequency and severity of nausea,
tween the nervous system and the immune sys- increasing appetite, and decreasing pain.
tem in the intestines. Cannabidiol has the ability
to control reactive gliosis in the central nervous THE COPIOUS FORMS OF
system, without any unwanted psychotropic ef- CANNABIS
fects. Just to clarify, CBD and THC are both can-
nabinoids but CBD does not have the psychoac- Cannabis can be utilized in various different
tive, or euphoric effects that THC is known to forms for the treatment of inflammatory bowel dis-
have. In this study it was found that upon histo- eases. Patients can use oral preparations such
logical examination that mast cells and macro- as edibles or tinctures to soothe the gut, smoke,
phages in the intestine were reduced. CBD also or vaporize. You can also use suppositories that
reduced TNF- expression and the presence of offer a direct impact on the gastrointestinal tract.
cleaved caspase-3. This study showed promis- Some of the popular varieties and chemotypes
ing results for the use of CBD and inflammatory used in inflammatory bowel diseases include
bowel disease. high beta-caryophylline (a terpene) strains for in-
flammation and diarrhea, high THC with myrcene
Cannabis has been used medicinally since 2737
and CBG (phytocannabinoids) for pain, and high
B.C.
CBD formulas for inflammation and constipation.
What many still have to realize is that cannabis
Word to the wise: When it comes to marijuana,
has been used in medicine since 2737 B.C. and
more is not necessarily better
our body actually has its own endocannabinoid
system. This system was first discovered in 1992 Many states offer medical marijuana use for the
by Dr. Raphael Mechoulam and his team. It is treatment of inflammatory bowel conditions. It is
composed of neuromodulators: arachidonoyletha- important to contact your local medical mari-
nolamide (anandamide, AEA) and 2- juana professional to ensure that you get the
arachidonoylglycerol (2-AG) and also CB1 and proper strains and dosages that are right for you.
CB2 receptors. AEA and 2-AG are our endoge- When it comes to medical marijuana, it is impor-
nous cannabinoids that we produce ourselves. tant to note that more is not better and you must
In our gastrointestinal system we have some CB1 get the proper products that are right for you and
receptors but mostly CB2 receptors. These re- your condition. When consuming THC products
ceptors control the immune and inflammatory re- you can experience side effects such as eupho-
sponse in the gastrointestinal tract. Cannabis ria and anxiety, so again, you want to make sure
contains various phytocannabinoids that have you start low and slow and make sure you are
anti-inflammatory properties. Therefore, it is not not operating any machinery.

58
RETHINKING What do canker sores, bad breath, heartburn, and hemor-
rhoids all have in common?
REFLUX AND PPI
USE All of these symptoms can indicate poor gastrointestinal health.
The GI system includes the mouth, anus, and everything in-
Shawna Eischens, ND (“Dr. E”) helps people
thrive physically and emotionally from all
between. From the salivary enzymes produced in our mouth to
over the world via two locations in Scotts- the hydrochloric acid in our stomach and peristaltic contractions
dale, AZ-Rockwood Natural Medicine Clinic
and Five Seasons Health. As a primary care
of our intestines, it’s all interconnected.
physician who focuses on mental and diges-
tive health, she is passionate about helping Naturopathic physicians in particular understand that digestive
people overcome obstacles to reach their
full potential. Outside of the office, she en-
health is an integral part of the healing process and can affect
joys volunteering with Naturopathic Medi- overall health in profound ways. Some conditions that I have
cine Institute and Big Brothers Big Sisters,
as well as exploring nature via foot, bike,
seen cured in practice by addressing the cause with properly di-
car, or boat. rected treatment include:

• Frequent UTI’s-Often, these coincide with or after frequent

antibiotic use, therefore, beneficial flora needs to be restored
with high quality probiotics. After the GI and urogenital flora is
balanced and the epithelial tissue is healed with proper supple-
mentation, the majority of patients report no future UTI’s.

59
• Eczema-Atopic dermatitis can resolve by Viola, what sweet relief to shut down the sup-
avoiding food intolerances, decreasing intestinal posed cause of these painful and bothersome
hyper-permeability (aka ‘leaky gut’), and/or find- symptoms, right? No, contrary to what you may
ing the indicated individualized homeopathic think, excess acid production isn’t the cause of
remedy. these concerns. There are other safe and effec-
tive ways to cure esophageal pain and erosion
• Gas/bloating-Encouraging parasympathetic
that can improve your overall digestion and
nervous system stimulation to help facilitate di-
health without harmful side effects.
gestion, supplementing with enzymes, finding
the indicated homeopathic medicine, and/or When we chew and swallow food, it travels from
avoiding food intolerances can help get rid of our pharynx to the upper esophageal sphincter,
bothersome gas or bloating. then downward via waves of muscular contrac-
tions, through the lower esophageal sphincter
• Diarrhea-Replenishing beneficial bacteria,
into the stomach. These bands of muscles,
avoiding food intolerances, and reducing stres-
known as sphincters, are brilliantly designed to
sors related to mental/emotional triggers through
open during swallowing, and close when we are
NET/neuro-emotional technique or the properly
not actively eating. When the sphincter lacks
prescribed homeopathic remedy are what I have
tone at the junction of the esophagus and stom-
found to be most effective for my patients with
ach, an opening is created allowing small
chronic or frequent diarrhea.
amounts of acid or food into the esophagus,
causing symptoms such as heartburn. Ironically,
EXCESS ACID PRODUCTION LOW stomach acid can prevent the body's natu-
ISN’T CAUSE FOR CON- ral response to close the sphincter even after
CERN food is introduced into the stomach. Overeating,
certain drugs, alcohol, coffee, food sensitivities,
and hiatal hernias may all contribute to a de-
Many people struggle with various digestive con-
crease of tone or reflux as well.
cerns, but considering that a medication for acid

PLAYING THE “FIND THE

reflux named Nexium is consistently in the top 5
most prescribed (often inappropriately and for
durations that are not recommended) medica- CAUSE” GAME
tions in the U.S, this topic is worthy of more dis-
cussion. PPI's or proton pump inhibitors such as My favorite game to play in practice is “Find the
Prilosec or Nexium are well known drugs that Cause. “Regarding reflux, the acid is not the
block the final pathway of acid production in the cause-it is only a SYMPTOM of a cause that
parietal cells of the stomach lining, specifically needs to be addressed. Shutting down stomach
affecting the enzyme H+/K+ ATPase (aka “proton acid to cure reflux long term is the equivalent to
pump”). This inhibition results in a nearly com- pouring water on a fire alarm and expecting the
plete reduction in gastric acid secretion. fire to stop. In this case, the “alarm” is the hydro-
chloric acid-a beneficial and necessary compo-

60
nent for digestion that our stomach is innately de-
signed to produce.
STRUCTURAL CAUSES FOR
CONCERNS
Decreasing the acid in the stomach may provide
temporary relief for some people with ulcers or
Structural concerns such as a hiatal hernia can
heartburn, but at what cost?
be a cause for reflux as well. A hiatal hernia is
Hydrochloric acid is needed to help us properly when part of your stomach protrudes higher than
digest protein, decrease the risk of the coloniza- the diaphragm into the chest cavity. This mis-
tion of candida and Clostridium difficile, and help alignment allows stomach remnants to go back
absorb nutrients such as vitamin B12, iron, and up into the esophagus, and impairs overall diges-
calcium. tion. Sliding hiatal hernias are most common and
can be easily corrected in office by a physician
Decreased hydrochloric acid (hypochlorhydria) who knows how to do this effective manipulation
has been linked to osteoporosis and increased to bring your organs back into alignment (View a
hip fractures, iron deficient anemia, rosacea, B12 live demonstration here:
deficiency (neuropathy, fatigue, memory loss), https://www.youtube.com/watch?v=uP65gn6UgH
and even reflux. Yes, acid reflux can occur or be o).
aggravated when your stomach does not have
ENOUGH acid. The pH of our stomach can be TECHNIQUE YOU CAN DIY
altered by factors such as an overgrowth of H.
pylori bacteria, stress, and food sensitivities as
You can attempt the following technique at home
well.
as well, although it is not as effective as the man-
A study in Circulation suggests that the contin- ual technique mentioned above. Drink at least 12
ued use of proton pump inhibitors accelerates oz. of water to add weight to the stomach, then
cellular aging leading to potential increases in stand on your toes or a step and drop down onto
heart attacks, kidney disease, and dementia.1 In your heels. This can create a similar effect to the
a prospective community-based cohort of more manual correction and bring your stomach back
than 10,000 adults, it was reported that PPI use into the proper position. People with hiatal her-
was independently associated with a 20% to nias may be bothered by various symptoms in-
50% higher risk of chronic kidney disease, as cluding these mentioned by 4 different patients,
well as previously being linked to acute intersti- all with sliding hiatal hernias, unbeknownst to
tial nephritis.2 them.

“I think I’m having a heart attack!”

“I’ve had chronic nausea, heaviness, and pain

for 15 years and nothing has helped.”

“I have anxiety with heart palpitations, and I can

feel this pressure in my chest.”

61
“I get full so quickly and it feels like food just sits References
(1)
there when I eat.”
https://www.ahajournals.org/doi/abs/10.1161/circulationaha.1
13.003602
These patients had instant relief upon sitting up
after correcting their hiatal hernia quickly in of- (2)
fice. Each of these patients continued to have https://jamanetwork.com/journals/jamainternalmedicine/fullart
icle/2481157
improved digestive health with complete resolu-
tion of all symptoms with an individualized treat-
ment plan that did NOT involve PPI’s.

BODIES ARE DESIGNED TO

BE IN BALANCE AND
FUNCTION OPTIMALLY

Our bodies are designed to be in balance and

function optimally by listening to and addressing
areas of dysfunction. The cause of reflux varies,
but may be as simple as a hiatal hernia adjust-
ment, increasing stomach acid and enzymes if
needed, avoiding food sensitivities or healing the
digestive tract using safe and effective natural
treatments that don’t cause harmful side effects.

If you are struggling with GI distress, reach out to

Dr. Shawna Eischens or another qualified naturo-
pathic physician for hope and healing.

62
WHAT DO STRESS The wall of your intestines is made up of a lining of epithelial cells. Each
AND TRAUMA epithelial cell is stuck to its neighboring cell using a “cell junction” – a

HAVE TO DO set of proteins and other molecules designed to keep the lining, or
membrane of your intestinal wall, as secure as possible. Without the
WITH YOUR GUT? help of these cell junctions, your intestinal wall would be “leaky” (leaky
A LOT! gut), and would allow undigested food and toxins to enter your blood
Dr. Ameet Aggarwal is a naturopathic doctor
stream, causing unhealthy inflammatory reactions throughout your
and psychotherapist (Gestalt, Family Constel- body.
lations, EMDR) with years of experience treat-
ing physical issues, anxiety, stress, depres-
sion, abuse, relationship issues and also work-
In order to work well, these cell junctions depend on various hormones
ing with UNICEF, UN Staff, and other large and chemicals in your body. These include chemicals produced by
organizations. Dr. Aggarwal focuses on heal-
ing the gut, liver, adrenal system and emotions
good bacteria (probiotics) in your gut, as well as hormones such as tri-
together to optimize health and happiness. iodothyronine (T3), which is the active form of thyroid hormone thyrox-
His online course (free videos on
health.drameet.com/p/intro) has been ap-
ine (T4) produced by your thyroid gland.
proved in the highest category for continuing
education for naturopathic doctors. Dr. Aggar- If levels of T3 drop, or the chemical environment in your intestine
wal was voted as one of the top 5 speakers on
2 world summits, which earned him recogni-
changes, then the cells of your intestine won’t be held together very
tion as one of the top 43 naturopaths to follow. well, leading to syndromes such as leaky gut and chronic inflammation.
He practices in Kenya and lectures around
the world, teaching students how to treat anxi-
ety and depression holistically. His book “Feel
T3 is the active form of T4, and T4 is converted into active T3 by the
Good” (free videos on deiodinase system in your liver, intestines, and other areas of your
drameet.com/p/mindbodybook is considered
to be one of the most comprehensive guides
body. Imbalanced levels of cortisol inhibit your deiodinase system and
to anxiety and depression. therefore can negatively affect levels of active T3.

63
Cortisol is produced by your adrenal glands. Dur- High amounts of cortisol suppress feel-good hor-
ing stressful periods, your adrenal glands go into mones such as dopamine, serotonin, and mela-
overdrive and release cortisol and adrenalin in tonin. This causes anxiety, depression, lack of
large amounts, causing many physical symp- sleep, a general sense of unease as well as crav-
toms. Your heart beats faster, breathing in- ings for carbohydrates (sugars), salt, and stimu-
creases, sugar is released into the blood for lants, such as coffee. Overconsumption of un-
more energy, and blood flow increases to the healthy food during times of stress will negatively
muscles and brain to provide more oxygen and affect your gut bacteria and microbiome (intesti-
energy. This keeps your body and brain alert and nal environment) and exacerbate symptoms of
ready for action. This state is also known as the leaky gut syndrome.
fight or flight response, which humans and
This is one of the possible reasons why I believe
other animals developed as a primal response to
physical conditions like eczema, asthma and ar-
threat and fear. This primal response still kicks in
thritis get worse with stress – the cortisol re-
when we experience stress today.
sponse affects the intestinal membrane and in-

STRESS AND TRAUMA flammation.

Treating Stress and Your Adrenal Glands

Unfortunately, in today’s world, we are under con-
stant stress, whether it’s from work, relationships, Whenever I suspect someone with adrenal is-
bills, deadlines, traffic, loud noises, computer vi- sues, I always start by helping them resolve any
brations, unresolved emotions, high cost of liv- traumatic, or stressful emotional experiences, ei-
ing, late nights, and other pressures of life. Your ther through psychotherapy or through energetic
adrenal system does not distinguish this form of medicines such as homeopathy. Unresolved
stress from the threat of an animal trying to at- emotions, or emotional holding patterns
tack you. It’s all about survival. We never have a (EHPs), continuously stress your adrenal glands
chance to switch off. at an unconscious level and degrade their
health. Resolving traumatic or stressful experi-
With adrenal stress, your body goes through vari- ences allows your adrenal glands to finally get a
ous phases. The first two, called alarm and adap- break from your unconsciously stressed mind.
tation phase, are when cortisol, adrenaline, and
noradrenalin are produced in large amounts to In addition to using psychotherapy and home-
continuously cope with stress. With prolonged opathy to resolve trauma and stress, I also find
stress, your adrenal glands do not switch off, these steps helpful in restoring adrenal gland bal-
and high levels of cortisol are continuously pro- ance:
duced, negatively affecting your deiodinase sys-
• Avoid stressful lifestyle habits, coffee, high-
tem, the conversion of T4 into T3, and the health
of your intestinal lining. sugar diets, recreational drugs, excessive alco-
hol, late nights, and stressful jobs, which all de-
plete your adrenal glands.

64
 Overconsumption of unhealthy food during
FOOD AND SUPPLEMENTS
times of stress will negatively affect your gut
bacteria and microbiome (intestinal THAT HEAL YOUR ADRENAL
environment) and exacerbate symptoms of GLANDS
leaky gut syndrome.
During stress, the amount of nutrients normally
found in food is not enough to meet the de-
• Reduce inflammatory foods in your diet be- mands of your adrenal glands and restore them
cause inflammation stresses your adrenal glands back to health. Using nutritional supplements,
to make more cortisol to manage the inflamma- which contain high amounts of nutrients, in addi-
tion. tion to eating healthy foods, is often necessary to
• Go to bed before or around ten o’clock at cope with stress and ensure a more complete re-
covery.
night, meaning lights out! and practice good
sleep hygiene. Foods such as avocados, potatoes, bananas,
chicken, peaches, cantaloupe, salmon, tuna,
• Keep a regular routine. Your adrenal glands
lima beans, and dried apricots nourish your adre-
release specific hormones at specific times of
nal glands.
the day, following a regular 24-hour cycle. They
are very sensitive to when you eat food, rest, ex- Vitamins B1, B2, B5, B6, and B12 nourish your
ercise, and sleep. Keeping your work, exercise, adrenal glands and should be used together. Vi-
and meal times regular ensures this regular cy- tamin B5, often called the anti-stress vitamin, is
cle is maintained. Sporadic meal times and activi- one of the best B vitamins for adrenal health.
ties force your adrenal glands to work outside of Stress, alcohol, excessive sugar consumption,
their natural rhythm and depletes them. and caffeine deplete your body of essential B vi-
tamins.
• Eat regular meals with larger amounts of
proteins and green vegetables compared to re- Vitamin C is crucial to nourishing your adrenal
fined carbohydrates and sugars. glands, improves your immunity, and reduces the
damage caused by toxins in the body.
• Exercise, meditate, and practice yoga and
deep breathing exercises to relax your adrenal Fats such as butter and fat from avocados, fish,
system daily. and chicken are nourishing to your adrenal
glands. Healthy oils such as coconut oil and
• Use treatments like acupuncture, acupres-
omega-3 and omega-6 oils from fish, nuts, and
sure, reflexology, Bowen therapy (a profound
seeds calm and rebuild your nervous system.
body therapy developed in Australia), or mas-
sage; all of which help to discharge stress and Melatonin, 5-HTP, Tryptophan, and Theanine are
improve health. supplements commonly used to promote sleep.

I also use certain herbs and supplements to nour- Phosphatidylserine is a fatty molecule that re-
ish the adrenal glands back to health. duces cortisol levels in your body and can help

65
reduce symptoms of anxiety and insomnia due to References:

excessive cortisol. • Hidal, J. T., and M. M. Kaplan. 1988. “Inhibition of thy-

roxine 5’-deiodination type II in cultured human placental
Zinc is one of the most essential nutrients for cells by cortisol, insulin, 3’, 5’-cyclic adenosine monophos-
your adrenal glands and is at its highest concen- phate, and butyrate.” Metabolism. 37(7):664-8.
tration in your adrenal glands. Zinc strengthens
• El-Tawil, A. M. “Zinc supplementation tightens leaky
your immune system, reduces fatigue, and has a gut in Crohn’s disease.” Inflamm Bowel Dis. February 1,
calming effect on the body. Zinc also helps with 2012; 18(2): E399. Accessed September 21, 2011. MEDLI-
absorbing B vitamins and helps produce vari- NE® is the source for the citation and abstract of this record.

ous adrenal gland hormones.

66
ARE YOU LOSING We live a very stressful time in the world these days. Lots of peo-
ple are coming in for sleep and gut issues related to stress. At
SLEEP? SLEEP, the time of this writing, there is a lot of upheaval shaking many of
STRESS AND THE us to our core. There is a lot of fear, anger, and anxiety floating
GUT around and it is hard to avoid. It has been a challenge for me,
Dr. Tara Skye Goldin is a Registered Naturo-
personally, to figure out how to balance my usual nature of tran-
pathic Doctor in the State of Colorado. She quility and optimism with the disturbing stories I am exposed to
practices in Boulder, Colorado. She is an ex-
pert in functional and naturopathic medicine
lately. It is also a challenge to stay engaged while also taking
with an emphasis on gut health, thyroid health, healing space for myself. As a healer, I know that before I can be
adrenal health, hormone balancing, HPV, auto-
immune disorders and digestion. She practices
of service to anyone else, I need to root into my spiritual and self-
at the Corca Center for Radiant Health in Boul- care tools to keep myself clear and balanced. Meditation, yoga,
der, Colorado, a holistic sleep center. She lives
with her husband, son and a tiny dog. She en-
getting out in nature and physical exercise has been a key part
joys hiking, gardening, paddleboarding, sing- of my sanity. And allowing myself to have social time with my
ing and has an avid geeky love for musical
theatre. You can reach her through her website
friends has also been crucial to my sense of wellbeing.
at www.taraskyegoldin.com.

67
IT IS MORE DIFFICULT TO People are generally having more difficulty sleep-
ing right now. I think this is because a lot of peo-
HEAL WHEN ONE IS IN ple have their sympathetic nervous system in a
SURVIVAL OR TRAUMA state of high arousal due to chronic psychologi-
MODE cal stress. Sleep and stress are related since as
cortisol levels become elevated under duress,
A lot of what is going on in the world right now sleep often goes out the window. Elevated corti-
seems to be pulling people outside of their heal- sol triggers the fight or flight response. The fight
ing process and engaging in the world in some or flight response keeps you on high alert in
way. This is, of course, an important step to take, case you have to respond to a crisis. Sleep is
but it also seems for real self-reflection to occur, challenged. Often, the first sign that all is not well
one needs to have a quiet internal space so that in Dodge City surround issues with sleeping.
healing can really deeply occur. This includes Whether that includes falling asleep, staying
sleep. It is hard to go deep into one’s own proc- asleep throughout the night or early morning wak-
ess when stress levels are elevated and sleep is ing, when stress is increased, sleep suffers.
elusive.

When there is a constant state of crisis going on

WHAT TO DO IF CORTISOL
in the world and outward activity of all sorts is re- IS ELEVATED DUE TO
quired, we usually tend to neglect our bodies STRESS?
We lose sleep, our cortisol levels skyrocket, our What if I cannot do anything right now to change
gut health is disrupted, decisions are made from the reality of the situation? This is where mindful-
the survival and fear center rather than from the ness and stress management techniques can be
heart center. Decisions made from that place are critical for health. Meditation, yoga, breathing ex-
often fear-based and may not pan out well in the ercises, nature breaks are all important.
long term.
There are many targeted non- drug supplements
Many in my community are coming in a crisis that can decrease cortisol levels to help you
and trauma state for acute issues, and putting sleep through the night without promoting seda-
the slower chronic issues on the backburner tion

A crisis state triggers the Sympathetic nervous Functional medicine testing can help determine
system which is known as the “fight or flight” how far on the spectrum your stress, or lack of
state, while the “rest and relaxation” state uses sleep, has affected you and how to remediate
the Parasympathetic nervous system. that. Not all supplements are equal and different
stages of your condition require differing ap-
ONE OF THE FIRST AREAS proaches.
WHERE I SEE GUT HEALTH
FLARE UP IS WITH SLEEP

68
SLEEP ISSUES CAN ALSO
BE A RESULT OF POOR
GUT HEALTH

The gut is also known as the “Second Brain.”

Much great information has been written about
this such as the GAPS Diet, Grain Brain, etc.
When the gut is out of balance due to disrup-
tions in the microbiome (the bacteria that live in-
side our gut), or from Leaky Gut Syndrome, in-
flammation occurs in the body and/or antigen
antibody reactions caused by food allergies. In-
flammation triggers Cytokine production from
the white blood cells.

When gut health is compromised with condi-

tions such as SIBO, IBS, Celiac, Inflammatory
Bowel Disease, Leaky Gut and other conditions,
the neurotransmitters that regulate sleep and
mood will be altered due to an increase in Cyto-
kine production.

Cytokines are also produced when one has a

fever, and you know how wonky your brain feels
when you are feverish. So, imagine how a low
level of inflammation produced by an imbal- ance or the sleep and stress issues.3 What a tan-
anced gut affects your neurotransmitters. This af- gled web we weave!
fects the brain as well as cognition. When cogni-
Getting proper sleep is extremely important to
tion is affected, sleep and your REM cycles will
one’s health as lack of sleep exacerbates psychi-
also be affected.
atric imbalances (anxiety, depression, bipolar dis-
Scientists have found that gut bacteria produce order, mood disorders), depresses the immune
neurotransmitters such as serotonin, dopamine system and increases the risk of mistakes and
and GABA, all of which play a key role in mood accidents while driving
(many antidepressants increase levels of these
Overall, lack of sleep impairs performance much
same compounds).1,2
in the same way that having a few alcoholic
Alternately, poor sleep also affects the micro- drinks impairs cognitive and motor performance.
biome so it can be a vicious cycle and difficult to Of course, sometimes poor sleep cannot be
determine which came first, the gut health imbal- avoided as when caring for a newborn, but then

69
the breastfeeding mothers get the added protec- 6. Try and keep your bedroom exclusively for
tion of oxytocin, which helps offset the lack of sleeping and sex. Reading, TV watching, work-
sleep one gets when caring for a baby. ing, computing in the bedroom can make it diffi-
cult to feel like you are retreating when you do
1. Manage stress levels. If life is throwing a lot
everything else in the same room. An uncluttered
of challenges your way be sure to find healthy
soothing atmosphere can also improve sleep.
ways to de-stress. Yoga, meditation, exercise,
massage therapy are often helpful tools to keep 7. A healthy diet lower in carbs and higher in
your neurotransmitters firing optimally. Which proteins. This type of diet helps to balance blood
brings me to … sugar and neurotransmitters as well as a lifestyle
that includes regular exercise is similarly condu-
2. GABA, gamma amino butyric acid is a neu-
cive to better sleep.
rotransmitter that is naturally secreted by the
brain. GABA has a sedative effect on the body 8. If you must work the night shift, please
and is available in supplement form. This can be keep it to a minimum as the nighttime is the most
taken at bedtime but be sure to check with your active time for the liver which aids in cellular re-
practitioner for proper dosing. pair and detoxification. Patients of mine that work
the night shift almost always find that their health
3. Warm milk and turkey contain the amino
worsens even if they sleep during the day.
acid tryptophan which increases serotonin pro-
duction. Serotonin is a mood elevator as well as 9. Sleep well my friends. Nighty-night!!!!
a relaxer. Unfortunately, tryptophan is no longer
available in the United States as a supplement
but its precursor 5-HTP is widely available.

4. Avoid reading the news or watching TV or

movies before bed. This can also stimulate the
brain in ways that are not conducive to sleep. References

1. Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-

5. Peri-menopausal women who are experienc- brain axis: interactions between enteric microbiota, cen-
ing sleep difficulty should also look at their tral and enteric nervous systems. Annals of Gastroenter-
relative estrogen/progesterone balance. ology: Quarterly Publication of the Hellenic Society of
Women with too much relative estrogen and Gastroenterology. 2015;28(2):203-209.

not enough relative progesterone often expe- 2. Collins, S. M. & Bercik, P. The relationship between in
rience sleep problems, especially right be- testinal microbiota and the central nervous system in
fore their periods. Natural progesterone is normal gastrointestinal function and
disease. Gastroenterology 136, 2003–2014 (2009).
more effective and has less side effects so
consider a visit to check in about your hor- 3. Wellman, LL, Oldfield, E.C. et al. Effect of sleep frag-
mentation on the microbiome-gut-brain axis Sleep, Vol-
mone levels.
ume 40, Issue suppl_1, 28 April 2017, Pages A32–A33

70
INDIVIDUAL DIETARY ESTROGENS OR
RESPONSES TO “PHYTOESTROGENS”
PHYTOESTROGENS Dietary estrogens or “phytoestrogens” have long been known
AND THE for the health impacts on those that ingest them. Their effects
MICROBIOME on reproductive hormones have even led to the hypothesis that
CONNECTION these substances are part of plants’ natural defense system
evolved to decrease fertility in the herbivore species that eat
Tara Nayak is a naturopathic physician with a
private practice in Philadelphia, PA. She spe-
them.1 Phytoestrogens are a controversial topic in the naturo-
cializes in personalized precision medicine pathic and nutrition world. Many patients ask if foods containing
including nutrigenomics and the microbiome.
Dr. Nayak is graduate of University of Bridge-
botanical variations of estrogen are safe especially in hormon-
port College of Naturopathic Medicine and a ally driven conditions such as breast cancer. The answer is: it
former resident at Dr. Peter D’Adamo’s Center
of Excellence in Generative Medicine. She cur-
depends on the person! So how do we know when and how to
rently serves as faculty at Maryland University use a phytoestrogen therapeutically? The conventional wisdom
of Integrative Health teaching “Nutrigenomics
and Epigenetics” as well as at UBCNM teach-
has been that of a dose dependent reaction, predicting the
ing “Generative Medicine I”. Outside of private body’s response to phytoestrogens based upon the amount in-
practice and education, Dr. Nayak has joined
up with Dr. Ginger Nash in creating and culti-
gested. However, recent research efforts in the personalized
vating “Feminology”, a movement dedicated to medicine field have uncovered the potential for a more nuanced
helping women find balance using the art and
science of female hormones.
prediction of safety and efficacy based upon the role of

71
genetics and symbiotic gut bacteria. The sci-
ence is young but we have some useful areas for
HOWEVER, HOW CAN PHY-
consideration! SICIANS CONTROL VARI-
ABLES TO GENERATE
Phytoestrogens are typically utilized for their
THE DESIRED RESPONSE?
weak binding affinity to estrogen receptors. This
binding can be used in both estrogen deficient
and estrogen dominant states. The goal is to ei- The metabolic transformation of phytoestrogens
ther provide a small amount of estrogenic effect is facilitated by key species in the human micro-
when it’s missing from the system or to occupy biome. Research to identify the “estrobolome,” or
the estrogen receptors and effectively block all of the bacteria known to metabolize estro-
more potent endogenous estrogens from bind- gens, has grown in recent years. This includes
ing. Clinically, however, we observe a largely var- the microbiomes actions upon phytoestrogens. A
ied response to treatment. For example, some 2001 study showed that the ingestion of prebiot-
menopausal women using therapeutic phytoes- ics in the form of fructooligosaccharides (FOS)
trogens see no effect, others see improvements “improved the bioavailability” of genistein and
in menopause symptoms, others have such a daidzein, the isoflavones found in soy.4 The
marked response that they start menstruating study suggested that through the nurturing of bifi-
again. This variation is due to the individual’s abil- dobacteria species in the gut the enterohepatic
ity to transform dietary estrogens into their hor- reabsorption and recirculation of isoflavones
monally active bioavailable metabolites. These were improved.
metabolites bind to estrogen receptors and in-
duce response typically with selectivity for one of LEVELS OF PHYTOESTRO-
the specific classes of estrogen receptors, estro- GENS AND DEPENDENCE
gen receptor beta (ER-β). This has been shown UPON THE INTESTINAL
to have a protective effect as ER-β is a tumor sup-
pressor shown to repress the effects of estrogen
MICROBIOME
receptor alpha and act as an anti-proliferative.2
Bifidobacteria species are known to have beta
In fact, stimulation of this receptor is associated
glucuronidase activity, an enzymatic reaction that
not only with beneficial effects in cancer but also
occurs in the gut to unbind estrogens freeing
as cardio and neuro protective as well as helpful
them for re-absorption through the intestinal
in hormonal symptoms such as vaginal dryness
blood stream. This same recirculation process
in menopause.3 Disturbances in the estrogen re-
occurred for isoflavones in the presence of the
ceptor ratios (alpha/beta) have been linked with
appropriate bacteria. We begin to see how levels
various diseases including metabolic syn-
of phytoestrogens utilized by the body are de-
dromes. Phytoestrogens represent a possible
pendent upon the intestinal microbiome. How-
therapeutic solution.
ever, there’s still yet another layer associated with
individual’s response to phytoestrogens based
on their gut bacteria.

72
 Studies approximate that only one third to these bacterial strains via supplementation as
one half of the human population are capable some strains are not found in any current probiot-
of metabolizing the soy isoflavone “diadzein” ics on the market. Dietary implementations asso-
into the anti-androgenic antioxidant equol and ciated with growth of bifidobacteria may in fact
attributed the interindividual differences to improve its growth such as ketogenic diet, green
tea, and Resistant Starch Type III.7,8 In theory,
EQUOL, THE BIOLOGICALLY by providing patients with growth substrates for
ACTIVE METABOLITE desired bacterial colonies we can attempt to bio-
engineer a terrain that encourages the growth of
The difference in human response to the phytoes- equol producing species we hope to increase.
trogen isoflavones found in soy relates directly to Other bacterial genera of interest with equol pro-
the ability to metabolize these substances into ducing power include Lactococcus, grown on
equol, the biologically active metabolite.5 Equol lactose, and Finegoldia, which grows in the pres-
production occurs via multiple strains of commen- ence of diadzein, the soy isoflavone that is trans-
sal gut bacteria including the same genus, bifido- formed into equol.
bacteria, that are responsible for increased reab-
sorption of estrogens via beta glucuronidase ac- PRELIMINARY EQUOL RE-
tivity. Studies approximate that only one third to
SEARCH INDICATES THE FOL-
LOWING IN TREATMENT OF
one half of the human population are capable of
metabolizing the soy isoflavone “diadzein” into
the anti-androgenic antioxidant equol and attrib- DISEASES
uted the interindividual differences to intestinal
microflora.5 Identifying equol producing bacteria Equol has some preliminary research indicated
has become a priority because of the correlation in the treatment of androgen mediated diseases
between equol production and a decreased inci- such as prostate cancer due to its ability to spe-
dence of hormone dependent diseases. As we cifically bind and block the hormonal action of 5
await further research, the indication for dietary alpha dihydrotesterone or DHT.9 Through bind-
and supplement effects in shifting the micro- ing free circulating DHT, equol prevents its inter-
biome provides promising potential for improving action with androgen receptors and they physiol-
equol production thus, reaping the beneficial ogic processes that occur as a result. Equol has
health effects of equol. also been associated with improving the ratio of
estrogen receptor alpha versus estrogen recep-
Providing patients with growth substrates for de-
tor beta activity. An imbalance in this ratio has
sired bacterial colonies attempts to bioengineer
been associated with hormonally driven dis-
a terrain that encourages the growth of equol pro-
eases including breast cancer. In fact, equol pro-
ducing species
ducers in one study generally had lower concen-
One of the key concerns becomes how to en- trations of estrone, estrone-sulfate, testosterone,
courage the colonization of the equol producing androstenedione, dehydroepiandrosterone
bacteria in the gut, rather than simply provide (DHEA), DHEA-sulfate, and cortisol and higher

73
concentrations of SHBG and midluteal progester- August 2006, Pages 2188–2193, https://doi.org/10.1093/jn/
136.8.2188
one, a hormonal pattern overall consistent with
lowered breast cancer risk.10 4. Uehara M1, Ohta A, Sakai K, Suzuki K, Watanabe
S, Adlercreutz H. Dietary fructooligosaccharides modify intes-
The scientific community clearly demonstrates tinal bioavailability of a single dose of genistein and daidzein
that prebiotics supporting the gastrointestinal mi- and affect their urinary excretion and kinetics in blood of
rats.J Nutr. 2001 Mar;131(3):787-95.
crobiome improves the efficacy of phytoestrogen DOI:10.1093/jn/131.3.787
therapies
5. Rafii, F. (2015). The Role of Colonic Bacteria in the Me-
So far, the scientific community has clear evi- tabolism of the Natural Isoflavone Daidzin to
Equol. Metabolites, 5(1), 56–73.
dence that prebiotics supporting the gastrointesti-
http://doi.org/10.3390/metabo5010056
nal microbiome improves the efficacy of phytoes-
trogen therapies. One can postulate further to 6. Vodnar, D. C., & Socaciu, C. (2012). Green tea in-
creases the survival yield of Bifidobacteria in simulated gas-
add in targeted bacterial growth substrates
trointestinal environment and during refrigerated
alongside bifido specific probiotics to attempt to conditions. Chemistry Central Journal, 6, 61.
improve equol production and reap the benefits http://doi.org/10.1186/1752-153X-6-61)
of estrogen receptor beta stimulation. There are
7. Uri Lesmes, Emma J. Beards, Glenn R. Gibson, Kieran
also currently direct equol supplements on the M. Tuohy, and Eyal Shimoni. Effects of Resistant Starch Type
market, whose effects on the microbiome are yet III Polymorphs on Human Colon Microbiota and Short Chain
Fatty Acids in Human Gut Models.Journal of Agricultural and
to be revealed! Though studies have not yet
Food Chemistry 2008 56 (13), 5415-5421. DOI:
caught up, we as naturopathic physicians can 10.1021/jf800284d
step forward into the progression of personalized
8. H. Aldercreutz et al, (1993) Inhibition of Human Aro-
medicine and use what we know to predict out-
matase by Mammalian Lignans and Isoflavonoid Phytoestro-
comes and prevent disease utilizing the micro- gens. Journal of Steroid Biochemistry and Molecular Biology.
biome in direct conjunction with food as medi- 44, 3, 147-153
cine! https://doi.org/10.1016/0960-0760(93)90022-O

9. Alison M. Duncan, Barbara

References:
E. Merz-Demlow, Xia Xu, William R. Phipps and Mindy
1. Hughes CL (Jun 1988). "Phytochemical mimicry of re- S.Kurzer. Premenopausal Equol Excretors Show Plasma Hor-
productive hormones and modulation of herbivore fertility by mone Profiles Associated with Lowered Risk of Breast Can-
phytoestrogens". Environmental Health Perspectives. 78: cer. Cancer Epidemiol Biomarkers Prev June 1
171–4. doi:10.1289/ehp.8878171. PMC 1474615 2000 (9) (6) 581-586
. PMID 3203635.

2. Uehara M, Ohta A, Sakai K, et al. Dietary fructooligo-

saccharides modify intestinal bioavailability of a single dose
of genistein and daidzein and affect their urinary excretion
and kinetics in blood of rats. J Nutr 2001;131:787-795.

3. Kenneth D. R. Setchell, Sidney J. Cole; Method of De-

fining Equol-Producer Status and Its Frequency among Vege-
tarians, The Journal of Nutrition, Volume 136, Issue 8, 1

74
75