My Notes from The Healthy Gut Summit
Datis Kharrazian DC, DHS, MS
Many more people today don’t want pharmachology anymore with all the side effects, more and more people want more natural options. Natural options have lot’s of support in the literature and they can be very effective to support many chronic conditions. Unfortunately we still have a system where we don’t have people learning this in medical school and we really have a need for this. At Loma Linda College where I teach students are shocked to see all the research related to natural medicine where they didn’t even know it existed. More colleges are starting to add elective courses in functional medicine.
In medical school we learn how all the systems work individually but we don’t really learn how they all work together. When we look at the brain/gut access we see the brain has impact on the gastrointestinal function and the gastrointestinal tract has a major impact on the brain, now this is called the gut/brain access or the brain/gut access. We have an explosion of research in this area, what we are learning is many neurodegenerative changes first start in the gastrointestinal tract. Many people don’t get diagnosed because they are thought of as having digestive issue problems when in fact their having their nervous system and gastrointestinal tract degenerate, they call that the enteric nervous system. We also have many people that have poor gut function and they start to get memory decline and neurodegenerative diseases. They are showing relationships in the scientific literature how brain function can impact gut and gut function can impact brain. They are seeing how many symptoms of early degenerative disease actually start in the gut.
When we look at this connection and the gut physiology and how it’s impacting the brain one mechanism that we have changes in is probiotics, the probiotics themselves produce post-biotic saccharides. When we look at bacteria they produce end products too and there is many chains of them. Polysaccharides have been published in literature where they found leaky gut, people could suffer from depression that probiotics changes can impact mood and cognition. When we look at gut bacteria we look at them as part of the gastrointestinal environment but in fact they actually produce their own signaling compounds called lipopolysaccharides and they have major impacts on the brain.
Recently a paper showed a gut peptide ghrelin could bind to the hippocampus part of the brain and impact memory and cognition. The peptides in the gut could cross the blood/brain barrier and have direct impacts on brain function. There is constant communication between the gut and the brain.
When doctors look at depression, cognitive disorders or focus issues they don’t really look at the health of the digestive tract and this is a big mistake and why we shouldn’t look at psychology in a compartmentalized fashion. That’s how people learn and then say there is no connection between what you eat and your gut and your brain function but there is. Functional medicine doctors know to look for this.
There has been research on certain strains of bacteria in the gut have an impact on how you process calories so when you eat proteins, fats and carbs you produce these into glucose and long and short chain fatty acids. These fatty acid ratios determine how you process calories, people who have a higher ratio of fermicutes they tend to always be hungry. When they process calories they don’t process them efficiently into energy and they promote adipose tissue buildup and fat build up on the body and lack of utilization of calories into energy. We know there is a link between obesity and eating disorders and the ratios of fermicutes and bacteroidetes. They have research on mice and rats and found that by changing the gut bacteria you can control if they are fat or skinny.
You can change this balance but it takes a few months to do it, it does not happen quickly and it really has to be a plant based diet. Diets high in animal fat and sugar tend to promote the balance that processes fat but you could take the supplement butyrate it can be beneficial and help short term, but you really need a lifestyle change. Raising the bacteroidetes makes you more efficient for your energy levels and function, fermicutes produce lipopolysaccharides that are very beneficial they produce species that dampen inflammation and have an anti-inflammatory effect.
We see diets high in fiber and plant based foods tend to make a shift in the microbiome that influences metabolism and how we process calories and how we convert fat and calories. There are good and bad polysaccharides, polysaccharides A has been shown to cure autoimmunity in animal models and dampen inflammatory reactions and really provide immune modulation. You can’t just take a probiotic you have to have the bacteria to make it. You have to change the microbiota of the gut, do this and you should see some differences in approximately three months.
Parkinson’s disease starts in the gut and it doesn’t start as tremors, what happens is when you look at one of the most common neurodegenerative diseases which is Parkinson’s we know that Parkinson’s takes place not because you lose your dopamine activity but it’s what’s called an alpha synucleinophathy it’s a protein that’s not cleared from neurons properly no one understands why this happens. It accumulates in areas and prevents normal neurotransmission from happening. They have found that this alpha synucleinopathy buildup begins in the gastrointestinal enteric nervous system.
The most common first symptom of Parkinson’s is actually constipation and lack of motility, people start to have reduced sense of smell, some stiffness and slower in their movements and mental speed is slower. Their chronic gastrointestinal symptoms may really be neurological that they really may be suffering from early Parkinsonism. This needs to be looked at in patients with gastrointestinal issues so they can begin support for brain health to make the best impact for the patient.
Parkinson’s has six different stages and stage six is when people begin to start to see tremors and no one really diagnosis it until they start to see tremors. It’s getting better in the health care model where they are looking at stiffness and slow movement but usually early signs are pretty much ignored because for the most part the therapy is l-dopa, different variations and names but L-dopa if given too early looses it’s effectiveness and develops another disorder called tardive dyskinesia where they just have twitches, muscle movements and side effects from it. They don’t like to use it until it’s more progressed so in the conventional model there really isn’t anything you can do.
In functional medicine they look at mechanisms that are neuroprotective whether it’s a high antioxidant diet or exercise to increase brain growth factors or there is a whole list of mechanisms we know about that could protect the brain. It’s all detailed in my book Why Isn’t My Brain Working. When your looking to support brain health and your looking at early Parkinson’s there is not many drug options for the most part. With many neurodegenerative diseases the key thing is to identify them early and apply interventions through diet, nutrition and lifestyle to really make a difference because when it’s done using pharmacological’s it’s usually done during the end stage with very little benefit.
Constipation means the gastrointestinal tract has decreased in motility, motility takes place from inputs in the brain stem,. These inputs in the brain stem signal the vagus nerve to activate the gut nervous system and this is when we start to move food and release enzymes. When we see people with chronic constipation that they have had for a long time and drinking water or exercise doesn’t make a difference for them we should start to worry if this is a brain to gut relationship, are they having signs of neurodegeneration.
We know that Parkinson’s begins in the gut but any neurodegenerative disorder in the brain may impact motility as well because 90% of the brains output goes through the stem where we have autoimmune function and a portion of that we have our vagal activity which causes us to have gastrointestinal motility. Lack of motility can be for any neurodegenerative disorder so people with chronic constipation and notice their brain function has gone down they really may have little effect in changing that until they improve their brain health. This is the difference between a gut problem and a gut/brain problem.
Research shows that traumatic brain injury causes intestinal change within 2-3 hours these include changes in immune selection, inflammation, intestinal permeability and these happen immediately after trauma with the brain. Even though effects happen immediately you may not feel symptoms until years later as the neurons degenerate slowly. When you have gut problems the doctor should also check if there are motility issues. Other than constipation another symptom is having trouble swallowing pills because the muscles in the back of the throat are related to the vagus nerve controlled by the brain. We see this with Autism and traumatic brain injuries. The good news is we can do a lot of things to make this more efficient. When we see this one of the things we have people do is gargle, if they can gargle with several large glasses of water a day as they gargle deeply and intensely they make the muscles in the back of the throat work and the vagus gets activated and you also activate the vagal response to the gastrointestinal tract.
Another thing you can do is coffee enemas but to make it more of brain vagal therapy you want to do and suppress bowel urgency so that what we have patients do is get the coffee enema and figure out how much coffee they can saturate it with. What coffee does is it has caffeine and the caffeine stimulates the nicotinic receptors and they cause you to have bowel movement and bowel activity. To get the biggest changes you have to feel those urgencies and try to hold the content of the coffee enema as long as you can. When you actively suppress the bowel response this activates the frontal cortex brain stem feed back and if they can do that over and over again they can start to restore plasticity in that area and they can see their brain/gut access function better. Same concept as when your trying to build muscles where you lift weights, your strengthening that area for better function in that feed back system. With children they have to be old enough to do this so with them we do the gag reflux on the tongue, gargle and sing loudly using the muscles at the back of the throat to activate the vagus. It depends on the child and what they are ready to do.
With Autism it’s not just diet and detox you also have to do something to activate the brain that is not communicating with the gastrointestinal system to get everything to work properly. I recommend the book Disconnected Kids. With each child you have to evaluate their symptoms depending on what part of the brain is not working. With the current research that is going on we feel we are getting close to helping these kids get well. It all starts with pregnancy and development in the fetal stage. There has to be some effort put on the mothers health, prenatal health is not just taking a prenatal vitamin. Mother’s that have chronic stress or live next to a freeway have increased risk of Autism. We know that if mothers have infections or underlying autoimmune diseases any type of methylation disorders or any combination of things can make the risk go up. We have to look at what we are doing to asses the mothers health, what are we doing to evaluate all the variables with risk factors for pregnancy, giving a prenatal vitamin isn’t enough. In the past five years there is a lot information that really shows there is an environmental autoimmune mechanism for Autistic changes happening during development.
Testing for gut/brain access we use Cyrex Labs and do a test called array 2 blood test that looks at antibodies and zonulin includen antibodies. The other thing we look at is blood/brain antibodies array 11 a chemical antibody panel. When you have a leaky gut it’s not advised to do chelation therapy until the gut/brain barrier is intact. The array 11 that test for the chemical antibodies if positive you have to be careful it means the person has lost their tolerance to environmental compounds and if you start to distribute the metals you can definitely trigger an autoimmune disease.
The gut/brain barrier is vulnerable, we know that it can be broken down by chronic inflammation, homocysteine, chronic stress and chronic infections. What’s happening is we have two types of cells in the brain, neurons for communication of brain activity and glial cells that are more than half the weight of the brain. These are immune cells there are twenty glial cells to every neuron. Once the glial cells get activated they don’t turn off and they don’t get activated unless the blood/brain barrier is breached. Now particles, chemicals and messenger peptides and proteins can turn on these glial cells promoting a neuroinflammatory cascade. The most devastating part of this is PANDAS, what happens when these kids have breached blood/brain barriers they get the typical streptococcus infection, but since the blood/brain barrier has been breached strep antibodies cross the blood/brain barrier and binds to the part of the brain that’s very similar to strep proteins called the basal ganglia and they develop neuropsychiatric disorders becoming different children. We can begin to heal this.
There needs to be a focus on the gut/brain access that most people are not thinking about and repair the vagal activity. The patient needs to educate themselves and then they can find the right practitioner to work with.
Disclaimer: The information contained on this site is for educational purposes only and should not be used as a substitute for diagnosis rendered by a licensed physician. It is essential that you discuss with your doctor any symptoms or medical problems that you may be experiencing.
M. Scherker medical researcher