THE GUT - MICROBIOTA - BRAIN AXIS: MOST DISEASE STATES ARE DIFFERENT MANIFESTATIONS OF THE SAME UNDERLYING ISSUESRead Now
MOST DISEASES ARE JUST DIFFERENT MANIFESTATIONS OF THE SAME THING
THE GUT-BRAIN-MICROBIOTA AXIS
WHERE THE RUBBER MEETS THE ROAD!
What you have to do is figure out how big a wrench it's going to take to jam the gears and stop this vicious cycle. Remember, drugs might change your symptoms, but they never stop the cycle. What I would like to do right now is take a quick look at some of the studies that show this cycle, and how this dysfunction all works together in unison (I chose these particular studies because if you are interested, you can look them up and read them in their entirety). The point of doing this?
For those of you who are deep into these and other similar disease processes, you need to realize there is hope (stick around and I'll prove it to you). One critical fact you must grasp before we begin is that it is not as likely as you have been led to believe that your children will be condemned to the same fate as you simply because of their genetics. Why not? Science has given genetics way too much importance as far as the development of most diseases is concerned. What do I mean by this? If you don't understand the difference between genetics and epigenetics as related to chronic inflammatory degenerative illnesses and autoimmune diseases, it is imperative that you take five minutes to read THIS POST on the topic. Also, if you are not sure what INFLAMMATION is (hint; it's not swelling or infection), don't bother continuing because it won't make sense.
- PARKINSON'S DISEASE: Listen to the conclusions from a two year old issue of the World Journal of Gastroenterology (Brain-Gut-Microbiota Axis in Parkinson's Disease). Make sure to look for all five entities mentioned in the cycle above (BTW, this is quoted word-for-word). "Parkinson’s disease (PD) is characterized by alpha-synucleinopathy that affects all levels of the brain-gut axis including the central, autonomic, and enteric nervous systems. Recently, it has been recognized that the brain-gut axis interactions are significantly modulated by the gut microbiota via immunological, neuroendocrine, and direct neural mechanisms. Dysregulation of the brain-gut-microbiota axis in PD may be associated with gastrointestinal manifestations frequently preceding motor symptoms, as well as with the pathogenesis of PD itself, supporting the hypothesis that the pathological process is spread from the gut to the brain. Excessive stimulation of the innate immune system resulting from gut dysbiosis and/or small intestinal bacterial overgrowth and increased intestinal permeability may induce systemic inflammation, while activation of enteric neurons and enteric glial cells may contribute to the initiation of alpha-synuclein misfolding." Why am I at least somewhat concerned about this nasty creature named by doctor Parkinson? I undoubtedly carry the gene (HERE). And for those who are not sure what GLIAL CELLS are (you'll see them come up time and time again), just click the link.
- NEUROPSYCHIATRIC DISORDERS: This collaboration (Gut-Microbiota-Brain Axis and Effect on Neuropsychiatric Disorders with Suspected Immune Dysregulation) between Greek and American scientists / physicians was published in HHS Public Access, and is one of the most amazing put-it-all-together studies I have yet to see on this topic. "Brain function and psychological make-up are now increasingly considered to have a reciprocal relationship with the gut. Disruption of the gut microbiota (dysbiosis) is known to contribute, among others, to the pathogenesis of GI diseases, and reported to directly induce inflammation and pain. Accumulating evidence suggests that the gut microbiota maintain bidirectional interactions with critical parts of the central nervous system (CNS) and the immune system through direct and indirect pathways. These involve the endocrine (hypothalamic-pituitary-adrenal (HPA) axis), immune (chemokines, cytokines), autonomic nervous system (ANS), and enteric nervous systems forming the microbiota-gut-brain axis. Antibiotics, environmental and infectious agents, intestinal neurotransmitters / , sensory vagal fibers, cytokines, essential metabolites, all convey information about the intestinal state to the CNS. Such interactions appear to influence the pathogenesis of a number of disorders in which inflammation is implicated such as mood disorder, autism-spectrum disorders (ASDs), attention-deficit hypersensitivity disorder (ADHD), multiple sclerosis (MS) and obesity (Obesity has been called a psychiatric disease) and is associated with depression and other neuropsychiatric disorders). Neuro/immune-active substances derived from the intestinal lumen can penetrate the gut mucosa, be transported by blood, cross the blood-brain-barrier (BBB) and affect the CNS. Acute stress increased GI and BBB permeability. Moreover, chronic stress disrupted the intestinal barrier and permitted penetration of luminal antigens, microflora metabolites, toxins and lipopolysaccharide (LPS) into the systemic circulation and the CNS." Did you notice that all five aspects of the cycle were present in full-blown Technicolor and Dolby Surround Sound?
- MULTIPLE SCLEROSIS: So, in light of everything that I've shown you, should we be even bat an eye when articles like STAT'S Gut Germs Play Role in Multiple Sclerosis, are published? No way! While it's certainly good to know (I've discussed this link at least twice before --- HERE and HERE), the real question remains; what are you doing about this since your doctor isn't doing much of anything other than prescribing more drugs? In the first of two brand new studies, both from last month's issue of PNAS, researchers compared the MICROBIOMES of 71 people with MS and 71 without MS. What they found was that "specific bacterial taxa were significantly associated with MS" (dysbiosis). But interestingly enough, they also found that there was a certain strain of bacteria that was "reduced in MS patients." Because the researchers believed this bacteria was associated with antiinflammatory properties, they introduced feces from the MS group into mice that had been genetically raised to be "germ free". The result was mice with fewer TREGS (T-suppressor cells that dampen immune system responses as to prevent autoimmunity) and fewer antiinflammatory cytokines, leaving them with symptoms of MS ("experimental autoimmune encephalomyelitis"). In the second study, the authors took identical twins, where one had MS and the other did not. They noticed that when they transplanted feces of the MS twin into mice that had been genetically raised to express "spontaneous brain autoimmunity," those mice were much more likely to develop an "MS-like autoimmune disease." I need to note to you; one major difference in MS patients is that they tend to have low sympathetic function (as opposed to high), which often results in heart, bladder, and bowel issues. By the way, I found studies over two decades old (Digestive Diseases and Sciences --- Multiple Sclerosis Patients Have Increased Intestinal Permeability) that showed this link via their title. The moral of this story is NEVER underestimate the importance of GUT HEALTH in dealing with chronic conditions!
- CHRONIC "LEARNED" PAIN: This two year old study was done at St. Louis' Washington University and published for the International Anesthesia Research Society (Identification and Treatment of New Inflammatory Triggers for Complex Regional Pain Syndrome: Small Intestinal Bacterial Overgrowth and Obstructive Sleep Apnea). "Complex regional pain syndrome (CRPS), formally known as reflex sympathetic dystrophy, is a neuropathic pain disorder that may fail to respond to current therapy... There is a known relationship of CRPS and the gastrointestinal tract. Dysbiosis (alterations of the microbiome) and increased intestinal permeability (which is present in SIBO) have been reported in CRPS, and these two conditions also cause chronic systemic inflammation. IBS is common in CRPS although the relationship has hitherto not been elucidated. In multiple studies, SIBO was found to be present in up to 50% of IBS-d patients." IBS and IBD are both known to be autoimmune, while SIBO is typically the result of a sensitivity to FODMAP-CONTAINING carbohydrates. And as you might imagine from its old name (Reflex Sympathetic Dystrophy), the sympathetic side of the ANS is hyped to the max in those with CRPS.
- INTENSE EXERCISE: Just ten short months ago, the Journal of the International Society of Sports Nutrition published a study called Exercise-Induced Stress Behavior, Gut-Microbiota-Brain Axis and Diet: A Systematic Review for Athletes. The European authors concluded that "The demands during intense exercise can initiate a stress response activating the sympathetic-adrenomedullary and hypothalamus-pituitary-adrenal (HPA) axes, resulting in the release of stress and catabolic hormones [these break your body down], inflammatory cytokines and microbial molecules. The gut is home to trillions of microorganisms that have fundamental roles in many aspects of human biology, including metabolism, endocrine, neuronal and immune function. The gut microbiome and its influence on host behavior, intestinal barrier and immune function are believed to be a critical aspect of the brain-gut axis. Recent evidence in murine models shows that there is a high correlation between physical and emotional stress during exercise and changes in gastrointestinal microbiota composition. Diet is known to dramatically modulate the composition of the gut microbiota. Due to the considerable complexity of stress responses in elite athletes (from leaky gut to increased catabolism and depression), defining standard diet regimes is difficult." There are the five; together again for what hopefully turns out to only be a 'limited engagement'.
So, what are you supposed to do if you have these or other inflammatory, degenerative, or autoimmune disease? The first thing you must is learn everything you can about it you can and make yourself an expert. Thanks to the internet; some diligent study on your particular condition (use PubMed or other databases of medical studies, as well as message boards), and a large percentage of you will be as knowledgeable as your doctor(s) on your particular issue. Face it; the gap between the cool stuff coming out of medical research (the stuff I showed you today) and the standard fare of CRAPPY DRUGS or WORTHLESS TESTS you get at your doctor visits makes the Grand Canyon look like the tiny ditch in your front yard. Be willing to step out of the box just a bit and watch what happens!
Secondly, using said information, sit down and create yourself a top-to-bottom EXIT STRATEGY. Although you may have to modify your plan along the way for any number of different reasons (including new information coming available) purpose in your heart to stick with it and work it as though your life depends on it --- because it probably does. Fortunately, I have created an extremely generic template for making this happen (HERE). For many of you, this is all you'll need. For the rest, there are people out there versed in FUNCTIONAL NEUROLOGY and FUNCTIONAL MEDICINE that can likely help. One last thing. If you are chronically ill, DO NOT go to sleep tonight without learning the basics of one of the hottest topics in the medical research field right now --- FECAL MICROBIOTA TRANSPLANTS.
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).
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