Controlling Inflammatory Bowel Disease using Diet not Drugs

Inflammatory Bowel Diseases (IBDs), which include both Crohn’s disease (CD) and ulcerative colitis (UC), are complex autoimmune diseases of the digestive system. As discussed in previous articles, the evidence base suggests that autoimmunity is caused by a combination of genetics, environmental challenges (diet, toxic load, stress, viral and bacterial load) and imbalances in the balance of the bacterial species of the gut (dysbiosis). The standard medical approach to managing IBDs is to suppress the immune system using steroids or anti-inflammatories, which can not only increase the risk of infections but may often also deplete vital nutrients from the body. Response rates to these medications are also often sub optimal.

The standard Western diet is both high in refined carbohydrates, rancid fats and low in fibre and nutrients. The Autoimmune Paleo (AIP) protocol (a more restricted form of the Paleo approach) often used as the basis of a dietary intervention to help clients with autoimmunity regain control of their health; temporarily eliminates gluten, grains, dairy, nuts and seeds, legumes, nightshades, eggs, food additives, sugar, tea, coffee and alcohol. The focus is on providing the body with nutrient dense whole foods, consisting of fish/meats, fruits, vegetables, herbal teas, meat stocks, bone broths and water. The rationale is to remove the foods that can often trigger inflammation. It is also important to include other life style modifications, as part of the overall strategy, including stress and toxic load reduction and appropriate forms of exercise.

The results of a small study published in the journal of Inflammatory Bowel Diseases 2017 called ‘Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease’, tracked the progress of 15 patients with active IBD, that had been living with this condition for an average of 19 years. Half of the participants were actively using prescribed medications.

The results of this study were remarkable – ‘clinical remission was achieved at week 6, by 11 out of 15 (73%) of the study participants’. The study then goes on to say that ‘remission by week 6, rivals that of most drug therapies for IBD’, without of course the side effects.

Clinically I have experienced a significant proportion of clients with IBD regain control using a personalised dietary and supplementation approach. It is extremely reassuring to see such an unusual study validate this approach.

 

 

 

We are not what we eat, we are what we absorb

When cells malfunction we ultimately present with disease. Nature does not label/define cell malfunction into various disease types such as arthritis/depression/cancer or cardio vascular disease; we do that. ‘There are no specific diseases; there are specific disease conditions.’ – Florence Nightingale. So why do cells malfunction? Cells, the building blocks of our body, all 36 trillion of them, malfunction for only a few key reasons. Arguably one of the most important of these reasons is lack of optimal cellular nutrition.

The biochemistry that is going on in all of us is unimaginably complex. Our cells are performing trillions of chemical reactions every second. So far we have discovered that the body requires access to over 250 individual nutrients for optimal cellular health (there will inevitably be more as our knowledge progresses). Even if genes are playing a part in the disease process, whether those genes become activated or not is intricately linked to nutrient triggers – nutrients can literally switch genes on and off. Medications cannot do that. This is the science of the rapidly expanding field of nutrigenomics.

Yes, to a certain extent we are what we eat, but to be more precise we are what we absorb! Nutrient absorption is fundamental to the whole process of optimal cellular health. It is normal to see clients presenting with multiple signs and symptoms of low nutrient status, even when eating what they would describe as a ‘healthy diet’. These include, fingernails that chip/break easily and have white spots, muscle cramps, cuts that heal slowly, decreased sense of taste/smell and bleeding gums.

Optimal absorption is dependent on optimal digestive system function. The whole system has to be in balance. Not only do we need to be in a relaxed state and consuming nutrient dense foods (however that on its own is becoming more and more difficult to do as we deplete our soils through relentless monoculture farming), but we also require sufficient stomach acid, bile flow and digestive enzyme status; a diverse and balanced micro ecology of the gut, optimal health of the small intestine (which can be damaged by the presence of coeliac disease, non coeliac gluten/wheat sensitivities) and the absence of small intestinal bacterial overgrowth (SIBO).

This is why when working with any client, no matter what their health condition, it is wise to start with a thorough evaluation of digestive health.

 

 

 

 

Neurodegeneration from a Functional Perspective

Neurodegeneration/neurological disease affects neurons (the building blocks of the nervous system in the brain and spinal cord) and includes Multiple Sclerosis, Parkinson’s, Alzheimer’s and Motor Neurone/Lou Gehrig’s disease/ALS.

Modern medicine uses medications to control symptoms. Whilst this is naturally the first line of treatment offered, investigating why neurodegeneration has developed is often not given the attention it deserves.

The functional approach to health is all about causation i.e why does something happen? The body consists of multiple interconnected sophisticated systems, that when working efficiently, promote optimal health. It is now clear that there is a ‘gut/brain axis’, which consists of bidirectional mechanisms of communication between these two distinct nervous systems. This includes a physical connection via the vagus nerve, compounds produced by gut bacteria that may access systemic circulation due to increased ‘leakiness’ of the gut and gut derived immune system chemical messengers/neurotransmitters and hormones. Why does this matter? In Parkinson’s, for example, constipation is now believed to be a very early symptom and the data suggests that being constipated increases the risk of developing Parkinson’s by up to 4 times; there is also evidence that alpha-synuclein clumps start in the gut and travel to the brain via the vagus nerve. What happens in the gut does not stay in the gut!

It is essential to construct a holistic functional picture in order to be able to provide the appropriate intervention. Functional testing is an important part of this picture.

The health of the digestive system is fundamental (cells require access to 250 different micronutrients (vitamins/minerals) to function properly, which depends on optimal digestive capacity even if eating ‘well’ – we are not what we eat, we are what we absorb), toxic and bacterial/viral load (how is the immune system responding to these environmental challenges), gluten sensitivities (coeliac/non coeliac gluten/wheat sensitivities), unidentified food sensitivities (which can contribute significantly to overall levels of systemic inflammation), histamine and gut barrier permeability (‘leakiness’).

By combining this data with conventional medical data, a personalised and targeted intervention can be implemented alongside any current modern medical programme, providing the client with a much greater opportunity to regain control of their health.

Finally, it is perfectly possible for gluten on its own to drive neurodegeneration. ‘Gluten sensitivity can be primarily and at times exclusively a neurological disease’ – Gluten Sensitivity as a Neurological Illness – Journal of Neurology, Neurosurgery and Psychiatry 2002.

 

 

 

There are over 3,000 skin conditions

Our skin is an amazing structure. There are over 3,000 known skin conditions, which include conditions such as eczema, psoriasis, vitiligo, acne, rosacea and seborrhoeic dermatitis. Data suggests that in the UK, 55% of the population have a skin disorder. These conditions often cause considerable discomfort and stress. Topical treatments such as balms/emollient creams/moisturisers and steroids are the normal course of action, often providing symptomatic relief, but these treatments unfortunately do not get to the root cause. So what are the key factors that in clinic often help to resolve these distressing conditions?

Optimal skin health is dependent on sufficient supplies of micronutrients including vitamins A, B3, B5, biotin, C, D (optimisation of vitamin D levels can reduce the severity of eczema in 4 weeks), E, K2, the minerals zinc, sulphur, selenium and silica and balanced essential fats. Nutrient density of the diet and efficient absorption are therefore key. We are not what we eat, we are what we absorb!

Absorption can be impacted by so many different variables including imbalances in the bacterial species of the gut (dysbiosis) – there is an irrefutable ‘gut-skin axis’ with skin health directly reflecting what is going on inside us; the presence of Small Intestinal Bacterial Overgrowth – SIBO (where the small intestine is overgrown with bacteria from the colon – correlated with rosacea); physical damage to the small intestine caused by undiagnosed coeliac disease (which is one of the most common lifelong disorders in North America and Europe) and inflammation caused by non-coeliac gluten/wheat sensitivity. The presence of a ‘leaky gut’ caused by dysbiosis can lead to a lack of ‘oral tolerance’ of any number of foods, which can drive skin inflammation.

Liver and kidney function are also important. The skin is a detoxification organ and if the liver and kidneys are under pressure then skin health may be impacted. So a proper evaluation of your environment is key (fabric conditioner, detergents and personal care products).

Finally excess histamine can often be a significant factor (stress is a potent histamine trigger), which is why a low histamine diet can often help. If this approach does work, then gut health and nutrient status warrant further investigation.

So if you have a chronic skin condition and want to regain control, work with a functionally qualified health professional. Everything in the body is connected – nothing exists in isolation.

Diabetes – An Intolerance to Carbohydrate

Diabetes is a condition where the body is unable to efficiently handle carbohydrate (sugar). This happens because of problems with the production of, or response to insulin (the hormone secreted by the pancreas that controls blood sugar levels). Diabetes can either be type 1 or 2 .

Type 1 diabetes (T1D), also called juvenile diabetes, is where the pancreas fails to make insulin and type 2 diabetes (T2D) is where the body does not respond appropriately to the insulin that is being produced and usually follows on from a period of ‘insulin resistance’. Both types cause too much sugar to be present in the blood. Inappropriately high levels of blood sugar can cause a myriad of health issues including but not limited to cardiovascular disease, nerve/kidney/eye/foot damage, skin conditions, Alzheimer’s and depression. T1D is an autoimmune condition (where the body’s immune system attacks the cells that make insulin in the pancreas) and T2D is considered to be primarily a lifestyle condition, although there is now also evidence that T2D also has an autoimmune component.

According to Diabetes UK, almost 3.7 million people in the UK have a diabetes diagnosis (with an estimated extra 1 million who don’t even realise that they are diabetic). It is estimated that 12.3 million people are at an increased risk of developing T2D in the UK i.e pre-diabetic. Diabetes has been described as being the ‘fastest growing health crisis of our time’, costing the country £1.5 million an hour or £14 billion per year (if you also include the cost of treating health complications). This is a real crisis, which is not being resolved by the current nutritional guidelines.

Diabetes is essentially an intolerance to carbohydrate. To quote a critical review titled ‘Dietary carbohydrate restriction as the first approach in diabetes management’ published in Nutrition in 2015 – ‘the benefits of carbohydrate restriction in diabetes are immediate and well documented’. It goes onto say ‘dietary carbohydrate restriction reliably reduces high blood glucose, does not require weight loss and leads to the reduction or elimination of medication’.

It is however critical that any diabetic that reduces carbohydrate intake, regularly measures their blood sugar levels and works very closely with their doctor so that their diabetic medications can be adjusted accordingly. Failure to do this could lead to the development of hypoglycaemia (low blood sugar), which can be life threatening.

Autoimmune Reset with Medicinal Mushrooms with Hifas Da Terra

I have been asked to speak at this seminar, which is being run from 10am on the 25th October 2018 at the Penny Brohn Centre in Bristol and is being hosted by Hifas da Terra – www.hifasdaterra.co.uk. More information and tickets can be bought by clicking  here

This event is designed to take you on a journey through the latest research relating to the processes that are now believed to be central to the initiation and development of autoimmunity. We will not only explore some of the key interventions that have been developed and are being successfully employed to help people presenting with these devastating conditions to take back control of their health; we will also present the science behind use of medicinal mushrooms in auto-immunity in clinical practice.

Medicinal mushroom have been used as a powerful tool in natural health for centuries. As adaptogens they have the potential to balance and regulate our immune response, an important step in auto-immune reset and recovery. We will explain the role of key medicinal mushrooms in auto-immune protocols, and take you through the mechanisms of individual active compounds and their role in human health and wellbeing.

What makes you, you, is unique to you…

Studies show that a quarter of the population in the UK are presenting with a chronic (long term) condition. These are non-communicable diseases. A quarter of adults are taking 3 or more medications, to manage their symptoms. This is the key point; the medications are designed to manage symptoms, not to get to the root cause of the problem.

Now, there is nothing wrong with treating symptoms. Most of us have taken a pain killer at some point in our lives to deal with acute pain and been extremely thankful for the result. However, when it comes to chronic health conditions please consider this analogy; if you have a nail in your shoe, you can either take a pain killer to reduce the pain, or remove the nail from the shoe. This is of course a slightly flippant example of the main principle behind the functional model of health, but it succinctly explains the difference between treating symptoms as opposed to the root cause.

The functional model of health is based on the fact that the body is composed of several highly interconnected sophisticated ‘functional’ systems, that when working efficiently, promote optimal health and well-being. These functional systems are intricately connected together and nothing exists in isolation.

We are all biochemically individual. What makes you, you, is unique to you. The functional model recognises that it is the summation of your environmental inputs (toxins, bacterial/viral load, stress, diet & lifestyle) over your life that are likely to have contributed to your current health concerns and that most chronic illnesses are typically preceded by a lengthy period of decline in one or more of the body’s functional systems. Family history and genetics can play a significant role in the development of health problems; however appropriate diet and lifestyle choices can do a great deal to lessen their expression (epigenetics).

It is through the taking of a detailed life history that the functional model aims to identify systems that may have been excessively challenged over your lifetime. When these systems are over stretched, it can lead to many symptoms, which often seem unrelated and hard to pin down. Once identified, these challenged systems can be supported through appropriate dietary and lifestyle interventions. As the body moves back towards a state of balance and optimal health, symptoms and health problems are more likely to resolve or lessen in their expression.

Coeliac Disease is not the only significant Gluten Related Disorder

Gluten related disorders (GRDs) include coeliac disease (CD) and non-coeliac gluten sensitivity (NCGS). The evidence base shows that GRDs (not just CD) are a serious threat to long-term health and well-being.

GRDs are fundamentally caused by the inability of the body to properly digest gluten (the storage protein in grains), typically driven by imbalances in the bacterial species of the gut in combination with genetic predisposition. Anyone with a GRD should completely eliminate gluten from the diet permanently in order to repair the damage that has been done and regain health and wellbeing.

CD is the autoimmune variant of GRDs where the immune system attacks and destroys the small intestine reducing the ability of the body to absorb nutrients and is connected with over 300 different conditions. CD can be diagnosed using a combination of blood, genetic and physical assessments.

NCGS on the other hand is not an autoimmune disease and is therefore generally viewed as being a much less serious condition. This is simply not true. There is also a ‘new kid on the block’ called Non Coeliac Wheat Sensitivity (NCWS) where gluten is not necessarily the trigger, but instead significant immune system reactions and damage to the intestine are being triggered by other components of wheat.

CD is therefore not the only GRD that should be taken seriously. The results of a large study in 2009 (American Journal of Gastroenterology) that reviewed 351,000 intestinal biopsies clearly showed that there was not only just as much inflammation detected with NCGS as with CD, but also that the increased risk of early mortality was 72% with NCGS compared to 39% with CD! If you then also consider that a recent study in 2015 (Gastroenterology) discovers that blood markers for the detection of systemic autoimmunity are nearly double with NCWS (NCGS is a sub section of this category) compared to CD, you can start to appreciate that both gluten and wheat can have serious implications for those individuals that do not have CD but instead NCGS/NCWS. Further research needs to be conducted in this area, but these findings are very revealing.

So, if you are presenting with any chronic condition that cannot be explained, then please seriously consider getting professional assistance evaluating the potential for the existence of a GRD. Remember that eliminating wheat/gluten before you have had a professional assessment is not advised.

Leaky Gut?

We will consume between 3 and 7 tonnes of food and drink in our lifetimes, all of which has to be broken down and then the appropriate nutrients absorbed across the gut barrier, before it can be utilised by the body. The gut barrier of the small intestine, is the size of a tennis court and is made up of a single layer of cells that not only regulate the flow of nutrients and water into the body, but also play a central role in how our immune system responds to the significant amount of dietary proteins and microbes that are ingested on a daily basis.

Nothing put into the digestive system is technically speaking inside the body until it has been absorbed across the gut barrier. It is the gut barrier that decides what to both let in and keep out of systemic circulation.

Research shows that the integrity of the gut barrier is fundamental to health and well-being. If the gut barrier is compromised, by ‘leaking’ between and/or through the cells (para and/or trans cellular hyperpermeability), unwanted substances might permeate through the gut barrier and provoke unwanted immune responses – fuelling chronic inflammation. As we have discussed many times before, chronic inflammation is the route cause of all chronic disease and is a recognised key factor in the development of autoimmunity.

Some of the conditions directly associated with ‘leaky gut’ include: coeliac disease, type 1 diabetes, rheumatoid arthritis, psoriasis, spondylitis, Parkinson’s disease, endometriosis, eczema, Crohn’s disease, colitis, multiple sclerosis, chronic fatigue syndrome, depression, anxiety and schizophrenia.

Leakiness between the cells of the gut barrier is controlled dynamically by a protein called zonulin. The higher the levels of zonulin, the greater the leakiness between the cells. The zonulin pathway is initiated by either the presence of pathogenic bacteria and/or gluten in the gut (which gives you a clue as to how the body treats gluten!).

Dysbiosis (imbalances in the micro ecology of the gut) and leaky gut will typically co exist. The presence of either or both of these conditions will drive a state of chronic inflammation. Fortunately you can repair ‘leaky gut’ and rebalance the micro ecology of the gut, regaining control of health and well-being.

The Problem With Coeliac Disease

Coeliac disease (CD) is not a minor ‘intolerance’ to gluten, it is an autoimmune condition where the body’s immune system attacks the small intestine, reducing the ability of the body to absorb nutrients from food. If left undetected, CD has the potential to cause significant long-term health complications. CD is one of the most common life long disorders in North America and Europe and only 1 in 8 coeliacs are ever diagnosed. These are disturbing facts.

Diagnosis of CD currently requires a positive blood test and then subsequently the detection of damage to the small intestine via an endoscopy.

The first problem is that less than 50% of coeliacs are presenting with the classical symptoms of diarrhoea and abdominal cramping. The majority of coeliacs are ‘silent’ in their presentation – no overt digestive symptoms but are presenting with signs and symptoms including iron deficiency anaemia, osteoporosis, arthritis, neurological degradation, depression, fertility issues, migraines and chronic kidney disease. This point alone, is likely to be having a significant impact on whether testing for CD is even to be considered.

The next potential issue is with the blood testing itself. The standard NHS test for CD is good if you are presenting with significant damage to the small intestine and your immune system is functioning properly. We know however that damage to the small intestine is a gradual process that can take years or even decades to manifest, the immune system is often underperforming and the markers being measured for are not broad enough. This can lead to very high rates of false negative results (up to 70%), which is a dangerous outcome if the result is that you are told that it is fine to consume gluten, when in fact it is not! Remember you have to be eating gluten and not taking any steroid or immune suppressing medication for any blood test to have half a chance of picking up an issue.

Finally, it is possible to have positive blood markers for CD and no damage to the small intestine – ‘latent’ CD (over and above the fact that the biopsies can often miss the ‘damaged’ areas of the small intestine).

Is it any wonder that CD is such a poorly diagnosed and managed condition?