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.

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?

Small Intestinal Bacterial Overgrowth?

Small Intestinal Bacterial Overgrowth (SIBO)?

The digestive system is about 30ft in length from entrance to exit and consists of the following major sections in order from top down: The mouth, throat, stomach, small intestine (duodenum) and large intestine (colon). As I have mentioned many times previously, the digestive tract is home to a complex community of bacteria (approximately 100 trillion), which should not only in balance for health and well being, but also should have the largest number of bacteria residing in the colon.

Sometimes, the small intestine gets overgrown with bacteria due to conditions such as low stomach acid, pancreatitis, diabetes, diverticulitis and coeliac disease, along with the use of certain medications (including immunosuppressants and proton pump inhibitors). This is called ‘Small Intestinal Bacterial Overgrowth’ or SIBO. These bacterial overgrowths produce either hydrogen and/or methane gas. SIBO can therefore be tested for using a breath test that measures levels of these gases.

The small intestine has the surface area of a tennis court and is crucial to the efficient absorption of nutrients from the diet. SIBO disrupts the ability of the small intestine to efficiently absorb nutrients (the bacteria end up competing for the nutrients that the body is trying to absorb) often resulting in a broad range of micronutrient deficiencies (including iron, calcium, and vitamins B12, A, D, E and K) and symptoms including nausea, bloating, vomiting, diarrhoea, malnutrition, weight loss, joint pain, fatigue, acne, eczema, asthma, depression and rosacea. The malabsorption of nutrients is likely to eventually impact every major system in the body, if left unchecked.

SIBO is typically treated with antibiotics, but reoccurrence rates are high and beneficial bacteria essential for digestive function will also be damaged. Research suggests however that certain herbal and lifestyle interventions are just as effective at treating SIBO.

In clinic, as I have mentioned many times before, it is always a multifactorial approach that delivers the best results. So this typically involves a combination of changing how much and how often you eat, what you are eating, adding in certain strains of probiotics, targeted supplementation, the use of herbs and essential oils and managing stress levels using techniques such as meditation, mindfulness, yoga, tai chi, deep breathing and autogenics.

Chronic Fatigue/Fibromyalgia and Energy Production

I regularly see clients presenting with chronic fatigue syndrome (CFS). This is where the client has fatigue that is so debilitating that they are virtually unable to function or undertake normal every day tasks. Often CFS presents as fibromyalgia, which is chronic fatigue with the added burden of widespread pain and stiffness throughout the body.

It is believed that the pain associated with fibromyalgia is caused when the mitochondria (the energy production plants in our cells) desperate to supply appropriate levels of energy to the body, switch from efficient aerobic (using oxygen) to inefficient anaerobic (not using oxygen) metabolism. This anaerobic form of energy production creates large amounts of lactic acid. Lactic acid, as anyone who pushes themselves hard when exercising knows, causes immediate muscle pain, which dissipates after a few minutes of rest. This pain however does not dissipate with fibromyalgia, as the body is unable to break the lactic acid down, due to mitochondrial dysfunction (not working properly). The excess lactic acid can also cause damage to the muscle tissue, presenting as very sensitive areas on the body. This process can feed on itself as the damage to the muscles releases a large number of free radicals (destructive molecules), which can cause additional damage if antioxidant status (the ability to neutralise free radical damage) is low.

Mitochondrial dysfunction is therefore one of the key areas to focus on when it comes to helping move the body back into balance with CFS and fibromyalgia. So what are the key ingredients required for healthy mitochondria? They require a raft of key nutrients for optimal performance, including but not limited to magnesium, B vitamins, essential fats, CoQ10, carnitine and alpha lipoic acid and must not be bathed in toxins.

Whilst clearly mitochondrial dysfunction is one of the key areas to focus on with these conditions, it should be noted that there are often multiple systemic imbalances going on, including but not limited to digestive dysfunction, poor antioxidant status, immune system dysregulation, chronic inflammation, viral infections, food and/or environmental sensitivities/allergies, thyroid and adrenal dysfunction and micronutrient deficiencies. Everything in the body is connected and nothing exists in isolation.

Once again looking at the body from a functional and holistic perspective is key to any potential solution to these devastating conditions.

Migraines

Migraines are debilitating vascular headaches, which usually happen on one side of the head. Migraines are thought to affect around 1 in 7 people with an estimated 190,000 migraine attacks every day in the UK affecting three times as many women as men and accounting for an estimated 25 million days lost from work and school each year.

The typical sequence of events is that an initial spasm happens in the wall of a meningeal artery (one of the arteries in the head); the spasm does not last long (a few minutes) and is followed by a paralysis of the wall of the artery, which can last for days. This paralysis leads to swelling and inflammation of tissues around the artery wall, causing the pain (migraine).

So what causes the spasm in the first place? Many factors are thought to be involved, but one of the key contributors is an over accumulation of toxins in the body. Liver and gut health are fundamental areas to critically evaluate and support due to the crucial role that these two organs play with respect to optimal detoxification.

If an imbalance in the gut bacteria (dysbiosis) is present (a common thread in my articles) then the ‘bad’ bacteria can cause an overproduction of histamine in the gut. Histamine is secreted by specialist immune cells as part of a local immune response to the presence of unwanted bacteria/triggers. It is the excess levels of histamine that causes blood pressure to drop too low and initiate the spasm that starts the sequence of events.

Unidentified food sensitivities (where the immune system is inappropriately responding to specific food proteins) causing elevated levels of inflammation are also potentially a significant trigger for migraines. Research and clinical experience would suggest that gluten related disorders (encompassing wheat sensitivity, coeliac disease and non coeliac gluten sensitivity – another common thread in these articles) are significantly correlated with migraines. Other factors involved would appear to be magnesium status (low magnesium is a significant and independent predictor of migraine risk) and B vitamin deficiencies.

Alzheimer’s a multi-factoral approach

Alzheimer’s disease (AD) is the most prevalent form of dementia and it is estimated that 160 million people globally by 2050 will have this disease.

So far the search for a single ‘silver bullet’ pharmaceutical approach to treating AD has not delivered anything other than a temporary slight improvement in symptoms with no long term impact on disease progression. Recent biochemical research however would suggest that AD is both triggered and perpetuated by a complex interaction of different factors and that a multi-factoral approach to treating this devastating condition may provide better outcomes.

Pioneering work is being undertaken in this area by Dr Bredesen, who describes dementia as being primarily a ‘metabolic problem’. In a small but ground breaking study published in Aging in 2014, a 90% success rate in both arresting and reversing early stage AD was reported. Dr Bredesen uses a combination of personalised dietary and lifestyle interactions (includes supporting digestive function, identifying imbalances in the gut, correcting identified nutrient deficiencies, optimising vitamin D levels, eating food over a particular window of time in the day, assessing metal toxicity, optimising sleep, increasing exercise and movement, reducing inflammation, identifying food sensitivities, supporting mitochondrial function and stimulating the brain) with the client to achieve substantial results over a 3 to 12 month period. Larger clinical trials are currently underway in the UK and USA.

These results on the face of it look to good to be true, but in reality simply reflect the obvious which is that chronic disease is rooted in the mismatch between our genetics and the modern world that we have created for us to live in. Your environment (diet, toxic load, stress/trauma, and infections) is fundamental to your long-term health and well-being and should be one of the first areas to seriously evaluate when confronted with any chronic condition. What makes you, you is unique to you and this is the premise behind the ‘functional model’ of health. Working with a functionally trained health practitioner on any chronic condition, along with the required work and commitment that these types of interventions require, can provide significant health benefits.

27th April 2017 Event at Arlington Arts (Newbury) – Sensitivities, Chronic Inflammation and Autoimmunity

Sensitivities, Chronic Inflammation and Autoimmunity
How food and environmental choices can impact your long-term health

Thank you to everyone that attended this event. We had 157 people turn up………..

You can view Part 1 of this seminar here: https://www.youtube.com/watch?v=BFOV00Phs7Y

Research shows that unidentified sensitivities (to both food and the environment) are often implicated in the development of and/or perpetuation of a number of chronic health conditions including but not limited to eczema, joint pain, IBS, indigestion, depression, anxiety, headaches, fatigue, weight gain, congestion and heart palpitations.

This seminar provides you with an easy to understand overview of the following key topics:
1) What is the difference between an allergy, sensitivity and intolerance?
2) What impact might unidentified food and environmental sensitivities behaving on your health?
3) Coeliac disease and non coeliac gluten sensitivity – the differences
4) Why simply cutting gluten out of the diet is not enough if you are a diagnosed coeliac
5) Sensitivities and autoimmunity
6) Items to carefully consider when choosing a sensitivity test
7) Personalised dietary and lifestyle interventions and the road to health