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 ent that , lifestyle) uts across your life that e to you. hat family historyyence and repair,rs that are likely to h (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 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 recent studies are now showing 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.

Food is the Most Powerful Medicine Known to Humankind

We all know that the NHS is under considerable pressure. The cost of diabetes alone to the NHS is over £1.5 million per hour (Diabetes UK). The conventional medical view on type 2 diabetes (T2D) is that this condition is irreversible and requires long-term medication to control.

We (the so called ‘alternative health care industry’) have known for sometime that T2D typically responds very well to specific dietary and lifestyle interventions. I have seen first hand clients come off/reduce their diabetic medications by making substantial changes to their diets and lifestyle (working in collaboration with their GPs). This scenario reminds me of the classic Mark Twain quote – ‘It ain’t what you don’t know that gets you into trouble, it’s what you know for sure that just ain’t so!’

I am therefore somewhat perplexed by the fanfare that has surrounded the results of a very recently published randomised controlled trial in The Lancet, that has concluded that after the participants focused on a weight loss programme for 12 months that ‘almost half achieved remission to a non-diabetic state and off antidiabetic drugs. Remission of type 2 diabetes is a practical target for primary care’. This is great news, but not new news. There is considerable existing evidence to suggest that calorie restriction (in particular carbohydrate restriction) is one of the most beneficial approaches to optimally managing diabetes, which after all is an intolerance to carbohydrate. Obviously any such intervention does need to be carefully managed by a suitably qualified health care practitioner in conjunction with the client’s GP/medical consultants. The reality is that standardising this type of approach, has the potential to save the nation around £7 billion with just this one condition!

It is time to stop simply focussing on how much more money the NHS requires and really start thinking about reducing overall load on the system, by using well managed dietary and lifestyle interventions that are supported by unbiased science, as opposed to ‘junk science’ which has a history of being sponsored by questionable institutional agendas. Food is one of the most powerful medicines known to human kind; maybe we should start to use it! We might end up experiencing a pandemic of wellbeing.

Urinary Tract Infections (UTIs) – breaking the vicious cycle

UTIs are very common, especially in women. It is estimated that 1 in 5 women will have a UTI at some point in their lifetime and once you have had one infection you are much more likely to have another. The standard medical treatment is with antibiotics. The problem with antibiotic treatment is that whilst it will tend to work in the short term (and is often an essential treatment to avert a more serious infection of the kidneys), there is an increased risk of developing imbalances in the beneficial bacteria (microflora of the gut and urinary tract) and antibiotic resistance (which has recently been described as a significant threat to our future health by Professor Dame Sally Davies – England’s Chief Medical Officer). It is the disruption of the microflora in conjunction with growing antibiotic resistance that are the key reasons as to why UTIs often re-occur.

Thankfully numerous clinical studies indicate that several natural substances work very effectively to help prevent UTIs and there is also considerable evidence to suggest that these natural substances can also work very effectively even in acute infection scenarios, as long as the intervention is initiated as soon as an infection is suspected.

The best studied natural agent to help with UTIs is D-mannose (a simple sugar – available from any good health store), and is very effective at helping control UTIs that are caused by E.coli bacteria. The majority of UTIs are caused by E. coli. When however E.coli is not the cause, the use of D-mannose is unlikely to help. There are a number of other bacteria that can cause UTIs and often it is possible to find out what bacteria are involved through testing. Once the species of bacterium involved has been identified a suitable natural intervention can be applied.

Another reason to consider, if natural compounds such as D-mannose do not work, is biofilm issues. Biofilms surround a collection of bacteria that are attached to the body, effectively creating a shield that protects them from being attacked/controlled (the best example of this is plaque on the teeth) – this makes this type of infection very difficult to control. The key to breaking this cycle is to therefore disrupt the biofilm, which can be done using specialised enzymes.

So, if you are presenting with regular UTIs and you want to break the vicious cycle, you might want to consider working with a  suitably qualified practitioner to improve overall gut health and the balance of the microflora, inbetween infections.

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.