Do You Have Irritable Bowel Syndrome?

It’s important to realize that IBS is completely different from another condition that sounds very similar, namely inflammatory bowel disease (IBD).

Inflammatory bowel disease is an autoimmune disease that can have very serious consequences.  But irritable bowel syndrome, even though it can cause debilitating pain, is a functional bowel disorder. In other words, there are no significant physical conditions that contribute to the problem; hence it’s a functional disease. So how do you know if you might be suffering from IBS? Common signs and symptoms include frequent:

• Abdominal discomfort and/or pain
• Spastic colon (spastic contractions of the colon)
• Bloating
• Gas
• Diarrhea
• Constipation 
• Weightgain

How to Treat IBS Without Drugs

Fortunately, there are some simple, basic strategies you can use as an alternative to the drugs that are typically prescribed, such as antispasmodics and antidepressants. These drugs may help control the symptoms but do nothing to address the underlying cause.

Avoid all sources of gluten — The first step for any patient that comes to my clinic with this problem is to go on a gluten free diet. Most people understand this means avoiding all forms of wheat, but you also need to be aware that there are many other hidden sources of gluten in your diet.

Gluten is a protein found in wheat, but it’s also found in other grains such as:

• Barley
• Rye
• Oats
• Spelt

Typically, avoiding gluten for a two to four weeks is enough to see significant improvement. In addition to gluten, food allergies can also play a role so be sensitive to that and start a trial and error process to determine which ones you have.

Get checked for parasites — Another comprehensive strategy, to make sure you’re not struggling with a physical condition that could be simulating IBS, is to have your stool checked for parasites. Some parasites, such as giardia, can sometimes be a contributing factor that needs to be treated. 

Tailor your diet to your personal biochemistry — Naturally, you’ll want to pay close attention to your diet. Ideally, you’ll want to eat according to your nutritional/metabolic type, as you have specific nutritional needs that are based on your personal biochemistry, metabolism, and genetic makeup.

Some people thrive on low-carbohydrate, high-protein and high-fat diets. A typical ratio for a might be 40 percent protein and 30 percent each of fats and carbohydrates, but the amounts could easily shift to 50 percent fats and as little as 10 percent carbohydrates depending on individual genetic requirements or conversely 50% Carbohydrates and 15% Fats. No one size diet fits all!

Others require the converse: a high carb, low fat and low protein diet. (However, it’s important to realize that there is a major difference between vegetable carbs and grain carbs, even though they’re both referenced as “carbs.” Grains convert to sugar, which is not something anyone needs in their diet in high amounts.) Others fall somewhere in between these Protein and Carbohydrate types and can afford to be less strict with their ratios of carbs, fats and proteins.

It’s important to realize that if you don’t eat a diet that is suitable for you, you’re likely to suffer health challenges, and a spastic colon is one possibility.  Part of metabolic typing is also to pay attention to the quality of your food. You’ll want to consume high quality, unprocessed food. Remember, 80 percent of the money society spends on food is for processed foods. If you choose foods like this you’re bound to experience physical complications, and it’s no big surprise that one of those complications could be in your gut.

Boost healthy bacteria in your gut — It’s also important to make sure you have enough healthy bacteria in your gut. You can get healthy bacteria from fermented foods or a high quality  pro-biotic supplement.

Now, once you lower the amounts of sugar and processed foods in your diet, you’re automatically creating a milieu that will support the growth of good bacteria and diminish growth of bad bacteria. But you can enhance that process further by eating fermented foods or taking a high quality probiotic. 

Take your fibre – Taking additional fibre can also be very helpful to control IBS symptoms such as constipation and diarrhea. Fibre such as psyllium tends to be particularly helpful, and is my personal favourite. Psyllium is adaptogenic fibre, meaning if you’re constipated it will soften your stool and help increase your bowel frequency, and if you have loose stools and frequent bowel movements, it will help with stool formation and decrease the frequency of bowel movements.

If you decide to use psyllium, make sure it is organic as nearly all the products out there are not, and the damage from the pesticide residue in most of the products far outweigh the benefit you would receive from the fibre itself. Metamucil is a classic non-organic psyllium.

Another good fibre is whole, organic flax seed. You can take a few table spoons of freshly ground flax seed per day. Another benefit of flax is that it’s also a high quality source of plant-based omega-3 fats, particularly ALA, which nearly everyone needs on a regular basis.

Address emotional challenges – Last but certainly not least, I’ve found that many people with IBS have an unresolved emotional component that contributes to their physical problem. This is also one of the reasons why antidepressants are frequently prescribed. Meditation, prayer, and psychological techniques and tools like the Emotional Freedom Technique (EFT) are all strategies you can use to effectively address your emotional challenges.

If irritable bowel syndrome is a condition that you or someone in your family struggles with, following these tips and recommendations can help you, or call us on 07980865892 or email guy@successfulhealthcoach.com and your family, to take control of your health.

The first-ever study of the evolution of the appendix and information on its critical function has just been released in the Journal of Evolutionary Biology. This is a follow-up to a report from about two years ago, when investigators at Duke University Medical Center proposed that the human appendix serves as a storage area for beneficial bacteria that can be used to repopulate the intestinal tract (gut) when good bacteria levels have been depleted by diarrhea or other gastrointestinal conditions. The gut needs various microorganisms, including beneficial bacteria, for digestion to occur.

The appendix is a two- to four-inch long pouch that is located near where the large and small intestines meet. Scientists have long speculated about the function of the appendix, especially since it is populated with immune system tissue. William Parker, PhD, assistant professor of surgical sciences at Duke and the senior author of the current study, and his colleagues now believe that the immune system cells protect the beneficial bacteria in the pouch until they are needed by the intestinal tract.

Parker and the other researchers propose that in countries without modern sanitation practices and endemic diarrhea-causing diseases, the beneficial bacteria harbored in the appendix can emerge and enter the intestinal tract after diarrheal symptoms have emptied the bowels. In industrialized societies that have good hygiene practices, however, the stored beneficial bacteria may not be needed or needed rarely. This idea supports the fact that removing the appendix today has no apparent negative impact on the body.

Appendicitis, or inflammation of the appendix, may be the result of too much sanitation, commonly referred to as the “hygiene hypothesis.” This hypothesis suggests that people who live in sanitary societies suffer with high rates of allergies and other immune system disorders because their immune systems are not challenged enough. In other words, we are so clean that when something does attack the system, it can overreact, resulting in inflammatory conditions, such as appendicitis.

In a Science Daily report, Parker said that our new understanding of the appendix may help us prevent appendicitis if we can challenge the immune system today much like it was back in the Stone Age. If we can do that, he said, “we would see far fewer cases of allergies, autoimmune disease, and appendicitis.”

SOURCES:
Duke University Medical Center, “Inside Duke Medicine”
Randal Bollinger R et al. Journal of Theoretical Biology 2007 Dec 21; 249(4): 826-31
Science Daily, August 21, 2009
Smith

There is no more contention around any health issue than the subject of how to choose foods that are right for you. People who want to eat healthy, nutritious foods are frequently confused about what to do. Many follow what they assume are healthy diets with the best intentions, only to unwittingly be causing health problems by eating foods that are harmful to them. The following discussion of this complex and misunderstood issue provides a starting point for making sensible food choices based on science, not opinions. The focus of this discussion will be on food intolerance and food allergies with a special emphasis on the newly discovered condition referred to as sub-clinical or hidden gluten intolerance. The purpose of this discussion is to help you understand the importance of eating foods that are well tolerated and to teach the value of avoiding those foods that can lead to health problems.

When it comes to eating the right foods, it is difficult for even the most well educated person to understand all the different opinions presented by doctors, nutritionists, fitness experts, magazine articles, etc. It is clear that there is little to no consensus on what constitutes a healthy diet or how to go about choosing foods wisely.

There are dozens of diets to help a person lose weight, enhance athletic performance, or incorporate foods such as soy products to help hormonal balance; in fact, there are diets for every imaginable purpose, but sorting through the contradictory advice has become so challenging that many people simply give up. Each week the media reports more and more information about the beneficial aspects of certain foods and the harmful attributes. Even the official government recommendations and the new “food pyramid” has replaced the old four food groups. The challenge is to wade through all the available information and find what is right for each of us as individuals.

First and foremost, any diet related advice must be based on sound physiological principles, not on personal experiences, preferences, current fads or product marketing. Science can guide us in terms of explaining the basic requirements for normal human physiology and function when it comes to how to eat. Additionally, there are sophisticated laboratory tests available that screen for food intolerance and food allergies to determine what specific foods are right for you. These lab tests can be used by anyone seeking to determine reliable, science-based dietary recommendations.

There are two general topics to investigate in determining the best diet for you. The first subject is coming to an understanding of the basic physiological principles around food and diet that apply to all of us. Scientists have known for decades that proper blood sugar control is absolutely required for maintenance of appropriate fat levels, to have good cognitive function, and to stimulate healthy immune function. The second issue each of us must investigate is what specific foods are harmful and which foods are well tolerated and health promoting for our unique body chemistry.

In my practice, I use an Adrenal Stress Profile to analyze cortisol and DHEA levels, revealing valuable data on how well patients have maintained blood sugar control over time. I also use gluten free diets and nutritional typing evaluate patients’ unique biochemistry and how they react to specific foods.

Gluten

Sub-clinical, or hidden, gluten intolerance is a health problem at epidemic proportions in certain populations in the western world and remains largely unrecognized by conventional medicine.

Definition of Sub-Clinical

Sub-clinical means – hidden. In other words, there are often no obvious symptoms that would direct a doctor or patient to suspect sub-clinical conditions. Since symptoms aren’t obvious and sub-clinical gluten intolerance often goes undiagnosed or misdiagnosed, many people can suffer from the health consequences related to sub-clinical gluten intolerance without understanding the true cause of their problems. By their very nature, sub-clinical problems are hard to recognize and frequently go undetected despite the best efforts of health professionals and patients.

Discovery of Sub-Clinical Gluten Intolerance

The condition of sub-clinical gluten intolerance was first documented in the United States by observations of physicians involved in treating patients with chronic fatigue, weakened immunity, and environmental illness. Over the course of many years, there has been continual work to uncover the nature and extent of this problem in the United States and Europe. In 1994, a technological breakthrough in the form of a highly specialized salivary test for sub-clinical gluten intolerance made more comprehensive investigation into this problem possible.

The First Tests For Subclinical Gluten Intolerance

The first tests for sub-clinical gluten intolerance in the United States were run on a large group of chronically ill patients. These patients had been previously unresponsive to all known treatments. Through laboratory research of this patient population of chronically ill individuals, it had become evident that they all suffered from some hidden inflammatory condition that had yet to be identified. The observation that there was a genetic component to the condition narrowed the range of possible explanations. At one point, researchers realized there could be a connection with the diets of this select group of patients and their unknown condition. When the initial salivary tests for sub-clinical gluten intolerance were run on several hundred people from this population, over 85 percent tested positive. This outstanding discovery has now been demonstrated time and time again with a wide range of patients.

In the last ten years through testing thousands of patients the subtleties of this condition have been gradually understood. The evaluation process has become even more comprehensive, and many of those people with this condition who may have gone undiagnosed in the past can now be accurately tested.

Relationship To Celiac Disease

Sub-clinical gluten intolerance is often confused with a medical condition called celiac disease, celiac sprue, or non-tropical sprue, sometimes referred to as gluten enteropathy or gluten intolerance. The reaction to gluten in celiac disease is similar to sub-clinical gluten intolerance, except as to the degree of intensity. Comparing sub-clinical gluten intolerance to celiac disease is like comparing first-degree sunburn from a day at the beach to a third degree burn from a fire victim. They are both burns, but vastly different based on the severity or degree of damage.

Celiac disease is not hidden, or sub-clinical, and as such it is easier to diagnose. A person with celiac disease may have blood in their stool or experience disabling pain when they consume gluten-containing foods. Other symptoms of celiac include steatarhea, which is undigested, and unabsorbed fat in the stool, and dermatitis herpetiformis, a skin condition. These obvious symptoms often lead doctors to recognize those with celiac in childhood when grains are first introduced in the diet. Others with celiac disease are not diagnosed until the adult years. In addition to the clinical presentation, celiac disease can be detected by a blood test and confirmed with a biopsy of the small intestine. The clear signs and symptoms of celiac disease make its identification relatively straightforward. Sub-clinical gluten intolerance, however, is difficult to diagnose based on symptoms alone.

Gluten/Gliadin

What exactly is sub-clinical gluten intolerance? Sub-clinical gluten intolerance refers to exposure to the gliadin molecule and to a specific inflammatory reaction taking place in the small intestine of afflicted individuals. In fact, gliadin intolerance would be a more scientifically accurate term than gluten intolerance to refer to this condition. Gliadin is a polypeptide, a long chain of amino acids, which is present in the gluten protein portion of certain grains.

This subject is confusing and there is much misinformation about gluten and gliadin. To clarify, gliadin, the molecule that causes the problem, is present in some, but not all gluten-containing foods. People with this problem must avoid glutens from the grains of wheat, rye, barley, kamut, spelt, teff and couscous. Some of these grains have lower concentrations of both gluten and gliadin than wheat does, but any food containing this specific gliadin, even from a lower concentration food source, is not well-tolerated by people with sub-clinical gluten intolerance.

This dietary restriction eliminates bread, pasta, bagels, and cereals. There are rice and almond-based breads available, usually found in the refrigerated section of your local health food store. There are also rice, sweet potato/yam, and corn-based noodles, and cereals, crackers and other gluten free substitutes on the market.

Safe Glutens

Rice, corn, oats, buckwheat, and millet have glutens, but the glutens in these foods do not contain the gliadin molecule that can provoke the inflammatory reaction; therefore, they are usually safe. Other safe grains include quinoa and amaranth. In some cases, people are allergic to rice, corn, oats, or millet, independent of the reaction to gluten/gliadin. Reading labels can be very misleading; don’t trust them. Some companies list their products as gluten free, without understanding the scientific basis of the problem with gliadin. For clarity of communication sub-clinical gluten intolerance will be used to refer to this sensitivity to gliadin in the rest of this discussion.

Soy

Soybeans are another food to which many people with gliadin intolerance react. It is best to avoid all concentrated forms of soy protein such as soy protein powders, tofu, and tempeh while you are first eliminating gliadin and then to reintroduce it back into the diet at a later time to see how reactive you are to soy. Even though soy has gotten a lot of attention in terms of its ability to help women with hormonal imbalances and bone loss, this does not hold true for those women who are gluten intolerant, as soy can actually cause inflammation and ultimately exacerbate hormonal imbalances and accelerate bone loss. Soy products can be very helpful for women who tolerate gliadin and have no allergy to soy. Much of the original research on the benefits of soy comes from Japan and China where gluten intolerance is not as common as it is in the United States. Additionally, the traditional diet of these Asian countries is rich in foods that help balance the negative issues associated with soy consumption.

Safe Foods

So, if you have sub-clinical gluten intolerance what can you eat? As already mentioned, rice, corn, millet, quinoa, amaranth, oats, and buckwheat are ok, unless you are allergic. There has been some debate about whether or not oats are “safe”, and while they do contain a small amount of gluten, it usually does affect most gluten sensitive people and can therefore be tolerated unless one experiences adverse symptoms. With sub-clinical gluten intolerance you can also safely eat any type of meat or poultry, including chicken, turkey, beef, pork, and lamb, and fish such as salmon. Any kind of vegetable and any type of fruit is o.k., as are all beans, and as mentioned, soybeans may be a problem.

Treatment

Obviously the main treatment for this problem is total avoidance of the offending gluten containing foods. In addition to this dietary change you can help decrease the inflammation associated with the gluten reaction with several natural products. Deglycerized licorice root can be used to assist in the healing process by further reducing inflammation and helping protect irritated tissue.

Most people don’t feel better immediately after eliminating gluten from their diets, as it can take 60 days for the inflammation to subside and up to 9 to 12 months for the lining of the small intestine to heal. On rare occasions an individual may experience significant improvement within weeks of beginning on a gluten free diet. In certain cases people may feel considerably worse upon initially starting a gluten free diet. For most people with this food intolerance, by around 6 to 9 months of being gluten free, noticeable changes have taken place.

Physiological Effects of Sub-Clinical Gluten Intolerance

Following are some of the physiological changes that result from sub-clinical gluten intolerance.

In those with sub-clinical gluten intolerance, gliadin causes a mucotoxic inflammatory reaction as it comes into contact with the wall of the small intestine. This reaction usually goes unnoticed at first. In fact, this low-grade inflammation may go undetected for years or even decades before it results in the expression of symptoms. The ultimate effect of this hidden wear and tear is the slow destruction of the healthy mucosa, or lining tissue of the small intestine. In some cases there may be symptoms in childhood such as allergies, asthma, reoccurring infections, a constant upset stomach, or milk intolerance. Often these symptoms fade in the early adult years only for the problem to reappear when a person is between 35 and 55 years of age.

Inflammation

Inflammation comes from the Latin root inflammare, which translates as “to set on fire” or “to flame within.” This “setting on fire” is a literal description of the actual destructive process gluten initiates. Inflammation is your body’s way of reacting to injury. When exposed to gliadin, the inflamed small intestine undergoes significant structural changes.

Inflammation is a familiar experience to everyone. For example, the reaction of the sinuses during a bad cold or flu is an inflammatory reaction. Other examples of inflammation are from the response to physical trauma, like pain from a low back injury or from hitting your thumb with a hammer. In all these situations the inflammatory response is activated. This response is the body’s attempt to repair tissue damage and prevent infections by quickly bringing our own internal 999-response team to the injury site. This physiological protection includes the immediate activation of a complex system that takes place regardless of the initial source of inflammation. The purpose of this physiological mechanism is to handle the insult, whether it is physical trauma, a viral or bacterial infection, or the gliadin molecule in those who are gliadin sensitive. In each case the body attempts to remove the harmful substance and quickly control the damage that has been caused.

With a mucotoxic reaction to gluten in the gastrointestinal tract, initially there will be heat, redness, swelling, and importantly a change or interruption in the normal function of the small intestine. On the cellular level, a series of events take place, including dilation or enlargement of blood vessels with increased permeability and blood flow. This brings more blood to the site of injury to provide greater protection in the form of white blood cells and other immune system cells. There is also an exudation, or leaking of fluids from the blood vessels into tissues with an accompanying swelling. This is followed by movement of leukocytes, or white blood cells, into the tissues for enhanced immune protection. Additionally, there is also fibrin formation. Fibrin is a thin white filament structure that aids in the physical repair process. We are all familiar with fibrin in its role in helping blood clot. In this case fibrin helps plug up any areas in the intestinal wall that require structural support.

12 to 14 hours after this series of physiological reactions, the body’s response to gliadin fades provided there is no further exposure. At this point the physical regeneration and repair process can begin. If you eat gluten again, the gliadin exposure is repeated, there is no let up in the inflammatory cascade and the damage to the lining of the small intestine continues.

Assuming there is no further exposure, the blood vessels return to normal size and normal blood flow is reestablished. Then the protective white blood cells degenerate or reenter the blood circulation, and cellular disintegration or proliferation takes place in which injured cells are replaced and swelling disappears with resorption of tissue fluid and breakdown of fibrin. The “999″ response team cleans up, packs up and goes back to wait for the next emergency call. Under normal conditions the inflammatory response eliminates the insult and removes injured tissue components. This process accomplishes either regeneration of the normal tissue architecture and return of physiologic function or the formation of scar tissue to replace what cannot be repaired. This whole sequence of events can take place each time a gluten sensitive individual eats gluten-containing food.

This inflammatory reaction goes largely unnoticed simply because it is not severe enough to cause immediate symptoms. If a gluten intolerant person eats gluten-containing foods for extended periods of time, over and over again, the low-grade inflammation can lead to a variety of problems. With long-term exposure, the results of this low-grade response to the gluten/gliadin molecule can be devastating to a variety of body systems. Its effect on the digestive system is the most immediate.

Digestive System

Good health requires proper digestion and absorption. Digestion is the mechanical and chemical breakdown of the food we eat. As food is digested it needs to be absorbed. Absorption is the process of bringing the nutrients from our gastrointestinal tract into the rest of our body’s tissue. Digestion is initiated when we chew food and begin to break it down with digestive enzymes. Food then enters the stomach where further breakdown occurs from the presence of stomach acid, called hydrochloric acid, and pepsin, which together begin the breakdown of proteins. From the stomach the products of digestion enter the small intestine.

Villi

The small intestine is called “small” because it is smaller in diameter than the large intestine. However, it is in fact longer and in many ways more crucial to our health than the large intestine. The lining of the small intestine consists of villi, fingerlike projections that stick out from the wall of the intestine into the lumen or center. These villi are between 1/2 and 1 1/2 mm long, just barely visible to the human eye. On the ends of the villi are microvilli, sometimes referred to as the brush border. These two adaptations, villi and microvilli, increase the surface absorption area of the small intestine up to 1,000 fold. It’s estimated that the entire absorptive area of the small intestine is roughly the size of a basketball court.

This total area for absorption can be compromised by any condition that irritates the lining of the small intestine. In gluten intolerance there is a destruction of the villi, referred to as villus atrophy. This leads to poor digestive function and affects many vital structures on the intestinal wall. Poor intestinal function caused by improper digestion of food is referred to as maldigestion or literally “bad digestion.” Inadequate absorption of nutrients is referred to as malabsorption: the inability to get the vital nutrients your body needs delivered to your cells.

Effect on Immune System/Hormonal System

One system significantly impacted by maldigestion and malabsorption in the small intestine is the hormonal system. I have treated hundreds of gluten intolerant patients whose indigestion problems were misdiagnosed as heartburn, IBS, and who suffer from chronic bloating and gas. Sub-clinical gluten intolerance creates a significant stress on the immune system and can lead to a compromised immune system. The mechanism of action occurs in several different ways. There are specialized immune cells that line the small intestine called immunocytes. These immune cells produce secretory IgA, a critical component of the thin, healthy mucous that is makes up your first line immune defense. The inflammatory response produced in individuals that are gluten sensitive destroys a certain percentage of these cells, and this in turn can lower your immune defense thereby opening the door to intestinal infections. Through this mechanism, parasites, bacteria, viruses, and yeast or fungal organisms can more easily infect someone who is gluten intolerant and suffering from a weakened first line immune defense. This lowered immune defense is referred to as depressed secretory IgA, and can result in many other food reactions. This is because secretory IgA also helps the body process food antigens.

Food Antigens

Food antigens can create significant health problems. An antigen is a marker that is recognized by our immune system as o.k. or not o.k. Antigens mark substances as foreign to the human body. The recognition of what is an o.k. antigen and what is not an o.k. antigen allows our immune system to attack and destroy harmful substances. For example, when you have a viral infection like the common cold, the viruses that infect us have antigen markers on their outer surfaces and our immune system recognizes these antigens and then makes antibodies to destroy the virus. Food is also foreign to the body and therefore has antigens. Typically we don’t react to food antigens. However, in some people food reactions do occur because of an inappropriate response of the immune system to antigens in food. Other people may be sensitive to pollen antigens or mold antigens and have reactions to these substances. The overall weakening or depression of our first line immune defense called SIgA makes us more susceptible to antigens of all sorts and can make a person highly reactive to food antigens who might not otherwise have this problem. This is another link between gastrointestinal stress and the immune system.

Corticosteroids

Another avenue through which sub-clinical gluten intolerance affects the immune system is through the inflammatory response. Many people have heard of corticosteroid medications such as prednisone or cortisone. They are used for a wide variety of medical purposes. Corticosteroid injections are used for joint and muscle injuries to reduce pain. Corticosteroid sprays and inhalers are used by people who suffer from asthma and allergies to improve function of the airways.

Cortisol

Our body also makes its own corticosteroids, the most abundant of which is the hormone called cortisol. With chronic, low-grade inflammation from gluten intolerance, or for that matter, any stress that inflames the digestive tract, our bodies produce increased levels of cortisol. Since cortisol is also one of the major modulators of immune function, this suppresses our immune response. As a matter of interest, this immune-suppressing role of corticosteroids is used in medicine in certain circumstances when immune suppression is the goal. With organ transplants, and in some serious autoimmune diseases, corticosteroids are used therapeutically to suppress immune function. However, in other situations, this immune-suppressing role of cortisol and corticosteroid medications works against our health.

When cortisol production becomes abnormal, our hormonal and immune systems are affected. While elevated cortisol suppresses our immune response, it also causes a catabolic/breakdown state to exist in our body, and symptoms of adrenal exhaustion will eventually appear: fatigue, depression, loss of libido, allergies, and frequent illness.

Mucosal Lining / Leaky Gut

There are also many connections between sub-clinical gluten intolerance and other intestinal problems. To describe this connection in more detail, we’ll review the structure and function of the small intestine.

The small intestine is constructed like a tube. The inside of the tube is the healthy mucosal lining. Mucosal tissues also line the sinus passageways, the lungs, the urogenital tract, the mouth, and throat. These lining tissues act as vital barriers to defend the body from infectious organisms. The small intestine lining tissue also performs the crucial function of absorption of nutrients. Under chronic inflammatory stress, this healthy mucosal tissue breaks down and a condition called increased permeability, also known as leaky gut syndrome, occurs.

Leaky gut syndrome refers to the loss of integrity of this mucosal or lining tissue. Having leaky gut syndrome is like having a screen door with large holes in it that allows flies and other insects to get through. With leaky gut syndrome the lining of your intestine becomes overly permeable and molecules that were not intended to cross into your blood stream enter, or leak in. This leads to a great deal of immune stress as your body tries to handle all these uninvited guests.

Lacteals

Gluten reactions also cause other problems. There are structures called lacteals that are located in the tips of the villi, which can be destroyed by reactions to gluten. These lacteals are responsible for helping in the absorption of fats by breaking them down into fine droplets. If this process is compromised it can result in poor absorption of healthy fats that are critical to your health.

This depletes the body’s source of fat-soluble nutrients leading to essential fatty acid deficiencies, low levels of vitamin A and vitamin E. Even if taken in supplements, the full benefit of fat-soluble nutrients will not be realized. Deficiencies of these nutrients depletes nutrients critical for the function of every cell in the body and negatively effects blood sugar control, nerve cell function, steroid hormone production, anti-oxidant formation, and many other processes.

It is also common for people with sub-clinical gluten intolerance to develop blood sugar problems, sometimes referred to as Syndrome X or Metabolic Syndrome.

Nutritional Deficiencies

The lack of normal absorption in the small intestine leads to predicable nutritional deficiencies. Calcium absorption can be poor, and this nutritional deficiency, coupled with abnormal corticosteroid production, can lead to accelerated osteoporosis. Iron, B12 and folic acid deficiencies are also commonly observed. This can lead to fatigue, mild depression, memory loss, and greater risk for elevated homocysteine levels, a key factor in development of heart disease.

Poor digestive function leading to maldigestion and malabsorption of protein will be reflected in amino acid deficiencies. Amino acids are the building blocks of our body and are vital for production of neurotransmitters such as serontonin. Low levels if amino acids result in low levels of neurotransmitters.

Our brain utilizes many different chemical messengers called neurotransmitters to communicate. They are made from amino acids found in protein containing foods. Improper digestion and/ or absorption of protein generates amino acid deficiencies, which directly effects how we think and feel. The prevalence of this problem can be seen in the numbers of people benefiting from prozac and other anti-depressant medications. This generation of anti-depressants are called SSRIs, or selective serotonin reuptake inhibitors. These medications prevent your brain from reabsorbing the serotonin naturally produced so that you experience higher serotonin levels. Serotonin, a neurotransmitter, is manufactured from an amino acid. Therefore, a deficiency in amino acids can lead to a serotonin deficiency. And, conversely, restoring normal amino acid levels can help restore normal serotonin levels.

If you either (A) do not eat adequate protein, or (B) cannot digest protein well, or (C) cannot absorb the amino acids from protein, you will develop amino acid deficiencies that ultimately effect brain function and other body processes. The approach taken in natural therapies is to look for causative agents, such as maldigestion and malabsorption and treat the cause of the deficiency directly, thereby improving the outcome. In this case, addressing dietary intake of protein, the ability to digest it with sufficient stomach acid and digestive enzymes and the ability to absorb is critical to optimal health. In certain people who have food sensitivities, this one factor can prevent recovery from weight gain, fatigue, recurrent infections and a cycle of chronic illness.

Depending on the extent of the problem, a person may need to undergo extensive nutritional counseling to restore normal levels of vitamins, minerals, amino acids and essential fatty acids. Natural therapies can be used with great success providing the appropriate foods are being eaten and normal gastrointestinal function has been restored.

Lactose / Sucrose Intolerance

Lactose intolerance is defined as the inability to digest the carbohydrate portion of milk products. The carbohydrate portion of milk is referred to as lactose or milk sugar. Lactose intolerance frequency accompanies gluten intolerance. Lactase, a specialized enzyme that aids digestion of lactose in milk products is usually lacking in people with sub-clinical gluten intolerance. Lactase breaks down lactose or milk sugar in the same way sucrase enzymes breaks down sugar or sucrose. Damage to the architecture of the intestinal wall and the subsequent decrease in enzymes for lactose and sucrose digestion leads to problems in digesting dairy products such as cheese, ice cream, and all types of milk products.

This enzyme deficiency is why people with sub-clinical gluten intolerance need to avoid pasteurized cow’s milk products. As the villi on the intestinal lining heal from a gluten free diet, most individuals will be able to tolerate raw or unpasteurized dairy products again in nine months to a year. In other people, there will be a more or less permanent sensitivity to dairy products.

However, in the initial two months of eliminating gluten, it is absolutely required to avoid all milk dairy products, because they will inflame the intestine lining just like gliadin does and prevent healing. This includes the complete elimination of pasteurized cow’s milk products such as cheese, yogurt, cottage cheese, and milk. Goat’s milk yogurt and goat or sheep’s milk cheeses such as feta cheese and others are acceptable alternatives. In this instance, eggs are not considered as dairy products. Raw or unpasteurized dairy products are healing foods for the damaged GI tract lining.

Multiple Delayed Food Allergies

Sub-clinical gluten intolerance often leads to the development of multiple delayed food allergies. Leaky gut syndrome and the accompanying premature leaking of food antigens into the bloodstream cause this. In time, this overexposure to food antigens causes the immune system to react, and foods that would otherwise be tolerated can become allergenic. Although the problem with food allergies is generated by the damage from gluten, removal of gluten and pasteurized dairy from the diet is not always sufficient to remedy this problem. Depending on your circumstances, your doctor may recommend a 4 to 5 day food rotation diet or food allergy testing. Many books are available from your local bookstores on food rotation diets.

There are different types of food allergies: some are immediate and some are delayed. Immediate food allergies are usually easy to recognize — for example, you eat a strawberry and get a rash. These don’t usually require testing to determine. However, delayed food allergies are hard to identify because the reaction may not appear for hours or days after eating the offending food. For example, eating an allergic food on a Monday night could generate a migraine headache or cause fatigue on Tuesday or Wednesday. Due to this difficulty in identification of delayed food allergies one of two strategies should be followed. The first choice is to follow a rotation diet. By doing this, even though the exact foods to which you are allergic have not been identified, you will be rotating all your foods, so that any delayed allergic responses will be significantly reduced. This reduces the stress on your hormonal/immune system.

The second option is to pursue additional testing for delayed food allergies. Multiple pathway food allergy testing is designed for this purpose. This testing is done from a blood sample and identifies exactly which foods you are reacting to. You will then know what foods to avoid and what foods are safe.

Allergy vs. Intolerance

There is a great deal of confusion and misinformation about food allergies and gluten. Gluten intolerance is not a typical food allergy. It is an inherited condition that leads to a mucotoxic, or inflammatory response. Gluten intolerance has a genetic basis, meaning it passes from generation to generation. Gluten intolerance is found most frequently in those with Irish, English, Scottish, Scandinavian, and other Northern European and Eastern European heritages. The research study published in the British Medical Journal in November of 1998 found previously unheard numbers of people suffering from celiac disease, the medical condition related to gluten intolerance. They found approximately one in 150 people with this condition. It is suspected the levels of sub-clinical gluten intolerance are much higher, perhaps as high as one in three Americans. Sub-clinical gluten intolerance and celiac occur less frequently in non-European populations.

It is important to note that many people who are gluten intolerant do not test positive on food allergy testing for wheat, rye, barley, and other gluten-containing grains. Do not be misled by the fact that you do not test positive to these gluten-containing foods. You still must avoid the offending gluten foods if you are gluten intolerant. Many people live for thirty or forty years with sub-clinical gluten intolerance and do not experience obvious symptoms. Some people who are constitutionally strong and eat small amounts of gluten-containing foods may never experience obvious symptoms. However, with or without obvious symptoms, intestinal damage is still taking place.

Food Cravings

Along with gluten intolerance comes food cravings, and it has frequently been observed that people crave that which they are allergic to. Please take note, if you crave gluten, there is a high probability that you are gluten sensitive.

Parasites

The structural changes to the small intestine from gluten intolerance create the perfect habitat for development of pathogenic infections. Inflammation in the small intestine causes a structure called crypts to deepen. The elongating of these crypts, referred to as crypt hyperplasia and deepening of the crypts, makes for a deep pocket where a pathogen such as a parasite can survive by evading the usual immune surveillance that occurs in the lining tissue. Inflammation also slowly destroys the immune cells that help protect this area and these two factors taken together create a situation where parasite infections can take hold and become chronic. Parasites deeply embedded in the intestinal lining can even be resistant to powerful antibiotic treatments.

Because of this, people with gluten intolerance need to rule out the possibility that they are harboring a chronic parasitic infection. Eliminating gluten from their diet can be the first step in getting these chronic infections cleared.

Candida

There is a relationship between Candida, an opportunistic organism in the gastrointestinal tract, and food intolerances. Inflammation caused by sub-clinical gluten intolerance and/or lactose intolerance weakens the immune response in the intestinal lining. This weakened mucosal immune defense can open the door for Candida to overpopulate and become invasive Candida (invasive means to invade and attach itself to the healthy mucous lining of the intestines).

Nutritional Deficiencies

Gluten intolerance causes multiple nutritional deficiencies, including inability to absorb fats, proteins, and carbohydrates. Malabsorption of fats leads to deficiencies in the fat-soluble vitamins such as vitamin A and E and K and importantly, the essential fatty acids from which we manufacture all our reproductive hormones and adrenal hormones including estrogen, testosterone, progesterone, cortisol and DHEA. Other nutritional deficiencies that appear early in the disease process include lack of calcium, folic acid, iron and vitamin B12. Lack of reproductive hormones leads to disruption of the normal menstrual cycle, causing PMS or menopausal symptoms. The combination of calcium deficiency and female hormone imbalances leads to osteoporosis, or weakening of the bones. Even if women take estrogen and calcium supplements, they may not be adequately absorbed. Folic acid, B12 and iron deficiencies lead to anemia, depression and increased risk of heart disease and neurological diseases. Lack of the anti-oxidants vitamins E and A compromise our ability to fight free radicals and can further contribute to degenerative conditions such as cancer and heart disease.

Tolerated Foods

• Beef, pork, lamb, any type of meat
• Poultry-Chicken, turkey, duck, any type of poultry
• Fish and Seafood — tuna, salmon, trout, halibut, swordfish, shrimp, clams, mussels, crab, any type of fish or seafood
• All vegetables
• All beans except soybeans
• Corn
• Rice, including wild rice, basmati rice, brown rice, black rice, white rice, rice flour
• Rice Bread
• Rice crackers
• Potato
• Millet
• Quinoa
• Amaranth
• Oats
• Buckwheat (not a wheat)
• Wheat and barley grass (has no protein)

Avoid

• Wheat
• Rye
• Barley
• Teff
• Spelt
• Cow’s milk and cream products (cheese, yogurt, ice cream, etc)
• Soy

Most common underlying causes of depression:

1. Neurotransmitter dysfunction caused by:

• Nutritional Deficiencies
• Neurotoxicity
• Neuron Bundle Damage from Physical Trauma
• Genetic Defects of Neurotransmitter Production

2. HPA axis dysfunction caused:

• Sleep disorders
• Blood sugar control problems
• Improper exercise
• Chronic pain or inflammation
• Emotional and spiritual disconnection

Based on my clinical experience the two most common underlying causes of depression include neurotransmitter dysfunction or hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Neurotransmitter dysfunction results from nutritional deficiencies, neurotoxicity or errors of metabolism. HPA axis dysfunction can result from any significant stress including lack of sleep, over or under exercise, poor blood sugar control, chronic pain or inflammation or emotional and spiritual disconnection.

There are of course serious cases of serious depression, suicidal ideation, manic-depression and other forms of mental illness. These cases require institutionalization and psychiatric medications. However, the vast majority of people diagnosed with “depression” can be successfully treated with simple, natural therapies because the origins of the problem come from poor lifestyle choices, not from an incurable mental health problem. As practitioners we need to be able to distinguish between who requires medical care and anti-depressant medications as they pose a danger to themselves or others and who is suffering from “lifestyle” generated depression that we can safely and effective work with.

Neurotransmitter dysfunction refers to abnormal levels of the 140 plus neurotransmitters present in the brain. Two “master” neurotransmitters that help regulate brain function and are acted upon by most anti-depressant medications include serotonin and dopamine. Serotonin is manufactured from 5 hydroxy-tryptophan and dopamine is made from the amino acid tyrosine. Research conducted by Dr. Marty Hinz of DBS Labs has demonstrated that vitamin C, calcium, cysteine and most importantly vitamin B6 are required for neurotransmitter production. While balancing brain chemistry through the use of amino acids requires expert knowledge and extensive lab testing, the crux of most neurotransmitter dysfunction is poor lifestyle habits.

Nutritional Deficiencies

Diets based on processed food with poor quality protein sources will lead to amino acid depletion and eventually results in neurotransmitter deficiencies. Our brains can only have sufficient neurotransmitter production if we eat a diet rich in high quality protein, appropriate for our metabolic type. Protein deficient diets and processed food or fast food based diets will rob us of the nutrients such as B6 that we require to maintain brain chemistry properly and depression will result. This then begs the question, should we even call this nutrient depletion syndrome depression? Neurotransmitter depletion leads to cravings for carbohydrates and compulsive overeating, forcing people into a downward spiral of weight gain and depression.

Anti-depressant medications can exacerbate neurotransmitter dysfunction. Over time these medications deplete neurotransmitters. This was first established by researchers at MIT in the 1960’s and has been repeatedly demonstrated in studies since then. However, most conventional medical doctors prescribing these drugs are unaware of these studies as they are not part of the typical pharmaceutical reps doctor education materials. In fact anti-depressant medications lead to short term flooding of the brain with more neurotransmitters and this artificial push is short lived as over time these neurotransmitters are degraded and broken down at a faster rate than they would be in a non-medicated individual. We end up with short term relief of symptoms and a worsening of the original deficiency state with ever lower levels of naturally available neurotransmitters. This means drug dosages need to be increased to maintain effectiveness, or patients need to change medications, or the medications eventually just don’t work as well as they once did and people have to live with the return of symptoms.

The natural therapy correction for this type of “depression” is switching to an organic foods based diet, eating high quality protein and farm fresh produce based on our metabolic type. This diet provides us with the critical amino acids, vitamin C, cysteine and B6 required for neurotransmitter repletion.

Neurotoxicity

Neurotoxicity is another leading cause of “depression”. Neurotoxicity refers to damage to the neuron bundles in the brain from neurotoxic drugs; neurotoxic pesticides and herbicides; heavy metals such as mercury and lead; parasitic infections such as giardia that release neurotoxins; and the thousands of chemicals now present in the environment that we are regularly exposed to.

When you really think about how neurotoxic our food and water supply has become, it is amazing we can be happy or think at all!

Neurotoxins destroy the firing capacity of neuron bundles. This leaves us with neuron bundles that do not conduct the nerve impulses we require to feel happy and at peace. Therefore we experience the results of low serotonin and low dopamine, namely, anxiety, depression, sleep disorders, brain fog, poor memory and a general lack of enthusiasm for living life to its fullest; we become “depressed”.

Neuron Bundle Damage from Physical Trauma

Head trauma also damages neuron bundles. Even one major head injury can damage neuron bundles and decreased neuronal firing. This too can lead to depression. These clients require extra attention to all the lifestyle principles of the HLC work to keep their brains properly functioning. Some with extensive head injuries may require additional natural therapy.

Some people are actually suffering from depression unrelated to HPA axis dysfunction, neurotoxin exposure or head injury. They may have been born with inborn errors of metabolism in production of the key neurotransmitters such as dopamine and serotonin. In this situation there is a limited ability to “correct” the problem. Typically with this type of depression there is a strong family history of mental illness, manic depression, suicide, alcoholism, drug addiction or other obvious signs that there is a genetic tendency to poor neurotransmitter function. This group of people can have life changing experiences if their brain chemistry is balanced through amino acid therapy. The conventional medical approach of anti-depressant medications can also provide benefits in treatment and relieve suffering.

We need to be astute enough in our assessments to identify these cases and refer them to an experienced psychiatrist or alternative medical practitioner. These are the truly mentally ill. In my experience they are few and far between when compared with the total number of client’s I have worked with diagnosed with “depression” and put on anti-depressant medications.

Case Study:

Patricia was a 47 year old female client. She complained of debilitating low back pain and numbness down the left leg, fatigue and depression.

She worked with a Level IV CHEK practitioner who developed a corrective exercise program that relieved her back condition.

The client was dramatically improved and had experienced considerable pain relief and improvement in mood. We also initiated an HLC assessment to complement her CHEK corrective exercise program.

As with all clients we started with the basics.

There were two issues of immediate concern: (1) Poor lifestyle factors (diet, sleep, stress and exercise related) leading to nutrient depletion and hormone down regulation; and (2) neurotoxicity.

(1) Poor lifestyle factors

To remedy this Patricia’s CHEK practitioner implemented an HLC program which included teaching her to eat for her metabolic type, hydrating, and making healthy food choices whenever possible by choosing organic and locally grown foods. Patricia discovered that making proper food selections had a strong effect on her sense of well being.

Patricia also agreed to eliminate gluten. I have observed hundreds of cases in my clinic in which gluten intolerance triggered depression through HPA axis down regulation. This occurs because the body’s reactions to gluten includes an inflammatory response in the lining of the small intestine causing abnormal cortisol production, which eventually results in depression via HPA axis down regulation. The scientific community recognizes that HPA axis problems are a leading cause of depression. As practitioners we must then make the leap to treat depression as an HPA axis dysfunction syndrome. Therefore any lifestyle issue that improves stress hormone production will help relieve the “depression”. Lack of sleep and the stress of her pain further exacerbated her cortisol problems. Lack of exercise and lack of chi-building activities completed the lifestyle factor catastrophe. Patricia needed rebuilding and repair of the HPA axis to heal. Interestingly, research has demonstrated exercising 3-5 times per week to reduce depression as effectively as the anti-depressant medication Zoloft.

Using HLC work-ups her CHEK practitioner improved her diet choices, having her eat properly for her metabolic type and getting her off of gluten. While the corrective exercise program got her out of pain, the lifestyle therapies working synergistically together began the healing process for her brain. This led to an obvious level of improvement in mood and energy levels.

Part of Patricia’s program included a concerted effort at reducing her level of neurotoxins. Neurotoxins can be found in many places. Since many pesticides and herbicides act as neurotoxins, an organic food diet was essential for reducing neurotoxicity. Patricia’s high levels of lead, mercury and cadmium seen on lab tests generated a further toxic load for her central nervous system. Her parasitic and fungal infections also put a burden on her detoxification system, while at the same time the digestive system problems reduced her capacity for absorbing key nutrients required to help assist the detoxification process.

Her treatment program included intensive focus on lifestyle factors and rehabilitative exercise; replenishment of neurotransmitters and detoxification through a Metabolic Typing diet, saunas and juicing; rebuilding of her adrenal hormone production by improving sleep patterns, reducing her stress by relieving her chronic pain; clearing her GI track of pathogens with a parasite and fungal cleanse and addressing her energetic blocks.

This treatment plan took place over the course of more than a year and she achieved complete remission of all symptoms and returned to work, active, depression free and pain free. I continue to look forward to our twice yearly check ups as her achievements in healing herself are inspiring.

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