Seven Reasons a Brain Injury can Destroy Your Gut!

Seven Reasons a Brain Injury Can Destroy Your Gut

According to the CDC, incidence of hospital visits for traumatic brain injury have increased over the past decade.  It is one of the leading causes of disability world-wide.  You may know that the gut and brain are intricately connected but did you know that many people who experience brain trauma often experience resulting gut issues?   The gut problems come from alternations in the gut-brain axis or the communication network between our intestines and our cerebral matter.   When this delicate network is disrupted, it may result in dramatic gastrointestinal dysfunction, chronic pain or even disability.

According to Dr. Kharrazian, there are seven key ways in which traumatic brain injury can alter GI function, each of which may contribute to your chronic gastrointestinal disorders.

1. Autonomic Dysregulation - this occurs when the autonomic nervous system no longer appropriately  controls things that should come automatically, like heart rate, breathing, and gut motility.   If the system becomes overactive to a sympathetic stimulus the result may trigger a chronic pain loop that is hard to control, leading to abdominal pain.
2. Disorders of visceral sensing and processing - Visceral sensing is the gut's way of telling the brain what is going on.   Sensations in the gut such as temperature, pH, contractility communicate with the brain to notify the body what is happening in the digestive system.  Disruption of these sensing circuits is one of the main factors implicated in irritable bowel disorders (IBS).  Brain injury often contributes to a broken communication network between gut and brain.
3. Increase in intestinal permeability (leaky gut) -  After brain  injury the tight junctions that connect the cells that line your gut often become dysfunctional and allow large molecules to enter from the digestive tract into the blood stream.  Normally these tight junctions are protecting you from the large molecules, such as undigested food particles, bacterial parts or other luminal contacts that could cross over into the blood stream.  We know that the increase in intestinal permeability is a key factor in the development of autoimmune diseases, from Hashimoto's thyroiditis to multiple sclerosis.
4. Compromise of intestinal mucosa - Very commonly after brain injury, there is a compromise in the health of the mucosal lining.  We see this in patients in the Intensive Care Unit (ICU) as well... anytime the body is under massive stress, there is a tendency for the mucosa that lines the gut to atrophy and die.  The changes we see are often immediate and occur within minutes after brain injury, severe trauma or infection.
5. Breakdown of the blood-brain barrier (BBB) - The BBB, as it is affectionately known, protects your delicate gray matter from outside chemicals and inflammatory agents that may cause problems if allowed to enter.  After a brain injury, this barrier is often compromised, allowing massive inflammatory triggers inside the brain where they do not belong.
6. Brain Immune Dysfunction  - The Central Nervous System (CNS) controls much of the immune system and the production of inflammatory signaling molecules, like cytokines.  If there is an injury to the signaling mechanism it may contribute to either over-activation or under-activation of the immune system  This can lead to either immune compromise or autoimmune disease, where the body attacks itself.
7. Impaired gut motility - Sadly we see this as a factor in many disorders such as intestinal dysbiosis and SIBO (small intestinal bacterial overgrowth).   The impairment in smooth muscle contractility of the gut mucosa leads to dysmotility. This dysmotility leads stagnation  and alteration in bowel function and even malabsorption.  Ultimately patients may have very severe symptoms related to this problem of abnormal peristalsis in the gut.

Can see how these many mechanisms of action on the gut after brain injury may contribute to chronic pain and dysfunction, not only in the gut but the immune system as well?  Here's some simple things you can do to ensure you will maintain a healthy gut for life!

So What Can I Do to Maintain a Healthy Gut?

1. Eat a variety of colorful organic and local produce
2. Avoid genetically modified foods and glyphosate which contribute to a leaky gut
3. Take a daily multi-strain probiotic to support your microbiome and immune system
4. Eat prebiotic-rich fruits and vegetables to feed your healthy gut bugs
5. Protect your noggin!  Wear a helmet if you are skiing, biking or doing any activity that involves risk of head trauma
6. Try Restore, my favorite new product to restore gut health and heal tight junctions.  Call Amy at #303-993-7910 if you would like more info....

Although we cannot predict or even prevent a head injury, it's important to realize that if it does happen to you, your gut function may be affected.   Start NOW to take steps to develop a healthy gut microbiome in the meantime!

If you know me well, you know one of the highlights of my week is the Farmer's Market in Boulder, Colorado.  Getting my weekly supply of seasonal dark leafy greens and fresh vegetables from local farmer's like Red Wagon Organics for my smoothies and juices and occasionally some of Plowshares organic bacon for my husband is an adventure and something we enjoy doing together on Saturday mornings!

A couple of weeks ago, I ran into Jake Burgart with Olea Estates olive oil, one of my favorite new finds at the local Boulder Farmer's Market.  I bought a bottle right away and was back for more the very next week!  (Yes, I eat that much olive oil!)  Not only was it absolutely pure and delicious but organic extra virgin olive oil is loaded with health benefits!

You can read all about the Chronis family tradition in Greece here.  Even now, they are one of the only few producers that certify our olive oil every year with both the European Regulations for Biological Products and with the USDA for Organic Products. You can taste and see the quality of pure first press olive oil, when you open a bottle of Olea. The deep green color, the thick consistency, the pure aroma, the exquisite taste, all contribute to separate Olea from other olive oils that I've tried.

Jake Burgart and friend at the Olea Estates Olive oil booth in Boulder on Saturday

"At Olea we do not produce anything but only our extra-virgin olive oil obtained by first press of our ripe and selected olives at temperatures under 27C. We do not blend refined oils and we use no other method of altering our olive quality, taste or color. We do not filter our olive oil, but we do guarantee uniform clarity and no cloudiness. See how we do it. Olea Olive Oil has the true, rich flavor of olive oil and all associated nutrients and is obtained by a strictly controlled and long lasting process, especially for the food connoisseur."

But perhaps the best thing is you can enjoy it freely with a guilt-free conscious as there are so many health effects of a Mediterranean diet rich in olive oil!

Here's just a few of the latest studies on health benefits of olive oil:

• A Mediterranean diet rich in virgin olive oil is associated with reduced weight gain.

• Mediterranean Meal with Olive Oil Keeps Blood Sugar Levels Lower than with Corn Oil

• Consumption of olive Oil Polyphenols Decrease LDL Concentrations in healthy men.

• Consumption of olive oil may decrease breast cancer risk.

• Olive Oil Polyphenols Reduce Bad Cholesterol and Plaque Formation

• Mediterranean diet rich in olive oil may reduce risk of metabolic syndrome.

• Dietary unsaponifiable fraction from extra virgin olive oil supplementation heals ulcerative colitis in mice.

• The Protective Effect of the Mediterranean Diet: Focus on Cancer and Cardiovascular Risk

• Antioxidant and anti-atherogenic activities of olive oil phenolics.

• Mediterranean Diet rich in olive oil may have protective effect in multiple sclerosis.

• A mixture of honey, olive oil, and beeswax for the management of hemorrhoids and anal fissures.

So be sure to stop by and tell Jake "hello" from Dr. Jill and get some of this new delicious crop of olives.  Who knows?  You just might run into me there next weekend ;-)

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Diet-induced Changes in the Gut Micro-biome

Diet-Induced Dysbiosis of the Intestinal Microbiota and the Effects on Immunity and Disease

Read full article HERE

Kirsty Brown  †, Daniella DeCoffe  †, Erin Molcan and Deanna L. Gibson  *

Department of Biology, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada;

Abstract

The gastrointestinal (GI) microbiota is the collection of microbes which reside in the GI tract and represents the largest source of non-self antigens in the human body. The GI tract functions as a major immunological organ as it must maintain tolerance to commensal and dietary antigens while remaining responsive to pathogenic stimuli. If this balance is disrupted, inappropriate inflammatory processes can result, leading to host cell damage and/or autoimmunity. Evidence suggests that the composition of the intestinal microbiota can influence susceptibility to chronic disease of the intestinal tract including ulcerative colitis, Crohn’s disease, celiac disease and irritable bowel syndrome, as well as more systemic diseases such as obesity, type 1 diabetes and type 2 diabetes. Interestingly, a considerable shift in diet has coincided with increased incidence of many of these inflammatory diseases. It was originally believed that the composition of the intestinal microbiota was relatively stable from early childhood; however, recent evidence suggests that diet can cause dysbiosis, an alteration in the composition of the microbiota, which could lead to aberrant immune responses. The role of the microbiota and the potential for diet-induced dysbiosis in inflammatory conditions of the GI tract and systemic diseases will be discussed.

Microbial changes in the GI tract have profound effects on host inflammatory and metabolic responses. For example, protein-rich diets increase the activity of bacterial enzymes such as β-glucuronidase, azoreductase and nitroreductase, which produce toxic metabolites that trigger inflammatory responses. Because of the intricate balance that exists within the microbiota, alterations in one group or species may not only affect the host directly, but can also disrupt the entire microbial community. For example, members from the phyla Firmicutes, Actinobacteria, Verrucomicrobium and Bacteroidetes can degrade complex carbohydrates not absorbed by the host and can also inhibit the growth of opportunistic pathogens such as Clostridium spp. and members of Enterobacteriaceae like E. coli . Dysbiosis can also alter the metabolic activity of other members of the microbiota in the gut. Thus, it is conceivable that some diets promote the growth of microbes that could have detrimental effects on their host while other dietary factors could promote beneficial microbes. It is unknown whether diet-induced dysbiosis is a transient or long-term event. If dysbiosis is a long-term event, then postnatal nutrition could be used to promote changes in the microbiota early in life during the development of a more stable microbiota. In support of this, consumption of formula supplemented with fish oil has the capacity to alter the microbial composition in the infant; however, it is unknown if these microbial changes would be long lasting or transient. Although this study did not identify the specific microbes that changed, nor did it examine the effect on intestinal immunity, it does suggest that the microbiota could be modified through dietary factors to enrich beneficial microbes and prevent diseases associated with dysbiosis.

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Dr. Jill's Summer Reading List

Top 10 Inspirational/Motivational

1. Love Does
2. Better Than Before
3. Circle Maker
4. Unexplainable, Pursuing a Life only God can make possible
5. The Life Changing Magic of Tidying Up
6. Quiet, The Power of Introverts in a World that Can't Stop Talking
7. Crazy Love
8. The Rise of Superman
9. The Gift of Imperfections
10. Love, Medicine and Miracles

Top 10 Healthy Living/Functional Medicine

1. Tox-Sick
2. Brain Maker
3. Missing Microbes
4. The Good Gut
5. Gut Balance Revolution
6. Why We Get Fat .... and What to Do About It
7. Why Can't I Get Better? Solving the Mystery of Lyme and Chronic Disease
8. Gluten Freedom
9. Wheat Belly
10. Autoimmune Solution

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Mind Altering Microbes: How your gut microbiome may influence your mood

"I've got a gut feeling about this"

While we have certainly heard that appetite and digestion are controlled by the enteric nervous system  (also known as "the master control panel in your gut"), who would've thought that the gut might also control your emotions and mood?  It's no wonder the old sayings, like "I've got a gut feeling about this", "That movie was gut-wrenching", or  "Come on, gut it out!" ring so true.  In fact I'd venture to say when we are trusting our intuition we associate it with having a "gut feeling" about something.

From the research it is now clear that gut microbes have an affect on inflammation, pain, eating behaviors, food cravings, mood and other seemingly unrelated symptoms, such as depression or uncontrolled anxiety.  In addition, it is common for depression and anxiety to co-exsist with disorders such as IBS (irritable bowel disorder).

It goes both ways...

Yes, it's true!  Did you know the gut-brain axis provides a way of communicating both directions using signals, such as neurotransmitters, hormones and cytokines?  This means that your gut bugs actually talk to your brain to influence emotions.  Equally important the emotions you feel and neurotransmitters produced by the brain have a profound effect on the gut as well.  We know that dysfunction in this communication between gut and brain can lead to various diseases, including depression and anxiety.  Who knew that the composition of your gut microbes could play such a great role in your mood?  The next time you get angry at your spouse or are overcome with sadness making you want to curl up in bed you can simply say, "Don't blame me...It's my gut microbes's fault!"  and you may be right on target!

The human gut is populated by more than 100 trillion microbes, which means there is more bugs in your gut than cells in your body.   And the genetic material contained by microbes in your gut is 150X that of the genetic material from human origin.  Most experts agree we have more than 1000 different species in our gut and over 7000 different strains.  We know that as we are exposed to stress, chemicals, antibiotics, and toxins, the diversity of the microbiome decreases and we know that the less diverse or microbiome, the more susceptible we are to illness and disease.

A baby's colonization of the gut first occurs at birth with vaginal exposure to the mother's microflora.  Did you know that c-section baby's have gut microbes more akin to skin flora than gut flora after birth?  And some studies show that throughout the entirety of life, they may never regain the normal diversity of vaginally delivered infants.

These are just a few of the functions of these bugs residing in your gut:

• Development of your immune system function
• Assisting with bowel movements and gut motility
• Maintaining intestinal cell barrier integrity (keeping the the good stuff in and the bad stuff out)
• Aiding in digestion and absorption of specific vitamins and minerals
• Controlling fat absorption and distribution

Pathways involved in communication between the gut microbes and brain.

Microbes and Stress

What is increasingly clear is that there is bi-directional communication between our gut microbes influencing the central nervous system and brain... and the reverse; communication between our brain influencing microbial composition.   Did you know that stress affects the gut microbes, too?

These are the top 3 ways that chronic stress affects the gut:

1. Increases the levels of inflammatory cytokines (IL-6, TNF-alpha) which can changes gut microbe populations.
2. Increases permeability of the gut lining, which is linked to many autoimmune diseases  (Hashimoto's thyroiditis, lupus, rheumatoid arthritis, multiple sclerosis and many others).
3. Allows bacteria to cross over into the bloodstream where the bacterial coating (LPS) can trigger an intense inflammatory response in the body.

So how do the gut microbes contribute to anxiety and depression?

Here are some of the mechanisms by which the gut microbes influence the brain and emotions:

• Altered microbial composition: Both probiotic ("good guys") administration and harmful infectious bacteria ("bad guys") have both shown to have an effect on the brain and emotions.  One study showed supplementation with probiotics decreased anxiety.
• Immune Activation:  Bacteria in the gut have been shown to activate the immune system and increase production of harmful pro-inflammatory cytokines.   There are many studies showing a link between increase in certain cytokines and depression (see below if you want to read more)
• Vagus nerve:  This is one of the main controls of the parasympathetic system that calms our fight or flight response and allows our body to relax and feel calm.  Activation of the vagus nerve and release of acetyl-choline has been shown to have a profoundly calming and anti-inflammatory effect on the body.  Most of the effects of gut microbes on the brain and body have been shown to be dependent on vagal nerve activation.
• Tryptophan metabolism:  Tryptophan is an extremely important amino acid and the raw material needed to make serotonin (think "the happy neurotransmitter") by the body.  There is a pathway, called the kynurinine pathway that involves metabolism of tryptophan and accounts for nearly 95% of the stores of tryptophan in the body.  In the case of pathogenic microbial infections in the gut (bacteria, yeast, or parasites) this pathway may be activated and "steal" from your body's tryptophan stores.  This leads to depletion of serotonin stores and may result in insomnia and depression.
• Microbial metabolites:  Bacteria in the gut help produce bile acids and short chain fatty acids (SCFAs) which are essential for human physical and mental health.
• Neurometabolites: Crazy but true... bacteria have the ability to produce many neurotransmitters and metabolites that have direct action on brain and thought.   Did you know studies show microbes can even influence your food cravings?!
• Bacterial cell wall sugars:  Perhaps most fascinating of all, the outer coatings of bacteria contain sugar molecules that can directly signal immune and hormonal systems into action.  This is the mechanism thought to be responsible for the healthy effects of probiotics on the gut and brain.

The bottom line is there is a growing body of evidence that suggests gut microbes play a large role in regulation in behavior and brain chemistry and are relevant to development of depression and anxiety.

So perhaps the best antidepressant is a healthy whole food diet and a high potency probiotic to fuel a healthy gut microbiome!

Check out Part II - Six Simple Steps to Treat Depression

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Further Reading:

• Psychoneuroimmunology Meets Neuropsychopharmacology: Translational Implications of the Impact of Inflammation on Behavior
• Inflammatory Cytokines in Depression: Neurobiological Mechanisms and Therapeutic Implications
• Cytokine variations and mood disorders: influence of social stressors and social support
• Increased IgA and IgM responses against gut commensals in chronic depression: Further evidence for increased bacterial translocation or leaky gut
• Mind-altering microorganisms: The impact of the gut microbiota on brain and behaviour
• Stress and the Gut

Functional Medicine: Empowering You to take control of your health...

Did you miss the Vail Living Well Experience?  Here's a few clips from Dr. Jill...

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The Gut Immune System Connection - An Animated Video

The gut mucosa connects with the largest population of immune cells in the body!  Is it any wonder that in functional medicine we assess your gut function as one of the initial steps in cases of allergies, asthma, autoimmune disease, eczema, crohn's disease, ulcerative colitis, IBS, celiac disease, arthritis and more?  

It’s often the first point of exposure to pathogens.   Many microbes use it as a entry point into the rest of the body. The gut immune system therefore needs to be ready to respond to pathogens but at the same time it is constantly exposed to harmless environmental antigens, food particles and commensal microflora which need to be tolerated. Misdirected immune responses to harmless antigens are the underlying cause of food allergies and debilitating conditions such as inflammatory bowel disease. This animation introduces the key cells and molecular players involved in gut immune connection and disease.



By checking your gut's microbial environment and taking a functional medicine approach to health and wellness, we can actually modulate some of the underlying immune dysregulation and eliminate your symptoms!

Nature Immunology homepage: http://www.nature.com/ni/index.html

Healthy Gut = Healthy You!

There is a microbial zoo living inside you, literally trillions of microscopic organisms―more than 10,000 different kinds of them―all co-existing with each other and you.

In fact they outnumber you ten to one and ninety percent of the genetic material, (DNA and RNA) in your body is not yours, it belongs to the bacteria that is located mostly in your gut, but some also live on your skin and even in your nose.

Exactly what those different life forms do has been the subject of some exciting research in recent years, and while a few of these organisms can sometimes wreak havoc with your system, the majority of these little "bugs" are good, helping you digest your food, stay protected from infections, and even keeping your immune system properly regulated to fend off autoimmune diseases like asthma, allergies, and diabetes.

The community of microbes living on and in your body is unique to you – like your fingerprints – and is now being regarded as a key contributor to your overall health.

More and more, science is finding that teeny tiny creatures living in your gut are there for a definite purpose. Known as your microbiome, about 100 trillion of these cells populate your body, particularly your intestines and other parts of your digestive system.

Although some of these bacteria can make you sick, the majority are good, and they work together as to aid your digestive system and keep you well. Beneficial bacteria, better known as probiotics, along with a host of other microorganisms, are so crucial to your health that researchers have compared them to "a newly recognized organ." We now know that your microflora influence your:

• Immune system function
• Brain development, mental health, and memory
• Obesity
• Genetic expression 
• Risk of diseases, including autoimmune disease, cancer, diabetes, and autism

According to the featured article in Time Magazine:

"Our surprisingly complex internal ecology has been a hot topic in medicine lately. Initiatives such as the Human Microbiome Project, an extension of the Human Genome Project, have been working tirelessly to probe potential links between the human microbiota and human health, and to construct strategies for manipulating the bacteria so that they work with us rather than against us.

...They've been linked to a range of nasty conditions, including obesity, arthritis, and high cholesterol. Now, two newer areas of research are pushing the field even further, looking at the possible gut bug link to a pair of very different conditions: autism and irritable bowel disease."

Most people, including many physicians, do not realize that 80 percent of your immune system is located in your digestive tract, making a healthy gut a major focal point in your efforts to achieve optimal health. In fact, the root of many health problems is related to an imbalance of intestinal bacteria.  

The beneficial bacteria in your gut has actually been found to help prevent allergies by training your immune system to distinguish between pathogens and non-harmful antigens and respond appropriately – and this may be one reason why they also appear so beneficial in conditions like allergies, asthma, and eczema

 Like it or not, the bugs in your gut have a lot to say about your health!  This is why I frequently test patients gut function for common complaints such as fatigue, migraines, mood disorders, depression, anxiety or insomnia, ecezma, allergies, asthma, autism, and even trouble with concentration & memory.  Getting the gut bugs back into proper balance is critical to your overall health and especially the health of your immune system.  The simplest way to jump start your overall health is pay attention to the gut...  Eliminate sugar and refined flours from your diet and add a high dose probiotic to you regimen.  You'll be well on your way to a happy and helpful intestinal "zoo"!

http://www.health.harvard.edu/healthbeat/the-gut-brain-connection
http://www.mercola.com/
http://www.metametrix.com/test-menu/profiles/gastrointestinal-function/dna-stool-analysis-gi-effects
https://wsunews.wsu.edu/pages/publications.asp?Action=Detail&PublicationID=32253&TypeID=1