The Essential Role of the Gut in Immunity

Is the Gut the Driving Force of Systematic Inflammation?

Dr Robin Martingale (2019)

Film Review

In the following video, ICU general and trauma surgeon Dr Robin Martingale explains the role of gut bacteria in protecting human beings from infection and inflammation. The key take home from his presentation is that it always seems to take the medical establishment at least 20 years to catch up with basic science research. Peer reviewed research about the role of the gut microbiome first appeared in medical journals about 20 years ago. When the mainstream media began reporting on the research around 2010, many  “alternative” health practitioners (naturopaths, homepaths, etc) began incorporating the knowledge into patient care. It’s only thanks to efforts of pioneers like Martingale, that some mainstream medical practitioners are finally incorporating it into mainstream medical practice.

The research Martingale presents shows a direct statistical link between modern humans declining diversity in gut bacteria* and the the epidemic of chronic illnesses we presently experience (eg diabetes, cardiovascular disease, autism, obesity, cancer, asthma, chronic fatigue, fibromyalgia and even mental illnesses, such as schizophrenia, depression and bipolar disorder). The mechanism here is a loss of “good bacteria” (symbiants and commensual) that protect us against endotoxin-producing pathogens (“bad bacteria”) that lead to chronic inflammation.

Martingale blames the loss of microbiome diversity to our increasing exposure to pesticides (especially Roundup), vaccines, chlorine, artificial sweeteners, emulsifiers (in processed food) and overuse of antibiotics.

He also presents numerous animal and human studies showing that obesity correlates far more closely with gut dysbiosis and systemic inflammation than lifestyle.

I found the ICU-related research he reported on the most interesting. For example, he cites one study that shows an 30% increase in ICU mortality in patients who have taken antibiotics in the past six months. And another showing a significant correlation between “leaky gut” syndrome and sepsis and multiple organ failure in ICU patients.

In the ICU at Oregan Health Sciences, where Martingale works, he has significantly increased survival rates by prescribing probiotics for all ICU patients and even fecal transplants** for patients with sepsis and multiple organ failure.

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*Human immunity is based on friendly gut bacteria that prevent pathogenic bacteria from producing endotoxin. When absorbed into the blood stream, the latter can can cause systemic inflammation.

**A fecal transplant involves the transfer of stool of a healthy patient to one with dysbiosis, an imbalance in normal gut bacteria.

Vitamin C

Vitamin C Basics

Dr Suzanne Humphries (2015)

 

Another excellent presentation by board certified nephrologist Suzanne Humphries – this time on the therapeutic use of vitamin C to prevent and cure illness. Her entire talk is based on peer reviewed studies that all doctors should be aware of (but for the most part, aren’t).

As one of nature’s most potent antioxidants, Vitamin C plays a vital role in restoring physiological balance when the body is under “oxidative stress.”** It’s also essential to maintaining the integrity of collagen (tendons and ligaments), blood vessels and mitochondria.***

Most mammals (human and other primates and guinea pigs are an exception) produce their own vitamin C. According to careful animal and human studies, the daily vitamin C dose should be 1500mg for healthy adults and 2000mg for people over 65.*

Vitamin C is used up quickly as it reverses the biochemical effects of oxidative stress, which is why people need to take much higher doses with illness, injury or psychological stress. They need higher doses still in infections that produce endotoxin, such as pertussis (whooping cough) and inflammatory bowel conditions. Smokers need to take an extra 25 mg vitamin C for every cigarette they smoke.

Studies show this vitamin is extremely helpful in controlling diabetes and all aspects of heart disease. Because it acts directly to reduce histamine levels, it tends to be more effective than antihistamine in treating allergic reactions. It’s also more effective than antibiotics in treating pertussis, tetanus and sepsis (blood poisoning). New Zealand doctors have been treating whooping cough with vitamin C for over 30 years.

It’s also effective in treating polio, snake bites, spider bites, burns, surgical trauma, and exposure to radiation, toxic chemicals, alcohol, and pharmaceuticals.

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*Continuing to ignore all these studies (under heavy Big Pharma influence), the medical establishment continues to recommend 75mg daily in females and 90mg daily in males.

**Oxydative stress is an imbalance between reactive oxygen and the body’s ability to detoxify reactive intermediates or repair the resulting damage.

***Mitochondria are tiny organelles found in every cell that are responsible for cell respiration and energy production.

Is Schizophrenia an Inflammatory Illness?

The Madness of Adam and Even: How Schizophrenia Shaped Humanity

by David Horrobin (2001 Bantam Press)

Book Review

The Madness of Adam and Eve advances a dual hypothesis: 1) that schizophrenia is a whole body disorder, rather than a “brain disease, as promoted by Big Pharma and the psychiatric fraternity and 2) that schizophrenia stems from the same series of genetic mutations that led to the appearance of the human species (homo sapiens) 100,000 years ago.

The specific biochemical “error” Horrobin credits for causing schizophrenia is a defect in the metabolism of arachidonic acid (AA), a fatty acid that facilitates smooth signal transmission between nerve endings. Horobin believes a genetic mutation around 100,000 years ago caused a massive increase in AA production, enabling a giant increase in dendritic connections between neurons. This, in turn, resulted in a sudden explosion in human intellectual capacity, as well as the sudden appearance of art, music and organized religion.

Horribin also maintains that schizophrenia was a relatively mild illness in hunter gatherer societies, owing to a diet rich in the omega 3 fatty acids essential for optiminal brain function. With the major dietary changes that accompanied the agricultural and industrial revolution, schizophrenia has become much more severe. The switch from omega 3 and omega 6 fatty acids to saturated animal fat was by far the most significant, as saturated fats can suppress the uptake and utilization of omega 3 fatty acids.

Horrobin’s hypothesis is born out by WHO research revealing that schizophrenia is more severe in the industrialized west, studies showing that schizophrenics improve when given large doses of the omega 3 fatty acid EPA, and the failure of schizophrenics to experience a “niacin blush”* when exposed to megadoses of niacin.

Aimed at a lay audience, The Madness of Adam and Eve doesn’t always distinguish clearly between theory and established fact. While Horribin’s ideas make an important contribution to the understanding of mental illness, his overemphasis on genetic determinism in the origin of mental illness is clearly dated. In 2002, the field of epigenetics** was still in its infancy and there was limited understanding of the role of noxious prenatal influences on gene expression and the development of chronic physical and mental illnesses. Nor was the role of harmful intestinal bacteria and endotoxin-related inflammation recognized in the etiology of autism, schizophrenia and depression.

His portrayal of the intellectual inferiority of Homo neanderthalensis (Neanderthal man) is also obsolete. More recent archeological evidence suggests that Neanderthal man was the intellectual equal of homo sapiens.

*A niacin flush is sudden reddening and burning of the skin caused when niacin promotes conversion of AA to the inflammatory peptide prostaglandin. Several researchers have proposed using a niacin skin test as a research tool in studying schizophrenia.

**Epignetics is the study of hormonal and other prenatal influence that affect the expression of genes as specific protein enzymes.

When Horrobin died in 2003, the British Medical Journal wrote a particularly nasty obituary describing him as “the greatest snake oil salesman of his age.” A decade of research into the beneficial role of omega 3 oil in the treatment of depression (particularly post natal depression, bipolar illness, schizophrenia and premenstrual syndrome) has clearly vindicated him. The supplementation of prescription psychotropics with omega 3 oils is now standard psychiatric practice. 

Research into his theory that schizophrenia is a whole body inflammatory illness, rather than a brain disease, is also advancing. More recent studies focus on inflammation caused by endotoxin-producing by gram negative intestinal bacteria. Thus far schizophrenics’ demonstrated impairment in prostaglandin synthesis has failed to translate into viable treatment options.

There have been numerous studies suggesting a beneficial effect of non steroidal anti-inflammatory (NSAID) medication (such as ibuprofen and naprosyn) in the treatment of schizophrenia. Unfortunately NSAIDs, like psychotropics, have numerous serious side effects, including peptic ulcer disease and reduced kidney function.

 

The Taboo Against Animal Fat

(The first of two posts about the damaging effect of the western diet on intestinal bacteria and human health.)

As a traditionally trained physician, I watch with horror and dismay as for-profit corporations intrude ever deeper into so-called evidence based medicine. I have written at length about the role of Big Pharma in corrupting good medical practice to promote the sale of prescription pharmaceuticals – and their bottom line (see Menopause: Made in the USA and Drug Companies: Killing Kids for Profit). The role of Food Inc in the dietary recommendations doctors (and government) make to patients and the public at large are even more insidious and damaging.

The current taboo against saturated animal fats is a case in point. For the past thirty years, doctors and government agencies have been lecturing us that diets high in saturated animal fats (found in red meat, whole milk, eggs, butter and lard) cause high cholesterol levels, heart disease and stroke. They have persisted in this three decade campaign against animal fat – despite the total absence of scientific research supporting a link between fat intake and high cholesterol levels – or heart disease and and stroke. In fact, growing evidence suggests just the opposite: diets low in saturated fats and high in sugar and refined carbohydrate promote obesity, type 2 diabetes, high cholesterol levels, high blood pressure, heart disease and stroke.

In other words, government and the medical fraternity have it backwards. Worse still, it appears that their purely theoretical (based on no evidence) phobia against animal fat may be the single most important factor in the current epidemic of obesity and type 2 diabetes.

An Unproven Hypothesis

The current taboo against animal fats is based on a hypothesis first promoted forty years ago when I was in medical school. The theory works like this:  consumption of foods high in cholesterol and saturated fats promotes high levels of blood cholesterol, which lead to calcified plaque formation in arteries, which restrict blood flow to the heart and brain, as well as increasing blood pressure by making blood vessels less elastic.

There’s a credible body of research linking high cholesterol levels to plaque formation and the latter to high blood pressure, heart attack and stroke. However there’s no research whatsoever linking diets high in animal fats and cholesterol to high blood cholesterol levels.

In March, Annals of Internal Medicine published a metanalysis of 72 scientific studies on the effect of different fats on heart disease. The authors conclude there is insufficient research evidence to support guidelines discouraging consumption of saturated animal fats.

The Work of Weston A Price

A growing body of evidence suggests that diets low in saturated fats are, in fact, harmful to human health. Many of these studies were inspired by the work of dentist Weston A. Price in the 1930s. Puzzled that Maori, Australian aboriginals and other indigenous groups experienced no tooth decay prior to adopting a western diet, Price studied their dietary habits. To his surprise, he discovered it wasn’t the direct effect of sugar on tooth enamel that caused cavities. His patients developed tooth decay because diets high in sugar and refined carbohydrates were deficient in basic nutrients essential for human health. When he helped them alter their diets, his patients not only avoided further tooth decay but healed existing cavities.

One of Price’s discoveries was that animal fats* provide essential fat-soluble vitamins (A, D, E and K) that play a vital role in the absorption of other nutrients essential for hormonal and neurological function and protection against chronic diseases, such as cancer and heart disease.

The Role of Intestinal Bacteria

More recent studies have elucidated the mechanism by which diets high in sugar and refined carbohydrate predispose to both high cholesterol levels and obesity. Some of this research is summarized in an April 2013 article in Mother Jones Are Happy But Bacteria Key to Weight Loss?

The article explains how high sugar and refined carbohydrate diets, coupled with massive antibiotic overuse in medicine and factory farming**, promote the growth of gram negative, endotoxin-producing intestinal bacteria. When endotoxin is absorbed into the bloodstream, it sets up a wide ranging inflammatory response that can manifest a variety of effects, including arthritis, eczema, psoriasis and neuropsychological syndromes such as autism, Asperger’s disorder, schizophrenia and ADHD. A number of studies suggest that high cholesterol levels are also an inflammatory response to this endotoxin. Others link endotoxin to inflammatory damage in the brain’s appetite center. An impaired appetite center will cause people and animals to eat indefinitely without ever feeling full.

The Mother Jones article also describes several studies in which obese patients lost weight by simply suppressing endotoxin-producing bacteria – by taking probiotics and eating fermented foods containing beneficial bacteria.

*The contamination of animal fats and dairy products, even when produced organically, with fat-soluble pesticides and other industrial toxins makes choosing “safe” saturated fats somewhat problematic. Classified as endocrine disruptors, many of these toxins mimic estrogen, which promotes the development and growth of breast cancer. For this reason, I prefer coconut oil as my saturated fat of choice.

**Factory farmed animals are routinely fed antibiotics to hasten and maximize growth.

To be continued.

photo credit: {Guerrilla Futures | Jason Tester} via photopin cc

Intestinal Bacteria and Chronic Illness

(This is the second of 2 posts about a possible link between intestinal bacteria, obesity, and other chronic illnesses.)

The most enlightening article I’ve seen about micrbiota (gut bacteria) research is an April 2013 article from Mother Jones. It explores the possibility that insulin resistance (see previous post) is actually an “inflammatory” process caused by the production of “endotoxin” by unhealthy gut bacteria.

The Major Health Implications of Dysbiosis

Owing to a doubling of obesity rates since 1980, this strikes me as a reasonable hypothesis. The mass marketing of antibiotics by Big Pharma, Food Inc (in livestock feed), and Monsanto (in genetically modified organisms) has led to epidemic levels of dysbiosis (a derangement in gut bacteria) in the industrialized world. In addition to skyrocketing obesity rates, the developed world has also experienced a significant increase in other dysbiosis-related conditions, including cancer, diabetes, and degenerative and autoimmune disease. It would also explain why children born to obese mothers (we acquire gut bacteria from our mothers) are more likely to suffer from asthma, attention deficit disorder, and autism.

The article cites research from the University of Washington showing that foods high in saturated fats and sugar promote the growth of endotoxin-producing inflammatory bacteria. Endotoxin, in turn, causes inflammatory damage to the the hypothalamus, the brain’s appetite center. When this occurs, people lose the ability to feel full and eat to excess.

The Mother Jones article also references studies in which volunteers improved their insulin sensitivity, as well as losing weight, by reducing their level of “inflammatory” bacteria. They accomplished this by consuming diets rich in fermented foods containing healthy, anti-inflammatory bacteria.

Most interesting of all are studies showing that bariatric (weight loss) surgery helps some patients and not others depending on their ability to grow a healthier microbiota (gut bacteria colony) following their procedure.

The Care and Feeding of Intestinal Bacteria

After suffering a sudden onset of so-called “irritable bowel” syndrome 20 years ago, I have a strong personal interest in dysbiosis. The Sydney GI specialist I consulted says the only effective treatment for most IBS sufferers is to re-establish a healthy microbiota.

The end of the article offers a number of suggestions how to accomplish this. The bottom line is to consume a diet rich in 1) fermented foods with live bacterial cultures and 2) complex carbohydrate and fiber-rich foods these organisms thrive on. Studies show that treatment with whole foods is always preferable to taking probiotics. Fermented foods contain literally thousands of strains of bacteria that work collaboratively with one another. Probiotic capsules, in contrast, contain a dozen strains at most and are likely to be destroyed by stomach acid

Examples of helpful fermented foods include sauerkraut (only if it’s made via fermentation), miso (fermented soybean paste), kefir (a fermented drink), and some yoghurts. To ensure the bacterial cultures are live, it’s best to ferment these foods yourself or get them from a reliable health food store. It’s also essential to check the label to make sure they aren’t pasteurized (pasteurization kills bacteria).

The foods these bacteria like to munch on include onions, garlic, potatoes, bananas, yams, apples, oranges, whole grains, Jerusalem artichokes, legumes and cruciferous vegetables (cabbage, broccoli, and cauliflower).

Looking after the new bacteria in my intestine is almost like having a new pet to care for. I can already tell from my symptoms which foods they really like: yam, cooked apples, and avocado. Luckily I’m pretty keen on them myself.

photo credit: www.cihr-irsc.gc.ca via photopin cc