Beer: Could It Be a Healthy Part of Life?

Beer the most widely consumed fermented beverage in the world.  Let me repeat: The most widely consumed fermented beverage in the WORLD.  And when you come from a functional medicine perspective, the word fermented is like gold.  Fermented foods and beverages have been around as a method of preservation for food since before refrigeration and using bacteria and yeast to turn food into probiotic powerhouses makes them healthy for us.  That probiotic content is something people pay big money for in the world of supplements because of the profound impact it has on the health of their gut microbiome, and in turn, many disease processes like Crohn’s disease, Hashimoto’s thyroiditis, anxiety disorders, and even obesity. 

Beer is simple, but the art is in crafting something tasty out of essentially water, starch, brewer’s yeast (Saccharomyces cerevisiae), and hops.

{Side note: The starch listed above is where the grains come in.  Glutinous grains are traditionally used and trying to accomplish the same outcome with gluten-free options is a very difficult task. Tip your hat to your local brewers if they’re able to make your gluten-free beer dreams come true, because it is a next-level art.}

And here we are, back at the table, talking about how we have more bacteria in our gut than cells in our body and the health and diversity of those communities of bacteria are how we stay healthy as a human species.  Undeniable at this point, but where does beer fit in?  It’s a fermented beverage and tons of people drink beer, but many of them are NOT healthy.  Does it have a place in this conversation?  What parts of beer are the healthiest?  Does beer really help breastfeeding and hormones?  Did you know they’re even talking about this in the cancer world?  Isn’t alcohol unhealthy?  Are there better beers to choose than others from a health perspective? Can you overdo it….I’m asking for a friend.

If you’re a science geek, I’m going to make you cry by skipping over all the details and references because at the end of the day, it takes hours to cover all that, and if you’re like me, I really just want know I can trust the assessment and then give me the conclusion.  So, that’s where we’re at: my opinion based on the hours of going down the rabbit hole for fun.

There are 3 things to consider when talking about beer for health:

  1. The influence on the microbiome
  2. The method of production and consumption
  3. The interaction with hormones

Is Alcohol Healthy?

No.  But there are interesting data around blue zones showing moderate consumption contributes to health and longevity.  So, it begs the question: Is it the type of alcohol or the way it’s consumed?  My opinion is that unpasteurized, fermented beverages like traditional wine, beer, and ciders are better for you than other options, in moderation, and consuming them WITH people complicates the benefit around what we know about community, conversation, friendship and the physiological and biochemical changes that come with that alone.  Red wine has been shown in studies to have the least detrimental impact on inducing leaky gut, and unfortunately, we can’t say the same for my spirit of choice: gin.

Nutshell: traditionally fermented options are best, in moderation, WITH friends

Now that we have the elephant out of the way, let’s have some beer…

What makes beer healthy?  {because I would love to tell my doctor}

I want to focus on one component of beer here: hops.  Hops are plants which contain compounds like polyphenols.  These may sound foreign, but it’s some of the same stuff you know about wine! Resveratrol is the polyphenol in wine that has gotten all the love over the years, boosting wine sales significantly after the research was published.  Hops have up to a 14% polyphenol concentration in the dried cones and while that encompasses phenolic acids, catechins and proanthocyanidins, I’m mostly obsessed with the flavonoids. 

{If you ever read my article on UTI’s, then you know it’s the proanthocyanidin content (PAC) in cranberries that work some magic on E.coli. Read here.}

In terms of flavonoids in hops, xanthohumol is where it’s at.  It contributes to the bitterness in taste but it is probably more important that when that compound hits your gut, your microbiome takes it and transforms it into a different compound.  Here’s the kicker, the genus responsible for this is Eubacterium.  This kind of bacteria is one of the largest butyrate producers in your gut, which for those that don’t know, butyrate is a short chain fatty acid that acts as fuel for your intestinal cells to thrive, keeping leaky gut at bay. You may have heard of them when talking about PREbiotics; the stuff that you get when you eat fibers to feed healthy bacteria in your gut.  Polyphenols do the same thing to some extent!  If you or your doctor have done a stool test on you, you may be more familiar with these bacteria being in the phylum of Firmicutes. 

{Side note for clinicians: If you see absent Firmicutes, you are not only likely seeing low diversity in your patient, low butyrate production, etc, but you are also seeing someone who may be deficient in their ability to benefit from polyphenols that require that bacteria to transform them into other compounds for a health outcome!  This area is something that I feel strongly about in terms of personalized and precision medicine in the future.  We are already studying the differences in drug metabolism based on someone’s age, sex, genes, and MICROBIOME, but we should be exploring the same principles to herbal medicinal interventions, too.  It does no good to provide someone a compound that they lack the ability to transform if transformation is necessary for the health outcome. Back to regular scheduled programming…}

They have done studies to watch the microbiome shifts using alcoholic and non-alcoholic versions of wine to try and determine where benefits are coming from, and sorry guys, they see more benefit in the microbiome shifts of people drinking polyphenol-rich beverages WITHOUT the alcohol. 

Nutshell: Wine and beer have these healthy polyphenols, but if you were trying to be perfectionistic, you’d prioritize non-alcoholic versions to have healthy impact on your microbiome. 

What are the best options to choose?

Prioritize the following:

  • Craft beer may ensure more traditional methods of production
  • Buying from smaller brewers locally, on tap, may improve the health aspects due to lack of pasteurization
  • Consider choosing non-alcoholic hop beverages for all the polyphenol benefits without the alcohol down-sides
    • I’m not sponsored in any way, but I am obsessed with HopTea, which is a tea brewed with hops and carbonated to give you all the feels of a beer, without the hangover

Beer and hormones?

I didn’t even get the fact that hops are considered a galactogogue, which basically means, helps breastfeeding moms with milk production.  They are also a phytoestrogen, which means they have estrogenic influence.  Yes, estrogen is so important that even plants make them.  This is often used in menopausal women to retain hormone balance to help hot flashes and brain neurodegeneration.  

This could be an entirely different blog for an entirely different time.  For now, I just wanted to share what I was learning about hops and the microbiome as my obsession for research in autoimmunity and my love of HopTea grows.  Until next time!


Cholesterol, Heart Disease, and What You Should Do

Coronary Heart Disease is our single most common cause of death and it is caused by something called atherosclerosis.  Atherosclerosis is a fancy term for “your vessels get more narrow due to plaques and that reduces the blood flow to whichever organ that vessel is going to.”  IF you have atherosclerosis of the coronary artery, then you have obstruction of blood flow to the heart…..hello, coronary heart disease: the number one killer.  Most people people are familiar with the most common form of coronary heart disease known as a HEART ATTACK!

Symptoms of the early stages:

  • During physical activity, people may experience chest pain that may go into the neck and left arm.  The pain goes away after rest in the early stages.
  • Fatigue during normal activities.  This is due to the lack of blood supply to the heart, so you feel fatigued doing normal activity.

Symptoms of heart attack:

  • Severe chest pain not connected to physical activity.
  • Fear, cold sweats, nausea

Given the fact that autopsies show that by the age of 60, 100% of people have some signs of atherosclerosis, it’s not surprising that people want to know what to do when the doc starts talking about this when they go in for their exam!

What causes atherosclerosis?

People have been led to believe that cholesterol and dietary fats are the root of all this nonsense. We’ve all had someone we know quit eating meat and eggs and opted for non-fat products in attempts to correct the cholesterol issues on their labwork. This is a myth you need to get comfortable rejecting, so keep an open mind here.  Atherosclerosis is an INFLAMMATORY condition! The plaques on the wall of arteries are not cholesterol stuck; it’s actually more like a damaged portion of the artery wall that is covered with a bunch of stuff, but the main component is actually tissue trying to repair that is mostly made from collagen.  The fat part of the plaque is mostly UNSATURATED FATS. This is complex, but the gist is:

  • Something in the bloodstream attacks the artery tissue
  • Immune cells come to the rescue to destroy whatever is attacking the artery tissue
  • Those immune cells call for more help by sending out the bat signal known as inflammation
  • As the body is trying to repair the damage, it grows more collagen and creates a cap on top of the plaque
  • When the inflammation stops, it becomes hard and calcium may take up shop there.  This is like a scar. THIS WOULD BE NORMAL AND WE ALL HAVE SOME SCARS IN OUR ARTERIES.
  • In atherosclerosis, the inflammation doesn’t stop and it forms something similar to puss in a wound.
  • Inflammation is driving the production of enzymes that break down collagen and if the cap over the area gets weak? Boom. Rupture.
  • Within second, the blood tries to thicken to stop bleeding, a clot forms, and the artery is blocked or a portion of it can break off and float downstream and stuck in another location.  This is what we all really fear.

Why avoiding cholesterol isn’t helpful:

The body uses fats and cholesterol as the building blocks for creating new cells and tissues in any healing process.  This is because a huge part of a cell is the membrane and it acts sort of like your skin.  Without it, what would hold in your insides?!  Those membranes are made out of fat and cholesterol and if you want to get geeky, many cells in the body have 50% of the membrane made from cholesterol. THE REASON WE SEE CHOLESTEROL IN AREAS OF PLAQUING IS BECAUSE THAT IS YOUR BODY’S ATTEMPT TO REPAIR THE DAMAGE TO THAT TISSUE!  It’s like saying umbrellas must cause it to rain, because every time it rains, I see all these people holding umbrellas.  Cholesterol is the umbrella.  It’s there BECAUSE OF THE TISSUE DAMAGE, not causing it.

Ok, so let’s cut to the chase.  You understand what I’m saying, so now you want to know what causes that arterial damage that starts this whole thing in the first place.  Without further adieu, let’s look at a list…

  • Chemicals: chemicals in your beauty products, medications, home cleaning products, cigarettes, pesticides, water, processed food.  I bet you had no idea that even what you slather on your skin goes straight to the bloodstream and could be contributing to heart problems!  Stay woke. (If you don’t know what that means, it’s ok, just keep reading)
  • Infections: if you have issues with the barriers between the outside world and inside of your body like gum disease, leaky gut, sinus infections, etc, then you basically have a highway for pathogens to get into your bloodstream and wreak havoc wherever they see fit, which means not just your arteries.  This is also a huge problem with autoimmune diseases and cognitive issues.  I bet you didn’t have any idea your oral hygiene could be a part of your heart disease.
  • Nutrient deficiencies: in order to repair, your body needs adequate building blocks and deficiencies in things such as b-vitamins, vitamin c, vitamin D and amino acids set you up for failure.  If you have b-vitamin deficiencies, you may see elevation in markers like homocysteine on your labs.  If your doc runs complex labs, you may also see vitamin C deficiency pop up as elevated Lipoprotein A. (you have a 70% greater chance of having a heart attack if you have elevated lipoprotein a!)

So, let’s simplify this into some actionable things you could do to help yourself:

  • Eat a healthy diet including lots of plants and good sources of healthy fats
  • Stop eating processed foods and excessive amounts of sugar
  • Clean out your beauty drawer from all the chemical crap (check out this website for information)
  • Work with a physician to get off as many medications as possible.  This is ironic when it comes to statins because statins cut off your ability to produce cholesterol, ultimately lowering your cholesterol numbers.  Knowing what you know now, is cholesterol trying to help heal or trying to hurt your vessels!  Bye, Felicia.
  • Take B-Vitamins, omega 3 fatty acids (1g for prevention or 3g for someone with active conditions), CoQ10 (100mg for those taking statins and want to prevent issues or 500mg if you are experiencing issues of statin use like forgetfulness or muscle/joint pain).  (If you want specific recommendations for the products I prefer, feel free to email me at angela@angelalucterhand.com for links to those)
  • Stop smoking.
  • Start exercising.

Take away points:

  • Prevention is key, so don’t wait until you have heart disease to take your diet and lifestyle seriously.
  • You MUST be on CoQ10 if you are going to continue to take statins.
  • Cholesterol is not the enemy, so do not go low fat in attempts to correct the problem.

Believe it or not, these cases are some of the easiest patient cases I take on!  It doesn’t take much time to see drastic changes in someone’s labwork in these cases, and the solutions are pretty simple when you compare them to more complex issues like cancer and autoimmune diseases.


Cancer, Chemo…Now What?

I want to start this post by saying there are thousands of people who have been touched by cancer, and I can’t imagine the decisions that have to be made under such circumstances.  Regardless of your stance on standard cancer treatments, there is a huge population of people, our people, that have been through it and deserve to know there are things they can afterwards that will help restore some of the health lost in collateral damage while going through treatment to save their life.  This post is for those people who have been there, done it, can’t change the past, but want to set up the best future possible for their health moving forward.  This is not a recommendation for cancer therapy, treatment, or anything of that nature.  This is the plan moving forward.

Are you with me? 

What is chemo and what does it affect?

Chemotherapy is just the name of drug therapy aimed at killing cancer cells under the premise that they multiply quickly and we don’t want them to spread.  However, it is not selective to cancer cells.  It has a major impact on ALL cells that grow quickly like certain blood cells and especially the cells of the intestines. Chemotherapy drugs and their byproducts are also toxic to these little organelles in our cells called mitochondria.  Mitochondria are responsible for producing cellular energy called ATP.  Now, that’s great, but what does this have to do with me!?  If you have been through chemo, you know these things are happening because the bowel issues that arise, and the fatigue that takes over.  And that’s ok.  You were fighting for your life!  But now we need to nurse those two things back to health if we don’t want recurrence, formation of neuropathy, autoimmune diseases, etc.  There is a chance you will never have 100% function in these areas again, but we can try our best!

How can I start healing my gut?

It’s not really a secret to health professionals that chemo changes the gut, but what I was surprised to find out while researching journals for specific measures of damage is that just one single day of chemotherapy increases the permeability of the intestines by 7 fold.  ONE DAY!  We are concerned about that permeability because damaging the cells in the intestines allows things that should stay in the intestines to get into the blood.  When they end up in the blood, your immune system freaks out and produces antibodies against them…rightfully so.  However, this is how we end up with certain systemic infections, allergies, and autoimmunity that has the potential to damage any organ’s tissue.  If the organ with the most depleted nutrients in reserve is your thyroid, then we may see Hashimoto’s.  If the organ is joint tissue, then maybe Rheumatoid arthritis.  This is an incredibly important issue to address.  Some very basic guidelines as to HOW to address this permeability are:

  • eat gluten-free
  • eat dairy-free
  • eat bone broth daily
  • eat fermented foods or take probiotics
  • consider supplements with growth factors like that signal cell repair like colostrum
  • don’t exercise too intensely
  • reduce stress
  • avoid alcohol and caffeine
  • get in the sun or supplement with vitamin D3
  • sleep 8 hours a night
  • consider periods of intermittent fasting to allow the GI tract to rest from digestion
  • juice fresh vegetables daily

How can I restore my energy?

We have almost all heard that we have 10 times the amount of bacteria in our body than we do cells.  A statistic you may not have heard is that we exponentially more mitochondria than bacteria!  Without these little guys in our cells, they don’t function.  It’s amazing to me that you can pluck the nucleus out of a cell, which contains the DNA, and the cell can still function because of the presence of mitochondria!  However, if you pluck out the mitochondria, it ends in certain, quick cell death.  So, these things are super important and are often the missing link behind conditions such as chronic fatigue syndrome, migraines, fibromyalgia, etc.  Today though, we are talking about how chemo negatively impacts your mitochondria.  Side note that certain antibiotics also have a negative impact on mitochondria…. Ok, back to what to do about it:

  • do burst exercise (it not only improves their function, but causes them to multiply)
  • intermittent fast
  • eat balanced macros (protein, fat, carbs) but try to slowly transition to lower carb for a while
  • eat some grassfed red meat
  • eat lots of organic, colorful vegetables and their juices
  • reconsider the use of statins or supplement with COQ10
  • use saunas
  • consider laser therapy

These are two areas that need your support in order to restore function to the best of your body’s ability.  It is ALWAYS essential to have a plant-based, whole food diet, good sleep, adequate exercise, and successful stress management.  However, those things are hard to implement sometimes without tools and a little direction.  Don’t be afraid to ask for help.  Remember that may mean looking to a different provider.  When we have fires, we call firemen.  When we need the building restored after the fire, we call contractors and carpenters.  Alternative care providers are not experts at putting out the fire necessarily, but they are the expert at RESTORING AND MAINTAINING HEALTH.  There are always additional things that can increase healing beyond basic lifestyle, and don’t be afraid to explore those things either.  Things such as massage, chiropractic, supplementation, infrared saunas, detoxification baths, etc.  They all have a place, and it’s your job to explore and find what feels right and works for you.  I hope this was helpful, although somewhat basic, it gets the basics across. ;)

*This is not intended to diagnose, treat, or direct care for any patient.  Consult your physician for information that would be right for your case.


Is Exercise Causing Your Leaky Gut?

When considering a healthy lifestyle, exercise is often a component of that.  The details of “what is healthy exercise” tends to be the real debate.  When prescribing exercise to a patient, the goal is always to have exercise induce healthy signaling to cells in order to enhance normal metabolism, detoxification, and hormone production.  We want this healthy signaling to happen while performing movement that is low risk because movement that may promote damaging signals or cause injury is counter-intuitive to the health agenda at hand.  This is an easier article to write if the focus is simply hormone production and low risk movement patterns.  It becomes more tricky when you start considering how exercise may be contributing to intestinal permeability, aka leaky gut.  If you are unfamiliar with this term, check out a prior article I wrote on what it is and how it happens here.

When you perform high intensity workouts or exercise for long durations, you actually induce intestinal permeability.  The fact that this happens can also be an argument to justify shorter durations and longer recovery times.  If we are thinking in general, it is probably not the best idea to be doing vigorous workouts on a daily basis because over-exercising is a real thing!  Not only can it begin to have a catabolic effect, induce cortisol issues, and create real fatigue issues, it can cause leaky gut.  Leaky gut is the precursor to autoimmune diseases and should not be taken lightly. This is also a part of exercise-induced immune suppression.  That’s right.  You actually have a period of time after exercise where your immune system is suppressed.  So, if you are a person that wants to train at an elite level and stay healthy while maintaining a normal intestinal lining, what do you do?

  1. Eat a diet free from foods that can contribute to intestinal damage such as wheat, processed foods, sugars, and commercial dairy products.
  2. Stay away from alcohol when in high training seasons.  Alcohol contributes to leaky gut.
  3. Get adequate rest and sleep for recovery.
  4. Don’t overtrain.
  5. Take supplements that will keep your immune system up:
    1. Beta-glucans are a yeast-derived products that prime neutrophils (immune cells) to act quickly and efficiently if you get an infection. Look for those containing “Wellmune”
    2. Colostrum is a product that contains antibodies to give the body a donated immune system in addition to growth factors that stimulate healing of the gut lining.

When athletes take colostrum during peak training season, they have virtually no sign of leaky gut in comparison to their counterparts that don’t take colostrum.  A recent study was just published on the topic, and it really is remarkable.  When we think about why colostrum can provide such a service to the intestine, we need to think about nature’s original intention.  Colostrum is the first milk produced for baby.  Every baby is born with leaky gut (this is normal for an infant!) but it’s colostrum and mother’s milk that provides the immune factors such as antibodies in addition to the growth factors that will ultimately create a normally developed intestinal lining.  In a bubble, this lining would never encounter processed food, antibiotics, excessive workouts, etc.  But we live in 2017 and people have so many damaging things happening in everyday life.

If you are an athlete that doesn’t want your exercise regime to cause damage to the intestines that will ultimately hurt the immune system, consider taking colostrum.  It’s a classic story that any athlete will tell you: inevitably, game day rolls around and that’s when you get sick!  Either that or it’s often during peak training season.  I wouldn’t want to train all year for something and then get sick right before competition!  We can use these types of discoveries to leverage food to our advantage in addition to knowing how to adjust lifestyle habits like exercise frequency. On a side note: there have been Olympic teams known to take colostrum because of the factors that enhance performance without it being a growth hormone type product.  So, there could be some performance benefits in addition to health benefits!

If you are interested in all the recent study details, click here!

If you are interested in protecting your intestines and immune system without changing your training schedule, check out my fullscript dispensary for Wholemune (beta-glucans) and IgG Protect (colostrum).  Many functional medicine doctors and chiropractors will have these products, too!


Autoimmunity and Exercise (Part VII)

At this point in the autoimmune series, you can understand why I was reluctant to write an article in the first place! It is so complex, complicated, and multifaceted. So, if I were going to touch on another lifestyle change someone can easily implement, it would be exercise. Unfortunately, exercise is one category where you can have too much of a good thing, especially if you suffer from autoimmunity. There is a point where movement is healthy, beneficial, and will IMPROVE your immune system. On the flip side, if someone’s system is under extreme demand, their adrenals are shot, and they are often stressed, you can easily overdo it. Then the question becomes, what types of exercise are best, and how much.
Exercise is very closely related to your adrenals and the production of cortisol. Cortisol is a steroidal hormone that helps you keep up with stress and is important in the fight or flight response. These spikes in cortisol production should be short-lived and not chronic by any means. However, many of us live stressful, hectic lives and some add tons of exercise on top of it. This is a recipe for adrenal fatigue, and if you want to read more on that, click here.  The more intense you exercise, the more cortisol you release.  This disrupts something we call the HPA axis, which is important in regulating hormones and the immune system.   The types of exercise that stimulate the HPA Axis disruption the most are chronic cardio and and high intensity exercise.  That means that if you have an autoimmune disease, you may be doing more damage than good if you try to run marathons (or any long distance) or Crossfit.  It doesn’t mean you can’t participate in these workouts, but it does mean you need to be smart about it!  Resistance training does not have the same effect on cortisol if it is practiced alone.  This means that weight lifting or body weight movements at lower intensities may be a great option for those with autoimmunity or adrenal fatigue! If you decide to participate in physical activity that is too strenuous for your body to keep up with the cortisol production, guess what, you can CAUSE LEAKY GUT.  We talked about how leaky gut is how this whole thing got started in the first place!  It’s a classic case of too much of a good thing.  Balance is key and more doesn’t always mean better.

As far as how exercise affects the immune system, it can cause a huge inflammatory response.  Any exercise someone does at more intensity that usual for longer than usual, is mobilizing neutrophils and natural killer cells.  This type of exercise also stimulates phagocytosis and increases the production of inflammatory compounds.  In studies, we see that following acute exercise,  the number of T and B cells (immune cells) drop below the levels they were BEFORE every working out.  This quickly recovers if someone has adequate recovery time.  However, if there isn’t sufficient days between these types of workouts, then it is common for athletes to get sick!

Now we understand that we may need to back off the intensity, how often should we be working out if we have an autoimmune condition?  I like to say High Intensity work should not be done more than 2 times a week.  That would include intervals, Crossfit, intense cardio.  You should leave at least 2 days between those sessions for proper cellular repair and recovery.  In between, yoga, walking, leisurely biking are all amazing, repairing options.  You can also add some resistance training  like weight lifting or body weight movements like squats, push ups, pull ups, etc to the mix.  The key here is to keep your heart rate down when you are avoiding high intensity.  This may mean doing less initially which seems counter-intuitive because we all want to look good naked. However, chronic cardio and too much high intensity activity are driving your adrenals into the ground.  Once that happens, your body will begin taking building blocks from hormone production in order to try to keep up with cortisol production.  It doesn’t care how fertile you are, heavy your periods are, or how horny you are if it is trying to survive a flight or flight experience! As far as our genetics are concerned, stressful situations are life and death.  That is why de-stressing is so important.

If you have cut out gluten, upped your fat soluble vitamins, addressed you stomach acid, and quit taking miscellaneous medications, this could be your next step in the equation.  Exercise should be a positive challenge to the body.  If overdone, it most definitely acts in the opposite direction.  Choose something FUN.  I like group classes because community makes every second fun for me.  I really enjoy sports. Join a sports club.  Take family walks.  Movement does not have to be a dreaded to-do on the endless list.  It should and could be something you ENJOY and LOOK FORWARD TO!  If you haven’t found that type of movement yet, then keep searching.  Different strokes for different folks.  The more you can do outside, the better, too.


Medications and Autoimmune Healing (Part VI)

Before we get started, let me say that I am not rendering advice on what to do with your medications in this article!  I am simply going to explore how some common medications may be obstacles in your healing process.  If you have followed this journey, we started with how an autoimmune disease happens, touched on the involvement of heartburn, gluten, nutrient deficiency, and discussed how leaky gut is involved.  Most of the medications I talk about, I will place in the category of things you can control.   That means I will not be talking about immunosuppressants or other common autoimmune meds; I will be talking about drugs like: antacids, antibiotics, birth control, steroids, and pain relievers. Let’s get started with heartburn meds because we talking about heartburn and stomach acid one of the first articles.

PPIs (aka Nexium or Prevacid) and H2 blockers (aka Pepcid and Zantac):

If you would like a reminder of how important stomach acid production is, feel free to re-read the heartburn article.  If we consider that any disease healing process requires adequate nutrients, we also must consider if we are able to get those nutrients based on the health and performance of our digestive system.  Stomach acid is a major component for the beginning of our digestion and without adequate amounts, we develop issues such as GERD, heartburn, H. pylori, and intestinal dysbiosis.  If you are taking a stomach acid reducer, you are hindering the first step in food breakdown.  This sets you up for impaired digestion, decreased nutrient absorption, possible infection, and leaky gut.  That’s a very basic understanding.  If we get more technical, PPIs have been shown to interfere with antigen presentation mechanisms by affecting lysosomes.  They also obstruct the work of cytotoxic C cells. These are IMPORTANT for immune function, so you can imagine if you have created the perfect environment for leaky gut, which can trigger an autoimmune disease, then impaired digestion setting you up for infection which can trigger an autoimmune disease, then took a medication for the heartburn that interferes with appropriate immune system functions…insert cry emoji here.

Birth Control Pills

I have spoken before in brief posts about hormone health and how taking the pill to correct hormone imbalance may be doing more harm than good.  I have also been vocal about the pill and it’s ability to significantly increase clotting risks in women that can result in strokes or pulmonary embolisms!  This is not a medication to be taken lightly, and from first-hand experience, I know these risks are not brought up.  I was speaking to a nurse the other day about how interesting pregnancy can be in autoimmune conditions and how that speaks to hormone involvement.  I have had autoimmune patients tell me their autoimmune condition completely goes into remission while they are pregnant, and they wish they could trick their body into believing it’s pregnant all the time!  Sex hormones play a role in immune system function, so the decision to artificially alter them, may be causing an immune system issue.  In addition to directly changing hormones, they cause disturbance in the gut flora resulting in dysbiosis and many times leaky gut.  Remember leaky gut being how autoimmune issues start?!

Antibiotics

Antibiotics save lives.  Period.  However, they are way over-prescribed and many people take them multiple times a year.  If you are doing everything right, it can still takes months for the assault of antibiotics on your gut flora to fulling repair.  If we KNOW that the bacteria in your gut account for the majority of your immune system, then how could you not be worried to take a medication that would wipe them all out?!  Antibiotics are often broad spectrum and will have no issues wiping things clean, good and bad.  Imagine having to rebuild your house every time it got messy.  That is the task you ask of your body when you take antibiotics for every sniffle, sneeze and infection.  It is often common for antibiotics to be prescribed without a culture which means your infection could be viral.  Viral infections are not killed by antibiotics.  Antibiotics kill bacteria.  Oops.  In a nutshell, antibiotic need may be more scarce than you think, it has a dramatic effect on the bacteria balance in your intestines, and they should be avoided if possible.

NSAIDS (aspirin, advil, aleve)

These anti-inflammatory drugs are non-steroidal but they are used widely to control pain and inflammation.  So widely, that you probably have bottles in your purse, your bathroom, your desk drawer, etc.  I can say that I don’t even have a single bottle of these around and if I needed one on some off chance, I would have to go purchase them.  Most people know the dangers of taking too much because your doctor will warn you about how bad it damages your gut, which can result in ulcers.  I hope this connection is screaming at you before I tell you….wait for it….if they damage the gut, and your gut houses your immune system, then it can’t be good for conditions concerning the immune system! A SINGLE DOSE OF NSAIDs damages the intestine of even a healthy person.  It does this by inhibiting an enzyme called cyclooxygenase which is essential for maintaining the gut mucosal barrier. They also inhibit the formation of the proteins that keep tight junctions together (remember that cell lining gate being damaged).  These drugs are popped like candy because most people see them as harmless when you can buy them in the store.

Well, those are the major ones I wanted to hit because so many people are unaware of the negative side effects.  If these are part of your “health” routine, you may be causing more damage than good.  If you have an autoimmune disease, these may be a part of your routine that you can control.  There are tons of natural compounds that fight infection and decrease inflammation.  These can be found widely in foods and many supplements now exist.  Try cooking with turmeric, adding garlic to everything, using onions abundantly, and fresh herbs are crazy good in the medicinal department.  Funny how all this complex material always lands us back at basic lifestyle changes.  Nature is so smart.

 


Vitamin Deficiency and Autoimmunity (Part V)

For this section, I am going to focus on fat soluble vitamins specifically, which means vitamin A, D, E, and K. Fat soluble vitamins can be stored for later use unlike water soluble vitamins and tend to be the most deficient in the American diet for various reasons.  Each one of the fat soluble vitamins has potent effect on the immune system and therefore, deficiency in any of them, can put us on the path to immune system disorders (if we aren’t already there).  Fat soluble vitamins are found widely in animal products, so this tends to be a sticking point in the world of plant power.  Don’t worry though, even if you are a vegetarian, you can still get these vitamins without having to eat meat.  If you are a vegan, however, this may a trickier component to address.

Vitamin A. Vitamin A is important in the scope of autoimmunity because it is important for maintaining mucosal barriers.  You know just how imperative this is for the avoidance of leaky gut which is the precursor to every autoimmune disease if you read my previous articles.  Vitamin A also plays a major role in inflammation due to its connection with neutrophils, macrophages, and natural killer cells.  If someone has depressed immune system due to Vitamin A deficiency, they are at great risk for repeated infections.  One can always turn to supplements, but I would rather have someone get this nutrient through food.  I will never quit saying “food is medicine.”  You can find it in grassfed butter, liver, and pastured egg yolks.  If the animals producing these products are not eating their appropriate diet, however, these are not present in nearly the same quantities.  This is the reason I hit home the idea of food quality being worth every penny.

Vitamin D. Vitamin D is my favorite to talk about because most patients come to me with standard blood work including vitamin D.  This is a testament to the agreement among most all health professionals how important it is! We have the most research on Vitamin D; therefore, we know it plays key roles in the expression of over 200 genes and the proteins associated with those genes.  We need it for mineral absorption and bone health.  Vitamin D is essential for healing via its pathways that help cell growth.  AND, it is important in immune system regulation.   Vitamin D is so closely linked to autoimmune diseases that it has been suggested the deficiency may be the  CAUSE (via environmental trigger) of lupus, diabetes type 1, MS, rheumatoid, psoriasis, and IBD.  We see geographic implication too when we consider RA.  We know for a fact that stats show higher rates of RA the further away from the equator.  Why would this matter?  Because most Americans are relying on sunlight as their source for Vitamin D production.  It is synthesized from cholesterol found in the cell membranes of skin cells when we absorb UVB rays from the sun. Someone reading this may be thinking “Great!  I’ll go get some Vitamin D supplements today!”  I wish it were that easy.  Vitamin D works alongside other fat soluble vitamins in addition to plant nutrients  and hormones.  Just taking a Vitamin D supplement doesn’t address the increased need for the other nutrients.  This gets crazy and complex in the world of supplementation.  You’d take 1,000 supplements and still not touch all the things you get from real food.  Additionally, if you didn’t address the dietary aspects like wheat, then you are ingesting foods that actually reduce Vitamin D in the body! Lifestyle matters.  There is no shortcut to going outside in the sun, ingesting healthy fat sources, and avoiding toxins and inhibitors.  Let me repeat: there is NO DRUG OR SURGERY that can make up for a lifestyle issue.  Period.  *Vitamin D levels for someone with an autoimmune disease need to much higher than the general population; therefore, being within normal range is not adequate!

I’m going to skip Vitamin E and say a quick word on Vitamin K because this one tends to be gaining clout in the health industry. Vitamin K is also essential for bone and tooth health and studies are being done on its link to osteoporosis for this reason.  It also plays a role in protecting against oxidative damage and regualtes the immune system.  Unlike other fat soluble vitamins, you can get this from fermented foods in addition to pastured animal products!  Bacteria produce this when they are doing their job and therefore, your bacteria in your gut can also make Vitamin K in your small intestines by converting K1 that they find in your leafy greens!  Let’s hope you haven’t been taking antibiotics regularly, or you may be at a deficit here, too.  Your bacteria levels are so important, and anything working against them is also helping the disease pathways catapult.

So, let’s just think about this full circle for a moment.  You were born with genes that give you a predisposition for some of this.  However, you don’t have it expressed necessarily unless you create the right environment.  You create that environment by taking antibiotics, heartburn meds, staying away from the sun (or blocking it), lacking grassfed animal products in your diet, eating things like wheat (possibly every meal!), and we haven’t even talked about the connection of stress! or exercise!  or sleep! or chemical exposure! You can now see why we have taken a massive wrong turn in our society when it comes to our food supply providing us nutrients, our lifestyles prioritizing stressful and depleting behaviors, and then our tools for correction are not addressing the underlying causes.  That is why we are not getting better.  That is why people get sick and stay sick.  That is why, despite the fact that I am ONE PERSON, I am on a mission.  Even if you read this and never do anything about it, I have done my job.  I am not here to make a decision for you.  But if you choose the same decision given all the information, then at least it’s informed decision making.  That’s more important to me than anything.


Gluten’s Part in Leaky Gut and the Autoimmune Cascade (Part IV)

If you have been following along, we have now established how an autoimmune disease starts, what gut permeability is, how stomach acid may be a problem, and now we can start talking about what causes it in our lifestyle that we can control!  On one hand, I am oversimplifying this part of the discussion so that I can focus on the aspects that you can actually have control over.  I am skipping over some of the things out of our control like certain genetic attributes, environmental exposures, and infections that may have been just bad luck in terms of wrong place, wrong time.  However, even those factors can be overcome most of the time with proper care.  So, lets get to it!

Gluten: Yes, I am starting with our beloved friend, gluten.  Why?  Because this is the most controversial topic that flies around and it’s simply hard for most people to understand how on Earth, eating a bagel and some bread can cause such a problem as serious as autoimmunity….especially if their physicians haven’t said a word about it, or may have even discounted the connection when a patient asks.  If I could have everyone start with A SINGLE change, this would be it.  Antibody production against gluten has been reported to affect as much as 30 percent of the population!  The mechanism by which it contributes to leaky gut has to do with zonulin.  Zonulin is a protein sent into the gut by that single layer of cells called enterocytes and regulates the opening and closing of the tight junctions (shout out to all my AP101 students!  remember those tight junctions I tested you over?!) that hold the cells together.  They are kind of like the pegs that allow legos to fit together in a flush manor.  Gluten has the ability to increase zonulin and therefore increase the amount of time those tight junctions are open, allowing undigested proteins, bacteria, and toxins to cross over inappropriately.

There are also pathways where a enzyme known as transglutaminase is affected.  Transglutaminase is an enzyme that is important in protein modification as they are produced in the cell.  (I promise to not start talking about transcription and translation!) This enzyme activity is increased in the lining of the intestines when we consume gluten.  Increase of this enzyme’s activity increases the likelihood of antibody production against gluten.  The bigger issue is that if antibodies are produced against this enzyme, we can’t perform tissue healing like we normally would. So, let’s say you have tissue damage and one of your body’s ways of helping heal it is to send transglutaminase to the site, but because of increased gluten ingestion, you have created antibodies against it.  Now you are sending this enzyme to all these sick parts and your immune system is going “OMG, what is he doing here?!  Produce more antibodies!  We are gonna need ’em to eradicate him!”   When you start eating a gluten free diet, you decrease the antibody formation against transglutaminase and you decrease zonulin activity, which allows those junctions to stay shut.

*This part is my opinion although is a topic of discussion.  Why now and not before?  Wheat has changed in various ways.  We have changed it from Einkorn wheat to dwarf wheat in order to increase crop yields and increase gluten levels for desired texture of baked goods.  We also now have an issue with Round Up Ready seeds causing damage to our DNA by damaging the microorganisms living in our gut.  We are also not preparing wheat products like we originally did.  We no longer, soak, sprout, or ferment grains.  We NEED to do that in order to get nutrients out of the bran.  Anyway, I don’t know what the largest contributing factor is, and it may just be a combo; but I do know, that many patients do extremely well without these products in their diet.

According to Dr. Peter Osborne (who is an expert on gluten sensitivity), there are 140 autoimmune diseases that science has identified and the ONLY SCIENTIFIC agreement for the cause has to do with gluten and its many mechanisms by which is can cause this cascade of events.  I chose not to focus on a few of the other pathways that I usually do in a health talk like lectins and their contribution.  However, know that there are even more reasons that gluten can cause changes to the intestinal wall!

I’m going to stop there and do another article on more causes because this could get overwhelming.  So, what can you do TODAY?  Try to cut out all of the wheat products in your diet and see how you feel.  No bread, pasta, pizza, donuts, beer, etc.  When you think about it, you may be consuming these things multiple times a day!  If it’s contributing to your issues, you can also understand just how damaging it may be to consume them so regularly.  This alone, will not likely cure anything, but it may give you a huge step in the direction of feeling BETTER.  Most people with autoimmune diseases are willing to entertain the idea that something can make them feel better, and you can only gain other health benefits in addition if you cut out all those junk foods often containing wheat.  Check out my blog recipes for more ideas, but there are so many options out there!  Don’t get overwhelmed.  Just start.


Intestinal Permeability and Autoimmune Disease (Part II)

I have written several articles about our bodies being hotels for bacteria, and when the bacteria levels are balanced and the microorganisms are happy, we are healthy.  These bacteria make up so much of our immune system, its hard for me to fathom why we haven’t placed more focus on their role in studying disease.  It’s gaining traction, and therefore most people have heard the buzz phrase “leaky gut” thrown around somewhere.  In this article, we are going to discuss what it actually is, and how it has to do with autoimmunity.

Let’s start with the basics.  From your mouth to your anus, you have one long tube with stops along the way.  The mucosal barrier that keeps food in the tube, and not in your tissue, it technically ON THE OUTSIDE!  I know it sounds crazy, but that tube running down the middle of your body is an exterior surface. It’s comprised of a single layer of cells; that’s it!  Pretty amazing if you think about how food goes in one and end and comes out the other.  After food goes in your mouth, it has stops along the way and one of them is in the small intestines.  The small intestines is where most of your nutrients are absorbed into the body. The way nutrients get into the body through the section of tubing we call the small intestine is by specific breakdown that occurs via acid, enzymes, bile salts, and bacteria.  Proteins are broken down into their lego parts, amino acids.  Fats are broken down into fatty acids, and carbs are broken down into simple sugars. Once food is broken down into its simplest form, it’s ready for transport into the body.

In order to get into the body, digested nutrients have to cross that single layer of cells called enterocytes.  On the other side of the wall lives blood vessels, lymph vessels, and immune cells of the gut.  The amino acids, simple sugars, minerals, and water soluble vitamins (like B vitamins) are transported via blood and the fatty acids and fat soluble vitamins (like A, D, E, and K) are transported through the lymph. A leaky gut occurs when there is damage to that single layer of cells and things that shouldn’t be able to cross over, do.  This damage can occur by sections of cells themselves being damaged, or the bonds between them being broken. When this happens, now we have things like pathogens, incompletely digested proteins, bacteria, and toxic substances entering the territory where immune cells live.  The immune cells immediately recognize them as foreign and plan an attack.  However, if any of them get through that line of defense, now we have them floating in the bloodstream. The body frantically tries to clean it all up, and this produces a fairly global inflammatory state.

I think it’s worth mentioning that those undigested proteins stimulate a part of the immune system that produce IgE antibodies.  Food allergies that cause difficulty breathing, swelling, ER visits…those are due to this IgE response.  This is a TRUE allergy.  However, when antibodies such as IgGs are produced, this is what we call a food sensitivity. The reason we call it a sensitivity is because the immune response produces symptoms of allergies for example, fatigue, mucus drainage, inflamed sinuses, and possibly even things like eczema.  This is what doctors are testing for when they do a blood panel for food allergies!  If you have ever had a food allergy/sensitivity test and it came back with a list of crazy amounts of foods like chicken, spinach, strawberries, etc., you are most likely NOT allergic to those foods.  This is nothing more than a IgG production because food proteins got into spaces they don’t belong.  Once you heal the gut and keep those foods from crossing the gut lining, your body will QUIT producing antibodies against them.  I see this all the time when I work with food allergies.  You can absolutely resume eating most of those foods without issue as long as appropriate care has taken place.  I got off track….back to the antibodies. Of those antibodies being produced, some can be autoantibodies.  When cytokines (chemical messengers) are released, it stimulates both the innate and the adaptive immune system.  This pokes the bear of the adaptive immune system that can result in an autoimmune disease.  If you remember from the previous article, this is where amino acid sequencing can get confused for our own tissues.

I hope I didn’t lose anyone with crazy words, but I think this connection between how the food we eat gets to places it shouldn’t, and the immune response that results is an important one to know!! Why? Because autoimmune diseases live in about 50 million DIAGNOSED people and cancer is only 12 million.  Heck, heart disease is 25 million!  Needless to say, this costs our country more than just $100 billion dollars in direct care costs, it is costing us our quality of life!  Anytime I have a patient that is able to go about their day without worrying about the symptoms of an autoimmune disease, I do a happy dance.  It gives them their life back!  This is priceless.  In the upcoming articles, I will talk about which foods can create the perfect storm, and other lifestyle factors that damage that single layer of cells that keep the good stuff in and the bad stuff out.  These are things you CAN CONTROL!  I’m getting pumped up…can you tell…welcome to what it feels like to be in the audience when I give a talk.  I just can’t help myself….


How does an Autoimmune Disease Actually Happen?

Without the audience having an in depth knowledge of the body, this can be a confusing process to explain.  However, I’m going to put on my teacher hat and try my best to explain how your body could ever be so confused that it begins to attack it’s own tissues resulting in diseases such as Multiple Sclerosis, Rheumatoid Arthritis, Crohn’s, Psoriasis, Hashimoto’s, etc.  Even though these diseases are present in different systems within the body, the same mechanism of trigger initiates the cascade.  Every autoimmune disease is an IMMUNE SYSTEM disorder.  However, most people focus on the system involved by taking thyroid medication for Hashimoto’s, creams for psoriasis, digestive aids for Crohn’s, and the list goes on.  Most of the heavy duty medications on the market for these problems are immunosuppressants.  That means their entire job is to dampen the ability of the immune system to function in hopes it will quit attacking itself.  This has a nasty side effect of also leaving patients vulnerable to sickness because their immune system is being shut down (hence the fine print in commercials saying not to take them if you are sick, in contact with the sick, etc.)  Many patients will say “Isn’t there a way to help this WITHOUT shutting down my immune system?!”  The answer is “absolutely,” but you will not find those methods in medication.  I hope now you are asking “HOW?!”  Let’s look at how it happens to try to address that question later…

Proteins: Proteins are the building blocks of life.  They are made up of things called amino acids and we use about 20 different amino acids to build every single kind of protein that we need.  Based on how you put the amino acids in sequence, you can create different kinds of proteins.  These creations make up the cells of your organs, your hormones, and the antibodies we call immunoglobins.  You may have heard of some of these amino acids without even knowing it!  We have all heard of tryptophan around Thanksgiving because people blame the sleepiness on it’s presence in turkey.  Maybe you’ve heard of Glutamine if you are in the fitness industry.  Perhaps phenylalanine has popped up as you search the risks of artificial sweeteners?  These amino acids are essentially the legos that make up parts of your structure.

Well, these proteins tend to have a lot of similarities to the proteins in other life forms such as animals, plants, and even viruses.  For heaven’s sake, we have 67% DNA similarity to an earth worm!  Like I’ve said before, this is why biological principles are important to know; we all exist under the same fundamentals!  Small sections of these proteins are recognized by antibodies.  This is the recognition system for our immune system to be able to ID, tag, and get rid of foreign invaders by recognizing specific amino acid sequences present on the protein structure.  When the antibody binds to one protein, it’s common that it will also attach to other proteins containing a similar sequence. This is a good thing if those other proteins are also foreign invaders, but it’s a bad thing if the other protein happens to be our own tissue.

Don’t worry though, we have a quality control system.  Because of so much shared DNA sequencing, this happens all the time!  It happens in everyone really.  However, we have a process called “selection,” that allows T and B cells to recognize self and they are destroyed.  This is all happening in the bone marrow and the thymus gland (hence T and B cells, haha…ok, not funny).   It can also happen via suppression where certain T cells shut down autoantibody production from any cells that may have escaped the first check.  In a healthy individual, this system of checks and balances works beautifully!  However, for those with autoimmune conditions, the body has a breakdown in the second process and simply can’t keep up with the quality control process of destruction.  Let’s just say your employee came in drunk and is no longer paying attention to the bad specimens rolling through!   So, it’s not really a problem with the body making antibodies against itself, because everyone does that.  It’s more about a faulty system in the ability to keep them at a minimum.

Once this breakdown occurs, it’s much easier for the body to then create another autoantibody to a different tissue, which is why so many autoimmune patients can then get another autoimmune disease fairly easily.  When enough damage has occurred to the tissue being targeted, you will start to express systems of the disease.  This is when you show up at the doctor with digestive distress due to Crohn’s, or unbearable joint pain due to Rheumatoid, or heaven forbid the neurologic symptoms of MS.  Here is where the fork in the road happens.  How do you treat it?  You can take medication to address the symptoms presenting, you can take an immunosuppressant to try and shut down your body’s ability to produce antibodies (to itself or to foreign invaders), or you can eliminate the triggers that cause the immune system to attack in the first place.

The environmental triggers for immune system attack can include anything from vitamin D deficiency, bacterial infections, silicone implants, chemical exposures, and yes, intestinal permeability (aka leaky gut).  Even though genes may create the perfect recipe for an autoimmune disease, the environmental triggers are really what start the cascade of events.  This is the reason why many people will say that genes load the gun, but lifestyle pulls the trigger.  This is why it is so important to be testing for underlying infections, nutrient deficiency, eliminating chemical exposure, and doing all we can to correct leaky gut.  If you correct intestinal permeability, you can reverse an autoimmune disease.  I have done this over and over with patients, and the changes in their quality of life and thought of such a different future makes me overwhelmed sometimes.  THERE IS ANOTHER WAY.  If you don’t believe that, then I can only imagine the thoughts that run through someone’s mind knowing it will only progress and get worse.  That part of my job breaks my heart.

The silver lining is that even though you can’t control your genes, you CAN control your lifestyle.  I will be writing a number of articles focusing on different aspects of this including the story of gluten, dairy, nightshades, and eggs in addition to the powerhouses I utilize with patients including ferments, broths, and organs.  I never know much to simplify my explanations to help someone understand the connection, so I have decided to go a little bit more in depth on the blog.  That way I have the easiest answer possible “Go take a look at the articles on the blog and let me know if you still have questions!”  For a professor, it’s like trying to teach 8 years of physiology in 30 seconds (because that’s how long you have until people tune you out if they aren’t understanding).  Good luck with that one!  I hope you enjoy, and if you have any questions you would like to make sure I touch on along the way, feel free to shoot me a comment!