How Inflammation Is Burning Your Health

This article originally appeared on Healevate.

Chronic inflammation = disease. This is a profound statement that has broad ramifications for health and disease management everywhere.

If you look at the root causes of almost every single disease and death, you’ll notice that chronic inflammation is a player in the process.

Some inflammation is good—in fact, it’s a normal, healthy biological process. It’s only when inflammation goes unchecked for extended periods of time that it becomes a big problem.

Think of inflammation as a smoldering ember. If you have a few embers in one room of a 10-story building, it’s a small problem that’s contained. But if you have embers in every room on every floor of that 10-story building, now there’s a problem. Just a little puff of air might rekindle these embers into an actual fire again. Eventually, the heat from this small fire could grow, and the whole building could go up in flames.

This is similar to what happens in the body. A minor infection might cause a fire that turns into smoldering embers, and these embers die out when the infection is gone (if you have a healthy immune response).

If you’re stressed out, not exercising or sleeping well, or have poor nutrition, imbalanced hormones, and GI problems, there’s a good chance you have smoldering embers burning throughout your body, creating a low-level systemic fire.

If you don’t identify the causes of these small fires, they’ll wreak havoc on your body and cause full-blown diseases like diabetes, heart disease, cancer, Alzheimer’s, Parkinson’s, dementia, stroke, autoimmune conditions, or hundreds of other major diseases.

The good news is that the power to change this is in your hands, because every action you take each day either contributes to health or causes disease.

What Exactly is Inflammation?

Inflammation is a big buzzword in the world of health now, and rightfully so. The word inflammation comes from the latin word “inflammare,” meaning “to ignite,” and it’s your body’s response to danger signals.

Classically, inflammation describes the body’s immune response and biochemical processes to remove harmful stimuli, such as pathogens, toxins, irritants, or even damaged cells in an attempt to preserve itself and heal. Then we have the physical manifestations of inflammation: calor (heat), rubor (redness), dolor (pain), tumor (swelling), and loss of function.

This process is apparent when you have a cut on your arm, a bad sunburn, or a pimple. It’s less obvious when you have a viral or bacterial infection, since you can’t see the signs. What we’ve described here is acute inflammation. Acute inflammation is a normal process necessary for life; it allows you to survive scrapes and infections. It has a beginning and an end.

Conversely, chronic inflammation persists without end in response to hidden infections, toxins, chemicals, and/or foods or from lack of counter-regulatory mechanisms (chemical “off” switches) in the immune system that should turn inflammation off.2 Persistent cellular stress or dysfunction caused by a high calorie, low nutrient diet, oxidative stress, and hormone imbalances perpetuates this process.

Chronic inflammation is never a good thing. The major danger with chronic inflammation is that it’s silent, causing destruction for years or decades before it’s noticed (usually as the first signs of a disease), leaving significant damage in its wake.1 It could be raging inside you at this very moment without you even noticing. This kind of inflammation is what underlies almost every chronic illness and disease known to man.

Acute and chronic inflammation share a common origin, although they end with two very different products. The main differences between the two processes are:5

Acute Inflammation:

  • Elimination or isolation of the stressor (infection, toxin, chemical, etc.)
  • Usually a local response (anaphylaxis is the exception)
  • Usually adaptive with an appropriate response that begins and ends
  • Usually short in duration
    Often noticeable

Chronic Inflammation:

  • Maladaptive (the normal mechanisms that quench inflammation aren’t working)
  • Self-perpetuating/self-limiting
  • Disrupts normal balance (homeostasis) in the body
  • Alters normal cellular function
  • Destroys cells and tissue over time (like the degeneration of joints in arthritis)
  • Long duration (months to years)
  • Often unnoticeable or hidden

How Does Inflammation Occur?

The inflammatory process is a complex symphony of the response of the immune system and its interaction with many different types of cells and biochemical signals.

There are two main branches—the innate immune response, which occurs quickly and is more simple and nonspecific, and the acquired immune response, which occurs more slowly, as it’s more specific and has memory (so when you encounter the same trigger, such as a virus, your body is prepared for the attack).

Triggers, such as infection or injury, induce a series of biochemical events. Numerous substances are released simultaneously by the injured tissues, causing changes to the surrounding tissues.6

Remember our 10-story burning building? You can think of your injured tissue doing this just like you would turn on the sprinklers to dampen the fire and alert the fire department.

There are many chemical messengers that function in this process; however, the important ones to note are histamine, serotonin, bradykinin, lipid (fatty acid) derived mediators, cytokines, and acute phase reactants.

These chemicals are the “fire department,” with their many tools to put out the fire. They’re responsible for actions such as swelling (increased leakiness of the blood vessels), relaxation (dilation) or tightening (constriction) of the blood vessels, airways, and intestinal smooth muscle, and sending out chemical messages that turn on genes, recruit more helpers to the scene, or produce substances involved in the inflammatory process itself.

Histamine: Most people are aware that histamine is involved in the inflammatory response given the significant notoriety of antihistamines with allergies.

What many people are unaware of is that it also functions as an excitatory (stimulating) brain neurotransmitter producing wakefulness and anxiety, which is why many people with severe allergies, hives, or GI infections don’t sleep well.5,6 Its highest concentrations are in the gut, skin, lungs, and central nervous system (CNS), where many of the symptoms are felt.

Serotonin: This substance is best known as a brain neurotransmitter responsible for keeping you happy, calm, and well-rested. It’s also known for its role in the gut, affecting motility (how food and waste move through) and secretion of digestive chemicals. 95% is produced in the gut, and it can be significant in inflammatory GI disorders. You know that feeling when you get butterflies in your stomach, then have anxiety and maybe diarrhea? That’s serotonin. Together, histamine and serotonin are some of the first responders in the inflammatory movement.3,5

Bradykinin: This protein isn’t well-known by name; however, you’ve felt its effects many times before, since it’s a significant chemical in the inflammatory process. Bradykinin causes many of the actions of the inflammatory process (swelling, pain, blood vessel dilation, etc.) itself, or it signals other cells to participate and release their chemicals. It can also increase histamine release, making a response more intense.4 Bradykinin is most often released from tissue damage or exercise.4

Lipid Derived Inflammatory Mediators: This is a fancy term for chemicals derived from the oxidation (the loss of electrons from molecules—think rust) of the omega-6 fatty acid, arachidonic acid (AA), and omega-3 fatty acids’ eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Like histamine, you may have heard of some members of this group of chemicals before, since prostaglandins and leukotrienes are called out in the inflammatory process in advertisements.

They’re short-lived, signaling molecules found in most cells that modulate all aspects of the inflammatory process, including the resolution of inflammation, and they have system-wide influence on nerve transmission, mood, and hormone secretion.5,7,8

Cytokines: These are the primary chemical switches that turn the immune response on and off. They activate and recruit other cells to the immune response and assist in antibody production. Cytokines are responsible for fever production and participate in the allergic response, as well as antimicrobial and antiviral activity.5,7,8

Tumor necrosis factor alpha (TNFɑ) is one of the most important cytokines involved in systemic inflammation; it regulates other cells of the immune response. It has antiviral and anti-tumor activity, and dysregulation is implicated in obesity, Alzheimer’s, cancers, depression, and IBD.5,7,8

Acute Phase Reactants (APR): APRs are a category of proteins produced in the liver that increase or decrease in response to inflammation. Some of the most notable are C-reactive protein (CRP), ferritin, and fibrinogen.

CRP increases rapidly with inflammation and marks damaged cells, making them easier to identify for elimination. Once it rises, it’s cleared rapidly from the system.11,12

Ferritin, an iron carrier protein, increases in response to most infections, except a few bacterial strains.11,12 Fibrinogen is a coagulation factor promoting clot formation that increases with inflammation. ESR (erythrocyte sedimentation rate), also considered to be an APR, describes the rate at which red blood cells fall in a one-hour period and correlates to fibrinogen levels.11,12

Other aspects of the inflammatory response involve the formation of antibodies to specific antigens and the blood clotting system. Antigens are proteins found on all cell surfaces, and when the immune system identifies them as foreign, it forms a corresponding antibody to it. Antibodies either neutralize the foreign invader or prepare it for phagocytosis (engulfing of a foreign particle for elimination).9

The process of blood clotting (coagulation) involves a group of proteins that convert clotting factors (such as prothrombin, thrombin, and fibrinogen) to a fibrin clot. The pathway is linked to inflammation since the clotting process, which occurs outside of a cell, can trigger the inflammatory signaling inside of a cell.

These processes operate in a feedback loop that promotes one another, and when left uncontrolled, this loop can be a problem in chronic inflammation—especially cardiovascular disease, clotting disorders, and hormone imbalances.10

All of these chemicals signal in various ways to elicit the response that produces redness, swelling, heat, immobility, and pain—as they should—but the body is smart and knows that the inflammation must end.

Dr. Robert Rountree, MD, states, “Simultaneously, the body activates biochemical counter-regulatory pathways (off switches) that produce anti-inflammatory mediators such as lipoxins, protectins, and resolvins. These are lipid mediators that are made on demand from the omega-6 fatty acid, arachidonic acid (AA), and the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) specifically for the purpose of turning off the inflammatory response.”2

This pro- and anti-inflammatory balance is the adaptive immune process, and it’s what should happen after an acute injury where the body identifies and responds to the insult or invasion, then repairs the injury and the process ends.

This process becomes a problem in two scenarios. First, when this response is exaggerated, producing a severe allergy or anaphylaxis. Second, when the cause of acute inflammation persists without end or the counter-regulatory mechanisms (anti-inflammatories) are compromised, producing chronic inflammation. Acute inflammation from a wound, infection, or a food allergy will cause systemic, chronic inflammation if not identified and treated.

Additionally, when the normal mechanisms that quench inflammation are decreased (or pro-inflammatory processes are increased), chronic inflammation will ensue. Inflammation begets inflammation, so it’s important to identify the triggers to stop perpetuating the cycle.

Functional medicine cardiologist Dr. Mark Houston says it best: “The body has a limited number of options to deal with an unlimited number of insults.”

Triggers of Inflammation

There are many triggers of inflammation, and often several are operating in concert together, propelling the cycle forward.

What these triggers have in common is that they generate free radicals or reactive species from oxidative stress and/or the inflammatory chemicals discussed previously.

Free radicals and other reactive species are produced as a product of oxidation, which involves the removal of one electron from an atom, rendering it unstable or reactive.

Your body obtains energy by combining fuel from the foods we eat with the oxygen we breathe in a controlled metabolic process that yields potentially dangerous oxidative byproducts that damage DNA, mitochondria, proteins, and cell membranes if we don’t have the appropriate antioxidant and anti-inflammatory mechanisms in place.

Oxidative stress isn’t only generated when you eat, but also during exercise, detoxification, and when the immune system is activated in the inflammatory response.

The good news is that many of these triggers are modifiable lifestyle factors or conditions that can be tested for, identified, and reversed. Dr. Mark Hyman, MD explains the importance of identifying the causes, explaining, “My job is to find those inflammatory factors unique to each person—to see how various lifestyle, environment, and infectious factors spin the immune system out of control, leading to a host of chronic illnesses.”16

The most common triggers are:

  • Diet
  • Stress
  • Dysbiosis
  • Infection
  • Hormone imbalance
  • Toxins

Trigger: Diet

Diet, for most people, is the single most important lifestyle change that can significantly impact chronic inflammation.

The food you eat sends chemical messages to your genes, which will either turn up or turn down inflammation. The following are pro-inflammatory foods (so you should think about avoiding them):

Gluten: A protein that has been hybridized (changed from its original form through breeding, not genetic modification) to the point that your body sees it as foreign and reacts to it. This reaction upregulates the immune system and will continue until the gluten is removed.

Food Sensitivities and Allergies: Gluten, dairy, corn, soy, yeast, eggs, and nuts are the most common offenders. When your body is constantly bombarded by these irritants, leaky gut, or increased intestinal permeability occurs, allowing larger food particles to enter your blood, and the immune system responds. Since you eat several times a day, the result can be a continuous cycle of inflammation and immune upregulation until the source is eliminated.

GMOs: Genetically modified foods that your body can’t identify can trigger an immune response similar to a food sensitivity. The largest GMO crops are corn, canola, soy, sugar beets, zucchini, yellow squash, and papaya, many of which are pro-inflammatory to begin with.

According to Dr. Tom O’Bryan, BT (botulinum toxin) in GMO foods has been shown to cause severe intestinal permeability in insects.23 Dr. O’Bryan also warns that BT toxins have been found in maternal and fetal blood, so we know they’re getting absorbed when we consume them.23

Sugar and Refined Carbohydrates: Your body is only designed to handle small amounts of natural sugar, and there are several issues with exceeding this amount.

First, refined sugar and carbs are genetically unfamiliar, which is a problem.11 Second, when you consume sugar or carbs, especially in large amounts frequently, it causes a rapid rise in blood sugar. If you need fuel, your body will use it; otherwise, it gets stored in muscles as glycogen or in fat cells.

If you have decreased insulin sensitivity or diabetes, this storage process is inefficient, leaving sugars in circulation, which spells trouble because it leads to the formation of free radicals from increased oxidation. Too much insulin release is pro-inflammatory as well.11 Excess sugar also promotes yeast overgrowth and dysbiosis (higher amounts of bad bacteria versus good bacteria), which further encourage inflammation.

Conventional Dairy and Meats: Meat and dairy raised in a conventional manner (grain-fed versus grass-fed) have the same health problems humans do, since they weren’t meant to eat grain.

Consuming all of these grains leads to a higher production of pro-inflammatory omega-6s and fewer omega-3s in these animals. When you eat them, you’re increasing your levels of pro-inflammatory fats as well. Some of the proteins (especially A1 casein) found in dairy are known to promote inflammation according to Dr. Kelly Brogan.13

Bad Fats: Most Americans have a dietary (and bodily) imbalance in their omega-6/omega-3 ratio, which causes your body to be in a pro-inflammatory state. Corn, safflower, sunflower, soy, and peanut oil are all omega-6s. Also, healthy fats such as olive oil, nuts, and nut oils are degraded (oxidized) when used in cooking at high heats or when storing them improperly, leaving them vulnerable to oxidation due to air exposure.

Consuming these now rancid (oxidized) fats is inflammatory. Chemically altered trans fats (hydrogenated oils, margarine) in processed foods are potent drivers of inflammation as well.

Processed Foods: These foods contain additives, colorings, dyes, and preservatives that your body sees as irritants or toxins. Because these foods are foreign to your body, they may induce an immune response.

Alcohol: It’s well-documented in literature that alcohol consumption decreases immune function.14 Alcohol and its by-products are direct toxins and irritants to the body, especially the gut, liver, and brain.

Advanced Glycation End-Products (AGEs): AGEs are produced as a result of a glycation reaction, when a sugar reacts with a protein or fat. AGEs form stable molecules that embed in tissues, causing oxidative damage, and are difficult for the body to get rid of. In food, they occur by cooking at high heat as with grilling, barbecuing, deep frying, broiling, and searing—basically anything that gives color or texture. The higher the heat, the more AGEs that form.

Meats, sugary foods, and processed foods are particularly high in AGEs. They also occur naturally in your body, and the higher your blood sugar, the more these will form, so limiting sugars and maintaining blood sugar is important. Fructose is particularly reactive, so limiting daily intake to 25 g or less is best.15

Low Phytonutrient and Antioxidant Consumption: A diet low in a broad array of plant-based nutrients is associated with increased levels of inflammation, even if you’re eating “the right things.” Decreased intake of fruits and vegetables is associated with developing inflammation that preceded metabolic syndrome and heart disease, among others.16

Trigger: Stress

Stress as a trigger for inflammation is just as important as diet is. It could be argued that stress is more so, actually, since stress comes in so many different forms that all add up when combined in our hectic modern lives.

Physical Stress: Trauma/injury, surgery, and exercise (too much or too little)

Chemical Stress: Toxins, metabolic waste and oxidation, infections, allergens, chronic illness, autoimmunity, medications, hormone imbalances, food, and drink.

Emotional Stress: Work, finances, relationships, job change, marital change, death of a loved one, birth of a child, etc. This is what people commonly refer to as “stress” in their lives. These stressors are often the hardest to control and can have a profound impact on healing.

It’s important to note that the body doesn’t discern between different types of stresses. Similarly, it can’t perceive the difference between good stress (birth of a baby or a new job) and bad stress (loss of job, divorce) and will react the same.

Anything that disrupts homeostasis will be perceived by the body as a stressor, and it will act accordingly in an effort to keep you alive.

Stress, like inflammation, is good when the response is appropriate and controlled. It initiates the ‘fight or flight’ response meant to keep you alive when danger is present (like when you encounter a bear and need to escape), like blood rushing to your brain to keep you focused. Simultaneously, non-essential functions like digestion and reproduction are decreased.

Just like with inflammation, counter-regulatory off switches exist so that the stress response ends. This was great in paleolithic times; however, in modern life, we have an overabundance of stress that doesn’t seem to stop.

Our stress response never ends, disrupting the mechanisms that should bring us back in balance. This causes several physiological changes that potentiate inflammation.

Chronic stress causes the sympathetic nervous system to be upregulated and increases levels of the stress hormone cortisol.

Over time, constant cortisol elevation leads to cortisol resistance, where the body must pump out even more to meet the same metabolic demands.

When this occurs for extended periods of time, cortisol levels become chronically low and adrenal fatigue develops. Cells of the immune system become insensitive to cortisol’s regulatory effect and don’t respond, which promotes inflammation.17

Not only does stress promote inflammation, but it also lowers immunity. A 2012 study by Dr. Sheldon Cohen revealed that prolonged exposure to a stressful event was associated with the inability of immune cells to respond to hormonal signals that normally regulate inflammation.

In turn, those with the inability to regulate the inflammatory response were more likely to develop colds when exposed to the virus. “The immune system’s ability to regulate inflammation predicts who will develop a cold, but more importantly it provides an explanation of how stress can promote disease,” Cohen said. “When under stress, cells of the immune system are unable to respond to hormonal control, and consequently, produce levels of inflammation that promote disease. Because inflammation plays a role in many diseases such as cardiovascular, asthma, and autoimmune disorders, this model suggests why stress impacts them as well.”17

Prolonged stress upregulates (turns up) pro-inflammatory genes, resulting in increased susceptibility to infection, slower wound healing and resolution of illness, and increased risk of serious illness and premature aging from the effects of cell damage.

Trigger: Dysbiosis

Dysbiosis occurs when there’s an imbalance between the beneficial and harmful organisms in you body, especially the gut.

Normally, you have helpful bacteria and even some yeast that help you digest food, produce nutrients, and protect you from harmful organisms as well as inflammation.

Dysbiosis arises when there’s a general imbalance between the good and bad flora, or when there’s a pathogen or infection present, such as SIBO (small intestinal bacterial overgrowth), Candida (yeast), or a parasite.

Research shows that a decrease in certain gram-positive bacterial species is associated with inflammation, since they’re responsible for producing short-chain fatty acids (SCFA), which act to decrease some of the inflammatory signaling molecules and enhance the immune response.18

Additionally, an increase of certain gram-negative bacterial species promotes inflammation because most of them contain lipopolysaccharide (LPS) in their outer cell membrane. This is an endotoxin—as the name suggests, that’s bad because it promotes inflammation by eliciting a strong immune response and contributing to leaky gut (increased intestinal permeability).

SIBO arises when there are more bacteria in the small intestines than there should be. Normally, there are much fewer bacteria in the small intestines than the colon since the small intestines function more in digestion and absorption of nutrients. SIBO infections can promote inflammation through the imbalance of bacteria, leaky gut, nutrient malabsorption, and the imbalance of histamine and serotonin.

Candida (yeast) is a fungus that aids in digestion and nutrient absorption. It’s opportunistic, becoming pathogenic and increasing in numbers if your immune system is compromised from stress or illness, or if your diet is high in sugar and carbohydrates.

Research shows that Candida infection delays healing, and the inflammation from the infection promotes further colonization of yeast, creating a vicious cycle of low-level inflammation and infection.19

Parasites are literally everywhere. Giardia (sometimes called beaver fever) and Cryptosporidium are some of the parasites that make the headlines occasionally, even though there are a plethora that exist. Acute parasitic illness manifests with the typical symptoms of diarrhea, vomiting, stomach pain, bloating, fever, and malaise. Most resolve with the normal immune response.

Chronic infections, however, can range from asymptomatic to severe, with blood and mucus-filled stools, profuse diarrhea, and malnutrition. These infections contribute to inflammation through decreased nutrient absorption, constant immune system attack, and interrupted sleep patterns.

Trigger: Infections

Infections other than typical GI infections are also a common source of inflammation; they often go undetected for long periods of time, allowing them to wreak havoc on the body and the immune system.

Some more obvious infectious agents are mold (fungal infection), Lyme and other tick-borne illnesses, and chronic viral infections like the Epstein-Barr virus (EBV). Less obvious and often hidden infections that can go undetected for years are abscesses from trauma or surgery, but especially dental procedures.

Mold: Describes a group of fungi that are ubiquitous. Their spores are often airborne and deposit everywhere, which is why you find white or green fuzzy patches on your produce or bread. It can be associated with dysbiosis or systemic infection.

The toxins (mycotoxins) that come from mold are very harmful, producing symptoms ranging from mild to severe fatigue, sore throats, nosebleeds, headaches, diarrhea, brain fog, food sensitivities, and memory loss. These symptoms often mimic other conditions, which delays diagnosis and allows inflammation to proliferate.

Tick-Borne Illness: Tick-borne illnesses are becoming more prevalent and are often hard to diagnose. Lyme disease, an infection acquired through the bite of a tick infected with the bacteria Borrelia burgdorferi, is the most well-known of this type of infection. Babesia, Rickettsia (Rocky Mountain Spotted Fever), Ehrlichia, and Bartonella are also frequently identified infectious bacteria from tick bites. These infections not only take a toll only the immune system itself, but also the gut, contributing to decreased GI motility and dysbiosis.

Chronic Viral Infection: A common but not often talked about cause of systemic inflammation. The problem with viruses is that they can remain latent (inactive) for extended periods of time and don’t reactivate until there’s a trigger.

Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are two herpes family viruses that can remain latent after initial infection and only become active again under stress or immunosuppression. EBV, the infectious agent in mononucleosis, is also associated with the development of several types of cancer and autoimmune conditions. Chronic activation of the immune system produces inflammation with undetected viruses.

Abscesses: Can occur after any type of tissue injury such as trauma, surgery, infection, or dental procedures (especially a root canal). They form when incomplete healing takes place, either from a physical barrier or because the body can’t mount an appropriate immune response to kill off the bacteria.

The constant activation of the immune system produces chronic inflammation, and many systemic symptoms can go on for years—this is one of the most difficult causes to detect, since most people forget about a procedure or discount an injury.

Trigger: Hormone Imbalances

Hormones need to be maintained in a delicate balance for proper function. When any hormone is too high or too low, many of the other hormones shift as well, causing imbalances throughout the system.

Cortisol, DHEA, insulin, estrogen, progesterone, and testosterone all have effects on each other, as well as other hormones, which all impact inflammation.

Generally, androgens (testosterone and DHEA) have a suppressive effect on the immune response and inflammation while estrogens increase the immune response. Research suggests:

“Low levels of androgens as well as lower androgen/estrogen ratios have been detected in body fluids (blood, synovial fluid, saliva) of both male and female rheumatoid arthritis patients, supporting the possibility of a pathogenic role for the decreased levels of the immune-suppressive androgens.

“Several physiological, pathological, and therapeutic conditions may change the sex hormone milieu and/or peripheral conversion, including the menstrual cycle, pregnancy, the postpartum period, menopause, chronic stress, and inflammatory cytokines, as well as use of corticosteroids, oral contraceptives, and steroid hormonal replacements, inducing altered androgen/estrogen ratios and related effects. Therefore, sex hormone balance is still a crucial factor in the regulation of immune and inflammatory responses.”

Adrenal fatigue with lowered cortisol and DHEA, estrogen dominance in women (with a relative low progesterone level), and low testosterone in men (with a relative elevation in estrogen) all create an imbalance that skews the body to a pro-inflammatory state. This state can be further exacerbated by poor blood sugar regulation.

Proper blood sugar regulation is critical in maintaining hormone and inflammatory balance. Excessive insulin is pro-inflammatory, as is the activity of the enzyme aromatase, which is increased by insulin.

Aromatase is the enzyme that converts androgens to estrogens, and it has a great deal of influence on the production and balance of sex hormones. Many cell types have aromatase activity, but adipocytes (fat cells) are of particular interest because the more you have, the more active aromatase is.

If you’re insulin-resistant, diabetic, or overweight, the enzyme aromatase will become upregulated, promoting inflammation. Insulin resistance (high insulin levels) and excess body fat increase estrogens, which increase aromatase and inflammation in a vicious cycle.

In addition, elevated blood sugar levels from insulin resistance create more inflammatory compounds, worsening the situation. This is why poor blood sugar regulation combined with excess body fat creates the perfect inflammatory storm and provides a base for many chronic illnesses.


Trigger: Toxins

Toxins are virtually all around us in modern life, from pollutants in the air we breathe, the water we drink and bathe in, and the foods we consume to the products we use to clean ourselves, our homes, and our possessions. They can also be produced in the cooking process and in our guts.

The process by which toxins cause inflammation is multifactorial. According to Chris Kresser, LAc, MS, “Environmental toxins interfere with glucose and cholesterol metabolism and induce insulin resistance; disrupt mitochondrial function; cause oxidative stress; promote inflammation; alter thyroid metabolism; and impair appetite regulation.”

The thyroid is particularly sensitive to chemicals and oxidative stress. With increased exposure, thyroid function decreases, producing a hypothyroid state that triggers weight gain and supports inflammation.

Toxins you’ll want to minimize exposure to include heavy metals (mercury, lead, aluminum, arsenic, cadmium, etc), tobacco smoke, air pollution outside and in the home, pesticides (organophosphates), herbicides, plastics (BPA, BPF, BPS, phthalates, polystyrene, PVC, etc.), chemicals (toluene, xylene), and preservative and chemical-laden personal care products and foods. This list is a good place to start, but it’s not exhaustive.

Toxins can also come from cooking at high heat. When food darkens in color, it not only produces AGEs but also heterocyclic amines (HCAs), especially in meats. Consumption of HCAs is linked to many types of cancer since it alters genes (mutation) and promotes inflammation.21 And if your detoxification systems are impaired, the effects can be magnified because of the free radicals and oxidative stress generated. Dr. Robert Rountree says, “Eating a burnt burger is really no different than smoking a cigarette.”24

Symptoms of Inflammation

Anything that ends in ‘itis’ means that it’s inflamed. Appendicitis literally translates to “inflammation of the appendix.” Other than the obvious ‘itis’ conditions, here are other symptoms associated with chronic inflammation:

Immune: Allergies, asthma, autoimmune disorders, chronic or recurrent infections that won’t resolve (such as sinusitis or UTIs)

Skin: Dermatitis, eczema, acne, rashes, hives, redness, pruritis (itchiness), petechiae (broken blood vessels)

Gastrointestinal: Food sensitivities, food allergies, GERD (acid reflux), IBS, IBD, and infection or dysbiosis that can produce gas, bloating, diarrhea, or constipation

Brain and Mood: Headaches, brain fog, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia

Nerves: Tingling, pins and needles, paresthesia

Hormonal: Poor blood sugar regulation (especially high blood sugar), weight gain or loss, imbalanced female and male hormone systems, poor sleep quality, thyroid imbalances, adrenal imbalances

Cardiovascular: Hypertension (high blood pressure), high cholesterol, anemia

Musculoskeletal: Joint and muscle pain, fibromyalgia

Liver: Poor detoxification, elevated liver enzymes

Chronic inflammation affects literally every cell in your body. Virtually all significant diseases and conditions are related to chronic inflammation.

If the above symptoms are ignored, they can become a full-blown condition like a heart attack, congestive heart failure, diabetes, cancer, Parkinson’s, Alzheimer’s, ulcerative colitis, Crohn’s, Celiac, Hashimoto’s (autoimmune hypothyroid), Grave’s (autoimmune hyperthyroid), stroke, Lupus, multiple sclerosis, rheumatoid arthritis, osteoarthritis, psoriasis, scleroderma, hepatitis, pancreatitis, autism, ADD/ADHD…the list goes on.

Lab Testing for Inflammation

Testing for inflammation can be exhaustive. This is a good list to start with to investigate general inflammation.

Root cause testing, including allergens, food sensitivities/allergies, heavy metal and toxin exposure, mycotoxicity, GI infections and dysbiosis, hidden infections, autoimmune conditions, and hormone testing may also be necessary.

General Inflammation:

  • High sensitivity C-reactive protein (hsCRP)
  • Erythrocyte sedimentation rate (ESR)
  • Ferritin
  • Homocysteine
  • Lipoprotein a (Lp(a))
  • Apolipoprotein A1 and B (Apo A1 and B)
  • Complete blood count
  • Vertical Auto Profile (VAP) cholesterol test or lipoparticle protein testing (LPP)

Adrenal Testing:

  • Salivary cortisol testing with DHEA

Blood Sugar Regulation:

  • Blood glucose (blood sugar)
  • Fasting insulin
  • Hemoglobin A1C

Oxidative Stress:

  • Telomere testing
  • 8-hydroxy-2-deoxyguanosine (8-OHdG)
  • Lipid peroxides

Treatment of Inflammation

The treatment of inflammation can seem daunting since there are so many different causes.

The easiest approach is to clean up the diet, add in nutrients and make lifestyle modifications.

If you’re not getting the desired results, do some further investigating into root causes such as food allergies, autoimmunity, GI infections, impaired detoxification, toxic exposures (mycotoxins, heavy metals, chemicals), hidden infections such as Lyme or EBV, and proper hormone balance.

Diet: Dr. Mark Hyman, MD suggests, “Eat an organic, whole foods, high fiber, plant-based diet, which is inherently anti-inflammatory. That means unprocessed, unrefined, real food high in powerful anti-inflammatory plant chemicals called phytonutrients.”27

As Dr. Josh Axe notes, “Antioxidants are self-sacrificing soldiers that donate an electron to neutralize free radicals and are consumed in the process.” He suggests eating brightly-colored vegetables and fruits, cocoa, and green or white tea.25

Dr. Hyman also recommends getting an oil change. “Eat healthy fats from olive oil, nuts, avocados, and omega-3 fats from small fish like sardines, herring, sable, and wild salmon.”27 These fats are anti-inflammatory and promote a healthy omega 3:6 ratio.

An elimination diet may help you find out if there are foods contributing to your inflammation. Eliminate these foods for at least 30 days and note how they make you feel when you add them back in.

Cooking your foods at a lower heat will help them retain nutrients and avoid forming harmful substances. Author Mark Sisson recommends poaching, boiling, steaming, braising, baking, or using a pressure cooker or crock pot.28 If you really want to grill or cook at high heat, marinating with olive oil, citrus, and herbs or spices will reduce toxin formation.

Nutrients and Supplements: There are many anti-inflammatory nutrients found in fruits, vegetables, teas, coffee, herbs, and spices. Here are some that can be helpful if you experience inflammation:

Magnesium and vitamin D exert anti-inflammatory action by decreasing cytokine production and prostaglandins, respectively.1,31

Vitamins C and E, zinc, and selenium function as antioxidants and protect against oxidative stress.

Curcumin blocks activation of a key protein that triggers the immune response and decreases cytokine activity according to research out of Ohio State University.29

Ginger is a root that has uses in many ancient traditional medicine systems. Ginger is an anti-inflammatory and a blood thinner.30

Boswellia (frankincense) is an Ayurvedic herb that, when taken orally or topically, provides anti-inflammatory properties through inhibiting pro-inflammatory enzymes.30

Alpha lipoic acid (ALA) functions as an antioxidant and supports healthy mitochondrial function.31

Essential fatty acids (EPA and DHA) from fish oil or krill oil is important since humans don’t efficiently synthesize it themselves. They modulate the inflammatory response and maintain balanced fatty acid ratios.1

Probiotics (“good bacteria”) increase the levels of healthy bacteria in your gut, which reduces inflammation.

According to neurologist Dr. David Perlmutter, turmeric (curcumin), green tea extract, pterostilbene (from resveratrol), glucoraphanin (from broccoli), and coffee activate an important anti-inflammatory pathway (Nrf2), and taking these nutrients as supplements can be far more effective at increasing antioxidant production than typical antioxidants.26

Lifestyle Modifications: These are some of these easiest and most effective ways to reduce inflammation. Incorporating them into your life as habits will help promote long-term inflammation management.

Exercise: This is one of the most effective ways to decrease inflammation, since it has so many benefits—improved insulin sensitivity and body composition, decreased stress (when you don’t overdo it), and decreased signaling of inflammatory chemicals.32

Stress reduction: Stress is one of the biggest contributors to chronic inflammation, and managing it essential to lifelong health. Identifying stressors is the first step. Once you’ve done this, create boundaries, say “no” when you have to, and make sure your feelings are heard and understood.

Relaxation: Learn to actively relax to engage your vagus nerve, the powerful nerve that relaxes your whole body and lowers inflammation, by doing yoga, meditation, deep breathing, or even taking a hot bath.27

Sleep: Getting adequate sleep is essential to healing. Aim for a minimum of 8 to 9 hours per night, and try to get to bed by 10 PM. Sleep in a dark, cool, and quiet room for the most restful results.

Unplug: Being constantly tuned in to your phone, computer, iPad, tablet, or TV exposes you to radiation and can also alter your sleep cycle due to blue light stimulation.

Detox your personal care products: If you won’t eat it, don’t put it on your body. Opt for natural or organic lotions and creams, shampoo, conditioner, toothpaste, deodorant, and fragrance. You can make many for low cost at home from coconut oil, essential oils, and other common household items.

Detox your home: Look for natural and organic products here too to avoid toxic chemicals. Many cleaners are now being made from enzymes and plant soaps. You can also make homemade ones from vinegar, lemon juice, baking soda, essential oils, and more. Keeping lots of green plants in the home helps detox the indoor air as well. Look for rubber plants, aloe, peace lilies, areca palm, golden pothos, and English ivy.

With a little detective work and some requisite effort, you could be well on your way to putting out the fire from within your own body that’s robbing you of your health. Learn to listen to your body and to notice the obvious signs. Your body is an incredible machine that’s designed to want to heal. All it asks of you is to provide it with an environment that’s conducive to this objective.

Testing For The Root Cause Of Your Digestive Problems

This article originally appeared on Healevate.

Nothing says good morning quite like pooping into a toilet hat and transferring part of that specimen, using a spoon, into a test tube. While this might sound a little gross on the surface, it can tell you a lot about your health.

The condition of your gut and how well you can absorb, utilize, and eliminate nutrients represents the foundation of health in your body. Digestive symptoms manifest as anything from brain fog, fatigue and acne, to diarrhea, gas, and bloating. The symptoms are vast and can be confusing, so clearly knowing what you’re looking for helps.

Symptoms of Digestive Problems

Understanding your symptoms can be a useful guide for choosing the correct test.

GI: Gas, bloating, belching, stomach pain, constipation, diarrhea, undigested food particles or fat in stool, gurgling in stomach, acid reflux, malabsorption, cankers, altered motility or gastroparesis, and food sensitivities or allergies.
Immune: Allergies, asthma, chronic sinus infections, frequent infections such as urinary tract infections, Candida overgrowth, and autoimmune conditions.
Liver: Poor detoxification, recirculation of toxins and hormones from bacterial deconjugation, increased or decreased bile production, and pain under the lower right ribs.
Skin: Itching, hives, acne, rosacea, rashes, eczema, psoriasis, and dermatitis.
Musculoskeletal: Joint pain, muscle pain, and fibromyalgia.
Brain and Mood: Headache, fatigue, neuropathy, brain fog, inability to focus, irritability, anxiety, depression, ADD/ADHD, lack of coordination or balance, and poor memory.
Hormones: Fatigue, poor temperature control, weight gain or weight loss, poor sleep quality, food cravings, poor blood sugar regulation, and hormone imbalances.

Which Test Do I Choose for Digestive Problems?

Choosing digestive tests can be a daunting task, especially when the symptoms seem to be coming from everywhere in your body. Starting off with the basics and expanding from there is always a good way to proceed when doing any testing.

The first thing to consider is if the symptoms suggest an acute infection, such as parasites or food poisoning. If this is the case, then testing to identify the organism is best. This usually involves a stool test and/or blood testing.

If your symptoms are chronic or more vague, then approaching tests with a broader scope can more easily pinpoint the root causes (there are often many). Dysbiosis, malabsorption, nutrient depletion, and GI dysfunctions like increased or decreased transit time often occur together.

When using this approach, the first goal is to identify and eliminate all pathogens, because if they’re present, you’ll have dysbiosis. Next, identifying the composition of the gut flora and checking immune and gut function will help direct treatment in the healing and rebuilding phases.

Occasionally, things don’t go like you want them to and further testing is warranted. Some companies offer specialty tests for food sensitivities or allergies (like celiac), detoxification, specific toxin testing, and hidden infections. We’ll get to these types of tests later on.

Digestive Testing

General tests can be completed by lab companies such as LabCorp or Quest, as well as specialty labs:

  • Stool testing (1- or 3-day)
  • Serum blood testing for infections such as bacteria or yeast
  • Antibody or antigen testing for certain bacteria, yeast, or viral infections

Functional tests are more in-depth than standard digestive tests. They’re provided by specialty labs and often require a practitioner to request them for you:

  • Organic acids dysbiosis profile
  • Comprehensive digestive stool analysis (CDSA)
  • Intestinal permeability
  • Lactose intolerance breath testing
  • SIBO (small intestinal bacterial overgrowth) breath testing

Stool Testing

Stool testing is just what it sounds like—an examination of your stool for good and bad organisms, toxins, and the presence of blood.

Typically, stool tests incorporate a stool culture of common bacteria, microscopic analysis for yeast, fungi, parasites, and blood cells, and sometimes testing for toxins that organisms excrete, such as the Shiga toxins (E. coli) or Clostridium difficile toxins A and B.

Additionally, most of the functional/specialty labs do antibody tests for hard-to-identify organisms, such as Giardia lamblia, Cryptosporidium parvum, Entamoeba histolytica, and Helicobacter pylori as a part of their normal stool testing.

One of the big differences is that some labs offer one-day tests while others offer three-day tests. The benefit to three days’ worth of samples is that there’s a greater chance of identifying elusive GI organisms.

That’s not the whole story, though. While most labs rely on traditional methods to identify organisms, some labs offer PCR-based testing, which means they’re using DNA to identify and only require one sample.

Standard stool testing is offered by traditional lab companies. Expanded stool testing is offered by specialty labs such as BioHealth Laboratory, Genova Diagnostics, and Doctor’s Data. DRG Laboratory offers PCR-based stool testing.

Serum Testing for Infections

Serum testing requires a blood draw, and the sample will be used to identify any organisms in your bloodstream. This may happen if you’ve had a systemic illness that may have spread from another area, such as the digestive or urinary tracts.

Bacteria, yeast, and other fungi are often identified in this manner. Yeast is especially important to consider here, because it’s opportunistic and will go beyond the limits of the GI tract in people with compromised immune function or co-infections.

This test is most likely to be conducted through a standard lab, at a hospital, or through your doctor’s office. It’s not something offered through specialty labs.

Antibody or Antigen Testing for Infections

Antibody testing is similar to serum testing in that it offers another means of identifying sometimes hard-to-locate organisms. Antibody testing can be done on blood or stool. When you have an infection, your body mounts an immune attack and creates antibodies against that specific organism’s antigen (the protein your body identifies as foreign).

Antibody tests measure your body’s immune response to an organism. This type of testing lets you know that there was an organism present at some moment in time, but it won’t necessarily tell you if it’s active, since antibodies can remain elevated even after the intruder is eliminated.

Similarly, antigen testing can identify the presence of an organism. Performing a stool antigen test for H. pylori is a preferred method, as it’s less invasive than other methods and is both sensitive and specific for active infection.

Antibody and antigen testing can be run through standard labs, as well as via BioHealth Laboratory, Genova Diagnostics, Doctor’s Data, and DRG Laboratory.

Organic Acids Dysbiosis Profile

Urinary organic acids measure the byproducts of your metabolic processes. Specifically, it’s measuring the metabolites produced by the bacteria and yeast living in your gut. This is a simple and non-invasive test, since it requires only a urine sample.

Intestinal bacterial overgrowth and yeast infections will cause elevated metabolites, and they’re also useful in assessing carbohydrate and protein malabsorption.

Urinary organic acid testing is available through Great Plains Laboratories and Genova Diagnostics.

Comprehensive Digestive Stool Analysis (CDSA)

Comprehensive digestive stool analysis is another way to evaluate the health of the GI tract. Using microbial growth-based cultures, biochemical assays, and microscopic evaluation, this thorough test assesses the status of beneficial and pathogenic microorganisms, including aerobic and anaerobic bacteria, yeast, and parasites. Specific analysis includes:

  • Identification of pathogenic bacteria, parasites, and fungi, and levels of beneficial bacteria
  • Protein, carbohydrate, and fat absorption via elastase and chymotrypsin levels, as well as the presence of meat and vegetable fibers and fats
  • Inflammatory markers including lactoferrin, lysozyme, eosinophil protein x, calprotectin, and the presence of mucus or blood cells
  • Immune function via sIgA levels (secretory IgA)

Many of these markers can also be tested as smaller profiles or individual tests. The full test is offered by Genova Diagnostics and Doctor’s Data, while DRG Laboratories can do a pared-down version with their stool PCR testing.

Intestinal Permeability Testing

This test provides a method for verifying the presence of increased intestinal permeability, also called leaky gut. Leaky gut allows food particles, toxins, and products of dysbiosis to enter the bloodstream, where an immune response mounts and inflammation is produced. It’s implicated in many conditions, from IBS to autoimmunity.

One version of the test, the Lactulose-Mannitol test, requires you to drink a solution of the sugars lactulose and mannitol. The degree of permeability is assessed by the amount of sugar recovered in urine.

An updated version of permeability testing called Intestinal Antigenic Permeability Screening assesses IgA, IgM, and IgG antibody reactions to bacterial endotoxins (LPS) that have entered the bloodstream. It also measures the tight junction proteins zonulin and occludin that break down in leaky gut, as well as a cell structure component called actomyosin. This test may more specifically show the route of gut barrier damage.

Genova Diagnostics and Doctor’s Data offer Lactulose-Mannitol testing. Cyrex Labs has the Array 2: Intestinal Antigenic Permeability Screening.

Lactose Intolerance Breath Testing

Lactose intolerance is one of the most common food intolerances in the US. Consumption of dairy that causes gas, bloating, diarrhea, and abdominal pain is an indication for this type of test. Inability to break down the dairy sugar lactose because of a lack of the digestive enzyme lactase or intestinal irritation results in lactose malabsorption and digestive symptoms.

This test requires you to drink a lactose solution and then take breath samples over a period of several hours. It measures the amount of hydrogen and methane produced when undigested and absorbed lactose is fermented by gut bacteria.

Genova Diagnostics offers this test.

SIBO Breath Testing

Small intestinal bacterial overgrowth (SIBO) occurs when large amounts of bacteria are present in the small intestine, where there are normally very few. The small intestine is where absorption largely takes place, so there’s little need of bacteria.

The symptoms are similar to lactose intolerance, because the bacteria are fermenting undigested foods (especially carbohydrates) and producing methane or hydrogen. Bloating, gas, abdominal pain, diarrhea, and constipation are classic symptoms.

During this test, you consume solution of glucose or lactulose, and then breath samples are taken over a period of 2-3 hours. The test measures the amount of hydrogen and methane produced when undigested and unabsorbed lactose is fermented by gut bacteria. High methane is associated with constipation, and high hydrogen levels correlate with diarrhea.

Genova Diagnostic and Commonwealth Labs both offer this test.

Summary

There’s certainly no shortage of digestive testing for you to explore. If you don’t get answers from basic tests, perhaps it could be time to consider more functional testing. Many of the tests referenced above can be ordered through Direct Labs, and can shed much light on the root causes of your health symptoms- and like G.I. Joe used to say, knowing is half the battle.

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When to Test for Blood Sugar and Metabolic Imbalance

This article originally appeared on Healevate.

To tell you that sugar is bad for you would be beating a horse that’s long been dead. We all get it by now. But what exactly does it do that’s so bad?

For starters, it’s a major source of inflammation, tissue destruction, brain degeneration, cardiovascular disease and depression.

Elevated blood sugar literally causes damage everywhere in the body and impacts other hormones, compounding this effect. What’s even worse is that it sets the stage for metabolic syndrome, diabetes and cardiovascular disease.

Low blood sugar doesn’t get as much press, since it doesn’t cause as much damage, but the downstream effects on other hormones are no less important.

Getting your blood sugar and metabolic hormones (such as insulin and cortisol) back in check is essential for reversing inflammation, aging, and many disease processes. Since blood sugar regulation reflects many disorders of metabolism, understanding the symptoms is the first step.

Symptoms of Imbalanced Blood Sugar and Metabolic Hormones

The symptoms of hypoglycemia (low blood sugar) include:

Brain/mood: Lightheadedness, jitters, fainting, dizziness, confusion, headaches, irritability, sadness, blurred vision/double vision, anxiety, hyperactivity, lack of focus.
Energy: Fatigue, weakness, energy surge post-meal or snack, feeling like you’re going to crash when you don’t have food, excessive hunger.
Hormonal: Hormone imbalances, especially low cortisol.
Metabolic: Sweating.

The symptoms of hyperglycemia (high blood sugar) include:

Brain: Brain fog, irritability, difficulty focusing and concentrating.
Neurological: Neuropathy, paresthesia, pins and needles, tingling.
Energy: Lethargy, feeling sleepy post-meal, fatigue.
Skin/hair/eyes: Dark patches of skin on neck, elbows, armpits, and knees (acanthosis nigricans), skin tags, wounds that won’t heal, loss of hair.
GI: Nausea, vomiting, stomach pain, fruity scent to breath, dry mouth.
Metabolic: Increased thirst and urination, rapid heartbeat, shortness of breath, high blood pressure, abdominal fat, high cholesterol or triglycerides, fatty liver.
Hormonal: Hormone imbalances including estrogen, testosterone, and cortisol, PCOS.

How Can I Test for Blood Sugar and Metabolic Hormone Imbalance?

Testing for blood sugar and metabolic hormone imbalance is more straightforward than other types of testing.

The goal is to find out if your blood glucose levels—and the hormones related to blood sugar management and metabolism—are functioning properly.

This can be determined with an initial set of tests that assess blood sugar levels and management, as well as hormone regulation. After initial testing is completed, additional testing may be warranted. If you find that you have elevated blood sugar with poor blood sugar management, evaluating inflammation, lipids, and cardiovascular markers is an important secondary step.

Blood Sugar and Metabolic Testing

Initial testing:

  • Glucose tests: Fasting glucose, 2-hour glucose tolerance test, hemoglobin A1C, and fructosamine.
  • Insulin tests: Fasting insulin and C-peptide.
  • Hormone tests: Adiponectin, leptin, and cortisol.

Secondary testing:

  • Inflammatory tests: Homocysteine, CRP, ApoB, Lp(a)
  • Lipid tests.

Glucose Testing

Fasting glucose (FBG) is the initial test completed when screening for blood sugar abnormalities and diabetes. It measures the levels of glucose in the blood after a period of fasting for at least 8 hours. FBG tells you if your blood sugar is high or low and can reflect metabolic imbalance. Blood glucose levels are largely dependent on 3 factors:

  1. The ability of the pancreas to produce appropriate amounts of insulin, as well the cells having the appropriate response and sensitivity to insulin.
  2. The liver’s storage and breakdown of glycogen (the storage form of glucose in muscles and the liver to be used later as energy).
  3. Adrenal hormone function (cortisol, epinephrine), which also impacts control of blood sugar levels.

Fasting glucose can also be measured daily at home with a glucometer.

A 2-hour glucose tolerance test (GTT) is done to assess how efficiently your body responds to glucose. This test requires an initial fasting blood draw followed by consumption of a 75 mg glucose drink. Two hours later, a second sample is drawn.

Normally, after you consume sugar, your body detects your high blood sugar, which causes the pancreas to release insulin so the sugar can be cleared from your blood and stored. The second measurement should be normal. If you have impaired glucose tolerance or insulin resistance, the blood sugar level will remain high.

Hemoglobin A1c (HbA1c) measures glycated hemoglobin, or glycohemoglobin, in the bloodstream. Glycohemoglobin is formed when circulating glucose combines with the hemoglobin in your red blood cells (RBCs).

RBCs have a lifespan of 120 days, so the amount of glycated (also called glycosylated) hemoglobin is directly proportional to the amount of glucose present in the bloodstream during that period of time.

The process of glycation is irreversible, so the greater the concentration of glucose in the blood, the more it will attach to the RBCs. HbA1c is used to monitor long-term glucose control and assist with the management of high blood sugar.

Fructosamine, similar to HbA1c, forms when glucose binds to serum proteins. Fructosamine levels represent the total amount of glycated protein in the blood. This is an irreversible glycosylation process reflecting the average lifespan of serum proteins—about 14 to 21 days. It’s used to monitor blood sugar control, but it’s less common than HbA1c.

Insulin Testing

Insulin is the hormone secreted by the pancreas in response to glucose in the bloodstream that facilitates the transport of sugars into your cells.

Fasting insulin levels are measured after a minimum of 8 hours without food to detect insulin resistance, as well as high or low blood sugar.

If the pancreas doesn’t produce adequate insulin or the body loses its sensitivity to insulin (insulin resistance), blood sugar will be elevated, while fasting insulin will be low because of the lack of insulin production and high with insulin resistance.

C-peptide levels reflect how much insulin the pancreas is producing. High levels of C-peptide indicate increased insulin production, usually in response to high blood glucose levels or insulin resistance.

This test is useful for monitoring treatment of hypoglycemia and diabetes, since it only measures the body’s insulin production. It can also be helpful in distinguishing between Type I (autoimmune) and Type 2 (metabolic) diabetes, the diagnosis of insulinomas (insulin-producing tumors), and when autoantibodies are produced against insulin. Because of this, C-peptide levels can be difficult to measure.

Metabolic Hormone Testing

Adiponectin is a hormone produced by adipocytes (fat cells) that promotes proper metabolism of sugars (carbohydrates) and fats (triglycerides). It also influences the body’s response to insulin.

High levels are beneficial and indicate efficient cellular energy production. Low levels are associated with metabolic syndrome, obesity, diabetes, and cardiovascular disease.

Leptin is largely produced by fat cells and works in a feedback loop with the brain to regulate appetite and satiety. When sufficient amounts of food are consumed, leptin signals to the hypothalamus, telling the body it’s no longer hungry. Low leptin should signal hunger, and high leptin should signal satiety. The level of leptin you have directly reflects your total body fat.

Leptin deficiency isn’t common, but leptin resistance, much like insulin resistance, definitely is. It reflects the body’s decreased sensitivity to the hormone, resulting in increased production. Even though there are adequate amounts of leptin, hunger is still present since the signal isn’t getting to the brain efficiently.

Cortisol is a hormone produced by the adrenal glands that literally impacts the entire body by decreasing inflammation, regulating the stress response and circadian rhythms, and controlling blood sugar.

If blood sugar is high, cortisol stimulates the storage of sugar in the liver as glycogen. If you have cortisol dysregulation (adrenal fatigue or excess cortisol), your normal regulatory functions don’t occur properly, resulting in blood sugar dysregulation.

Cortisol follows a natural rhythm, peaking in the morning and falling throughout the day. Measuring this curve is best achieved through a salivary or dried urine cortisol test with four measurements.

Metabolic Inflammatory Testing

Homocysteine is an amino acid produced as an intermediate product in the metabolism of the amino acids methionine and cysteine (the process is called methylation).

If methylation doesn’t occur properly due to a lack of key nutrients like B12, B6, and folic acid, or because of a genetic mutation (MTHFR), homocysteine levels can rise in the blood.

Elevated homocysteine is associated with an increased risk of Alzheimer’s, cardiovascular disease, and stroke, since it directly damages the lining of the blood vessels. People with poor blood sugar regulation and diabetes are at an increased risk for elevated homocysteine.

C-reactive protein (CRP) or high sensitivity CRP (hsCRP) is an acute phase reactant protein produced mostly in the liver in response to inflammation. Elevated CRP is highly associated with metabolic syndrome, diabetes, high blood pressure, and cardiovascular disease, as they share the common root cause of inflammation.

Apolipoprotein B (ApoB) is a protein involved in fat metabolism and is a component of low density lipoproteins (LDL), also known as “bad” cholesterol. Elevated levels are associated with insulin resistance, high cholesterol, atherosclerosis, and heart disease.

ApoB100 is an even more specific marker, as only one molecule of ApoB100 attaches to each LDL particle, allowing for the total number of lipoproteins in circulation to be quantified. ApoB100 is a better marker of cardiovascular risk than LDL.

Lipoprotein a (Lp(a)) consists of an LDL particle bound to the protein apoA. Levels of Lp(a) have a significant genetic component, and levels remain relatively constant over your lifetime. Elevated Lp(a) is a risk factor for cardiovascular disease.

Lipid Testing

Lipid testing determines whether or not a person’s cholesterol-carrying proteins are healthy or not. The standard lipid panel that measures LDL (low density lipoprotein), HDL (high density lipoprotein), and triglycerides measures total serum lipid numbers only. It can be a good general marker of cardiovascular disease (CVD) risk, especially when viewed with other biomarkers such ApoB and Lp(a).

Elevated levels of LDL and triglycerides, especially when taken in the context of other biomarkers, are associated with an increased risk of CVD, as is low HDL. This test is available through LabCorp and Quest and in expanded profiles from Spectracell, Genova Diagnostics, and Doctor’s Data.

Lipoparticle protein testing provides a more accurate assessment of your cholesterol and cardiovascular risk, as it measures the particle numbers and density. When considering each lipoprotein, size does matter. For example, LDL particles can be small, medium, or large, and the amount of cholesterol within the particles varies widely. Smaller particles are more predictive of cardiovascular disease and plaque buildup, since they can penetrate the arterial walls where the larger particles can’t.

Remnant lipoproteins (RLP) and intermediate density lipoproteins (IDL) are also associated with increased CVD risk. Large, buoyant HDL (HDL2) corresponds to a decreased risk of CVD. LabCorp and Quest offer this and call it VAP testing. Spectracell calls it Lipoparticle Protein Testing, and Genova has the CV Health Profile.

All testing that we’ve discussed can be done through Direct Labs, who has contracts with the traditional and newer labs. If you’re experiencing any of the symptoms mentioned earlier in this article, it could be worthwhile to get some simple testing done so you can know where you stand and make corresponding changes, if and where necessary.

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How Gut Dysbiosis is Making You Sick

Article originally published on Healevate.

Bacteria and your microbiome are an integral part of who you are—think of yourself as a bacterial hotel.

In fact, the bacteria living in and on your body outnumber your body cells by 10 times!

While there are 10 trillion cells in your body, there are 100 trillion bacteria that comprise an estimated 400-1,000 different species that coexist within you.2

The vast majority of them reside within your GI tract, weighing in at about 3-4 pounds.2,3,6

These bacteria have coexisted with us for millennia and are beneficial, helping us thrive by assisting in digesting and absorbing foods, producing vitamins and short-chain fatty acids, killing potential pathogens, maintaining a healthy weight, and supporting detoxification, inflammatory, immune, and hormone functions.6

The good bacteria and even a small amount of yeast are vital to your survival. Studies show that people with poor bacterial colonization after c-section birth and/or lack of breastfeeding have more health problems.3

While most of these organisms are helpful and essential, some are harmful and cause significant damage to the delicate balance of the ecosystem that exists in your gut.

What Exactly is Dysbiosis and How Does it Occur?

Dysbiosis occurs when harmful organisms, such as bacteria, fungi (yeast and mold), viruses, and parasites take over the gut environment and change your physiology such that it favors their survival (and that of other pathogens) to the detriment of your health.

What constitutes a healthy microbiome is constantly being redefined as more research is done. Recent research suggests that we may need to consider viruses, in addition to bacteria, as part of our commensal microbiome. “There have been suggestions that every individual harbors approximately 8-12 chronic viral infections at any given time, and these may be harmful only in the limited percentage of the population that has a certain genetic predisposition.”

The good bacteria collectively act as the Chief Operating Officer in your gut, keeping vital day-to-day functions occurring effortlessly without you even knowing it.

They help maintain immune and hormone function, modulate inflammation, protect you from pathogens, and metabolize and produce nutrients.

The primary reason this harmonious equilibrium of organisms can be maintained is that there’s a system of checks and balances so that one group can’t take control; however, when this balance is disrupted by stress, diet, medications, or toxins, dysbiosis is the result.

Dr. Leo Galland, M.D. simply states, “Dysbiosis is an unfavorable imbalance of the bacteria resulting in an intestinal flora that has harmful effects. The principal factors that regulate the composition and distribution of the GI flora are diet, motility, the nature of GI secretions, immune function, and the ingestion of antibiotic or probiotic substances.”8

Over time, the change in the intestinal ecosystem causes considerable chronic local and systemic effects. Dr. Gerard Mullin, M.D. asserts that, “Dysbiosis is not so much about the microbe as it’s about the effect of that microbe on a susceptible host; it’s about the relationship between the host and the microbe.”14

For example, people with inflammatory or autoimmune conditions often present with a pathogenic inflammatory response to a non-inflammatory microbe due to the activation of the immune system and the inflammatory chemicals produced in that interaction.12

If it’s caught and reversed quickly, you may not have too many ill effects. However, if this condition is allowed to progress, it can lead to serious health problems ranging from gas, diarrhea, constipation, and acne to joint pain, chronic fatigue, and autoimmunity.

Further, intestinal dysbiosis can lead to dysbiosis of other mucosal areas such as the mouth, nose, lungs, skin, eyes, and vaginal and urinary tracts, making you more vulnerable to other infections.

Triggers of Dysbiosis

Triggers for the development of dysbiosis are usually multiple and cumulative—meaning that the more you experience these as a part of your lifestyle, the more likely you are not only to have dysbiosis but also to have many of the symptoms associated with it. The main primary contributors to dysbiosis are:

  • Poor bacterial colonization
  • Medications
  • Stress
  • Diet
  • Environmental toxins
  • Infections

Trigger of Dysbiosis: Poor Colonization

The first step toward dysbiosis can actually occur during your birth. The process of vaginal birth naturally initiates the critical event of bacterial colonization.

Infants born this way have a microbiota that reflects their mother’s fecal and vaginal flora, where those born via cesarean section have a flora reflective of the hospital environment and the health care workers.3,12

Children born through c-section are also at risk of delayed access to breast milk, which can be an additional detriment to the development of a healthy flora.3

Research by Giacomo Biasucci et al. in the September 2008 issue of the Journal of Nutrition showed that the gut microbiota after c-section was characterized by a lack of Bifidobacteria species, which are thought to be important to the postnatal development of the immune system, whereas vaginally delivered neonates showed a predominance of these species.3,12

It’s also important that women who want to conceive are aware of the health of their intestinal flora, as infants born to women with dysbiosis also have dysbiosis. Taking care of GI infections and imbalances, as well as supplementing with specific probiotics, will help impart a healthy flora to the baby.

Trigger of Dysbiosis: Medications

Several categories of medications can directly impact the health of the GI flora. The most significant ones include:

Antibiotics: This class of medications is the most common and significant cause of major alterations in normal GI tract flora.6

Depending upon the scope of antimicrobial activity, antibiotics can wipe out multiple categories of beneficial organisms, leading to dysbiosis—the antibiotics don’t differentiate between the good guys and bad guys

If this impact is significant, beyond general dysbiosis it can produce an overgrowth of existing flora such as yeast (Candida) and Clostridium difficile, resulting in potentially severe and life-threatening (in the case of C. difficile) systemic effects.

PPIs: Proton pump inhibitors that block stomach acid (HCl) production provide a gateway for dysbiosis to develop, as HCl is critical to the normal process of digestion and acts as defense against pathogens. PPIs are known to directly alter the gut flora as well.

NSAIDs: Chronic use of nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen sodium, aspirin, and indomethacin can inhibit the growth of good bacteria and alter the gut flora, resulting in leaky gut, which further perpetuates dysbiosis.

Hormone-Based Medications: According to Gut and Psychology Syndrome author Dr. Natasha Campbell- McBride, M.D., “The use of birth control pills and immune system-altering steroidal hormones change the gut flora by harming the beneficial bacteria.” Widespread use of hormone-based medication isn’t often mentioned yet is a significant contributor to dysbiosis.

Trigger of Dysbiosis: Stress

Stress is one of the most important triggers of dysbiosis, as it’s something most of us have plenty of in our lives, and we don’t do much to counterbalance its effects.

The biochemical effects of stress, such as decreased blood flow, oxygenation, motility, enzyme output, and nutrient absorption directly impact the intestinal flora.18

Dr. Gerard Mullin, M.D. explains that “stress directly suppresses the beneficial bacteria Lactobacilli and Bifidobacteria, which are critical to GI health.”14

Further, chronic stress diminishes immunity by depleting the antibody secretory IgA (sIgA), as well as essential hormones, and promotes inflammation, which can all result in a leaky gut. 6,14

The catecholamine hormones (adrenaline and noradrenaline) stimulate growth of gram-negative organisms such as E.coli, Yersinia, and Pseudomonas, which promote inflammation and immune system activation by producing the endotoxin LPS (lipopolysaccharide).3,6,14

Many of these gram-negative bacteria are normal inhabitants of the large intestine; however, when the good flora are diminished, they can’t keep growth of these opportunistic organisms in check. This leads to dysbiosis and inflammation.

All of this culminates in a vicious, self-perpetuating cycle when you’re chronically stressed.

Trigger of Dysbiosis: Diet

Diet, along with stress, exerts the most impact on the balance and health of the gut flora.

“The composition of the diet has been shown to have a significant impact on the content and metabolic activities of the human fecal flora. Some diets promote the growth of beneficial microorganisms, while others promote activity that can be harmful to the host,” according to Hawrelak and Myers in their 2004 review study. 6 The following categories are major contributors to dysbiosis:

  • Sulfates: Consumption of foods high in sulfates promotes the growth of bacteria that produce a toxic gas called hydrogen sulfide (think stinky egg smell), which results in depletion of colonic nutrients and leaky gut. Foods high in sulfates include eggs, cruciferous vegetables, dairy, dried fruit, alcohol, meat, baked goods, and processed foods.6
  • High Protein: Excessive consumption of protein, especially in the presence of enzyme deficiency, allows bacteria to ferment the undigested protein particles and produce toxic metabolites such as ammonia, indoles, phenols, and sulfides, which are carcinogenic and promote migraines and mood disorders.6,7 High protein diets can also promote inflammation and hormone imbalance through the action of some bacterial enzymes such as beta-glucuronidase.6,7
  • High Sugar and Carbohydrates: Diets high in sugars and simple carbohydrates are characterized by increased bacterial fermentation and decreased intestinal transit speed, allowing for toxic metabolites to sit in the intestines longer and potentiate inflammation.6,7
  • Bad Fats: Eating a diet high in trans fats and certain chemically processed or genetically modified fats inhibits the growth of protective bacteria.7 These fats include any trans fat labeled “partially hydrogenated,” shortening and margarine, as well as oils including canola, corn, soybean, peanut, sunflower, and safflower.
  • Processed Foods: Preservatives, dyes, emulsifiers, surfactants, additives, and flavoring all negatively impact the health of the gut flora, as they’re toxins. When you read a label, generally if you can’t pronounce it or don’t know what it is, you shouldn’t eat it.

Food sensitivities and allergies represent a potent trigger for dysbiosis, as the immune system reacts to the protein peptides of the offending foods by producing pro-inflammatory chemicals called cytokines that damage the intestinal mucosa, not only leading to a leaky gut but also making the environment inhospitable to the good flora.

In conditions such as Celiac, where the immune system is reacting to the family of gluten-related peptides, it’s been discovered that the gut microbiota plays a significant role in the development and progression of the illness.

Research has found that levels of beneficial flora such as Lactobacillus and Bifidobacteria in Celiac patients is much lower than in healthy individuals.7

Overall, higher incidence of gram-negative and pro-inflammatory bacteria present in the microbiota is linked to the symptoms associated with the disease by favoring the pathological progress of the disorder.7

Studies have also noted that a similar profile of decreased good bacteria and higher levels of bad bacteria are seen in the development of food sensitivities and allergies to milk, eggs, and nuts.7

It’s important to note that you can develop a food sensitivity or allergy at any time in your life to any food, not just the common ones (gluten, dairy, soy, corn, eggs, shellfish, and nuts).

GMO (genetically modified organism) or hybridized foods also represent a potent source for dysbiosis and the development of food sensitivities, as they aren’t as recognizable to your immune system as the original food form. This can trigger an inflammatory and immune response in the gut, potentiating dysbiosis.

Trigger of Dysbiosis: Environmental Toxins

Environmental toxins are everywhere—metals, volatile organic compounds (VOCs), and chemicals are found in the air, water, soil, industry, and products used on your body and in the home.

Food can also be a significant source of toxins depending upon where and how it’s grown, as well as if it’s processed.

If you’re a fan of grilling your food, you are adding yet another layer of toxins from the heterocyclic amines (HCAs) that are produced in the tasty charred portions. The cumulative effect of exposure to these substances over time can have a profound impact on the health of your intestinal microbiome, potentially leading to dysbiosis.

A 2008 study found that the volatile derivatives from metals such as mercury, arsenic, bismuth, and antimony exert their toxic effects on human health not only by direct interaction with host cells but also by disturbing the physiological gut microflora.18

The metals not only alter the composition of the organisms in the gut, but the bacteria themselves can transform the toxic metals into even more toxic compounds. Toxins of all kinds shift the balance of the flora into supporting the harmful organisms over the favorable ones.

Trigger of Dysbiosis: Infections

Toxins are not only acquired from the external environment but can also be prevalent internally, because they’re produced from infectious organisms such as certain bacteria, mold, yeast, viruses, and parasites. These organisms contribute to dysbiosis because they produce toxins that are detrimental to your body by:

Altering normal GI function: The organisms exert their damaging effects by decreasing gut motility, decreasing the amount of stomach acid and digestive enzymes, and altering bile production. These mechanisms help ensure their survival.16

Promoting inflammation: GI infections promote inflammation through the production of toxins such as lipopolysaccharides (LPS) in certain gram-negative bacteria and mycotoxins from mold. They also generate several different types of immune responses, which promote inflammation and also produce autoimmunity.16

Altering the GI flora: The gut microflora is often already compromised to some extent when a GI infection occurs. The infective organisms increase dysbiosis by their mere presence and by making the intestinal environment more hospitable to other pathogens and opportunistic commensal organisms (organisms that are normally found in the intestines of healthy individuals that take advantage of your compromised physiology).

After infectious organisms take hold, you may experience gas, bloating, diarrhea, constipation, or even no gut-related symptoms at all.

Brain fog, fatigue, sleeplessness, joint pain, depressed mood, and anxiety are often related to these infections. Some of the most common organisms include:

SIBO: Small intestinal bacterial overgrowth occurs when organisms from the colon inhabit the small intestine, where fewer bacteria reside.

Escherichia coli, Streptococcus, Staphylococcus, and Klebsiella are species frequently associated with SIBO. SIBO is complex, because the constituent organisms vary widely from person to person, as do symptoms, which can include constipation, diarrhea, gas, bloating, belching, stomach pain, malabsorption, brain fog, mood disorders, headaches, fatigue, and rashes, among others.

Parasites: Giardia lamblia, Blastocystis hominis, Entamoeba histolytica, Dientamoeba Fragilis, and Endolimax nana cause a majority of the parasitic infections the U.S.8,20

Acute parasitic illness manifests with symptoms of diarrhea, vomiting, stomach pain, bloating, fever, and malaise, while chronic infections range from asymptomatic to severe, resulting in bloody and mucus-filled stools, profuse diarrhea, and malnutrition. Parasitic infections are also related to interrupted sleep patterns and tooth grinding during sleep.

H. pylori: Helicobacter pylori is a spiral-shaped bacteria that is estimated to inhabit two-thirds of the world’s population. Some people happily coexist with it while others develop chronic conditions, because it can become opportunistic.

It alters immune function and stomach acid production to aid its survival while you experience reflux, indigestion, gas, bloating, and stomach pain.

Candida: Candida (yeast) is a fungus that lives in your mouth and intestines to aid with digestion and nutrient absorption.19 It can become pathogenic and rapidly increase in numbers if your immune system is compromised from stress or illness.

The infection can be almost anywhere in your body, from the mouth and stomach to the urinary tract, skin, and lungs. Some symptoms associated with Candida include sugar cravings, depression, anxiety, gas, bloating, headaches, rashes, and skin discoloration.

While the previously-mentioned infections are commonly related to dysbiosis, some important and often overlooked sources of infection include:

Mold: Mold is a fungus like Candida, and both are ubiquitous. Some common types of mold associated with dysbiosis include Aspergillus, Penicillium, Stachybotrys, and Alternaria.

The toxins produced from mold can be very harmful to the good gut bacteria and the host (you). These toxins produce symptoms ranging from mild to severe fatigue, sore throats, nosebleeds, headaches, diarrhea, brain fog, food sensitivities, and memory loss.

Tick-borne Illness: Tick-borne illnesses are prevalent primary infections or co-infections that can result in dysbiosis through several mechanisms.

First-line treatment of these infections often involves the use of antibiotics for weeks in acute cases and for months for chronic infections, killing off the good bacteria and promoting yeast overgrowth according to Dr. Leo Galland.21

These infections also result in “Bell’s Palsy of the gut,” ranging from paralysis of the gut to decreased GI motility, allowing dysbiosis to occur. 21,22

Lyme disease, an infection acquired through the bite of a tick infected with the bacteria Borrelia burgdorferi, is the most commonly-known infection. Babesia, Rickettsia (Rocky Mountain Spotted Fever), Ehrlichia, and Bartonella are also frequently identified as infectious bacteria from tick bites. Symptoms include rash, fatigue (often chronic), fever, aches, stiffness, brain fog, and constipation.

Viruses: Chronic viral infection is a common but often ignored cause of dysbiosis. Enteric (GI) viruses play an important role in the microflora of the gut, as they’re present in all of us and affect not only our gene expression but also the composition of the gut microbiota.

A 2014 study notes, “Viruses may act directly on the host epithelium and immune system to induce inflammation, or may alter luminal bacterial composition that then provokes disease.” 23

A further complication is that some viruses such as cytomegalovirus (CMV) and Epstein-Barr virus can remain latent after initial infection and only become active again under stress or immunosuppression, producing inflammation and GI symptoms that don’t appear to be related to the current pathological process.23

Symptoms and Effects of Dysbiosis

Alteration of the gut microbiome can have wide-ranging consequences on a person systemically—these effects aren’t limited to the gut.

The inflammatory process generated by dysbiosis is one of the primary root causes in many conditions.

The inflammation produces chemical changes in the body that activate the immune system, and it also increases or decreases the expression of certain genes, enabling the disease process to evolve.

What began as smoldering embers becomes a systemic wildfire when there’s no intervention or lifestyle change, allowing a simple process to potentially become a complex condition that is difficult to manage.

Symptoms of an unstable gut microbiome include:

  • GI: Gas, bloating, belching, stomach pain, constipation, diarrhea, undigested food particles or fat in stool, gurgling in stomach, acid reflux, malabsorption, altered motility or gastroparesis, and food sensitivities or allergies
  • Immune: Allergies, asthma, chronic sinus infections, frequent infections such as respiratory or urinary tract infections, Candida overgrowth, and autoimmune conditions
  • Liver: Poor detoxification, recirculation of toxins and hormones from bacterial deconjugation, increased or decreased bile production, and pain under the lower right ribs
  • Skin: Itching, hives, acne, rosacea, rashes, eczema, psoriasis, and dermatitis
  • Musculoskeletal: Joint pain, muscle pain, and fibromyalgia
  • Brain and Mood: Headache, fatigue, neuropathy, brain fog, inability to focus, irritability, anxiety, depression, ADD/ADHD, lack of coordination or balance, and poor memory
  • Hormone: Fatigue, poor temperature control, weight gain or weight loss, poor sleep quality, food cravings, poor blood sugar regulation, and hormone imbalances

Treatment of Dysbiosis

Treatment of dysbiosis can be as basic as using probiotics and gut-supporting nutrients in the most simple cases, or it can escalate to treating multiple infections and addressing autoimmunity in more complex cases.

Identifying and resolving all triggers and making appropriate lifelong lifestyle changes are key to reversing dysbiosis and eliminating inflammation.

The process of addressing triggers should begin with identification and elimination of all potential pathogenic GI infections through testing. Non-pathogenic bacterial overgrowth must also be identified and treated. This should be the first step of a comprehensive 5R program that includes these components:

1. Remove sources of irritation and inflammation:

  • Remove all sources of parasitic, fungal, and bacterial infections in the gut (from mouth to anus). If you take care of these without resolution of symptoms, look into viruses, mold, and other infections like tick-borne illnesses. Infections of the jaw from root canals and dental work are sometimes a source of hidden infection that should be investigated as well.
  • Eliminate foods that contribute to inflammation and all known food allergies. An anti-inflammatory, whole foods-based diet is best.
  • Try to eliminate the use of medications known to contribute to dysbiosis and irritation of the intestinal lining.
  • Refrain from alcohol consumption, as you’re trying to restore bacterial balance in the gut.
  • Reduce toxin exposure by eating organic when possible, using cleaner personal care and home products, and filtering your home air and water. Many green plants provide natural toxin filtration.
  • Prepare foods so that there are no charred areas produced. Marinating foods with lemon, garlic, and rosemary for several hours before cooking will help buffer the effects of any char that is produced.

2. Replace the nutrients your body needs to heal:

  • Beginning a meal with digestive enzymes and betaine hydrochloride will allow for proper breakdown and absorption of nutrients.
  • Prebiotic fiber such as FOS and inulin from onions, garlic, blueberries, asparagus, bananas, chicory, and artichoke promote the growth of beneficial bacteria and discourage harmful ones. Since these fibers are non-digestible by humans, the good flora can use them as a nutrient source. They also help prevent constipation and diarrhea by maintaining colonic balance.12
  • Fermented foods such as yogurt, kefir, kombucha, sauerkraut, kimchi, and some varieties of pickled vegetables are cultured with bacteria and yeast strains that help maintain intestinal flora.
  • Resistant starches, or starches that resist digestion until they reach the colon, can be found in raw potatoes, green bananas, green plantains, parboiled rice, lightly-cooked and cooled potatoes, or legumes (that have been soaked and sprouted). Once the resistant starches reach the colon, the bacteria digest or ferment them, producing short-chain fatty acids (SCFAs) that support bacteria and intestinal cell health and modulate inflammation. Added benefits are that they help improve insulin sensitivity, as well as blood sugar and body composition.
  • Soluble (completely fermentable) and insoluble fibers (little to no fermentation) like grains, fruits, vegetables, and psyllium also provide nutrients to the beneficial bacteria and help prevent constipation.12 They keep your bowels moving.

3. Re-inoculate with good bacteria to restore the flora:

  • Using a high-quality probiotic with at least 50 billion CFU twice daily will help restore the gut flora. Lactobacillus and Bifidobacter species are best in most cases; however, there are other beneficial strains that can be used. Start off using them slowly and work up to the recommended doses.
  • Fermented foods such as sauerkraut, kimchi, and kombucha, as well as kefir and yogurt (you can use dairy or non-dairy based), contain live, active cultures that will help the good bacteria stick around.
  • Fecal Microbiota Transplant (FMT) may be necessary for some people who‘ve had severe infections such as C. difficile or other resistant bacterial infections who need to go further than just a probiotic. It’s used to treat a variety of intestinal diseases associated with pathological imbalances within the microbiota. The process involves having a fecal transplant from a donor that has been screened for the correct bacterial balance in order to restore the flora.10

4. Repair the gut lining and normal physiological functions:

  • Dysbiosis often involves leaky gut as well as disruption of normal physiological processes of digestion, which all need to be addressed in order to maintain a healthy flora and GI function. This includes using betaine HCl to increase stomach acid, digestive enzymes to assist the pancreas, intestines, and liver until they produce adequate levels on their own, and sometimes ox bile to assist the liver in the digestion of fats.
  • Additionally, motility—the ability to keep waste and toxins moving through the GI tract—often needs to be repaired and restored. Ginger and d-limonene are good agents to stimulate GI motility. Exercise or movement and proper hydration are also great ways to keep the bowels moving.

5. Rebalance your body to heal faster and maintain vibrant health moving forward:

  • Calming the nervous system and decreasing stress through breathing techniques, meditation, yoga, Tai Chi, or walks in nature are great ways to achieve this. Stress for most people is unavoidable, so learning to manage it through creating boundaries, learning to say no, or having a proper outlet to release it is key.
  • Exercise and movement are also essential in decreasing stress and maintaining the balance of the body and the brain.
  • One of the most important measures you can take is to fall asleep at a reasonable hour (10 pm is ideal), as well as get at least eight hours of high quality, uninterrupted sleep. Sleep is crucial to the healing process, as well as the maintenance of overall good health.

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