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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7 Interventions to Stop the Eczema Flare Before It Erupts

Get out of the Stress-Eczema Flare-Clear Skin-Repeat Cycle 

Is your life causing your eczema flares? Read on to find out if it is…

I believe it’s possible to teach old dogs new tricks. Yes, I’m referring to myself as an ‘old dog’ even though I’m not that old! However, it’s a fitting phrase to describe when I decided to retrain myself not to get stuck in the cycle of stress-eczema flare-clear skin-repeat.

My pattern was pretty obvious. I take good care of myself on every front except…drum roll…stress management. This is true for most of us, but this is a huge part of what I do to help heal people.

Yet, I wasn’t doing it for myself.

I was too focused on my job, side projects, and raising my son who was a baby at the time.

I dove into everything head first and never said no. I was all GO, GO, GO, 24/7.

Until my body would hit the wall from stress and I’d start get flare ups on my hands, wrists, forearms, stomach, and thighs. Tingling would turn into little red spots that itched so bad they’d spread out like an oil spill. Broken, inflamed skin would leave ugly patches.

I was especially embarrassed of my hands, wrists, and arms because people could see them. The palms of my hands and wrists were the worst unfortunately and people would sometimes look a little too long when I handed them payment, opened doors, or waved hello.

It’s amazing how many things our hands are involved in and how self conscious you can become once you’re aware that people are looking.

Gloves year round, anyone???

My usual approach was once I got sick of dealing with it, I’d really dial in my diet, take anti-inflammatory herbs, and engage in some stress reduction. That usually did the trick.

The itching would soon begin to subside, redness would retreat, and the bumps and patches would fade. After several weeks of being “good,” my skin would be clear again. AWESOME!!!

Then, I’d go back to my normal routine and inevitably have a flare up within a couple of months that was worse than the one before. It also started to get harder to treat.

Clearly I had a very short memory and I wasn’t learning from my past history!

Breaking the Cycle

After this cycle had been going on for over a year, I decided something need to change (there’s a longer version of this story that I’ll save for another day, but I’ll share the most important piece now).

The key change in retraining myself was managing my stressors. I needed to practice what I preached to my patients. Priority number one was establishing boundaries and stepping away from being a “yes” girl. I started to say “No” to many opportunities when I felt I had too much on my plate or felt I couldn’t give 100%. I also said “No” to social and family events if I was busy or starting to feel like I was being pulled in too many directions.

I also did a better job of decompressing and taking care of me, which meant giving myself breaks to exercise and have some quiet down time daily to do some deep breathing, journaling, or meditate (even if I had to sneak away to the “bathroom” to get it 😉). I also made consistent sleep a priority as much as I could with a nursing baby.

These are habits I’ve maintained to this day, except I don’t have to hide in the bathroom anymore for peace and quiet!

Stress management was the single biggest change I made to break the cycle, but I also developed strategies to tame a flare if I felt one coming on that I’m going to share with you.

7 Interventions to Stop Your Flare Before It Erupts

1. Clean your diet up. Most of us let our diet go when we’re under stress. Naturally, our bodies crave sugar and carbs to fuel our stress response (but we’re not running away from tigers and lions anymore). Sugar in general promotes inflammation, but so do gluten and dairy. I recommend eliminating these first if you haven’t already. Eating a diet focused on whole foods- meat, fish, eggs, veggies, fruits, and healthy fats will be supportive of calming inflammation.

If you’ve already pared down your diet, you might be sensitive to something else you’re eating. Start paying attention to how you flare responds to food. Do certain ones make you itch more? Do they give you other symptoms of inflammation like mucus production or joint pain? Is the response immediate or delayed?

Using a diary requires some effort, but it’s the best way to track the effects of diet and lifestyle. When I feel a flare come on, I open up an spreadsheet on my computer. I make columns for meals, immediate and delayed reactions, supplements, exercise, stress, sleep, and observations. I record everything that was notable and if nothing is notable I leave that spot blank. This way I can identify immediate issues, but also patterns that may otherwise be hard to see. This is actually how I figured out that I had a histamine issue.

2. Avoid Histamines. These nasty chemicals are produced in the inflammatory response and are part of the reason you itch. You can be consuming them in food or supplements like probiotics. There is a detailed list in my free triggers guide “Eczema: Seven Sneaky Sources Making Your Flare Worse.” Additionally, fish, seafood, cured and deli meats, aged cheeses, dried fruits, citrus fruits, pickles, and any fermented foods such as yogurt, kefir, kombucha, and sauerkraut. Basically, if it’s aged in any way- pickled, preserved, fermented, dried, salted or cured, it contains histamines. That makes left overs a no-go too.

Unfortunately, bone broth which is very healing, also contains high histamine levels, so watch out for any histamine related symptoms including itching, runny nose, mucus or phlegm, redness, etc.

Some strains of the probiotic group Lactobacillus (L. casei and L. bulgaricus) are known to produce histamine which may aggravate your eczema. From my clinical experience, I’ve also seen patients have a histamine reaction to other probiotics too, so pay attention to how your body responds to them. Remember- everyone is unique and we’ll all have different reactions to different substance.

3. Consume anti-inflammatory foods (or their supplement form). I’m a big fan of food as medicine. Some of the best anti-inflammatory foods are herbs and spices, specifically turmeric, ginger, and garlic. Together, these are pack a triple threat anti-inflammatory, antimicrobial, and gut and skin healing punch. They can be consumed easily in meals- especially any Asian or Indian recipes, added to smoothies, pre-made tea bags, or in this healing tea/infusion recipe.

The supplement forms can be used too. Sometimes you’ll find an anti-inflammatory combo with all or a few of these ingredients or they can be used separately. I prefer to use them for specific actions when using them as separate often highly concentrated supplements. In this capacity is use turmeric (curcumin) for inflammation, ginger for gut healing and calming, and garlic as an antimicrobial.

4.  Avoid extreme temperatures. Whether you’re indoors or outdoors, or doing things like bathing or exercising, really hot or cold temperatures can have a negative effect on eczema. In the past, I’ve had a histamine reaction during exercise that resulted in extremely red and itchy legs in both summer and late fall. It’s really hard to workout when you stop to scratch every 10 seconds (plus people stare at your tomato red legs)!

Similarly, hot showers will do the same to me. I know when I’m in a flare to keep showers lukewarm or even cold.

5. Take a timeout. Not the kind where you sit in the corner and think about what you did wrong, but to similarly be still and contemplate. A couple of times each day take 10 minutes to just sit in silence while deep breathing. This doesn’t have to be a full on meditation (although if you want to- go for it because it’s amazing for stress reduction). The point is to let your mind quiet down and focus your intention to calmness and healing.

We spend all of our time in a stressed out, fight or flight mode (a.k.a. sympathetic nervous system ), which promotes inflammation, rather than the rest, digest, and reproduce mode (a.k.a. parasympathetic nervous system), which promotes healing. Chilling out, naps, eating, and sex are way more appealing anyway!

6. Laugh and play. Similar to the previous point, taking time to laugh and play does wonders for inflammation and counteracting the effects of the sympathetic nervous system. If you’re in a flare you might need to take a “personal day” from work.

Send the kids to school (if you have them) and just chill out watching funny movies or meet a comedic friend for lunch. When the kids come home, do something fun like playing games or something you all enjoy together. If you don’t have kids, grab a spouse, partner, or friend do your favorite activity.

The goal is enjoy life and put a smile on your face. There are lots of positive chemical effects that occur in your body when you smile, laugh, or share intimate moments with those you’re close with.

Bonus tip– if you’re a stay at home mom with a baby or small kids it’s hard to take a personal day. Instead of calling in sick to your boss, call a friend or family member to watch the kids for a couple hours (or more if possible) so you can focus on some fun or alone time. No running errands or chores- this time is for you to enjoy yourself!!

7. Pamper your skin with healing moisture. Once you get out of your not-too-hot shower, be sure to apply moisturizer ASAP. I’m a fan of my healing salve recipe, however, there are many options, especially if you’re just into the beginning of a flare. Coconut oil, shea butter, or a combination of the two may just be enough to get your skin going in the right direction. If you start to develop lesions, bumps, or extreme redness, the salve might be a better choice.

There are also many choices available online now too. I’ve had many clients tell me about creams and lotions that have worked for them. The key here is to get a clean and green one- avoid synthetic chemicals, dyes, and scents. Many of the good natural formulas have a base of coconut oil, shea butter, beeswax, and/or tallow (usually from beef) combined with essential oils or healing herbs. Going with a blend like this will help avoid topical reactions on the skin.

What remedies have you tried that have helped calm your symptoms down? Let us know in the comments section. Thanks!

Eczema: The Autoimmune Disease Everyone Seems To Be Overlooking

The No Cause, No Cure Paradigm for Eczema is Wrong

I’ve always been a questioner. This is why I believe eczema can be healed and reversed (and new science backs this). When I was a little kid, I asked lots of questions because I wanted to know how and why things worked. Conversations I’d frequently have with my parents would go something like this:

Me: “Why does my tummy hurt?””

Parent: “Probably because you just swallowed your gum.”

Me: “Why would gum make my tummy hurt?”

Parent: “When you swallow your gum it can stick to your insides.”

Me: “Why would it stick to my insides?”

Parent (frustrated): “Oh, I don’t know, it just does!”

At this point I usually stopped the dialogue because I was clearly annoying my parents and I was frustrated that I didn’t get the answers I desired. Even as little kid I couldn’t understand why gum wouldn’t be digested like the rest of my food?? It also didn’t make sense to me that it would stick to my insides. There is always a reason why (even if not everyone know the answer).

Those same feelings of frustration and disbelief came to the surface for me when I was told I had Eczema. I was instantly transported back to my childhood when I heard the words “there is no known cause or cure.” It was so infuriating and disheartening.

No cause. No cure. Yet, you’re still miserable, with a very real rash that makes you crazy because you want to keep scratching it incessantly and your doctor hasn’t provided you with any help at all. This is exactly how I felt.

The majority of conventional medicine still clings to the old idea that eczema, also known as atopic dermatitis, is purely a topical rash that makes your skin red and itchy, causes lesions, and is related to allergies.

And if you’ve ever had an eczema breakout you know that this isn’t just something to brush off, or something you should have to live with-  it’s a problem that affects the way you look and feel too.

I’ve never accepted the no cause, no cure paradigm- there’s always a reason why something is happening. Your body just doesn’t start to malfunction- it’s way too smart for that. There are complex physiological processes that occur over time that culminate in conditions like eczema. We’ll get into the details of that later.

Those of us in the functional medicine community, as well as many researchers, are redefining what eczema actually is. In December 2014, this groundbreaking study published in The Journal of Allergy and Clinical Immunology confirmed what many of us suspected all along- that eczema is indeed an autoimmune condition. The study showed that by blocking 2 key proteins involved in the body’s ability to fight off bacteria and viruses, the eczema was reversed. In the process of eczema, these proteins mistakenly target the body’s own tissues, causing an autoimmune reaction which can result in the body attacking the skin. That sounds like a cause to me!

But before we get into the details of how eczema develops as as autoimmune (AI) condition, let’s review what eczema is and briefly discuss the types.

What is Eczema?

As an inquisitive and frustrated kid, I’d reach for the encyclopedia when I got one of those “it just is” answers from an adult. Encyclopedias helped, but were still limited in information on many topics.

Now we have an overabundance of information coming at us 24/7 thanks to the internet, but it’s hard to digest and make sense of it all. So, let’s break eczema down.

Eczema is more commonly referred to as Atopic Dermatitis (AD) clinically. That term is very telling since atopy or atopic is Greek for “being out of place” and dermatitis is “inflammation of the skin”. What’s interesting is that in my graduate training (which was conventional medical clinical pathology) we learned that atopy refers to an allergic reaction or hypersensitivity occurring in a part of the body NOT in contact with the allergen. Based on this definition you’d think that conventional medicine would’ve realized the cause of eczema isn’t occurring on the skin level, but that hasn’t been the case.

Eczema or Atopic Dermatitis (AD) is defined by the Mayo Clinic as “a condition that makes your skin red and itchy. AD is long lasting (chronic) and tends to flare periodically and then subside.” It’s the most common type of eczema and research suggests that a family history of atopic conditions such as eczema, allergies, asthma, and hay fever is a predisposing factor in developing it. The data compiled from my research analyzing over 7,000 patients shows that 1 in 5 people with a family history of eczema have eczema. 20% is significant.

Eczema: The Autoimmune Disease Everyone Seems To Be Overlooking

Typical symptoms include:

  • Itching, which may be mild to severe, especially at night
  • Raw, sensitive, swollen skin from scratching
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Weeping wounds
  • Thickened, cracked, dry, scaly skin
  • Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees

Eczema symptoms and appearance differs from person to person. A mild form might look like red, irritated, and slightly speckled skin, to more severe forms where the skin is significantly inflamed, with lesions that are bloody and weeping. Discolorations often occur during the outbreaks and as the skin heals.

7 Types of Eczema (Yes, …there’s actually more than one)

There are many different types of eczema according to various sources. You could go a little crazy researching them all on Dr. Google, so we’ll cover the most common ones here.

Most varieties of eczema are named for where they occur or because they look slightly different than your typical atopic dermatitis. Regardless of where it located or how it looks, it’s still eczema.

  • Contact Dermatitis occurs when an irritant or allergen contacts the skin causing redness, burning, swelling and sometimes blisters. It can be caused by things such as frequent hand washing, solvents, chemicals, foods, metals, animals, pollen, and plants like poison ivy. For the record, I don’t believe contact dermatitis should be classified with these other forms of eczema as the cause is external contact and can happen to anyone regardless of health conditions and family history. It doesn’t appear to be AI in nature.
  • Dishydrotic Eczema occurs on the palm side of fingers, palms of hands, bottom of toes, and soles of feet. It presents as red spots, bumps, or blisters. Scaly patches, flaking, and deep cracks can form from damage to the skin. This type is 2 times more common in women. I can vouch for that since this one type that I had in a very classic presentation which makes it easier to distinguish from some of the other types.
  • Hand Eczema is different from dishydrotic in that it occurs on the back of your hand and fingers, as well as the webbing between fingers. It visually looks more like typical atopic dermatitis.
  • Neurodermatitis, also called Lichen Simplex Chronicus, which is similar to AD in that there’s significant itching but differs in that the surrounding skin is healthy. It occurs in isolated patches that look thick, discolored, dry, scaly or flaky and can be mistaken for psoriasis. There can be underlying dysfunction of the nerves in this area.
  • Nummular Eczema, also known as Discoid Eczema is characterized by coin or circular shaped lesions that can be raised. Inflammatory reactions occurring in the body and dry skin are thought to play roles in developing this type of eczema. It can look like ringworm which is a fungal infection so it’s worth ruling that out.   
  • Seborrheic Dermatitis, Scalp Eczema, or Cradle Cap typically occurs in areas where there are high concentrations of oil producing sweat glands including the scalp, face, neck, upper back, shoulders, and chest. Individuals with immune system dysfunction are at increased risk for seborrheic dermatitis. It can have an oily or greasy appearance, unlike the other types of eczema, with white to yellow flakes.
  • Stasis Eczema/Dermatitis, also called venous stasis dermatitis, is a special type of eczema that occurs in areas where there’s decreased venous blood flow resulting in pressure build up causing fluid leakage from veins. Red, swollen, flaky, itchy skin occurs initially and if not taken care of can progress to ulceration, infection, and/or permanent thickening or scarring of the skin.

What Causes Eczema

If you type in ‘causes of eczema’ in Google, you’ll get a variety of answers like:

  • No true known cause
  • Dry or irritable skin
  • Genetic variant that affects the skin’s barrier function
  • Stress
  • Immune system dysfunction
  • Hormone Fluctuations
  • Bacterial or viral infections or imbalances
  • Environmental conditions such as cold, dry weather or humid, hot weather
  • Allergens

Unfortunately, while many of the above are absolutely true, most conventional doctors still treat it like it’s a condition that only occurs on the surface and don’t address most of that list. They’re likely to suggest topical treatments and possibly tell you to avoid a couple of foods, allergens, and hot or cold weather. They neglect the impact of the true root causes beneath the surface.

The worst fact of all is that some doctors are still of the old school thinking that there is no cause or cure for eczema.

Thankfully, research is evolving and know we know otherwise.

Given that eczema is now considered an autoimmune condition, we know the conditions need to be ‘just right’ for one to manifest.

These are the 3 key factors that come together to initiate autoimmunity:

  1. A genetic predisposition/family history
  2. Intestinal permeability (leaky gut)
  3. Environmental triggers such as stress, infection, gut or skin dysbiosis (imbalance between the good and bad bugs), food sensitivities or allergies, trauma, hormone imbalances, toxins, and nutrient imbalances.

With autoimmunity, the immune system mistakenly targets a body tissue and tries to attack it like it’s a foreign invader. If you have eczema, this means that the autoimmune process is attacking your skin. And to get rid of eczema, you need to address each of your root causes, which are covered in numbers 2 and 3 above.

For me, the perfect storm for eczema flares was high stress levels, hormone imbalances, GI infections and dysbiosis, leaky gut, and food sensitivities. Histamine containing foods, exercise, and hot showers made it even worse. This scenario is very similar for most of my clients as well.

A New Paradigm for Eczema

Just like when I was a kid, I wasn’t satisfied with the explanation of what causes eczema, so I developed my own process to explain the cycle of how it occurs.

Stage 1: Flare Up

You know when a flare up is coming because your body send you little signals in the form of tingle, slight itchiness or a burning sensation. On the inside the panic begins to set in and you’re thinking, “Oh no, not again!” These are the subtle hints that you’re body is unhappy and it’s trying to tell you. The flames have been stoked and a fire is beginning to burn inside.

From a physiological standpoint, your immune system is activated from one or more triggers like foods, chemicals, toxins, or microorganisms (bacteria, fungi, parasites, viruses) and has begun attacking your body tissues. Having a genetic predisposition toward eczema or autoimmunity, and a leaky gut make this the perfect storm.

At this point, trying to stop or slow the flare is a good idea as it will help begin to reverse the inflammatory process. Start with your diet as many significant triggers for eczema are food related. At a minimum go gluten and dairy free, but likely you’ll find other foods that need to be avoided while you heal.

Getting stress under control right now is key as it’s often what pushes you over the edge into a flare. It’s hard to eliminate it, but try to manage stressors by maintaining boundaries, saying no, or asking for help. If you can completely eliminate a stressor (like avoiding a toxic person or situation) even better! Also, finding an outlet like journaling, deep breathing, meditation, or walks in nature can profoundly reduce the stress response.

Stage 2: Outbreak

Your flare up transitions to a full blown outbreak when the tingle, burn or minor itch escalates to constant itching causing red, inflamed skin with welts, wounds, and/or blisters. At this point it can appear to be treatment resistant since all of the root causes likely haven’t been addressed.

The outbreak occurs when the inflammatory process mediated by the immune system goes unchecked. The inflammatory chemicals have kicked up and are peaking resulting in your extreme discomfort and many symptoms. During this phase eczema can interfere with life, making social gatherings, work, sleep, and sanity difficult due to the incessant itching. There’s a full blown inflammatory fire raging inside.

Getting to the bottom of all of your triggers and root causes is essential now so you can heal.  Addressing diet and stress may do the trick for some, but others may require deeper digging or testing which is easiest with assistance of a trained professional. Even though I do this for a living, I call upon my friends and colleagues to make sure I’m not missing anything. We can all use some help now and then!

If you haven’t begun dialing in your diet- there isn’t a better time. You need to focus on taming the fire burning within. Anti-inflammatory supplements and foods are super important now. This blog article I wrote provides a recipe, as well as 6 healing foods and supplements to help put out the flames.

Topically, some people may benefit simply from coconut oil, but I personally didn’t and many of my patients echo that sentiment. The same can be said of shea butter. However, by combining these an easy and wonderful healing salve can be made.

Eczema Healing Salve Recipe

  • ½ cup unrefined, organic coconut oil
  • ½ cup unrefined, organic shea butter
  • 10 drops calendula essential oil
  • 10 drops yarrow essential oil
  • 10 drops rosemary essential oil
  • 5-10 drops frankincense essential oil

Mix these together in a bowl by hand or with a mixer. It will be hard and clumpy at first, but eventually will soften and everything will come together. Note: you can play with the essential oils as some people respond better to certain ones than others. If you can’t some of these, that’s fine too. These all have healing, calming or anti-inflammatory properties.

The most important thing to remember in the outbreak phase is the root causes. If you don’t identify and address them all, your eczema is likely to return at some point.

Stage 3: Healing

Relief is in sight!  This is when you start to feel better and symptoms are less severe, but still present. You may or may not be itchy. Your skin still shows signs of irritation, but no open wounds and blisters. It may also appear thick, leathery, scaly, dark, or ashy now. The fire within is now just smoldering embers.

Your immune system is now ramping down and under control, but in physiological time things go slow which is why there are still visible signs (think of how long it takes to completely heal a cut or broken bone).

Steering clear of dietary triggers or any other triggers you’ve identified through self investigation or testing is still a must to maintain healing. Continue use of natural topicals to protect the skin and help rebuild integrity. Nutrients like vitamins A,C, D, and E, biotin, zinc, selenium, and collagen support healing and skin structure.

Stage 4: Clear Skin

Hooray!! When you’re suffering through an eczema flare you often don’t think this day will come, but it is possible to completely reverse eczema and have clear skin again. You’re skin is fully healed and looks great again. No more hiding in long sleeves or gloves!

Think of this stage as maintenance or dormancy. You immune system is finally calmed down and balanced so the attack on skin is over. The fire is out completely!

Maintaining a healthy diet, stress levels, and getting adequate sleep will help keep you here in your happy place.

Common Treatments for Eczema

Again, if you look eczema treatments up in Google, you’ll get a list that looks like this:

  • Over-the-counter medications such cortisone cream, Benadryl cream, or antihistamines (Benadryl, Claritin, and Allegra)
  • Prescription medications topical corticosteroids, oral steroids, and oral antihistamines.  
  • Moisturizers that contain petroleum jelly, mineral oil, or synthetic emollients like lanolin or glycerin
  • Special baths with bleach, salt (sea salt or table salt), baking soda, epsoms salts, oatmeal, or apple cider vinegar.  
  • UV Light/Phototherapy
  • Wet Dressings
  • Stress Reduction

While the medications may be helpful at first for managing symptoms, they don’t address the root causes and the eczema returns. Long term, the topical creams can damage the integrity of the skin and the topical steroids and oral medications shut off the body’s natural inflammatory response which is counterproductive to healing the body.

The moisturizers typically suggested sometimes work and other times cause more irritation due to the ingredients. Unfortunately, if they do work it’s only addressing issues at the skin level and not what’s beneath the surface.

Special baths can definitely be helpful in managing symptoms, but some need to be use with caution. I am personally not a fan of the bleach baths, ever. Sea salt, table salt and apple cider vinegar can be great, however should be tested first since they could irritate open wounds. Oatmeal baths are also very soothing as long as you know you don’t have Celiac or it’s skin variant called Dermatitis Herpetiformis. If you do, you should probably avoid oatmeal completely as it’s often contaminated with gluten.

Phototherapy from the sun is my preferred use. While using phototherapy lamps that emit UV light definitely have benefit, there are a few more risks associated with them due to broader spectrum of the light rays, such a burning, blistering, accelerated aging/breakdown of the skin, and skin cancer. More recently narrow band UVB therapy, which uses a smaller spectrum and thus less radiation, is a better option for artificial light therapy.

Wet dressings can be very helpful in healing eczema when used with natural moisturizers. However, topical corticosteroids are often used and I believe they’re a bad long term strategy for the reasons given above.

My Methodology for Healing Eczema

While some of the commonly used treatments listed above can be helpful at soothing or even resolving some symptoms, they’re all missing the most important factor: addressing the ROOT CAUSES.

Even if you’re in remission and asymptomatic, you’re still at risk for a flare up because you haven’t addressed the important factors lingering beneath the surface. You’re trigger might be work, family, or financial stress, a stomach virus or infection, passing of a loved one or pet, a divorce or separation, moving to a new town or job, or even injuring yourself exercising.

My major trigger was always work related stress (or not addressing it) as it is for so many that suffer from eczema.

The good news is that I healed my eczema and we, together, can heal yours too.

My process starts with a detailed history, from birth until now, that identifies all of the contributing factors to your eczema and what potential root causes need to be investigated.

Next we order the appropriate tests to identify your specific and individual underlying causes.

From there, I design a comprehensive program based on your results and history that addresses all of your root causes in a systematic way. We don’t throw the kitchen sink at you all at once and hope it works. Instead, the plan is outlined in a step-by-step manner that makes it easy for you to follow and allows your body to heal.

If you’re tired of living in the eczema cycle of remissions and flare ups, or have an active, raging outbreak that itches so bad and looks so horrible it’s affecting every aspect of your life and you don’t think it will ever end, I invite you to work with me and my team to heal your eczema for good.

We’ll work together to put the pieces of your health puzzle in place. We’ll guide you at every step with a plan of action to get your body healing and skin happy again.

If you’d like 1-on-1 support troubleshooting which root causes are contributing to your Eczema, and get a specific plan to reverse it, the first step is to book a 1-hour “Eczema Root Cause Troubleshooting Session”.