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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Why Taking Care of Your Liver Will Leave You Feeling Shiny and New

This article originally appeared on Healevate.

Most of us have?felt that special feeling. You know the one. Great night out with friends, maybe even a special someone. And then the next morning rolls around. THAT feeling.

You wake up to a pounding head, nausea, aches, brain fog and an inability to focus. That?s your liver screaming at you.

Those extra few drinks just needed to happen, huh?

So those are obvious signs that we recognize easily, but did you know that when your hormones are out of whack, your blood sugar is erratic, and you constantly feel sluggish, your liver is STILL?speaking to you?

Most of us are great at listening to our bodies when we experience something as uncomfortable and excruciating as a bad hangover, but we?re more likely to ignore the signs when they?re less obvious or when they require lifestyle changes that we may not want to make.

The liver is the largest internal organ and has extraordinary resiliency, as it?s bombarded daily with an onslaught of assaults from air pollution, environmental toxins, medications, and microorganisms (bacteria, mold, fungi, and viruses).

?We are exposed to 6 million pounds of mercury and over 2.5 billion pounds of chemical toxins each year,? according to Dr. Mark Hyman.4 But the amazing liver isn?t fazed?it has the highest regenerative capacity of any organ in the body.

It?s clear that it takes a lot to knock the liver down, but somehow, in our crazy, high-stress lives, we find a way to do just that.

Impaired detoxification and liver function is the predecessor of many systemic diseases, including liver disease. At least 30 million people, or 1 in 10 Americans, has some type of liver disease.1

If you consider some of the other conditions where liver function is important, including autoimmunity, cancer, cardiovascular disease, diabetes, and high cholesterol, it?s obvious that proper liver function and detoxification are central to health. So it?s important that we recognize the signs of impaired detoxification before it has the chance to become a full-blown condition, because reversing it is much easier than reversing most chronic diseases.

What Exactly is Liver Detoxification?

Detoxification is the process of transforming and removing harmful substances from the body. Normally, the liver takes a toxic substance, then neutralizes and transforms it so that it can be eliminated in a healthy way that doesn?t damage the body.

Once your liver detoxifies and breaks down a substance, it?s excreted to the blood or bile for elimination. Blood products are filtered through the kidneys and eliminated as urine, while bile products are sent to the intestines and eliminated as feces. Some items are also eliminated through sweat and breathing.

When detoxification doesn?t occur efficiently and properly, the liver becomes taxed and sluggish, which impacts almost every system of the body in some way. The liver plays a role (to varying degrees) in most biological functions, being responsible for over 200 tasks. Here is a short list of some other liver functions that detoxification impacts:2,3

  • Conversion of harmful ammonia to urea
  • Clearance of bilirubin (if there?s a buildup of bilirubin, the skin and eyes turn yellow in a condition called jaundice)
  • Storage of essential vitamins and minerals, and conversion to their biologically active forms
  • Regulation of amino acid and protein metabolism
  • Maintenance of hormone balance

Impaired detox results in changes to all of the above processes, which can manifest as imbalanced hormones, high cholesterol, blood sugar abnormalities, decreased immune function, increased inflammation and pain, and a variety of symptoms ranging from fatigue and brain fog to rashes and headaches.

How Does Liver Detoxification Become Impaired?

Impaired liver detoxification occurs when any substance or disease process compromises the liver?s ability to perform its basic metabolic functions.

When your liver can?t function properly, toxins and metabolic waste back up and accumulate in your body, making you feel horrible and causing damage to your cells.

A good way to imagine this is to think about it like taking out the trash. If you empty the waste bins throughout your house daily, even every couple of days, you?re probably in good shape.

But what if you let it pile up for?a month, or even a year? Pretty soon you?re looking like you belong on a late-night cable TV show because your house is teeming with bacteria, mold, parasites, and volatile chemicals, soon to be deemed uninhabitable by the health department. When your liver can?t empty the trash on a continual basis, this is what happens inside your body.

Damage to your liver cells can occur through a variety of mechanisms:3

  • Metabolic disorders such as obesity, diabetes, and fatty liver
  • A high sugar and carbohydrate diet or processed foods
  • Illnesses that produce toxins and inflammation or promote malabsorption
  • Infections such as Candida, viral hepatitis, and any GI infection/dysbiosis
  • Drugs and supplements
  • Pollutants, chemicals, and heavy metals such as BPA, parabens, smog, pesticides, fluoride, mercury, arsenic, etc.

What all of these processes have in common is that they damage liver cells in some form, whether from oxidative stress, inflammation, or a lack of the nutrients the liver needs in order to work properly. The damage results in impaired detoxification systems.

Detoxification processes in the liver are controlled by many genes and the Phase 1, 2, and 3 detoxification pathways. In order for detoxification to occur properly, the genes that control the process need the correct nutrients and environment (epigenetics) to properly regulate the enzymes that control the detoxification pathways.

One group of genes that have received publicity lately are the methylation pathway genes (MTHFR, MTRR, CBS, COMT, etc.), and rightfully so. This group of genes plays a central role in detoxification, as well as neurotransmitter, hormone, and amino acid metabolism, cardiovascular health, DNA synthesis, and gene regulation.

Sometimes there are changes in a gene?SNPs, or single nucleotide polymorphisms?that alter the function of the corresponding enzyme that controls a process such as detoxification.

When you have an SNP, it changes the gene?s instruction manual, which alters the way the enzymes work.

For instance, if you have one copy of an MTHFR (methylene tetrahydrofolate reductase enzyme) gene SNP, you?ll have a 30% reduction in the activity of the enzyme. If you have 2 copies of the SNP, you?ll have a 70% reduction in enzyme activity and significantly impaired detoxification. Many people have multiple SNPs in this pathway, resulting in reduced detoxification capacity.

Similarly, the 60 cytochrome P450 (CYP450) family of enzymes that are primarily found in the liver play a significant role in the breakdown of toxins. SNPs affect the CYP450 enzymes as well?especially those involving drug metabolism.

?Depending on the gene and the polymorphism, drugs and supplements can be metabolized quickly or slowly. If a cytochrome P450 enzyme metabolizes a drug slowly, the drug stays active longer and less is needed to get the desired effect. A drug that?s quickly metabolized is broken down sooner, and a higher dose might be necessary to be effective. Cytochrome P450 enzymes account for 70 to 80 percent of enzymes involved in drug metabolism.?5

The Phase I detoxification system is controlled by these CYP450 enzymes and is the first step toxins go through in the breakdown process. Once toxins enter this pathway, the substance undergoes a chemical transformation, producing an intermediate that?s often as toxic or more toxic than the original substance.

This isn?t a big problem if your Phase 2 detoxification pathways are sufficient, but there can be SNPs here too, reducing the process? efficiency and causing you systemic problems.

Phase 2 detoxification reactions involve the conjugation (coupling) of the Phase 1 intermediate to a substance, making it water-soluble and suitable for elimination via urine and bile (feces).

The Phase 2 conjugation reactions are glucuronidation, sulfation, methylation, acetylation, amino acid conjugation, and glutathione conjugation.

Essentially, what?s happening in all of these processes is that the intermediate is combined with a specific type of molecule that neutralizes it for elimination. For example, in methylation, a methyl group (CH3) is transferred to the intermediate. Once this process takes place, the neutralized substance can be eliminated.

Phase 3 of detoxification takes the neutralized substance and transports it out of the liver cell to be excreted in the urine or bile.

Diet, nutritional status, illness, toxic burden, dysbiosis, and SNPs all affect the efficiency of the detox pathways, and vice versa. Identifying any potential roadblocks and cleaning up your personal environment and/or lifestyle is necessary to have detoxification systems running at peak performance.

Triggers of Impaired Liver Detoxification

We have toxins around and inside us that come in many forms. If we don?t have healthy detox processes, they accumulate and cause damage all over our bodies. Common triggers of impaired liver detoxification are:

Diet: High sugar and carbs, processed foods, charred foods, xenoestrogens, water, GMOs, and conventionally-raised meats contain toxins.

Nutrients: Low levels of necessary amino acids, vitamins, and minerals impede efficient detoxification processes.

Dysbiosis: Infections and an imbalanced microflora produce toxins.

Leaky Gut: Increased intestinal permeability allows toxins into circulation that wouldn?t normally enter the bloodstream.

Toxins: Medications, supplements, alcohol, and environmental chemicals and metals burden the detoxification pathways and can directly damage the liver.

Stress: Psychological stress, toxic relationships, and illness produce biochemical changes that impair detoxification.

Diet

Dietary triggers of impaired liver detoxification are many and significant, since you eat multiple times every day. This provides lots of opportunities to ingest something harmful.

High sugar and carbohydrate diet: When you eat excessive sugar and carbohydrates or refined foods, they need to be stored somewhere if you aren?t using them for energy. They end up stored in the body as fat and in the liver as glycogen.

Over time, if this process continues, the liver becomes inundated with fat, which compromises its function and promotes inflammation and insulin resistance, according to Dr. Mark Hyman.6

Processed foods: Any foods that come from a package may contain trans fats, preservatives, colorings, dyes, additives, and artificial sweeteners that are seen as toxins by your body. Additionally, some foods you think are safe may not be. Most cans are lined with BPA, rendering the foods inside very unhealthy.

According to Dr. Joseph Mercola, ?High acidity?a prominent characteristic of tomatoes?causes BPA to leach into your food. BPA is a toxic chemical linked to reproductive abnormalities, neurological effects, heightened risk of breast and prostate cancers, diabetes, heart disease, and other serious health problems.?7

Charred/browned foods: Cooking foods until they have color may impart lots of flavor, but you?re also getting a hefty dose of toxins along with it. Grilling is the worst culprit.

Dr. Mercola says, ?Heterocyclic amines (HCAs) are hazardous compounds created in meats and other foods that have been cooked at high temperatures.

Similarly, polycyclic aromatic hydrocarbons (PAHs) form when fat drips onto the heat source, causing excess smoke, and the smoke surrounds your food, transferring cancer-causing PAHs to the meat.?7 HCAs and PAHs are also present in deli meats.

Xenoestrogens: Xenoestrogens are substances that mimic the hormone estrogen. Foods and chemicals are sources of these compounds. Not only are they endocrine disruptors, but also toxins and carcinogens. Soy is the most common dietary source. Consumption of soy is linked to infertility, thyroid disruption, and breast and prostate cancers. Toxins produced in the processing of soy include nitrosamines, lysinoalanine, MSG, and aluminum.7

Water: Water can be one of the most toxic things we consume daily. Water can have microorganisms, chlorine, fluoride, agricultural and manufacturing runoff, pesticides, or heavy metals. Dr. Deanna Minish states, ?Current estimates suggest that there are more than 2,000 toxins in tap water.?14 Bottled water is often not much better.

GMOs: Genetically modified foods contain genes that aren?t native to the original organism, and your body sees them as foreign and toxic. Corn, for instance, might contain Bt toxin or Roundup Ready genes so that it withstands pests better. These toxins degrade the stomach of the target insects and are now found to be harming humans, causing allergies and immune system activation similar to that of inflammatory conditions.8

Further, the pesticide Roundup (glyphosate) has been proven to have harmful mechanisms. According to Dr. Mercola, a recent study found that ?glyphosate inhibits cytochrome P450 (CYP) enzymes, a large and diverse group of enzymes that catalyze the oxidation of organic substances.? This, the authors state, is ?an overlooked component of its toxicity to mammals (which means humans).

By limiting the ability of these enzymes to detoxify foreign chemical compounds, glyphosate enhances the damaging effects of those chemicals and environmental toxins you may be exposed to.?9

Conventional meat and produce: Food grown or raised with conventional methods (non-organic) has some level of toxicity. Meat, poultry, and fish can be given antibiotics and drugs that affect their growth.

Vegetables and fruit can contain pesticides or be genetically engineered. One potent class, the organophosphates, are linked to infertility and impaired growth and development, and they?re known neurotoxins.

Nutrients: In order for detoxification to proceed the right way, it requires adequate amounts of the necessary raw materials to do so. These include amino acids, B vitamins, minerals, antioxidants, and sulfur-containing compounds. Deficiencies will result in impaired detox processes.

Dysbiosis

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

When this happens, the bad guys can produce toxins themselves or even undo all of the work the liver has done (deconjugation), allowing toxins back into circulation. While many organisms produce toxins (bacteria, mold, yeast, and parasites), here are some examples:

Candida: Yeast ferments sugars into ethanol and acetaldehyde, which are carcinogens that cause alcohol toxicity and hangovers. Candida increases levels of ammonia, which is another toxin.3 Yeast also produces toxins that allow them to bore into the intestinal wall, as some parasites and bacteria do.12

Clostridium difficile: Also known as C. diff, this bacteria produces several toxins that act on the gut and other cells of the body. These toxins are responsible for the awful diarrhea associated with an acute C. diff infection.

Mold: Molds are ubiquitous and often ingested in air and food. According to Dr. Jill Carnahan, ?Some molds secrete mycotoxins. Exposure to mold and mold components is well known to trigger inflammation, allergies and asthma, oxidative stress, immune dysfunction, and neurological damage in humans.?13

Leaky Gut

Increased intestinal permeability, also known as?leaky gut, occurs when the cells that line the?intestinal tract become irritated and compromised, actually spreading apart and allowing particles that wouldn?t normally enter the bloodstream to pass through. This causes the immune system to react to these substances, producing inflammation.

Some of the irritants that cause leaky gut are toxins ingested in medications, alcohol, food, and water, as well as the byproducts of any allergic or sensitivity reaction. Further, dysbiosis and any gut infections compound this effect by the contribution of the toxins they produce.

When you have a leaky gut, your overall toxic burden is increased, because many more substances enter circulation than usual, and your liver has to detoxify all of them. This can place a significantly increased burden on the liver.

Toxins

Toxins are everywhere in our modern society. Unfortunately, our exposure to medications, supplements, chemicals, pesticides, pollutants, petrochemicals, heavy metals, tobacco smoke, and even alcohol are byproducts of contemporary living, and most of us have exceeded our liver?s natural capacity to cleanse us. If we can?t rid ourselves of these toxins, they accumulate and are stored in the body.

Heavy metals are everywhere?in the soil, in our homes and food, and as byproducts of industries, car exhaust, and tobacco smoke, so they?re hard to avoid. Things like lead, mercury, arsenic, cadmium, and aluminum are damaging toxins by themselves, but they also compromise our detoxification pathways, making matters worse.

According to Dr. Mark Houston, ?Mercury, cadmium, and other heavy metals have a high affinity for sulfhydryl (SH) groups, inactivating numerous enzymatic reactions, amino acids, and sulfur-containing antioxidants (NAC, ALA, GSH), with subsequent decreased oxidant defense and increased oxidative stress.?15

This means reduced antioxidant and detox capacity. He further states, ?Mercury induces mitochondrial dysfunction with reduction in ATP, depletion of glutathione, and increased lipid peroxidation; increased oxidative stress is common.?15

Persistent organic pollutants (POPs) include PCBs, DDT, dioxins, pesticides, flame retardants, Triclosan (the antibacterial chemical in personal care and cleaning products), and other chemicals. Like other toxins, they?re heavily present in food, water, soil, air, and products we use.

Over 80,000 POPs have been released into the environment, and we lack information on how they affect human health. We know they?re particularly toxic, causing infertility and endocrine hormone disruption as well as being immunotoxic, neurotoxic, and carcinogenic.16 They?re also linked to cardiovascular disease, obesity, and diabetes.16

Even medications and supplements can have adverse effects on detoxification by damaging the liver. Certain prescription and over-the-counter drugs list liver damage as a side effect and a risk. Some of these include antidepressants, antipsychotics, corticosteroids, non-steroidal anti-inflammatory medications (NSAIDs) (particularly acetaminophen (Tylenol)), and others.3 Some herbal supplements are implicated here as well since they can be toxic to the liver if not used appropriately, such as kava kava, skullcap, and germander.

Stress

Not only do we have toxins that come from the outside, but we also generate them from within. Psychological stress, toxic relationships, illness, and anything else that disrupts your body?s natural balance produces biochemical changes that impair detoxification. But to fully understand toxicity, you must understand the concept of total load.

Dr. Mark Hyman explains this idea well. ?This is a total amount of stressors on your system at any one time, and what happens is like a glass filling over with water. It takes a certain amount to fill the glass, and then, after a certain point, you put more in and it overflows. When our detoxification system is overwhelmed, is overloaded, that?s when we start getting symptoms and get sick, but it may take years of accumulated stress and toxins to get to that point.?18

He further points out that stress is a significant contributor to the total toxic load, including ?the mental, emotional, and spiritual toxins that affect us; isolation, loneliness, anger, jealousy, and hostility, which all translate into toxins in our system.?18

Dr. Deanna Minich elaborates on that concept, stating, ?When we don?t properly ?eliminate? unhealthy emotions, we may experience increased levels of stress. Stress not only causes inflammation, but can elicit poor digestive function.?Those who experience chronic stress have a difficult time maintaining a positive outlook on life and are at greater risk for disease and premature death.?17

Chronic stressors cause an imbalance between the sympathetic (fight or flight) and parasympathetic (rest and digest) nervous systems, producing increased levels of the stress hormone cortisol. Over time, the constant cortisol elevation and demand leads to cortisol resistance and diminished cortisol.

Cortisol is the main anti-inflammatory hormone in your body, and when levels are low, inflammation increases. This results in oxidative stress and free radical damage. This in and of itself can damage the liver, but it also increases the toxic load the liver must clean up. Further, these changes can also perpetuate dysbiosis and leaky gut.

Symptoms of Impaired Liver Detoxification

The symptoms of impaired liver detoxification are system-wide in the body.

Inflammation/immune: Pain, weight gain, lipomas (benign fatty tumors/deposits), cellulite, allergies, autoimmune conditions, recurrent infections, stuffy nose

Digestive/gastrointestinal: Gas, bloating, cramping, pain, diarrhea, constipation, inability to digest fats (oil in toilet or greasy stools), reflux (GERD), IBS, gallstones, nausea, bad breath, food sensitivities, allergies

Blood sugar: Hypoglycemia (low blood sugar), fatty liver, Type 2 diabetes, cravings

Brain/mood/energy: Brain fog, dizziness, vertigo, fatigue, lethargy, depression, irritability, poor concentration, headaches, poor sleep, poor memory

Musculoskeletal: Chronic fatigue syndrome, fibromyalgia, muscle pain, joint pain

Skin/hair/nails: Rashes, hives, dermatitis, eczema, pruritis (itchy skin), excess or lack of sweating, acne, rosacea, liver spots (brown spots), red skin, flushed face, red/itchy palms, yellow skin or eyes, itchy eyes, dark eye circles, body odor, hair loss, cankers

Hormones: Hormone imbalances, PMS, severe menopausal symptoms, inability to lose weight, infertility

Detoxification: Multiple chemical sensitivity (MCS), inability to tolerate medications or alcohol, poor tolerance to hormone treatments

Lab Testing for Impaired Liver Detoxification

Liver function and organic acid testing is important so you know the state of your liver and detoxification pathways. When considering toxin testing, you need to be cautious, because some of the tests actually liberate toxins from storage in your cells, which can cause problems, especially if you have a leaky gut.

In general, it?s a good idea to make sure liver function has improved and the gut is healthy before testing and treating toxins.

General tests for liver function and blood sugar:

  • Total bilirubin
  • AST (aspartate aminotransferase)
  • ALT (alanine aminotransferase)
  • GGT (gamma glutamyl transpeptidase)
  • ALP (alkaline phosphatase)
  • Fasting insulin and glucose
  • CMP or comprehensive metabolic panel (will have most of the liver tests on it)

Functional tests:

  • Organic acids
  • Amino acids?urine, blood
  • Heavy metals testing?hair, urine, feces, blood, red blood cell
  • Toxic chemicals (such as BPA, phthalates, parabens, organophosphates, etc.)
  • DNA profiles for methylation and detoxification

Treatment of Impaired Liver Detoxification

Supporting healthy and robust detoxification takes a little effort. Cleaning up your diet,environment, and lifestyle and adding in some supporting nutrients will lighten the load on your liver.

Detoxifying your diet is a good place to start, since we consume foods and liquids many times every single day.

Drink lots of water every day! Have at least eight glasses to flush your system. Add some liver for an added boost.

Eating organic and GMO-free will help you avoid many toxins.

Make sure your diet is rich in phytonutrients. Certain plants are known to support detoxification. The Brassica family, which includes broccoli, cabbage, cauliflower, and kale, contains the sulfuric compounds sulforaphane and indoles (I3C) that activate the Nrf2 gene, which increases many of the detoxification enzymes, especially in Phase 2.10,11,20 Garlic also has sulfur compounds that exert the same effect. Other Nrf2 activators include curcumin from turmeric, capsaicin from hot peppers, and resveratrol from grape skin or wine.11,20

Many leafy green herbs and plants support detoxification, including dandelion greens, cilantro, parsley, watercress, and chard. Use them in cooking, salads, smoothies, and juices.11,19

Artichoke, asparagus, and beets are healing to the liver with antioxidants that prevent liver damage. Artichoke is also one of the best stimulators of bile flow.11,19

Be sure to wash your produce well?even if it?s organic.

Cook with lower temperatures to avoid generating harmful chemicals. If you must grill, marinating with olive oil, lemon, and herbs such as rosemary, thyme, and oregano will help decrease the amount of HCAs and PAHs formed.

Avoid packaged foods as much as possible, including drinks in plastic bottles.

Invest in a water filter that filters out chlorine, fluoride, metals, and microbes. Most sink-mounted and pitcher systems don?t do this.

Drinking green tea also supports Phase 1 and 2 detoxification pathways by increasing CYP activity.11,20

In addition to detox-supporting foods, there are nutrients obtained in supplements that directly support the liver and detoxification process.

Amino acids: This is one of the most critical nutrient groups, as these acids function in the detoxification process itself and serve as antioxidants.

N-acetylcysteine (NAC) is the precursor to glutathione, the master antioxidant of the body and a significant component of Phase 2 detoxification.

Cysteine and methionine contain sulfur and contribute to the sulfation pathways. Methionine is also a methyl donor to the methylation pathway in its activated form, S-adenosyl-methionine (SAMe). Glycine also performs conjugation down the glycination pathway.10,20

Glutathione: Taking glutathione itself as a supplement or through IV therapy is helpful when levels need to be increased.

B vitamins: The B complex vitamins, especially B5, B6, B12, and folic acid are significant co-factors in the Phase 1 and 2 detoxification reactions that help drive the reactions forward. The methylation pathway is also very dependent on sufficient levels of B12 and folic acid.

Minerals: Iron, magnesium, zinc, and selenium are all minerals that support the detoxification process as co-factors or through antioxidant functions.20

Antioxidants: Antioxidants such as alpha lipoic acid (ALA), vitamins A, C, and E, and flavonoids play an important role, since the detox process inherently produces free radicals that need to be quenched.10,11,20

Milk thistle: Silymarin is the polyphenol in milk thistle that promotes detoxification. The antioxidant capacity of silymarin can lower the liver?s oxidative stress associated with toxin metabolism, which has the effect of conserving cellular glutathione levels.11

Calcium-D-Glucarate: This nutrient helps prevent the deconjugation of toxins in the intestines by bacteria, thus preserving them for excretion.

Probiotics: Probiotics will help maintain the balance between good and bad bacteria in the gut, which supports healthy elimination and immune functions that in turn support the liver.

Diet and nutrients can support the detoxification process itself, but the other half of the?equation involves cleaning up your world.

Lifestyle changes involve some work, since they require you to read labels, investigate your personal environment, and make some changes, but the benefits to your health are worth it.

Start reading labels: The more you know about what you put in, on, and around your body, the better. If you can?t pronounce it, you should probably avoid it. Knowledge allows you to make healthier choices for you and your family.

Clean up your products: Choose more natural personal care products, toiletries, baby products, home cleaners (especially window and bathroom cleaners), and lawn fertilizers. These products are laden with preservatives and chemicals. Baking soda, coconut oil, white vinegar, lemon, and essential oils can fill many of these roles without the unwanted toxins.

Detox your furniture and home: Furniture, paint, flooring (especially carpet), and building materials also contain chemicals that give off gas, meaning they constantly emit these toxic compounds into the air and you breath them in. Opt for more natural materials like bamboo, latex, wool, and organic cotton.

Get some houseplants: Many houseplants such as English ivy, rubber plants, peace lily, golden pothos, spider plants, Boston ferns, queen ferns, and dwarf date palms are all great at filtering toxins from the air.

Air filters: Having HEPA filtration added to your heating and cooling system will result in more toxins and fine particulates being removed from your home air.

Open your windows: Indoor air can be more toxic than outdoor air, so open your windows and let your home and office breathe.

Shower filter: Invest in a shower water filter or a whole house unit. Your skin is the largest organ in your body (and the liver is the largest organ inside) with a high capacity for absorption. It will absorb toxins in the water you bathe in.

De-stress: Lower your stress levels by finding ways to either decrease your stressors and create boundaries or find appropriate outlets like talking, journaling, or exercising. Getting out into nature can be especially helpful.

Toxic relationships: If you have a person in your life who?s causing you to feel bad, hurt, angry, or frustrated, you should let them know if you can. If you can?t, then try to limit contact with them.

Sleep: Getting 8-9 hours of sleep per night is important, since this is when your body regenerates and heals.

Exercise: Movement is essential in keeping elimination going. Moving keeps your lymph and blood pumping, promotes bowel movements, counteracts inflammatory processes, and lets you sweat.

Sauna: Sweating is also a critical component of detoxification. You can do it through exercise or using a sauna. Saunas increase circulation and metabolic rate. Studies show that many metals, especially cadmium and nickel, are eliminated through sweat at higher levels than through urine.15

Bowel movements: Make sure you have 1-2 bowel movements per day. Daily elimination through the bowels, urine, and sweat are vital for proper detoxification.

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Why Autoimmunity Is Keeping You Sick And How To Reverse It

This article originally appeared on Healevate.

Do you feel fatigued even after you get a full night of sleep? Do you have achy muscles and joints, brain fog, an inability to concentrate, or insomnia? Do you get rashes, eczema, hives, or skin irritation? Do you have a?hard time?tolerating cold or heat? Do you get diarrhea, bloating, constipation, or stomach pain?

If you answered ?yes? to several of these, there?s a good chance you have an autoimmune condition. Many people suffer for years with a vague set of symptoms that look like many other conditions but can?t be clearly defined or put in a box. Today we know this previous gray area actually defines the symptoms that precede or are involved in the process of autoimmunity.

This inflammation-based condition is a hot topic receiving lots of press right now in the health world, especially in holistic functional medicine and natural medicine spaces. This is partially because some AI conditions are now easier to diagnose, but much is due to the fact that we now understand the role of the gut and root causes as mediators of autoimmunity, not just a breakdown of immune function. This is a message practitioners, patients, and researchers want to get out, as autoimmune diseases are so prevalent?they affect at least 50 million Americans.1

Until recently, it was standard thinking that AI couldn?t be reversed, but now we know differently. Identifying the root causes and reversing intestinal hyperpermeability (leaky gut) are at the core of reversing the autoimmune process in the body. Doing this, combined with some diet and lifestyle changes, could have you healing and feeling like an elevated version of yourself.

What Exactly is Autoimmunity?

Autoimmunity, at its core, occurs when the immune system attacks healthy tissues that it?s mistaken as a foreign invader.

Previously, science believed that it was purely immune dysfunction or an overactive immune system that caused autoimmune conditions. Knowledge has advanced now, and we know that there are lifestyle triggers that lie at the heart of immune system dysfunction. These triggers, combined with genetics and epigenetics (the environmental influence turning genes on or off) are what regulate the AI process.

There are more than 90 diagnosable autoimmune conditions today.2,6 Some of the more common conditions are ankylosing spondylitis, Addison?s disease, Celiac disease, Crohn?s disease, Graves? disease, Hashimoto?s thyroiditis, Lupus (systemic lupus erythematosus or SLE), myasthenia gravis, multiple sclerosis, psoriasis, rheumatoid arthritis, Sjogren?s disease, ulcerative colitis, and Type I diabetes, as well as allergies, asthma, dermatitis, and eczema.

This is only a short list of the conditions that have been described and categorized. In reality, you can have an autoimmune assault on any tissue in your body, and that process may not yet be defined, which can make diagnosis frustrating for you.

Even though there are many different types of AI conditions that are on a vast spectrum, they share one thing in common?that they?re all inflammatory in nature.

Chronic systemic inflammation sets the stage for an upregulated immune system that causes the body to attack itself.

The good news is that getting to the bottom of the root causes and making lifestyle changes can have a profound impact on the course of the autoimmune process, meaning that an AI disease doesn?t necessarily have to be defined to start reversing the process and healing.

How Does Autoimmunity Occur?

Dr. Amy Myers, MD, explains, ?Autoimmune diseases are born when your body is working hard to defend itself against something potentially dangerous, such as an allergen, a toxin, an infection, or even a food, and it fails to differentiate between the intruder and parts of your own body. Mistaking certain types of tissues for harmful substances, your body turns these antibodies against itself, wreaking havoc on your organs.?1

The origin of autoimmune conditions is multifactorial and additive, in that it takes a genetically predisposed person in the right environmental circumstances with a leaky gut to develop an improper immune response. Family history accounts for one-third of the risk for developing an AI condition, as certain genes have been identified that directly affect the immune system and play a role in its hyperreactivity.14

Dr. Alessio Fasano, MD, the director of the Center for Celiac Research & Treatment at Massachusetts General Hospital for Children, has spent decades researching autoimmunity and how the immune system malfunctions, which led him to deduce that every autoimmune disease has three basic ingredients: a genetic predisposition, an environmental trigger, and a leaky gut.8,14

He explains that identifying the first two components was easy, since science has long known that AI conditions tend to run in families and that they can be triggered by infections, but the leaky gut component wasn?t identified until 2000, when he and his research team isolated the protein responsible for regulating gut barrier function, zonulin.14

Leaky gut, or increased intestinal permeability, arises when gut barrier function is compromised, allowing large particles that don?t normally enter the bloodstream to pass through. These particles are then triggers, causing the immune system to respond.

The environmental triggers are food sensitivities, allergens, toxins, and stress, which turn on the genes that initiate the AI process. This also generates chronic inflammation that perpetuates leaky gut and immune system activation.

Once the environmental triggers have entered the bloodstream, the immune system becomes primed and ready to defend, launching a biochemical war.

This war creates inflammation that activates certain genes, sustaining the immune response and allowing it to continue. As the war rages on and the immune system is on high alert, some confusion may arise, and the body may begin to attack itself.

One of the mechanisms believed to fool the immune system into thinking your body?s cells are pathogens is molecular mimicry. Molecular mimicry arises because there are specific protein sequences, or antigens, on the surface of certain microbial cells or foods that are similar to certain body cells such as the thyroid, intestinal cells, or nerves, essentially tricking the immune system. It loses its ability to clearly discern between self and non-self.

According to the ?Thyroid Pharmacist? Dr. Izabella Wentz, ?This inadvertently causes a cross-reaction with our ?self? antigens, i.e., our own cells. This case of mistaken identity is thought to trigger the start of autoimmunity.?4

Similarly, another mechanism of autoimmunity occurs when toxins alter DNA and cause gene mutations. These mutations change the structure of tissues, causing the immune system to identify them as foreign and producing an assault on your body.

Triggers of Autoimmunity

The triggers that produce autoimmunity often occur together with the immune system responding to multiple ?insults? at the same time, since chronic inflammation mediates this process. Identifying the triggers and eliminating them is the key to reversing inflammation, calming the immune system, and shutting down the AI process. Common triggers of autoimmunity are:

  • Leaky gut
  • Dysbiosis and infection
  • Food sensitivity
  • Toxins
  • Stress

Trigger of Autoimmunity: Leaky Gut

Intestinal hyperpermeability, or leaky gut, starts when a trigger such as toxins, dysbiosis, stress, or food sensitivity creates inflammation, causing a dysfunction in zonulin, which regulates gut barrier function.

Fasano states, ?Zonulin works like the traffic cop of our bodies? tissues. It opens the spaces between cells, allowing some substances to pass through while keeping harmful substances out.? 6,8

Intestinal hyperpermeability occurs when there?s a breakdown in the function of zonulin, allowing larger particles such as bacteria, toxins, and partially-digested food particles through the intestinal walls to the bloodstream, where the immune system generates a reaction to clear them out. In genetically-susceptible individuals, these substances can eventually elicit an exaggerated or erroneous response, and the body can begin to assault its own tissue.

Leaky gut provides an easy access gateway to the immune system, when normally these particles would be kept out of the bloodstream. Under normal circumstances, when you encounter a typical foreign invader, such as a virus, bacteria, parasite, fungus (mold and yeast), or toxin, your immune system should answer by generating a response to anything it perceives to be a threat to your survival. In the case of autoimmunity, these large particles that have entered the bloodstream through a leaky gut cause an immune response that produces antibodies to the particles themselves and to the tissues of your body.

The causes of leaky gut must be eliminated and intestinal barrier function properly restored in order to reverse autoimmunity.

Trigger of Autoimmunity: Dysbiosis and Infection

Dysbiosis is the product of an imbalance between the beneficial and harmful organisms in your body, especially the gut. Healthy individuals have lots of the good guys within the GI tract that assist with digesting food, producing nutrients, and protecting from harmful organisms and inflammation.

When there?s a general imbalance between the good and bad flora, or when there?s an infection present, such as SIBO (small intestinal bacterial overgrowth), Candida (yeast), parasites, or mold, dysbiosis will arise. This imbalance allows for leaky gut to occur, since chronic inflammation develops as a byproduct, and it contributes to the deterioration of the intestinal barrier.

Native (commensal) and infectious organisms, like large particles leaked from the gut, can also trigger autoimmunity through molecular mimicry. Your body mounts an immune response, which is great when it zeroes in on a cold virus that shouldn?t be there, but it?s a problem when it mistakenly assaults your thyroid while it?s attacking H. pylori.4

There are many organisms implicated in the molecular mimicry process of autoimmunity, such as H. pylori (causes stomach ulcers and GI infections), Yersinia enterocolitica (causes GI infections), and Borrelia burgdorferi (causes Lyme disease), which may trigger Hashimoto?s thyroiditis.4

When the immune system sees Klebsiella pneumoniae, Shigella, Chlamydia trachomatis, and several other gram-negative bacteria, it ?recognizes? the self protein HLA B27 and attacks, inducing spondyloarthropathies, which are inflammatory conditions that include ankylosing spondylitis, psoriatic arthritis, and reactive arthritis (Reiter?s Syndrome).5 Viruses can also be triggers, as with multiple sclerosis and lupus, as well as the Epstein-Barr virus (EBV).5

Many other AI conditions can have a molecular mimicry component as well.

If you have an AI condition, it?s worth investigating to see if you have dysbiosis or an infection that may be perpetuating the process.

Trigger of Autoimmunity: Food Sensitivities

Food sensitivities are very common in those with autoimmunity. The usual suspects are gluten, dairy, eggs, nuts, soy, and corn, although you can have a reaction to any food you eat, especially those you consume frequently. Lectins, which are proteins found in legumes and grains, also activate the immune system and are implicated in autoimmunity.

These sensitivities generally arise when the partially-digested food particles enter the bloodstream through a leaky gut. Additionally, under the right circumstances, a cross-reactive process may ensue as well.

In another case of mistaken identity, foods produce a cross-reactive response through the same antigen-antibody-mediated process that the microorganisms produce.

According to PhD scientist Sarah Ballantyne, aka The Paleo Mom, ?For those 20% of us with Celiac disease or gluten-intolerance/sensitivity (whether diagnosed or not), it?s critical to understand the concept of gluten cross-reactivity. Essentially, when your body creates antibodies against gluten, those same antibodies also recognize proteins in other foods. When you eat those foods, even though they don?t contain gluten, your body reacts as though they do. You can do a fantastic job of remaining completely gluten-free but still suffer all of the symptoms of gluten consumption?because your body still thinks you?re eating gluten.?7

Gluten is one of the most sensitizing substances we consume, and eating the cross-reactive foods can be just as bad, since they elicit the same response. Common cross-reactive foods are rye, barley, spelt, Polish wheat, oats, buckwheat, millet, sorghum, amaranth, quinoa, corn, rice, potato, hemp, soy, teff, milk, chocolate, yeast, coffee, sesame, tapioca, and eggs.7

When you have an autoimmune condition, you?re best served by eliminating gluten completely and any cross-reactives that are triggers for you. There?s no middle ground here?it?s all or nothing, because even one little bite will provoke a potentially hazardous flare-up.

Trigger of Autoimmunity: Toxins

When it comes to autoimmunity, you need to be concerned with the toxins inside and outside the body.

Toxins are all around us in the air, water, soil, and our food supply. We?re exposed to astounding amounts of pollution. Over 80,000 chemicals have been introduced into our society since 1900, and only 550 have been tested for safety.9

Dr. Donna Nakazawa, MD and author of The Autoimmune Epidemic, calls these?environmental toxins ?autogens,? since they create a reaction against the self.9

The toxins we take in can alter our DNA, producing gene mutations that change tissues. The immune system can attack these tissues since they?re not identical to your healthy tissues. Furthermore, the toxins can alter gene expression by turning on genes that promote inflammation, which can then produce autoimmunity and leaky gut. These are some of the more common toxins:

Heavy metals: Mercury, lead, cadmium, bismuth, arsenic, tin, and aluminum

Plastics: BPA, BPS, BPF, and phthalates

Food: Pesticides, herbicides, BT toxin (from GMOs), preservatives, additives, colorings, Teflon (non-stick cookware), and aflatoxins on peanuts and grains

Environmental chemicals: Chlorine, fluoride, bromine, xylene, dioxin, toluene, and PCBs

The organisms that normally reside within us, as well as the pathogenic invaders, can also produce toxins. Mold produces mycotoxins. Bacteria have two toxic mechanisms?the excretion of toxins called exotoxins and the endotoxins on the cell membrane of gram-negative bacteria. These toxins activate the immune system and produce inflammation.

Trigger of Autoimmunity: Stress

Chronic stress has many negative impacts on health, especially with regard to autoimmunity.

Chronic stress produces constant activation of the sympathetic nervous system (fight or flight) and increases levels of the stress hormone cortisol. Over time, constant cortisol elevation leads to cortisol resistance, where the body has to produce more and more to achieve the same response. When this happens for prolonged periods of time, cortisol levels become chronically low, and adrenal fatigue develops. Cortisol is the primary anti-inflammatory hormone in your body, and when levels are chronically low, low-grade inflammation rages, paving the way for autoimmunity.

Additionally, chronic stress alters immune function over time, causing some aspects to be amplified and others to be diminished, producing dysregulation.

A 2009 study on autoimmunity revealed that ?most interestingly, the release of endogenous glucocorticoids [cortisol] is critical in regulating the severity of disease activity in patients with inflammatory conditions such as rheumatoid arthritis (RA). Blocking of cortisol production results in a flare-up in disease activity in RA patients, while surgical removal of the adrenals in patients with Cushing?s disease has been reported to exacerbate autoimmune disease.? This clearly illustrates cortisol?s critical role in immune function and inflammation.10

Chronic stress produces physiological changes such as decreased blood flow, oxygenation, motility, enzyme output, and nutrient absorption that directly impact the intestinal flora and gut function.11 Since 70-80% of the immune system is within the gut, this means decreased gut and immune function, which can impact autoimmunity. Further, stress diminishes immunity by depleting the antibody secretory IgA (sIgA) as well as essential hormones, and it promotes inflammation, which can all result in a leaky gut.12

Symptoms of Autoimmunity

Autoimmune conditions are characterized by a myriad of symptoms that can be vague and varied, waxing and waning, making diagnosis difficult. Inflammation, being central in the AI process, is the root of many of these symptoms.

Immune: Allergies, asthma, chronic or recurrent infections that won?t resolve, or yeast infections

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity (sun sensitivity), hair loss, nail pitting, or dry eyes, skin, and mouth

Gastrointestinal: Food sensitivities, food allergies, stomach pain, GERD (acid reflux), IBS, gas, bloating, diarrhea, constipation, or gastroparesis (delayed stomach emptying)

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, or insomnia

Nerves: Tingling, pins and needles, numbness, or paresthesia

Hormones: Poor blood sugar regulation (high or low blood sugar), weight gain or loss, cold intolerance, imbalanced female and male hormone systems, poor sleep quality, thyroid imbalances, adrenal imbalances, or multiple miscarriages

Cardiovascular: Palpitations, hypertension (high blood pressure), high cholesterol, anemia, or blood clots

Musculoskeletal: Joint and muscle pain, muscle weakness, or fibromyalgia

Liver: Poor detoxification, elevated liver enzymes, or chemical sensitivity

Lab Testing for Autoimmunity

Lab testing for autoimmunity can be exhausting and broad, since there are so many options. It?s best to start with the basics first and consider general blood tests.

General AI Tests:

ANA (anti-nuclear antibody)
ESR (erythrocyte sedimentation rate)
CBC (complete blood count)
CRP (C-reactive protein)
APA (antiphospholipid antibodies)
RF (rheumatoid factor)

GI Infections:

Stool analysis (general)
CDSA (comprehensive digestive stool analysis?looks at organisms, inflammation, and leaky gut)

Food Sensitivities/Allergies:

IgE test for allergies
IgG or IgA test for sensitivities/intolerance
Mediator release testing

Once you?ve pursued these avenues, testing for specific conditions may be in order, such as TPA (thyroperoxidase antibody) and TGA (thyroglobulin antibody) for Hashimoto?s. Cyrex labs has several tests specifically designed for autoimmunity, food intolerances, and intestinal permeability. The Array 5: Multiple Autoimmune Reactivity Screen tests twenty-four different tissues for AI activity.13

Treatment of Autoimmunity

Treating autoimmunity can be?easier than you think. Many people get some level of resolution with lifestyle changes and even further resolution when specific lab testing uncovers hidden infections, toxicity, or low cortisol levels that can be treated.

The easiest way to work your way through treatment is to take a systematic approach so you can more easily see what?s working and what isn?t.

Diet: This is the best place to start, since you?ll need some time to identify which foods you should be avoiding; making permanent dietary changes can yield massive benefits when it comes to autoimmunity.

The first step is to begin a 30-day elimination diet. You can make this basic and eliminate the usual suspects that trigger reactions like gluten, dairy, corn, soy, and nuts, but you?d be better off eliminating known AI triggers as well. These include seeds, eggs, legumes and grains (because of the lectins), and nightshades (all varieties of peppers, potatoes, eggplants, etc). You may even choose to stop eating gluten cross-reactive foods as well if you know you have issues with gluten. After 30 days, you can begin the re-introduction phase to see if you have any reaction to each food.

If you want to jump right into a diet change, Paleo can be a good place to start, since it naturally eliminates many of the AI triggers. The first study ever completed on autoimmunity and the Paleo diet was published in 2014 by Dr. Terry Wahls, MD and author of The Wahls Protocol. Although it was a small study, it illustrated the beneficial effects of adopting a Paleo diet in relation to AI disease?especially a reduction in fatigue.3,15

The Autoimmune Paleo diet takes it one step further and eliminates all food triggers of AI. Dr. Ballantyne has the Paleo Approach, and Dr. Datis Kharrazian both have versions of this that are great resources. Dr. Kharrazian?s AI diet focuses on gut healing and is a simple version that includes many meats, vegetables, fermented foods, coconut, certain herbs and spices, low glycemic fruit, and some condiments.16

With all of the diet information out there, knowing what to eat can be very confusing, but with some work you can do it. As with any diet, you need to tailor it to your own specific biochemical needs. This means that some of the foods on the ?avoid? list might be okay for you, and some acceptable foods may not be.

You need to figure this out to optimize your diet and health. Find your ?you? diet.

Nutrients and Supplements: There are so many different nutrients necessary for treating autoimmunity and inflammation. The following are some examples of anti-inflammatory and gut-healing nutrients you can start with:

Magnesium, vitamin D, and EPA/DHA (omega-3 fatty acids) are recommended by Sarah Ballantyne for their important anti-inflammatory and immune-modulating effects.3,17

Vitamins C and E, zinc, and selenium function as antioxidants and protect against oxidative stress.17

Glutathione is a critical nutrient, as it?s the master antioxidant in the body, and there?s a significant breakdown with its function in AI. Taking supplemental glutathione (or its precursor, NAC (n-acetyl cysteine)) with alpha lipoic acid (ALA) and glutamine will help recycle glutathione efficiently. ALA also functions as an antioxidant and supports healthy mitochondrial function. Glutamine is an essential nutrient for intestinal cells and helps repair leaky gut (along with glutathione).18

Probiotics (?good bacteria?) increase the levels of healthy bacteria in your gut, which reduces inflammation and combats leaky gut.17

Digestive enzymes and betaine HCL are often necessary, since nutrient malabsorption plays a role in leaky gut and AI.17

Clean up your life: Eat organic foods, avoid GMOs, and choose more natural cleaning and personal care products to reduce the toxic burden on your body.

Reduce your stress levels: Stress is one of the main contributors to inflammation and poor immune function. Identify and manage your stressors. Reduce stress by creating boundaries, honoring your feelings, and organizing your life.

Relax: Take time-outs during the day to unplug and rest. Schedule downtime to give your body a rest by journaling, yoga, or meditation. Do what speaks to you.

Get into nature: Nature has significant healing benefits, so try to get out and enjoy it at least once per week.

Sleep: Getting adequate sleep is essential to healing. Avoid blue light stimulation from TVs, phones, and tablets for at least 2 hours before bed. 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.

Exercise: Moving your body is important to maintaining health and the healing process, but know your limits. Pushing too hard or too fast can delay your recovery. Give yourself adequate rest time, and only do what your body is telling you it can handle. In general, long-duration endurance exercises deplete cortisol and promote inflammation, so it may be best to avoid this and opt for walking, hiking, yoga, pilates, or weight lifting.

Empower yourself: Knowledge is power, so educating yourself on your condition makes you your best advocate. This knowledge will equip you with the best opportunity to manage your AI condition to give you the best quality of life.

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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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How I Solved My Pregnancy Constipation

I?m going to share how I achieved amazing poops since pregnancy constipation is one of the worst symptoms women often have. For some, that claim sounds unattainable. I was one of them given my experience with baby number one?

My First Pregnancy

During my first pregnancy, I suffered from horrible constipation. My stools were little, tiny rabbit pellets that took forever to come out. ?Plus, I wasn’t going every day.

I was miserable because I was used to having perfect Bristol scale #4’s. ?As a functional medicine practitioner, this is what we view as ideal. Now I was having #1?s which signifies severe constipation. I tried several forms of magnesium, eating more vegetables, and dried fruits such as prunes, and nothing changed. I resigned myself to the ?sentence? of pregnancy constipation and chalked it up to hormones.

After the birth I figured I was in the clear…

No such luck. Things got even worse. I didn?t think that was possible.

My First Post-Partum

I was reluctant to share these details, but I know how important it is to have healthy bowel movements. And, I don?t want you to go through what I went through.

The delivery of my son was wonderful (not easy, but wonderful). My midwives said to make sure I pooped within the first couple days, but I was caught up in baby bliss and didn?t really pay attention. I tried to go several times, but I was still really sore from the delivery.

Truth: I pooped during the delivery and that was the last time I?d go for 2 whole weeks!

On day 14, I had an extreme urge to go since the stool had been building up. I sat on the toilet for 30 minutes. Nothing. I got up, moved around, squatted a little, and tried again. Nothing. 45 minutes later, my husband was concerned so he came to check on me (to make matters worse we had visitors and they wondered where I?d disappeared to). ?Talk about embarrassing!

I told him what was up and sent him away. I was too proud to ask for help.

I hung out in the bathroom for another hour and still nothing. I had to feed the baby so I took a break and finally asked for stool softeners and an enema. The stool softeners didn?t help so I swallowed my pride and tried the enema. All by myself.

Not a good idea for anyone, let alone someone who just gave birth. I?ll spare you the details, but there was lots of crying, a mess, and I ended up having my husband administer it. Probably the most humbling experience of my life. BUT I HAD RELIEF!

After that, my stools slowly became more regular and I was back to normal.

My Second Pregnancy

I vowed if I got pregnant again, I wouldn?t let myself stay constipated.

This time my diet was dialed in from the beginning and I was taking probiotics, fish oil, and Natural Calm magnesium. It staved off the constipation until around week 14. I slowly went from #4?s to 1-2?s again as the progesterone ramped up in my body. Progesterone causes the muscles in the walls of the intestines to relax resulting in constipation. It’s also responsible for slower emptying of the stomach and heart burn.

My midwives suggested a different magnesium supplement that also had calcium. I gave it a try and it helped a little, but not enough. ?So, I put on my clinician?s hat and thought, ?What would I tell a patient?” When working with patients and magnesium doesn?t help, we usually suggest adding in other minerals like potassium and calcium via food and/or supplements.

Ding! Ding! I had a major “a ha” moment. That’s when the magic combination was conceived!

Pregnancy Constipation Relief

I made myself a smoothie loaded with fiber, healthy fats, and?important mineral rich foods since these are known to combat constipation. It actually works so well so sometimes I need to dial down the fiber!

Pregnancy Constipation Smoothie

The starred ingredients are important since they either have high fiber or mineral content from magnesium or potassium. Avocados, dates, and bananas are the real whole food stars here.

8-12 ounces of water (can substitute coconut water* or liquid of your choice)
? small banana*
? avocado*
1-4 dates (I used 1-2 for the first 2 trimesters and 3-4 during the third)*
? – 1 serving of this fiber blend*
1 serving of protein of your choice (I rotated between collagen and pea/chia protein)
? cup frozen berries

Additions: 1 handful of leafy greens or tablespoon of raw cacao powder to change it up.

This recipe can be altered to taste and amounts for effectiveness. It?s a nutrient bomb for growing baby and mama, as well as keeping constipation away! It’s kept me going for most of the 2nd and 3rd trimesters, and I’m hoping postpartum too!

What have you tried to remedy pregnancy constipation?