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Do you ever feel like your own worst enemy when it comes to health? In the case of autoimmune diseases, this is what people are often led to believe. Most people are told their immune system is making a mistake and their only option is to shut off the immune system with drugs, but this is far from the truth. In reality, the immune system is doing its job exactly like it is supposed to.

So what gives then? Why are more and more people being diagnosed with autoimmunity? The first thing is first – a person has to have a genetic predisposition to autoimmunity. In a person that is susceptible to developing an autoimmune disease, exposure to certain triggers can cause a gene to be expressed which can lead to the immune system attacking one’s own healthy tissues. It is this genetic susceptibility that accounts for why only certain people develop full-blown autoimmunity after being exposed to a trigger and why the trigger is not as problematic for another person without these genes.

There is more research starting to show that there are multiple things going on in our environment that are contributing to the rise of autoimmunity. One is the “hygiene hypothesis’ – basically our environment is too clean. Kids don’t play in the dirt and everything is sanitized on a regular basis. This goes hand-in-hand with the ‘old friend’ hypothesis. Since developed countries don’t get exposure to certain parasites and infections, these countries are seeing higher levels of autoimmunity than people of the same genetic background in different parts of the world. For example, Africans have a genetic predisposition to Lupus, but West Africans have a lower incidence of Lupus than African Americans. Lastly, the environment in developed countries is becoming saturated with more and more chemicals that our immune system was never designed to deal with, especially on a daily basis.

For most autoimmune diseases to occur, there is also more and more research solidifying the concept of a ‘leaky gut’ that is present when autoimmunity starts. The bacteria in our GI tract play a pivotal role in not only developing and maintaining this barrier of protection but also educating our immune system as we grow. It is important to note that one of the chemicals that has been shown to alter how bacteria in the gut work and be the most damaging is Glyphosate (found in Round-Up and sprayed on GMO crops).

Ever since the discovery that gluten causes Celiac Disease, there is now a race to determine the triggers of other autoimmune diseases. These triggers can vary, and so can the autoimmune disease they are correlated with. Some triggers can be a single event (like a hit-and-run), but it appears that it is an accumulation of these triggers that initiates autoimmunity in most cases. In the example of Celiac Disease, it appears the gluten sprayed with Round-Up is more likely to trigger an immune response than gluten not sprayed with these chemicals.

Common Triggers

Drugs

Methyldopa is a drug that is used to treat high blood pressure. It has been shown to cause an immune response that leads to a condition called Hemolytic Anemia. Basically, red blood cells are attacked and broken down by the immune system.

Beta-Blockers are prescribed to treat angina, abnormal heart rhythms, and high blood pressure. There is a correlation between these and Lupus. Lupus is an autoimmune disease that can attack multiple types of tissues in the body like the nervous system, kidneys, liver, heart, lungs, skin, and blood.

Statins have been associated with myopathy (muscle weakness) and in severe cases can lead to rhabdomyolysis where the muscle tissue is broken down by the immune system. In the worst-case scenario, this can lead to kidney failure and even death.

Supplements

It was long thought that adding iodine to salt could prevent goiters. People were given high doses of iodine to help with their goiters. While it is true that iodine does help reduce the size and frequency of goiters, levels of iodine that are too high are known to trigger Hashimoto’s Thyroiditis. Hashimoto’s  Thyroiditis is a disease where the immune system attacks an enzyme in the thyroid glands responsible for making thyroid hormones. The latest research is showing that iodine intake should not exceed 135mcg/day.

Pregnancy

Or other estrogen fluctuations like birth control, hormone replacement therapy, or even monthly cycles can trigger autoimmunity. Most autoimmune diseases are more prevalent in women, sometimes as high a ratio as 9:1 because of how hormones affect immune system functions. This trigger can not only be due to the fluctuating levels of estrogen but also because oral birth control pills change how the bacteria behave in the gut.

Major stresses or trauma

This isn’t specific to developing a certain autoimmune disease but is a common trigger for someone with autoimmunity genes. This can range from a mental stressor like a loss of a loved one, unemployment, or a divorce, to a car wreck or surgery. A traumatic brain injury is also another event that can lead to autoimmunity, especially since it has been shown that within 12 hours of a Traumatic Brain Injury, a person develops a leaky gut because the brain can no longer properly coordinate the function of the GI tract.

Foods and Food Additives

There is growing research that it is not only certain food proteins that are problematic but also the chemicals that are added to food or sprayed on the ingredients that is also driving a rise in autoimmune disease.

By far, the most problematic protein in the human diet is gluten. There are many different parts to wheat, and most people are only screened against alpha-gliadin and tested for Celiac, but there can be other components of wheat that cause issues for people. There is a crossover of the genes that put someone at risk for developing autoimmunity and a reaction to gluten. That is why there is such a high correlation between gluten and autoimmune disease.

One of the worst chemicals that people are ingesting on a regular basis is Glyphosate. The research is becoming clearer that this chemical (when combined with aluminum – also in Round-Up) is very detrimental to our microbiome and gut health, immune health, as well as brain health. If a person’s autoimmune disease promotes a leaky gut (like Celiac Disease), then they are at a higher risk of developing other autoimmune diseases, especially if offending triggers are not removed. About half of people with one autoimmune disease have more than one. This is referred to as poly-autoimmunity.

There is also research that an increase in certain additives such as salt, sugar, emulsifiers, transglutaminase, and nanoparticles are also a factor in the increasing rise of autoimmunity because they have been shown to increase intestinal permeability or leaky gut.

Pathogens and autoimmunity

Almost every autoimmune disease investigated is linked to one or more infectious agents. There is a strong correlation between different types of pathogens and different types of autoimmune diseases. Coincidentally, people with autoimmune diseases are more than twice as likely to acquire infections. Prescription immune-suppressant drugs can contribute to this, but a big player is an immune dysfunction that caused their autoimmune disease in the first place.

There are several ways a pathogen can contribute to autoimmune disease progression, but we will only discuss two. The first is a process called molecular mimicry. This is where on a molecular level the part of the pathogen that the immune system attacks look like a part of a person’s own cells. Another process is called bystander activation. This occurs when a virus invades a cell and replicates itself. This infected cell is tagged by the immune system as bad and can signal an attack on healthy tissue that wasn’t part of the initial reaction to the virus.

Virii

• Coxsackie – Is correlated with GAD-65 antibodies leading to Type 1 Diabetes and Stiff Person Syndrome. This can also be exposed to a fetus while in the womb. However, it seems there are other factors in place before exposure to this virus that is initially driving type 1 diabetes in some cases
• Hep B – This virus has been associated with the immune system attacking Myelin Basic Protein which drives Multiple Sclerosis, as well as being associated with Fibromyalgia.
• Hep C – This version of hepatitis is associated with Autoimmune Thyroiditis, Crohn’s disease, Pemphigus Vulgaris (PV), Vasculitides, Antiphospholipid Syndrome, and Cryoglobulinemia.
• EBV – Epstein-Barr Virus is associated with several autoimmune diseases. Lupus (skin and joint symptoms), RA, Giant Cell Arthritis, Wegener’s Granulomatosis, Polyarteritis Nodosa, MS, Sjögren’s Syndrome, and Polymyositis
• Rubella – This particular virus has been shown to provoke Lupus, but more of the neuropsychiatric symptoms such as depression and psychosis.
• Cytomegalovirus – This has been shown to have a link with Lupus, Systemic Sclerosis, Type 1 Diabetes, Rheumatoid Arthritis, and Vitiligo

Bacteria

• B Hemolytic Streptococci – There is a correlation between these bacteria and Rheumatic Fever and heart autoantibodies. It is estimated that up to 1/3 of heart attacks are autoimmune in nature, typically following an infection.
• Group A Beta-hemolytic streptococcal and PANDAS. PANDAS is where the immune system starts to attack the brain and children can start to develop OCD behaviors, as well as tics. There are sometimes other symptoms such as depression, anxiety, other mood changes, and even thoughts of self-harm.
• Campylobacter Jejuni – Has a strong correlation with Guillain-Barre Syndrome (peripheral nerve gangliosides) where people experience muscle weakness. More recently this bacteria has been associated with anti-CdtB antibodies (what causes a person to bloat) and Vinculin. This is the nervous system in the GI tract called the Enteric Nervous System, which is responsible for things like bowel motility and can contribute to SIBO (Small Intestinal Bacterial Overgrowth) due to less bowel motility allowing bacteria to flourish in the small intestine. 
• H. Pylori – This bacteria has been associated with several autoimmune diseases such as Autoimmune Gastritis, Henoch-Schonlein purpura, Sjogren’s syndrome, Autoimmune Thyroiditis, and Raynaud’s syndrome. Coincidentally, H. Pylori has been demonstrated to actually decrease the incidence of certain autoimmune diseases such as Inflammatory Bowel Disease like Crohn’s and Ulcerative Colitis. The difference appears to be due to whether a strain is pathogenic or not.
• Lyme – Associated with antibodies to a part of the joints called Endothelial Cell Growth Factor, as well as autoimmunity to a part of the brain called the limbic system. This part of the brain is responsible for controlling emotions like fear and anger, and instincts such as hunger, dominance, and care for offspring. Lyme has been known to mimic a wide variety of ailments and diseases, as well as re-activating co-infections.

Parasites

• Trypanosoma Cruzi has been associated with autoimmune cardiomyopathy, a disease where the actual heart muscle has trouble working correctly.
• Toxoplasma Gondii and Autism Spectrum Disorders. ASD is a multifactorial problem, and there will never be a single ‘smoking gun’ for this spectrum of diseases. There is evidence that infection with T. Gondii will alter Testosterone and Dopamine levels in the brain, as well as negatively impact areas of the brain responsible for learning, cognition, and behavior. Also, T. Gondii was associated in patients with Primary Biliary Cirrhosis
• Helminths – Unlike most parasites, there is research showing that Helminths can actually decrease the chance of developing an autoimmune disease, and slow the attack on tissues of people that already had an autoimmune disease. Specifically, helminths were shown to decrease the severity of IBD, MS, RA, and Type 1 Diabetes. The way they work is by altering how the immune system communicates in autoimmune diseases to calm the inflammatory process down. They do this for their own survival, but a person with autoimmunity can benefit as well.

Fungi

• Aspergillus has been shown to involve the immune system in the lungs, leading to breathing issues.
• Below we can also see the high level of neurological antibodies in people exposed to toxic molds

Candida has been demonstrated to be a problem for people in developing MS directly, as well as Vitiligo. A few of the major reasons Candida is so bad is because it can promote a leaky gut but also changes the immune function to increase the likelihood of developing the autoimmune disease for people with genetic susceptibility.

Vaccines

As mentioned before, it appears the ‘burden of disease’ is what drives an autoimmune response. Not only is the research indicating it can be due to repeat exposure of multiple pathogens as described above, but the adjuvants in vaccines like aluminum which are designed to provoke an immune response can provoke the immune system too much in a genetically susceptible person leading to autoimmunity. Also, the recombinant proteins (aborted fetal cells) are hypothesized to cause autoimmunity through molecular mimicry. Below is a table of the current findings of specific vaccinations and their correlation with autoimmune disease.

As you can see, there are several contributing factors to what is perpetuating an overactive immune response. It is important to find a Functional Medicine Practitioner that will take into account not only how the different organs in the body are being affected and destroyed, but also how to effectively remove these triggers. Some things can be started immediately, especially if a person knows they have an autoimmune disease or suspect they do. Three things a person can do for themselves are to:

• Eat organic
• Eat gluten-free
• Remove chemicals in the environment – i.e. stop wearing perfumes and other care products or cleaning products that are problematic

References

http://www.ncbi.nlm.nih.gov/pubmed/26223095 

http://www.ncbi.nlm.nih.gov/pubmed/24914359 

http://www.ncbi.nlm.nih.gov/pubmed/25424202 

http://www.ncbi.nlm.nih.gov/pubmed/25676324 

http://www.ncbi.nlm.nih.gov/pubmed/26773256 

http://www.ncbi.nlm.nih.gov/pubmed/26643061 

http://www.ncbi.nlm.nih.gov/pubmed/26772647 

http://www.ncbi.nlm.nih.gov/pubmed/19643667 

http://www.ncbi.nlm.nih.gov/pubmed/26040054 

http://www.ncbi.nlm.nih.gov/pubmed/23091569 

http://www.ncbi.nlm.nih.gov/pubmed/23044924 

http://www.ncbi.nlm.nih.gov/pubmed/25451629 

http://www.ncbi.nlm.nih.gov/pubmed/25309376 

http://www.ncbi.nlm.nih.gov/pubmed/24678255 

http://www.ncbi.nlm.nih.gov/pubmed/24688790

When a child is born, the earliest parts of the brain that start to develop are the primitive reflexes. They are present during the first few months of life to help with survival, but within the first year are replaced by postural reflexes instead. Plainly speaking, the forebrain begins to inhibit the hindbrain and these postural reflexes are a more mature response that control balance, coordination, and sensory motor development. This process helps a child reach developmental milestones on time.

If these primitive reflexes are not inhibited correctly then they can contribute to issues like poor sleep, energy levels, impulse control, balance, coordination, immunity, sensory perceptions, poor motor control and fine motor skills. This sequela of events can lead to a child being given labels like ADHD, ASD, SPD, global apraxia, and other learning disabilities. Not only do we see these retained primitive reflexes contributing to symptoms listed above but can also contribute to all levels of social, emotional, and intellectual learning.

There can be several reasons for the retention of primitive reflexes. The birth process is a key factor so a C-section birth or traumatic birth could contribute to their retention. Falls, hitting the head, lack of tummy time and emotional traumas can be a factor as well. There can also be underlying metabolic dysfunction that can make it difficult for neurons to grow and the postural reflexes to develop, so a mother’s health during pregnancy is something to consider as well.

There are 8 primitive reflexes that will be discussed. Key features like what the primitive reflexes are responsible for, as well as how to test for any retained primitive reflexes.

Moro – The Moro reflex acts as a baby’s primitive fight/flight reaction and is typically replaced by the adult startle reflex by four months old. If a child experiences a retained Moro reflex beyond 4 months, they may become over sensitive and over-reactive to a sensory stimulus resulting in poor impulse control, sensory overload, anxiety and social immaturity. Some additional signs of a retained Moro reflex are motion sickness, poor balance, poor coordination, easily distracted, unable to adapt well to change, as well as mood swings. While the child’s eyes are closed or looking away, an adult can clap their hands by the child’s ear. If the noise startles them and they flail their arms outward, this is a sign of a retained reflex. Also, if a child tries to stand on one leg and has poor balance and falls over this can be another positive sign.

Rooting Reflex – The rooting reflex assists in the act of breastfeeding and is activated by stroking a baby’s cheek near the corner of their mouth, causing the baby to turn and open her mouth. Retention of the rooting reflex beyond four months may result in difficulty with solid foods, poor articulation, and thumb sucking.

Palmar Reflex – The palmar reflex is the automatic flexing of fingers to grab an object and should integrate by six months. If the palmar reflex is retained, a child may have difficulty with fine motor skills, stick their tongue out while writing and exhibit messy handwriting. They may also have speech and language problems and even anger issues. This child may also have trouble holding pencils and markers in the traditional tripod grip. If a parent strokes the child’s palm with a paintbrush (or lightly with a fingertip) the fingers should not flex. If their hand flexes this is a sign the reflex is retained.

ATNR – Asymmetrical tonic neck reflex (ATNR) is initiated when laying babies on their back and turning their head to one side. The arm and leg of the side they’re looking should extend while the opposite side bends. This reflex serves as a precursor to hand-eye coordination and should stop by six months. Ask the child to get on all fours with the arms straight, fingers pointing forward and the head in neutral. With their weight over their hands, the parent rotates the child’s head left or right. If their elbow bends on the opposite side of head rotation or the weight shifts posteriorly (i.e. off the hands) then the reflex is probably present.

Spinal Galant Reflex – The Spinal Galant reflex happens when the skin along the side of an infant’s back is stroked, the infant will swing towards the side that was stroked. This reflex helps with the birthing process and should inhibit between three and nine months. If it persists, it may affect a child’s posture, coordination, attention and ability to sit still. Retention of the spinal Galant reflex is also associated with bedwetting. With the child on all fours, lightly stroke down one side of the lumbar spine towards the hips. If they move their back (typically arching or away from the stroke) then the reflex is probably present.

TLR – The tonic labyrinthine reflex (TLR) is the basis for head management and helps prepare an infant for rolling over crawling, standing, and walking. This reflex initiates when you tilt an infant’s head backward while placed on the back causing legs to stiffen, straighten and toes to point. Hands also become fisted and elbows bend. It should integrate gradually as other systems mature and disappear by 3 1/2 years old. If retained, the TLR can lead to poor muscle tone, tendency to walk on toes, motion sickness, and poor balance. To test this reflex, have the child stand straight with his feet together.  Have them close their eyes and then look up for several seconds and then look down for several seconds.  Make sure that you have your hands ready to catch the child in case they fall.  Notice any swaying or movement, locked knees or holding of breath when the head is tilted either up or down, all which are indicators of a retained TLR.

Landau Reflex – The Landau reflex assists with posture development and technically isn’t a primitive reflex as it isn’t present at birth. It is when a baby lifts his head up causing the entire trunk to flex and typically emerges at around 3 months of age. It is fully integrated by one year. If the landau reflex persists beyond this point, children may experience short-term memory problems, poor motor development, and low muscle tone. When holding the infant face down in the air, the baby’s legs will arch up if the head is up and drop down if the head is lowered. This is normal up to about 1 year. If it persists past one year of age, this means the reflex is retained.STNR – Also known as the crawling reflex, symmetrical tonic neck reflex (STNR) is present briefly after birth and then reappears around six to nine months.  This reflex helps the body divide in half at the midline to assist in crawling – as the head is brought towards the chest, the arms bend and legs extend. It should disappear by 11 months. Developmental delays related to poor muscle tone, tendency to slump while sitting, and inability to sit still and concentrate can result if the STNR is retained. Usually, this can be a child that skips crawling. With the child on all fours with the weight forward over their hands, the parent flexes the neck fully (looking down) and holds for 5 seconds, then slowly extends the neck (looking up) and holds for 5 seconds. Repeat 3 times. If the child alters their body position by shifting their weight backwards, flexing their elbows, or arching their back then the reflex is probably present.

The current treatment for a SIBO is an antibiotic called Rifaximin. Some other antibiotics used are metronidazole and neomycin. People usually have to go on multiple rounds, and this can lead to a barren gut. As all bacterial populations diminish, the mucosal layer starts to lose its integrity. Think of it as a field with no grass in the rain, the dirt starts to wash away. Sometimes a person will also be prescribed a pro-kinetic drug to help with motility. These usually consist of drugs that stop the reuptake of neurotransmitters not being made or utilized correctly such as serotonin. Unfortunately, the recurrence rate of this route is over 90%, as the underlying issues mentioned above are not addressed.

Diet and SIBO

As far as eating for a SIBO, there is a lot of variation from different sources. Ideally, a diet should be customized for an individual based on food sensitivities, co-infections, and digestive chemistry. To get started on a diet, a general rule of thumb is no:

• grains
• legumes
• high fructose fruits
• fructan containing vegetables
• dairy
• natural or artificial sweeteners
• gums and fibers
• protein shakes with gums

However, the longer a person goes without foods the harder it is to reintroduce them and have the immune system tolerate them. This is the concept of oral tolerance. When working with a patient, a large goal we have is for them to be able to eat foods that used to cause symptoms and they are okay with reintroducing them. This shows that we have “fixed the gut” instead of just avoiding foods.

By design, the stress response shuts off digestion. Another thing that can impede motility can simply be a person holding it while at work or out because they don’t like to use a public restroom. Between the large and small intestine, there is a valve, kind of like a trap door. Holding in a movement can keep this valve open, and allow bacteria to migrate from the large intestine to the small intestine. Unfortunately, this can become a vicious cycle. The brain can have trouble controlling the gut, which leads to a lack of nutrients, which leads to even further brain degradation, and as bacteria increase they can decrease motility even more if they make methane. Since the autonomic nervous system regulates things like enzyme production and secretion, bowel motility, control of valves, and blood flow this is an important reason to also address how the brain is or isn’t coordinating these organs and systems. 

The immune system and SIBO

There can be an impairment of the immune system as well that can lead to these symptoms. This could be from a long-standing infection such as Lyme or Candida. If a person has Crohn’s or Ulcerative Colitis or another autoimmune disease, then that could be a problem as well due to the immune-suppressing drugs. Ultimately, as the mucosal layer of the GI tract fails and loses its barrier function, the immune system can’t keep the bacteria in check.

On the low end of the totem pole, anatomical issues can lead to bloating. The most common of these are surgeries such as gastric bypass, the removal of intestines valves, or scar tissue.

Testing for SIBO

There are different methods available to test to see if SIBO is causing your bloating. Some people will get a scope and the doctor will do a culture. This is pretty expensive and invasive, plus 99% of the bacteria in the gut die when exposed to oxygen, so they don’t grow too well in culture.

A more common test is a breath test. In this scenario, a person will ingest a drink that the bacteria can metabolize, and then the test will look for hydrogen and methane. Not all bacteria in the gut produce methane and/or hydrogen, and sometimes motility (too fast or too slow) can give a false positive or a false negative. If a person does have SIBO, this will definitely cause a flare, so I personally don’t have patients drink sugar to measure something that is secondary in nature. Remember, SIBO is usually due to something else. 

There is also a blood test that looks for antibodies. As the gut barrier breaks down, the immune system will create an increased rate of antibodies to LPS. In some people, the immune system can’t make sufficient antibodies, or a SIBO can be present with the barrier still intact (meaning it isn’t leaking yet) and can also give a false negative.

A good option for a person with bloating is to do a functional stool test. Although the test won’t directly ‘see’ a SIBO, the test can help evaluate the environment that allowed it to grow, as well as see how the bacteria are influencing the environment. A good stool test can look at the immune function, digestive enzyme production from multiple organs, as well as bacterial activity in the GI tract.

Lastly, a person can go off of symptoms. If a person bloats after ingesting carbohydrates like pasta and bread, then odds are they have a SIBO.

Beating the Bloat

Do you feel bloated some of the time, or even worse, all of the time? If you have a ‘food baby’ after your meals, then you want to read this. One of the more common reasons why a person bloats after eating is due to an issue called SIBO. SIBO stands for ‘small intestine bacterial overgrowth’. For the most part, the bacteria aren’t usually pathogenic – just too many in the wrong place. Once they get where they shouldn’t then we start to have symptoms. Unfortunately, a person is usually wrongfully diagnosed with IBS, and with about 15% of Americans complaining of IBS, that is a lot of people that are not getting relief. Beano, Miralax, and Immodium AD will never address bacterial levels, or what allowed SIBO to happen in the first place.

Symptoms of SIBO

As you have probably guessed, one of the most common complaints is bloating, and it is usually after eating carbohydrates or a high fiber meal. The reason this happens is bacteria metabolize the carbs and fiber and produce two types of gas. The first type of gas is called methane. This is actually a defense mechanism of the bacteria to also decrease bowel motility, leading to bloated and constipation. This happens because the methane gas shuts off the synthesis of a chemical called serotonin. Contrary to popular belief, the vast majority of serotonin is made and used in the gut. However, with an inflammatory condition like SIBO, the body doesn’t produce serotonin, instead, it makes other chemicals called kynurenic and quinolinic acid. When this starts to happen, now a person is bloated, constipated, depressed with brain fog, and might even have trouble sleeping.

The other type of gas is hydrogen gas. These are sometimes made by a type of bacteria called sulfur-reducing bacteria (these patients pass gas that has an eggy odor to them, also their skin changes color when exposed to cheap jewelry). When the bacteria make hydrogen, there is also typically a lot of toxins made as well, called lipopolysaccharides (LPS). From the point of view of your body, it is easier to eliminate a toxin than to absorb it and then have to deal with it. For this reason, the LPS is combated by histamine made in the bowel lumen. This increases bowel motility and causes diarrhea. This is very good for the body, believe it or not, as LPS is a substance that promotes a leaky gut, autoimmunity, and brain degeneration (think Alzheimer’s). This person will complain of bloating, diarrhea, weight loss, and malnutrition – even if they are supplementing.

Fatigue is present with a lot of the people that also have the above complaints. Regardless of constipation or diarrhea, there is typically malabsorption present. With some, the stomach doesn’t get acidic enough, and the bacteria compete for the protein and amino acids. Multiple processes in the body require these amino acids, but some very important processes are making neurotransmitters, building cell walls, and liver detoxification. Also, the ability to make glutathione (the bodies major antioxidant) requires adequate amino acids, vitamins, and minerals. When the stomach gets acidic enough, then the food is properly digested, the food is sterilized, and signals are sent to the brain to tell the other digestive organs to start doing their job because the food is coming.

Another mechanism of malabsorption is that bile secreted by the gallbladder is made into a substance called lithocholic acid. This causes oxidative stress (rust) to the GI cells, immune cells, and the nerves in the gut called the enteric nervous system (ENS). As this bile is degraded, this leads to poor fat digestion and absorption. Proper fat absorption is necessary for sex hormone production, cell walls, and especially neurons. Also, the fat-soluble vitamins don’t get absorbed as well.

Poor absorption can also stem from damage to the actual GI cells. The GI tract is like a shag carpet rolled in on itself. The shags have a name called villi. These villi account for the vast surface area of the intestines, as well as absorption. When these get damaged, a person can have problems absorbing iron, B12, amino acids, and minerals. These villi also produce enzymes called ‘brush-border enzymes’ that break down sugars such as lactose, maltose, and sucrose (this leads to symptoms when a person consumes dairy or fruit). All the brush-border enzymes are important, but there is also one called diamine oxidase (DAO). This DAO is supposed to break down histamine in food, as well as histamine released by the body to combat the LPS. If this histamine doesn’t get broken down, then this leads to a bigger inflammatory response resulting in even worse absorption.

The fatigue can also come from anemia, either iron or B12 type anemia. A person can even be low in these if they are taking a supplement due to poor absorption.

Mechanisms and SIBO

Although several people can have the same symptom, it can be caused by a different problem. A common cause of SIBO is a reduction in stomach acid. There can be several reasons the stomach isn’t making any, and they can include:

• Proton pump inhibitors
• Chelation therapy
• H. pylori
• Autoimmunity
• Pernicious Anemia
• Cancer
• Alcohol intake
• Eating too fast
• Eating under stress
• Drinking too much fluid with meals
• Nutrient depletion
• Dehydration

The primary focus should be on why the stomach doesn’t work. The reason the stomach must get acidic is so signals can be sent to the brain to help regulate hunger, satiety, and metabolism. Typically a person is diagnosed with GERD and given a medication that actually worsens the problem. Usually, a person will complain of bad breath, acid reflux, distaste for meat, belching, and a ‘heavy’ feeling in their stomach.

Another issue that can lead to bloating and a SIBO is poor motility and valve control. This is termed the brain-gut axis. In a nutshell, signals from the ENS relay info to the brain, and the brain responds accordingly. This two-way street is always in motion. Speaking of motion, the brain uses a nerve called the vagal nerve to stimulate bowel motility through something called the motor migratory complex (MMC). Inflammation in the GI tract can degrade the ENS, which causes poor communication. There are triggers such as strokes, MS, or TBI that can degrade this system relatively quickly, but the most common cause of poor motility is an overactive stress response.

We breathe more than we eat or drink, so of course the impact can be huge on how our body operates.

With breathing we usually think of stuff like the brainstem and if someone has something like sleep apnea, but it is so much more.

In this picture we see how people simply being aware of their breath without focusing on stuff outside of their body, but instead doing a fancy thing called “interoceptive attention” which doesn’t sound that sexy until you start to see how different regions of the brain start to work together.

The ‘Acc’ is for the anterior cingulate cortex which helps with stuff like empathy, impulse control, emotions, and decision-making.

The ‘insula’ is known for stuff like sensory-processing, decision-making, and motor control. The ‘premotor ctx’ does a lot, but it is most known for preparing us for the exact movements we want to make.

Last, but not least, is the hippocampus. Of course we think of those memory centers, but there is also connections to the emotion associated with those memories.

Without getting sciency – find a good breath rate and simply focus on that. Once it becomes routine breathing in that pattern, then think about something that is happy or something you are grateful for.

Then, bada-bing, you got yourself some brain-cohesion stew