Death Begins in the Gut

The human intestine maintains within its inner cavity a complex, crowded environment of food remnants and microbial organisms (called “the intestinal flora”) from which the body derives nourishment and against which the body must be protected. The relationship between the human host and her army of microbes is described by the Greek word, symbiosis, which means “living together”. When symbiosis benefits both parties, it is called mutualism. When symbiosis becomes harmful, it is called dysbiosis.

The first line of protection against dysbiosis and intestinal toxicity is strict control of intestinal permeability, the ability of the gut to allow some substances to pass through its walls while denying access to others. The healthy gut selectively absorbs nutrients and seals out those components of the normal internal milieu which are most likely to cause harm, except for a small sampling which it uses to educate and strengthen its mechanisms of immunity and detoxification.

Bacteria form the largest segment of the intestinal flora. The number of bacteria in the large bowel (about a hundred trillion) exceeds the number of cells in the human body. Intestinal bacteria perform some useful functions, so that our relationship with them is normally one of mutual benefit. They synthesize half a dozen vitamins, supplementing those which are obtained from food. They convert dietary fibre–that part of food which humans cannot digest–into small fatty acids which nourish the cells of the large intestine. They degrade dietary toxins like methyl mercury making them less harmful to the body. They crowd out pathogenic bacteria like Salmonella, decreasing the risk of food poisoning. They stimulate the development of a vigorous immune response. Four-fifths of the body’s immune system is located in the lining of the small intestine.

Bacteria are dangerous tenants, however, so that dysbiosis is a common problem. As powerful chemical factories, bacteria not only make vitamins and destroy toxins, but also destroy vitamins and make toxins. Bacterial enzymes can inactivate human digestive enzymes and convert human bile or components of food into chemicals which promote the development of cancer. Some by-products of bacterial enzyme activity, like ammonia, hinder normal brain function. When absorbed into the body, they must be removed by the liver. People whose livers fail this task, because of conditions like cirrhosis, develop progressive neurologic dysfunction resulting in coma and death. For them, the administration of antibiotics which slow the production of nerve toxins by intestinal bacteria can be life saving.

The immune reactions provoked by normal intestinal bacteria may be harmful rather than helpful. Inflammatory diseases of the bowel, including ulcerative colitis and Crohn’s disease (ileitis), and several types of arthritis have been linked to aberrant immune responses provoked by intestinal bacteria. Two types of aberrancy have been described. First, intestinal bacteria contain proteins which look to the immune system very much like human proteins; they confuse the immune system and may fool the body into attacking itself. Second, fragments of dead bacteria may leak into the wall of the intestine or into the blood stream due to a breakdown in the mechanisms which regulate intestinal permeability. Circulating through the body, bacterial debris is deposited in tissues such as joints, provoking an attack on those tissues by an immune system trying to remove the foreign material.

Unlike bacteria, parasites appear to serve no useful function. The part of the immune system which they stimulate does not strengthen the organism to resist serious infection; instead it contributes to allergic reactions, so that parasitic infection increases allergic tendencies.

Our digestive system is perhaps the most significant system in terms of its importance to us. It is simply not possible to live and continue growing if we cannot digest and assimilate the food we take in. It has also been labelled the “brain” of the body. In Oriental Medicine, the abdominal area which houses the Hara for the Japanese and the Tan Tien for the Chinese is the reservoir of life force and vitality. It is also our early warning system. When we are feeling a little under the weather, we often feel queasy when we think of food. When we are feeling nervous and agitated, we say we have butterflies in our stomach.

Most literature on detoxification refers to liver enzymes, as the liver is the site of the majority of detoxification activity for both endogenous and exogenous compounds. However, the first contact the body makes with the majority of xenobiotics is the gastrointestinal tract. Over the course of a lifetime, the gastrointestinal tract processes more than 25 tons of food, which represents the largest load of antigens and xenobiotics confronting the human body. Furthermore, since most drugs are consumed orally, the gastrointestinal tract is also the first contact with many drugs. It is not surprising, then, that the gastrointestinal tract has developed a complex set of physical and biochemical systems to manage this load of exogenous compounds.

Several factors influence how much of a chemical ends up in the system, requiring detoxification by the liver. The gastrointestinal tract initially provides a physical barrier to exogenous components. As previously discussed, the gastrointestinal tract is the second major site in the body for detoxification. Detoxification enzymes such as Cyp3A4 and the antiporter activities have been found in high concentrations at the tip of villi in the intestine. Adequate first pass metabolism of xenobiotics by the gastrointestinal tract requires integrity of the gut mucosa. Compromised barrier function of the mucosa will easily allow xenobiotics to transit into the circulation without opportunity for detoxification. Therefore, support for healthy gut mucosa is instrumental in decreasing toxic load.

In the last 20 years of practice, I have found all allergies and complex chronic disease have their origins in some kind of gut dysfunction. Keep your gut healthy. For the last twenty years I have been helping people have healthier “guts”.

Be well
Dr Sundardas

Is Your Thyroid Happy?

Hypothyroidism is a condition in which the thyroid gland fails to function adequately, resulting in reduced levels of thyroid hormone in the body. Cretinism is a type of hypothyroidism that occurs at birth and results in both stunted physical growth and mental development. Severe hypothyroidism is called myxedema.

There are many causes of hypothyroidism. Hashimoto’s thyroiditis, an autoimmune disease of the thyroid gland, may lead to hypothyroidism. Some medical treatments, such as surgery or radiation to the thyroid gland, or certain drugs like lithium and phenylbutazone, may also induce this condition. Extreme iodine deficiency, which is rare in the United States, is another possible cause. Failure of the pituitary gland or hypothalamus to stimulate the thyroid gland properly can cause a condition known as secondary hypothyroidism.

Some people with goiter (an enlargement of the thyroid gland) also have hypothyroidism. Goiter can be caused by iodine deficiency, by eating foods that contain goitrogens (goiter-causing substances), or by other disorders that interfere with thyroid hormone production. In many cases the cause of goiter cannot be determined. While natural therapies may help to some extent, thyroid hormone replacement is necessary for most people with hypothyroidism.

Dietary changes that may be helpful: Some foods, such as rapeseed (used to make canola oil) and Brassica vegetables (cabbage, Brussels sprouts, broccoli, and cauliflower), contain natural goitrogens that appear to act by interfering with thyroid hormone synthesis. Cooking has been reported to inactivate this effect in Brussels sprouts.Cassava, a starchy root that is the source of tapioca, has also been identified as a goitrogenic food. Other goitrogens include maize, sweet potatoes, lima beans, and pearl millet.

Lifestyle changes that may be helpful: Preliminary studies have found an association between multiple chemical sensitivities and hypothyroidism. One study found a correlation between high blood levels of lead, a toxic substance, and low thyroid hormone levels in people working in a brass foundry. Of the 47 workers tested, 12 were considered hypothyroid; many of these individuals also complained of depression, fatigue, constipation, and poor memory (symptoms of hypothyroidism).

What is of great concern is not clinically evident hypothyroidism that is clearly testable and reasonably understood. It is sub-clinical hypothyroidism which is harder to detect and far more prevalent. Subclinical hypothyroidism can be detected or identified in the following ways:

1) Barnes Test: Measuring your temperature when rising in the morning on a daily basis.
If your temperature is consistently one degree centigrade or less, suspect your thyroid is under the weather.

2) Iodine patch test: Paint an iodine patch on your skin and watch to see how long it takes to disappear. If your thyroid is functioning well the patch will take more than 24 hours to disappear.

3) Blood Tests: Most physicians measure only T4 and TSH. However, T3 is a more sensitive marker for subclinical thyroid function. The T3 reading is often in the lower third range or clinically in the low range. Alternatively you can do both a T3 and reverse T3 test. In the presence of subclinical hypothyroidism, the reverse T3 will be high and T3 will be low.

Occupational exposure to polybrominated biphenyls and carbon disulfide has also been associated with decreased thyroid function. Nutritional supplements that may be helpful: The relationship between iodine and thyroid function is complex. Iodine is required by the body to form thyroid hormones, and iodine deficiency can lead to goiter and hypothyroidism.

Sources of iodine include foods (iodized salt, milk, water, seaweed, ground beef), dietary supplements (multiple vitamin/mineral formulas, seaweed extracts), drugs (potassium iodide, amiodarone, topical antiseptics), and iodine-containing solutions used in certain laboratory tests. Many nutritional supplements contain 150 mcg of iodine. While that amount of iodine should prevent a deficiency, it is not clear whether supplementing with iodine is necessary or desirable for most individuals. People wishing to take a nutritional supplement containing iodine should consult a doctor. Experimental animals with severe zinc deficiency developed hypothyroidism, whereas moderate zinc deficiency did not affect thyroid function.

Selenium also plays a role in thyroid hormone metabolism. Recently, severe selenium deficiency has also been implicated as a possible cause of goiter. In one study, it was reported that giving 50 mcg of selenium per day to people who were deficient in both selenium and iodine decreased thyroid function in those who were already hypothyroid. Other researchers have suggested that selenium should not be given to people who are deficient in both selenium and iodine, without first giving them iodine or thyroid hormone supplementation. There is no research demonstrating that selenium supplementation helps people with hypothyroidism who are not selenium-deficient.

Desiccated thyroid, also called thyroid extract, is used by some doctors as an alternative to synthetic thyroid hormones (such as thyroxine and levothyroxine) for people with hypothyroidism. Thyroid extract contains two biologically active hormones (thyroxine and triiodothyronine), whereas the most commonly prescribed thyroid-hormone preparations contain only thyroxine. One study has shown that the combination of the two hormones contained in desiccated thyroid is more effective than thyroxine alone for individuals with hypothyroidism. One doctor reported that in his experience, thyroid extract works better than standard thyroid preparations for some people with hypothyroidism.Glandular thyroid products, which are available from health food stores, have had most of the thyroid hormone removed and would therefore not be expected to be effective for individuals with hypothyroidism. Intact desiccated thyroid is available only by prescription. People with hypothyroidism who want to use desiccated thyroid must first consult with a physician.

Be well
Dr Sundardas