Healing leaky gut

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Healing leaky gut

Postby TheBrain » Fri Sep 02, 2016 11:47 am

Juliegee wrote:Apologies for going off topic... Allyson, you mentioned in another post that you healed your leaky gut. Congrats! Was that Dxed via SIgA? Out of curiosity, how did you do it? I don't have any yeast, nor "bad" bacteria, but I still have a leaky gut and SIBO :?.


Thanks, Julie. It was a very long journey to get to the point of finally healing my leaky gut. I blasted it with an arsenal of interventions over a period of years, and I don't know with certainty which interventions actually worked. Maybe all of them did, but perhaps it would have been a quicker process if I had done them around the same time or in some specific (but tighter) order. For example, following a leaky gut diet before getting rid of my candida overgrowth ultimately failed to heal my leaky gut.

I was not officially diagnosed with leaky gut by a test. However, if someone (like me) has an autoimmune disease and many food sensitivities, it's a given that leaky gut is present. (I have even heard experts say don't waste your money on testing for leaky gut if you have those issues going on, but I did the testing relatively recently because I wanted to check on my status, and Dr. Bredesen recommended the test.)

Could you elaborate on how you were diagnosed via SIgA? I'm unaware of that method. I know of the Cyrex Labs test and the lactulose/mannitol urine collection test.

During my journey, I supported my digestion with digestive enzymes (like Susan suggested in the other thread), but also with betaine hydrochloride (HCL) with pepsin. My stomach acid was too low, so I needed help digesting protein. (Most people taking Pepcid or other acid-reducers actually have low (not high) stomach acid.) I now take a digestive enzyme supplement that has a small amount of HCL in it, but I used to need to take several capsules of HCL with each protein-containing meal.

The fact that you have H pylori suggests you might have low stomach acid.

Besides that, the first major step forward was finally killing off my candida overgrowth (which I suspect was systemic, not just in my gut). I won't go into the details about that, as you don't have a candida issue. But as I mentioned in another thread, resolving your gut infections (H pylori and SIBO) is key to healing leaky gut.

The next step forward happened when I began following the paleo autoimmune protocol (AIP). I started consuming homemade chicken bone broth (in the form of soup with lots of veggies, herbs, and olive oil; this is my typical breakfast). Bone broth, whether from chicken, beef, or some other source, is rich in minerals that support the immune system and contains healing goodies like collagen, glutamine, glycine, and proline. The collagen especially heals your gut lining and reduces intestinal inflammation.

I also started eating homemade lacto-fermented vegetables. I personally believe ferments are better than most probiotic supplements, though I do both.

But a HUGE part of the AIP is determining what your food sensitivities are and eliminating them from your diet (at least temporarily; some can later be safely reintroduced after your gut heals). When we eat foods we're sensitive to, we inflame our intestines. Sarah Ballantyne is, IMHO, THE expert on the AIP. But there are others, like Eileen Laird and Mickey Trescott.

I also had to heal my gastritis and GERD, which were other sources of inflammation in my digestive tract. I used the natural healing method described in a book I can't find at the moment. It included replacing HCL supplements with drinking bitters before meals, taking deglycyrrhizinated Licorice (DGL) before and in between meals, etc.

I also drank slippery elm tea and marshmallow root tea (both made at home from dried herbs I bought in bulk). Slippery elm, for example, contains mucilage, which helps to heal the gut lining. Here's a bit of text about that from mindbodygreen.com's article titled: 8 Supplements to Heal a Leaky Gut.

It might have kind of a strange name, but slippery elm has been used as an effective gut healer for centuries in the United States. This supplement both contains mucilage and stimulates nerve endings in the body’s intestinal tract to increase natural mucus secretion, which is an instrumental part of the stomach’s protective lining and helps combat ulcers and excessive acidity in the digestive system. It also contains important antioxidants that help relieve inflammatory bowel symptoms.


Actually, that article is pretty good. I took all of those 8 supplements around the same time (and before, in some cases), except I stopped L-glutatime because I was getting that in my bone broth. And note that the recommended caprylic acid is antiviral and antifungal, so you wouldn't need that.

If you would like a step-by-step approach (which would be more efficient than my round-about, figure-out-one-thing-at-a-time approach), I'd recommend the Solving Leaky Gut program developed by Jordan Reasoner and Steve Wright from http://www.SCDLifestyle.com. They promote the Specific Carbohydrate Diet (SCD), but they have gone deeply into the topic of gut healing and have many relevant articles on their web site. They aren't medical professionals but two young engineers who, as their one page states, "overcame digestive problems, skin issues, and hormone issues using real food, supplements, and lifestyle changes. Since then, they've made it their mission to help others do the same. So far they've helped over 160,000+ people in 157 countries."

I bought their Solving Leaky Gut program, but I had already done a lot of what they recommend. They have a free webinar about their program on Tuesday, September 6 at 8 pm Eastern. If you're interested, you can register here:

http://solvingleakygut.com/webinar/internal-leakygut2/

I later bought their Solving Leaky Gut Masterclasses (which I believe is now part of their Solving Leaky Gut program). I've attached a PDF that lists the speakers and the topics they discuss. (The program includes the mp3s and transcripts for each masterclass.)

List of Masterclasses - Solving Leaky Gut Masterclasses.pdf

You'll see that one of the masterclasses is by the naturopath Allison Siebecker. Her class is titled: "The SIBO-Gut Connection." As far as I'm concerned, she is THE expert in SIBO. Check out her web site at http://www.siboinfo.com.

Best of luck on your journey, Julie! Hopefully, now that you know what's going on, you'll finish your journey in a reasonable amount of time. I know you have a lot of pieces to your health puzzle. But you'll get there.
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Re: Healing leaky gut

Postby Tiramisu1984 » Fri Sep 02, 2016 1:15 pm

Alysson, Thank you so much for your lengthy post. I took the Genova Labs test, and scored low on inflammation, but very,very low on healthy bacteria. Imbalance areas: Beneficial Bacteria ▼, Total SCFA ▼, n-Butyrate ▼. Does that mean I have a leaky gut?

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Re: Healing leaky gut

Postby TheBrain » Fri Sep 02, 2016 2:09 pm

T, I don't know if this means you have leaky gut (you might), but it sure sounds like you have gut dysbiosis, which can contribute to or cause leaky gut. Did you have any "bad" bacteria that are overgrown? Or any bacteria that's beneficial when under control but not good when overgrown? Did you recently take antibiotics?

For example, the results of my last stool test (in April 2014) showed no growth of lactobacillus species, a very small population of bifidobacterium, but high levels of Escherichia coli (E. coli). I had the kind of E. coli that was beneficial when in the appropriate quantity, but it was clearly an overgrowth.

Around that time, I started chowing down on lacto-fermented vegetables and taking a variety of probiotic supplements (it's good to regularly switch brands), so I'm pretty sure I'm doing better with the lactobacillus and bifidobacterium species; however, I still have gut dysbiosis per my relatively recent Cyrex Labs test. I should probably do another stool test at some point, but I keep hoping my remaining digestive complaints will just go away and that would be my proof that my gut dysbiosis has healed.

I suspect that my good bacteria got so low because my diet had become so restricted, and I wasn't doing enough to feed my good bacteria. Maybe six months ago, I started using a stevia supplement that has only one other ingredient: inulin. Gut bacteria like inulin, which is a prebiotic.

Of course, eating lots of vegetables provides fiber (for example, onion contains inulin), and some folks on this forum have discussed resistant starch as a way to feed good bacteria. I haven't explored that option yet to any significant degree, but it's probably time to do so.

I suspect you, too, might need to do more to feed your good gut bacteria.

Did your doctor order the test? If so, what did he/she say about your results?
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Re: Healing leaky gut

Postby TheBrain » Fri Sep 02, 2016 2:26 pm

T, I just recalled that you were recently diagnosed with Lichen Planopilaris. If this is, in fact, an autoimmune disease, then I would say you do have a leaky gut. Alessio Fasano, an esteemed pediatric gastroenterologist and celiac disease researcher who put celiac disease on the map in the United States, has convincingly shown the connection between leaky gut and autoimmunity. I have to run and can't point to any studies at the moment, but I can poke around this weekend.

Okay, here's an abstract titled Leaky gut and autoimmune diseases. Alessio Fasano, MD, is the author.

Autoimmune diseases are characterized by tissue damage and loss of function due to an immune response that is directed against specific organs. This review is focused on the role of impaired intestinal barrier function on autoimmune pathogenesis. Together with the gut-associated lymphoid tissue and the neuroendocrine network, the intestinal epithelial barrier, with its intercellular tight junctions, controls the equilibrium between tolerance and immunity to non-self antigens. Zonulin is the only physiologic modulator of intercellular tight junctions described so far that is involved in trafficking of macromolecules and, therefore, in tolerance/immune response balance. When the zonulin pathway is deregulated in genetically susceptible individuals, autoimmune disorders can occur. This new paradigm subverts traditional theories underlying the development of these diseases and suggests that these processes can be arrested if the interplay between genes and environmental triggers is prevented by re-establishing the zonulin-dependent intestinal barrier function. Both animal models and recent clinical evidence support this new paradigm and provide the rationale for innovative approaches to prevent and treat autoimmune diseases.
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Re: Healing leaky gut

Postby Tiramisu1984 » Fri Sep 02, 2016 2:26 pm

Wow. Thanks. My doctor is on an extended vacation (he ordered the test). I don't know how to feed the good bacteria and I suspect that like you, my restricted diet has led to some of these issues. No antibiotics. I have no gut issues - nothing. In view of the auto immune dx, and my hair loss issue, I don't think i should await his return (the 12th is my follow up).

Candida is a real issue. Congrats on getting it under control.

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Re: Healing leaky gut

Postby Tiramisu1984 » Fri Sep 02, 2016 2:33 pm

Alysson, I am wondering if some of my issues are related to discovering that I have developed a lactose intolerance and a rather abrupt cessation in consuming Greek yougart every day. The bone broth sounds good BTW. Is the tea bitter?

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Re: Healing leaky gut

Postby Sandy57 » Fri Sep 02, 2016 5:22 pm

Alysson great informative posts. Not an issue for Sandy or I, but good stuff for those that have these issues.
Frank

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Re: Healing leaky gut

Postby Julie G » Fri Sep 02, 2016 6:16 pm

Ditto- great post, Alysson! This is all very new to me. Thank you for sharing your journey and congrats on your improvements. I found this great paper that focuses on defining intestinal permeability or "leaky gut." It appears to result from a dysfunction between intestinal macrobiotics and mucosal immunology. Figure #1 from the paper linked below offers a nice graphic that demonstrates the interconnectedness.
12876_2014_Article_189_Fig1_HTML.jpg

Intestinal permeability – a new target for disease prevention and therapy
http://www.nature.com/mi/journal/v4/n6/ ... 1141a.html

My problem stems from the fact that I have very little secretory IgA (5.6- Reference Range: 51 - 204 mg/dL) as measured in the stool and blood. This is apparently a first line immunological defense. I also have a SIBO as measured by a breath test with very high levels of methane without any commensal or dysbiotic bacteria and loads of good bacteria...hmmm :?. Apparently, I have no yeast or parasites, but the 3 decade old h. pylori infection and Babesia duncani could be playing a part in all of this. FWIW, here's a very general handout that all SIBO, leaky gut patients get from the California Center for Functional Medicine. It offers step-by-step instructions on healing one's gut.

Anti-Microbial Protocol
PRINCIPLES:
* Antimicrobials are used along with probiotics and targeted nutrients to help reestablish a healthy gut microbiome. 

* Antimicrobials (GI Synergy and Lauricidin) should be taken at least one to two hours before or after taking the probiotics. 

* For your probiotics, Prescript Assist and Ideal Bowel Support may be taken on an empty stomach, but MegaSporeBiotic is best taken with or just after a meal. 

* The prebiotic Partially Hydrolyzed Guar Gum (PHGG) may be taken with or without food. You may try taking it before bed in the case that it causes some mild GI distress or discomfort. 

* Iberogast and MotilPro may also be recommended as part of your treatment plan to help support normal bowel motility (normal muscular contractions of the gut help to sweep bacteria through the small intestine, treating or preventing overgrowth). 

* Start out slowly with the supplements and gradually increase your doses as tolerated. (Please see specific dosing recommendations below.) Symptoms of microbial die-off are varied, and may include any of your usual symptoms in addition to digestive distress, skin rash, and fatigue. If you experience any of these symptoms, reduce the antimicrobial doses for a time before increasing. You do not want to exceed your body’s detoxification capacity. 

* As you increase your probiotics, if you experience gas, bloating, or undesired changes in stool frequency, then decrease the dose until the symptoms pass. You may then either continue on at the lower dose, or try increasing to two capsules daily. 
Keeping in mind the above principles, there is flexibility in timing your antimicrobials and probiotics. If you are taking activated charcoal as part of your treatment it can be taken at any time when it will be at least 90 minutes before or after other treatments. Here is one example of how to time your therapies, based on eating three meals a day. This sample protocol is designed for the maximum doses, but as you start your healing, you will not be taking your treatments at the frequency described. 
Your specific combination of supplements will vary depending on several factors. In this example the following antimicrobials are used: InterFase Plus (more specifically this is a biofilm disruptor), GI Synergy and Lauricidin. The following probiotics are used: Prescript Assist and MegaSporeBiotic. In addition, this example also uses Digestzymes, Betaine HCl (since SIBO is often associated with low stomach acid and decreased digestive capacity) and Partially Hydrolyzed Guar Gum (PHGG) to support the growth of healthy gut bacteria. 


Sample Day

-On rising: InterFase Plus Prescript Assist
-Breakfast: 
(at least one hour after taking InterFase Plus) Digestzymes and Betaine HCl Lauricidin
GI Synergy
-Lunch: Digestzymes and Betaine HCl Lauricidin
MegaSporeBiotic
-Late afternoon
:(at least one hour before dinner) InterFase Plus
-Dinner: Digestzymes and Betaine HCl Lauricidin GI Synergy
Partially Hydrolyzed Guar Gum (PHGG)
-Before bed: Prescript Assist

SPECIFIC DOSING INFORMATION:

Antimicrobials

InterFase Plus may be started with one capsule twice daily, on an empty stomach, and slowly increased to three capsules twice daily. Dose increases should be gradual and only as tolerated based on your symptoms. (Specifically this is a biofilm disruptor and can be taken with probiotics.)

Lauricidin pellets may be started from 1/4 teaspoon to one full teaspoon two to three times daily, taken with cool liquid. Increase up to one full teaspoon three times daily, with meals,
as tolerated.

GI Synergy may be started at one pack daily, and increased up to one pack twice daily, with breakfast and dinner.
Probiotics

Prescript Assist is best started with one capsule per day. After one week, increase up to two capsules daily. If you develop uncomfortable symptoms, such as gas and bloating, decrease the dose until your symptoms resolve, and then increase to one capsule twice daily, or maintain one capsule daily, depending on your symptoms and goals.

MegaSporeBiotic can be started with one capsule daily, and increased up to two capsules once daily. This is best taken with or just after a meal.

Ideal Bowel Support (containing Lactobacillus plantarum) may also be used if you have high methane gas on your SIBO breath test. We recommend L. plantarum based on research indicating this specific strain of Lactobacillus may help address methanogen overgrowth. Please take one capsule of Jarrow Ideal Bowel Support twice daily for two months, then decrease to one once daily for at least one more month or as recommended. This can be taken at the same time as Prescript Assist.

Partially Hydrolyzed Guar Gum (PHGG)
This is a prebiotic that supports the growth of healthy gut bacteria. Take one scoop mixed in water once daily with or without food. You may try taking it before bed in the case that it causes some mild GI distress/ discomfort.

MotilPro
MotilPro supports healthy gut motility, or muscular contractions, by supporting the neurotransmitters in the gut. Take two to three capsules of MotilPro twice daily between meals.

Iberogast
Iberogast is an herbal formula that improves GI motility and can be thought of as an adaptogen, meaning that it increases bowel motility in people with constipation and decreases motility in people more prone to loose stools. During the first 30 days of treatment about 20 drops of Iberogast should be taken at the beginning of meals. Iberogast may be used beyond treatment to support normal motility and prevent SIBO recurrence with a maintenance dose of about 20 drops before bed.

Digestive Enzymes and Betaine HCl
Bacterial overgrowth is often associated with low stomach acid and impaired production or secretion of digestive enzymes. These supplements can be taken at the beginning of meals to improve digestion and nutrient absorption. You can experiment with the dose of Betaine HCl that is right for you, but no more than six to seven capsules per meal should be used. You may find that with smaller meals you need less of this digestive support.
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Re: Healing leaky gut

Postby TheBrain » Sat Sep 03, 2016 11:26 am

Tiramisu1984 wrote:Wow. Thanks. My doctor is on an extended vacation (he ordered the test). I don't know how to feed the good bacteria and I suspect that like you, my restricted diet has led to some of these issues. No antibiotics. I have no gut issues - nothing. In view of the auto immune dx, and my hair loss issue, I don't think i should await his return (the 12th is my follow up).

Candida is a real issue. Congrats on getting it under control.


It sounds to me like you have no gut symptoms (except for the lactose intolerance symptoms you later mention). However, it sounds like you do actually have gut issues: gut dysbiosis and very likely leaky gut. It's not that unusual to have no symptoms. I have heard of people with diagnosed celiac disease who have no gut symptoms. It's called silent celiac disease, and even though there are no symptoms, serious damage is being done to their small intestine. I'm not saying you have celiac disease. I'm just using it as an example.

I suspect your doctor wouldn't have an issue with you going forward with the teas (which taste fine with stevia added), but he might want to weigh in on your gut protocol supplements. I know that feeling of waiting for an appointment and wishing it were TODAY, but the 12th isn't that far off.

Let me share this experience: I had my first appointment with my new FM MD and told him I planned to see a naturopath for a protocol to heal my gut dysbiosis. He was perfectly fine with that and asked me to upload her protocol to his portal when I had it in hand. So a week or so later, I had a very lengthy first appointment with this naturopath, and she developed a protocol for me. The visit cost me $245. I uploaded her protocol to my MD's portal. Not long afterward, I received a call from my MD's nurse (and wife). My MD didn't like the protocol and wanted to offer his own protocol. It was up to me, I was told, but that's what he wanted. I expressed my frustration that he could have told me during my first appointment with him NOT to see this naturopath. Instead, I wasted $245, and more than ever, I don't have money like that to throw away. I did decide to have him give me a protocol, which we haven't gotten to yet. We've planning to discuss the matter at my appointment with him (on the 12th).

So... I suggest you share with your doctor what you have learned from this thread: from me, from Julie, and from anyone else who contributes between now and the 12th. And then see what he recommends.

And thanks for acknowledging my healing from candida. I had that darn problem at least since my 20s!
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Re: Healing leaky gut

Postby Julie G » Sat Sep 03, 2016 11:27 am

I've noticed some recent pushback on the forum re. admonition's against meat and other animal products. It resonates with me because of my very low SIgA and overall depressed immune system. I've religiously followed Michael Pollan's advice (Eat food, not too much, mostly plants) over the past 3-4 years and watched my immune system tank. This blurb from one of my medical reports has made me rethink that dogma.
Secretory IgA (sIgA)
The concentration of sIgA is abnormally low in this specimen. Immunological activity in the gastrointestinal tract can be assessed using secretory immunoglobulin A (sIgA). Secretory IgA is the predominant antibody, or immune protein the body manufactures and releases in external secretions such as saliva, tears, and milk [1]. It is also transported through the epithelial
cells that line the intestines out into the lumen. Secretory IgA represents the first line of defense of the GI mucosa and is central to the normal function of the GI tract as an immune barrier [1]. As the principal immunoglobulin isotype present in mucosal secretions, sIgA plays an important role in controlling intestinal milieu which is constantly presented with potentially harmful antigens such as pathogenic bacteria, parasites, yeast, viruses, abnormal cell antigens, and allergenic proteins [1]. Secretory IgA antibodies exert their function by binding to antigenic epitopes on the invading microorganism, limiting their mobility and adhesion to the epithelium of the mucus membrane [2]. This prevents the antigens from reaching systemic circulation and allowing them to be excreted directly in the feces.

Mental and physical stress as well as inadequate nutrition have been associated with low fecal sIgA concentrations. This includes dietary restrictions, excessive alcohol intake, body mass loss, negative moods, and anxiety [3]. One study found depressed levels of sIgA in malnourished children, particularly protein malnourishment, that responded well to nutritional rehabilitation with a significant increase in sIgA [4]. This may be because the synthesis and expression of sIgA requires adequate intake of the amino acid L-glutamine [3]. Animal studies have demonstrated that a glutamine-restricted diet can result in a 50% decrease in sIgA levels [5]. An increase of dietary L-glutamine can restore GI immune function by protection of
cells that synthesize sIgA [6]. Saccharomyces boulardii is a nonpathogenic yeast that has been used for the treatment of acute infectious enteritis and antibiotic-associated diarrhea
[7]. Significantly elevated levels of sIgA and subsequent enhanced host immune response have been found following S. boulardii administration in mice and rats [8,9].

References:
1. Crago SS, Tomasi TB. Mucosal Antibodies, Food Allergy and Intolerance. Bailliere Tindall/W.B. Saunders 1987;167-89.
2. Roberts JA. Factors predisposing to urinary tract infections in children. Ped Neph 1996;10:517-522.
3. Carins J, Booth C. Salivary immunoglobulin-A as a marker of stress during strenuous physical training. Aviat Space Environ Med 2002;73(12)1203-7.
4. Teodosio MR, Oliveira ECM. Urinary secretory IgA after nutritional rehabilitation. Braz J Med Biolog Res 1999;32-421-426
5. Alverdy J. Effects of glutamine-supplemented diets on immunology of the gut. J Parent Enteral Nutr 1990;14(4):1095-1135.
6. Burke DJ, et al. Glutamine-supplemented total parenternal nutrition improves gut function. Arch Surg 1989;24:2396-2399.
7. Alverdy JA. The effect of total parenternal nutrition on gut lamina propria cells. J Parent. Enteral Nutr 1990;14(suppl).
8. Qamar A, Aboudola S, Warny M, et al. Saccharomyces boulardii stimulates intestinal immunoglobulin A immune response to clostridium difficile toxin A in mice. Infect Immun 2001;69(4):2762-5.
9. Buts JP, Bernasconi P, Vaerman JP, et al. Stimulation of secretory IgA and secretory component of immunoglobulins in small intestine of rats treated with Saccharomyces boulardii. Dig Dis Sci 1990;35(2):251-6.


In an effort to heal, I'm increasing my overall protein intake, especially animal protein. I'm drinking daily bone broth and enjoying grass-fed meat at least once a week, if not more. I just wanted to share my cautionary tale as evidence that there's no one-size-fits-all diet that works for us all. The strategies we think are helping us, may not be :?.


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