Researching Autoimmune Diseases:Part II-Leaky Gut and Food Intolerances

"What we find changes who we become." ~ Peter Morville, British author and president of Semantic Studios, an information architecture and findability consulting firm

     Autoimmune diseases (AI) all begin with a dysfunction of the gut mucosa. This is now a researched and documented fact that has become solidified in research and literature in the last year and a half. 

     What is the gut mucosa?  It is the largest and most dynamic immunological environment of the body which is a clue to why all AI disease begins in our guts. It's often the first point of pathogen exposure and many microbes use it as a beachhead into the rest of the body. 

     Our intestines have a top layer of mucosa with villi--these look like fat strands of fingers which increase surface area and regulate nutrient absorption. This layer is made up of a particular type of cell called epithelium. These are some of the fastest growing cells in our body which is why they are frequently targeted in cancer treatment--even if the cancer is not in our digestive tract. The chemo drugs cause our epithelium cells which also line our mouths, esophagus, stomach, small and large intestine and rectum, to slough off and die, leaving us raw and unprotected literally from mouth to anus. Often cancer patients undergoing chemo will die not from cancer but from toxic cell overload. So many cells--most of them healthy--have died and the liver and kidneys cannot process the dead cell load which causes them to shut down. (Coffee enemas can stop this from occurring.) 

     This layer of intestine forms a barrier between itself and the layer underneath where there are clusters of cells with spaces in between called junctions. In a healthy digestive tract a tight junction is regulated. Interocytes (a particular type of cell) form space between the junctions. They allow electrolytes and minerals to pass through and keep larger molecules and pathogenic bacteria from escaping. More than sixty proteins regulate this space. A tight junction is regulated so that enzymes can capture nutrients (vitamins, minerals, amino acids, and hormones) from our digestive tract and deliver them wherever they are needed by our bodies. This is the act of nutrition and this process provides the fuel our bodies need to function. This is actually why we have to eat and drink. If there is a breach in its integrity we have illness. Food may remain undigested for a variety of reasons, especially if there are pancreatic issues or a lack of digestive enzymes.

The Importance of Enzymes

     These amazing proteins do more than just help remove grass and blood stains from our clothes! Yep your biological laundry detergent is called that because it has enzymes in it. Enzymes are specific amino acid proteins that act as catalysts to living cells. Enzymes are required by our bodies for every single function we undertake--blinking our eye, smacking our lips, yawning, muscle contraction, breathing, and digestion to name a few. Digestion is the single most difficult process our bodies undertake!! Think about that, because we indiscriminately pop food and drink into our mouths all day long and give it little to no thought once we swallow it.

     Enzymes are the human body's life force. They exist in all living things so of course our food has enzymes in them as well. When we are cooking a meal, that lovely smell of meat roasting or coffee brewing is caused by the enzymes dying off from exposure to heat. Raw food and food heated to a very low temperature has living enzymes in it. The safe register of temperatures seems to be 117F/47C for liquids and 150F/65C for solids. This is why we go into a food related coma after indulging in loads of food as part of a celebration like Christmas. Most of that food has been cooked and no longer has any enzymes in it. We overload our digestive system and it must literally borrow enzymes from everywhere else in our bodies in order to deal with the process of digestion. This is also why when we are seriously ill, our food should be fresh, organic and as raw as possible. Our immune system has marshaled our enzymes to go into battle and it needs a massive amount of available enzymes to do that. Fresh squeezed juices are ideal because they will literally digest themselves without using enzymes from our body functions. This allows more enzyme availability to our immune system for healing. Two thirds of our immune system is in our gut for good reason: we take in pounds and pounds of food requiring being broken down and it all has bacteria on it--probiotic (good) and pathogenic (bad).

Gut Permeability (Leaky Gut) 

   Undigested food will rot in our guts and it will present itself under the cell layer between our digestive system and the rest of us--the gut mucosa. This absorptive mechanism is as big as a tennis court and one cell thick. Food proteins cross a compromised gut mucosa into the bloodstream. These proteins are attacked by our our immune system defenses and they settle into our joints. Look at your fingers. If you have developed hard knobs at the joints of your fingers you have a leaky gut. 

See the pronounced knobs at the first joint of my finger? Those are caused by leaky gut syndrome and inflammation. Our blood stream seeks to dump the garbage escaping from our guts that our liver and kidneys cannot process. The spaces in our joints are available space. Inflammation of our joints is the result.  

Arthritis is often a signal of this issue as our immune system creates an inflammatory response to food particles and gram negative bacteria escaping from our guts. Our joints become inflamed as a response.

     This is why it is crucial to avoid regular or prolonged use of all NSAIDS (Ibuprofen, Aspirin, Paracetamol/Tylenol, Motrin, Aleve. These over the counter anti-inflammatory pain relievers cause leaky gut, destroying sections of your gut mucosa. For this same reason we need to avoid inflammatory foods in our diet and avoid foods that activate our immune systems. If gut permeability or leaky gut syndrome lasts long enough the epithelial cells cannot repair themselves  quickly enough or the repair cannot last before the cells are destroyed by the next onslaught of NSAIDS and inflammatory food and drink. 

     When this permanent breakdown occurs malabsorption results in malnutrition. We could eat loads of food all day but our guts can no longer access and deliver the nutrients in our food to our bodies where they are needed. Some of the signs of leaky gut and malnutrition are excessive shedding of hair, gas and bloating, intolerance to fats, transit times changes in bowel movements (BMs), undigested food and change of color in BMs, and fluctuating between diarrhea and constipation. All foods from first bite to BMs should move through our systems in 24 hours and they should not smell putrid. Gut permeability is one of the causes of gut dysbiosis which is a bacterial imbalance in out gut. We don't have enough or any pre and pro-biotic bacteria and we are overloaded with pathogenic (disease producing) bacteria. Proper digestion can no longer take place.

     Digestion begins in our mouths with Amylase which is a digestive enzyme in our saliva. It continues in our stomachs which are filled with very potent acid to kill off pathogenic bacteria, then continues in our small intestines. Our large intestine breaks down fermentable and starch resistant fiber and primarily removes the water from the digested and processed waste products and stores it for a short time until we void it.

Acid Reflux 

     One of the big issues for people with digestive upset is prescription drug use. Our stomachs are high in acid and low in PH, about 1.2, 1.5, to 1.7. Often those experiencing bloating and gas will take Nexium (Esomemprazole). This purple pill brings the PH in the human stomach up to 5--from the PH of battery acid to that of vinegar! We need the high acid PH to break down proteins and when our stomach acid is too weak we can experience issues with mood swings, muscle function, lack of energy and even a mild shift in stomach acid can result in the formation of auto-immune antibodies to protein, by a factor of 10, causing gut permeability. Most of us don't produce enough acid. Clues are an insufficiency of vitamin B12 production, fatigue, headache, odor intolerance, neuropathy (tingling hands, feet and legs), insufficient magnesium and potassium causing involuntary eyebrow twitches, calf and foot cramps, and muscle fatigue.
     Aging causes us to manufacture less hydrochloric acid in our stomach and yet this is the population that ingests the most acid reflux medications. Soda pop and sugar also inhibits our ability to make adequate stomach acid.

Inflammation
      Crohn's and Colitis are inflammatory bowel diseases. Inflammation contributes to a host of other AI diseases such as Rheumatoid Arthritis, Hashimoto's disease, Asthma, and Psoriasis and others so it is a huge issue to address in seeking good health. There has been a 25% increase in inflammatory bowel disease world wide. The main cause of inflammation in the body is a reaction to things that cause inflammation to occur. Inflammation metabolically demands our bodies use all of the available vitamins and minerals to support the anti-inflammatory process. This process also uses all of the available amino acids taurine, glutathione and glycene and our bodies do not produce these essential amino acids. They must be replaced in our food or with supplements. Also our digestive tract cannot function without enough glutathione. It is key to healing from any kind of digestive tract surgery or illness. What kind of foods cause an inflammatory response? The answer to this can vary from person to person but first and foremost is gluten.

Gluten Intolerance
     Antibodies are a type of blood protein produced in response to and counteracting a specific antigen (toxins or foreign substances which produce an immune response). Antibodies combine chemically with substances which the body recognizes as alien, such as bacteria, viruses, and foreign substances in the blood. Lectins and glutinen/gliadin found in gluten bind to human tissue and can cause inflammation to occur if our bodies mistake the bound human tissue for the food causing an allergic reaction. Antibodies form which attack and destroy tissue--intestines, brain, bone, thyroid, heart...
     We humans are not ruminants; we did not evolve as a species to digest grass grains such as wheat, rye and barley. The thing is, it is not a case of either you suffer from gluten intolerance (GI) or you don't. The majority of humans on our planet have a response to gluten/gliadin. Patients who have removed gluten from their diets for three months and then ingested gluten again often risk their lives. It is like a switch is flipped and a six fold increase in deaths with one ingestion of gluten can occur. 
     Genetics is behind most of this. We inherit or fail to inherit from our forebears the ability or inability to manufacture certain levels of the protein heptoglobin (Hp) which binds to excess hemoglobin (another protein responsible for transporting oxygen in our blood). There are two ways we can inherit this protein depending on whether or not it is present in the DNA we inherit from each of our parents at the moment of conception: Hp1 and  Hp2. which arose in human populations as a duplicate of Hp1. Three genotypes of Hp, therefore, are found in humans: Hp1-1, Hp2-1, and Hp2-2. (If you find this confusing think of what you learned in junior high school science classes about inheritance of blue and brown eyes). If you test for Hp and are found to have Hp1:1 you will be okay eating gluten. If you have 2:2 you must never eat anything with gluten in it--not one molecule. Those with Hp 1:2 are okay for about an hour before GI kicks in and they will suffer from gut permeability for up to three hours after ingesting gluten. Research shows that individuals with AI diseases manifesting in childhood such as Asthma and Diabetes type and have inherited either Hp 1:2 or 2:2. Those with Coeliac disease always have Hp 2:2. 
     There are also other genes involved which I won't go into. This inheritance is driven by cultural factors. Populations that experience difficulty digesting gluten are Japanese, Southern Chinese, Koreans, Africans from the Western Sahara, Northern India and the Punjab, Northern Italians, Sweden, Finland, Norway, Denmark, and Irish for whom wheat was not grown or eaten before the 18th century, Indigenous North, Central, and South Americans, and the Balkans.
     If you live in a country like America or Australia where all of the population except indigenous peoples are immigrants or come from immigrant populations then its important to know your genealogy. Research undertaken by the NHS indicates that one in every 100 Britons has Coeliac disease. Given that this is a northern climate and wheat farming came late to the Island, combined with the large immigrant population here I am not surprised. 
     In a patient survey done for FMS offices throughout North American, ninety percent of those who cut out gluten from their diets for one month felt better and had more energy. Now if you are not GI then simply being mindful of which products include gluten and cutting back on how much gluten you ingest can make a positive difference in your health because just as we did not evolve to eat red meat every day, we didn't evolve to eat, breath, and absorb gluten very often. It is a similar thing with soy. The Japanese eat soy in tofu and sauce but not every day. In the west soy has become ubiquitous. It is yet one more ingredient in everything and ingesting as much soy as we do is not healthy. Research shows high levels of soy can induce breast cancer.  
     The symptoms of Gluten Intolerance are bloating (all human bodies contain yeast. Think about what happens when yeast, wheat, and liquid come into contact with one another), diarrhea, constipation, smelly feces, abdominal pain, headaches, fatigue, skin rashes, depression, unexplained weight loss, and your digestive tract shuts down.
     Wheat is in everything!! Besides the obvious items such as baked goods, it is in toothpaste, lipstick, body cream, shampoo,  spices, shredded cheese, sauces and condiments, soups, ready made meals, frozen seafood, chicken and other meats, vitamins, supplements and pharmaceutical drugs.
     One final note about the distinctions between Coeliac disease, gluten intolerance and diet fads. Coeliac disease is not simply an intolerance. It is a severe allergy to gluten and a total inability to tolerate or digest gluten. Brain damage and death can result from exposure to gluten as result. If you have a parent with Coeliac disease you have a one in then chance of developing it yourself. Some individuals are born with the disease active and some don't develop symptoms until shortly after birth or later in life. Their bodies cannot digest and synthesize any form of gluten and further, ingesting gluten can cause serious brain damage for them. So imagine for a moment you have given birth to a baby that has Coeliac disease and of course, you won't know this until months go by as your child fails to thrives, slowly starving and withering before your eyes.   
     Individuals like myself who have tolerated gluten from birth up until some point in life when an AI disease manifests with an inability to digest glutenare what is known as NCGI-Non-Coeliac Gluten Intolerant. But trust me when I tell you that the distinction for me is irrelevant. I am okay eating glutenized foods while chewing, swallowing, and my body is breaking it down in my stomach. The minute however the gluten leaves my stomach I am in a world of terrible pain--pain that makes labor pains seem by comparison, mild. My intestines and colon immediately begin swelling, feeling as though  someone has filled them with expanding foam insulation and it hurts like hell. the swelling is so sever that my liver, kidneys and ribs ache. There is no way to get comfortable or reduce the pain. I have to live with fifteen to thirty hours of excruciating pain as the glutenized food moves slowly and I do mean slowly through my intestines where a battle between the gluten and my immune system is being waged which makes digestion negligible. Peristalsis (the contraction of the intestine and colon to move food and waste products through the gut) often comes to a halt and life revolves around severe pain that radiates out in endless waves from my guts. I cannot sleep, eat, walk, sit, lay down or engage in any activities to try and take my mind off it...I am trapped in a cage of terrible pain that won't go away. For me Codeine is the only thing that removes the pain, but it has the side effect of making one constipated which can obviously cause further troubles. I will do anything not to experience this pain again--ever. I consider myself lucky that my digestive tract is not so damaged that a stoma is necessary. I can change my diet and control the disease.
     Diet fads come and go and currently going gluten free is the latest health fad with unfortunate consequences for Coeliacs and NCGI individuals who attempt to eat out in restaurants. The majority of food handlers and servers in public eating facilities don't understand the deadly consequences for people who ask for gluten free foods. Thinking of it as a fad, they don't realize that foods for Coeliacs and NCGI individuals must be prepared separate from foods with gluten in them and the prep area must be gluten free, and often food establishments will list an item on their menu as GF when it has been cross contaminated with gluten during the preparation. I experienced this first hand when I queried the owner of  Baked Onboard--the Pizza boat, I asked it he offered GF pizza. He replied cheerily "Nope but I do have a sourdough pizza and as long as you aren't Coeliac then you can eat it. NCGI people have tolerated it just fine." Well, actually no I can't and I suspect his customer that do were not NCGI but those trying out the newest diet fad for health reasons.     

Lactose Intolerance
 The inability to digest the sugar lactose in dairy products is also inherited and interestingly enough the map of intolerance by ethnicity is nearly the opposite of the map for gluten intolerance. Cultures in which lactose intolerance is common are those countries in the south: Central and south America, Africa--especially south Africa, Southern India, China, Japan, Korea, Malaysia, and all Indigenous peoples in most areas of the world. That's a lot of folks who cannot properly digest dairy and ignoring this issue can and does cause Leaky gut which can eventually lead to an AI disease. 
     The symptoms of lactose intolerance are abdominal bloating with pain and cramps,  diarrhea, gas, nausea, vomiting and borborygmi which is a loud on-going rumbling, gurgling sound from the stomach.

Vitamin D-the Vitamin Which is NOT a Vitamin!
    Finally, low amounts of Vitamin D puts us at risk for developing AI disease and cancer--it is just that important!! The prime level of Vitamin D is 30 nanograms or above. Vitamin D isn't actually a vitamin at all--it is a steroid hormone. If you plan to rely on absorption from the sun for your Vitamin D here is the scale of exposure: at least 15% of your body must be exposed. Fair skinned folks actually need forty minutes of exposure and that obviously cannot happen all in one go! Your exposure needs to occur over a period of days. If you are olive skinned you will need eighty minutes of exposure and if you are very dark skinned you will need an hour and twenty minutes of exposure. It should also be obvious to anyone with two brain cells to rub together that Sunscreen inhibits the absorption of Vitamin D. Finally do it when you are dirty! Human skin creates a layer of oil called sebum. Our bodies need sebum on the surface of our skin in order to metabolize sunshine and turn it into Vitamin D so don't go out after showering and expect to manufacture anything but a tan or a sunburn
     One way of getting more D in your diet is to eat more mushrooms, but first lay them out in the sunshine for twenty minutes. Mushrooms are just like humans in that they do not internally manufacture Vitamin D but if they sit in the sun for nearly half an hour they will make Vitamin D and store it, for our bodies to use when we eat them.

Sugar
     Processed sugar triggers the release of inflammatory messengers called cytokines. These cells are produced by our immune system so eating large amount of sugar causes our immune system to being a hunt for a culprit. It is i like the boy who cried wolf. Eat too much sugar too often and AI disease results as the immune system goes into overdrive and is never allowed to rest.
     How much sugar is too much? for a healthy person the maximum amount of sugar one should eat daily is 25 grams or 6 teaspoons. The average human in First world countries ingests at least 19.5 teaspoons of sugar daily. This includes sugar of any color, fructose, glucose, sucrose, maltose and galactose. did you know that excessive amounts of sugar cane lead to early dementia? Sigh....so if you need a little sweetening in your life I suggest you keep it low and opt for glucose which is the only sugar our brains need to function. I learned from my local beekeeper that spring honey which is lighter and sets up quicker than summer or autumn honey which is darker and lot more fluid, that spring honey contains more glucose and the other two seasonal honeys contain more sucrose.
     Type 2 diabetes is in the process of being redefined from a metabolic disorder to an autoimmune disease. Immune cells cause inflammation if fatty tissue that protects our internal organs. As we gain more weight and develop more dense layers of fat around our organs  becoming a health threat. Our immune system kicks into overdrive and begins producing Killer T and B cells involved in antibody response, causing inflammation in the fatty tissue which over time inhibits the fat cells' ability to respond to Insulin, allowing fatty acids to leach in to the blood stream and diabetes results.
     Okay I will stop here for now and my next post will cover environmental toxins and AI disease. My fourth and final post on this subject will cover diet and supplements.