June 26, 2017

New study demonstrates alterations of the gut microbiome in chronic fatigue syndrome

In a recent study published last month in Microbiome, Cornell researchers have identified biomarkers of chronic fatigue syndrome in gut bacteria as well as inflammatory microbial agents in the blood.

This is very interesting but should come as no surprise as many of these individuals commonly has gastrointestinal disturbances. The gut microbiome has been associated with many chronic health conditions from autoimmune disease to neurological disorders.

Doctors have often been puzzled by chronic fatigue syndrome. This is a condition with no known triggers and its diagnosis typically requires extensive testing. Patients often complain of fatigue, muscle and/or joint pain, sore throat, headaches, sleep disturbances, post-exertional malaise, and gastrointestinal symptoms.

In this study, the research team was able to correctly diagnose myalgic encephalomyeletis/chronic fatigue syndrome (ME/CFS) in 83% of patients through stool samples and blood work. The study consisted of 48 individuals diagnosed with ME/CFS and 39 healthy controls to provide stool and blood samples. Overall, the diversity of gut bacteria was significantly reduced. In addition, there were fewer bacterial species known to have anti-inflammatory properties in ME/CFS patients, a similar observation seen patients with inflammatory bowel disease.

Furthermore, researchers identified specific markers of inflammation in the blood, which are likely due to intestinal permeability. Bacteria in the blood will trigger an immune response which can exacerbate symptoms increasing the severity of the condition.

The question we must ask is the altered gut microbiome a cause or a result of the disease? This data demonstrates that the gut microbiome in patients with chronic fatigue syndrome is not normal. This further confirms that CFS is no of psychological origin.

When it comes to any gastrointestinal dysfunction, it is important to rule out viruses, fungi, and other pathogenic bacteria in the gut that may be causing or contributing to patient’s symptoms. Healthcare providers should consider a stool analysis for these individuals using molecular/PCR based techniques.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Ludovic Giloteaux, Julia K. Goodrich, William A. Walters, Susan M. Levine, Ruth E. Ley, Maureen R. Hanson. Reduced diversity and altered composition of the gut microbiome in individuals with myalgic encephalomyelitis/chronic fatigue syndrome. Microbiome, 2016; 4 (1) DOI: 10.1186/s40168-016-0171-4

Heavy exercise induced intestinal permeability: New study suggests gut support for athletes

There was an interesting article published last week in American Journal of Clinical Nutrition on heavy exercise induced intestinal permeability in athletes. When one thinks of nutritional supplements in athletes, they usually think of nutrients that increase enhance energy and sports performance. However, athletes commonly suffer from gut issues that are often not identifies or addressed. ‘Leaky gut’ occurs from dysfunction in the intestinal barrier. This intestinal barrier in the gut is only one cell layer thick. It is essential for the absorption of nutrients and preventing large molecules and bacteria from getting into the blood stream.

It is a particular problem for those taking part in heavy exercise or who are active in hot conditions. It can lead to gut issues in athletes as well as more serious conditions like inflammatory bowel and autoimmune disorders.

In this study, researchers demonstrated that zinc carnosine and colostrum can have a significant value for athletes.

The study included 8 participants in a four-arm, double-blind placebo-controlled test. The participants were divided into groups receiving either the placebo, zinc carnosine, colostrum, or zinc carnosine and colostrum for 14 days prior to exercise. These nutrients were taken 2 and 14 days after starting treatment. They noted that during heavy exercise, athletes had a 2 degree increase in body temperature, which may have been a factor in inducing intestinal hyperpermeability. This significant stress on the body and central nervous system may also play a role.

The clinical trial was parallel to cell culture experiments to uncover the mechanisms of zinc carnosine and colostrum.

The results showed that zinc carnosine improved the function of the intestinal barrier which was further enhanced when colostrum was added. These findings demonstrate the importance of zinc carnosine and/or colostrum in preventing leaky gut associated with heavy exercise but also as an important nutrients to consider for athletes. When working with athletes, there is often a disconnect between fitness and health.

As a competitive powerlifter, I work with many of these athletes. Due to the stresses they put on their bodies and increased metabolic demands, many often have debilitating gut issues and inflammatory bowel diseases.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Glen Davison, Tania Marchbank, Daniel S March, Rhys Thatcher, and Raymond J Playford. Zinc carnosine works with bovine colostrum in truncating heavy exercise–induced increase in gut permeability in healthy volunteers. American Journal of Clinical Nutrition, June 2016 DOI: 10.3945/ajcn.116.134403

New study shows low commensal bacteria in multiple sclerosis patients

According to a new study published earlier this week in Scientific Reports, researchers are saying low amounts of beneficial bacteria or a dysbiosis in the gut microbiome may have a direct association to multiple sclerosis (MS). This is not new information, however, it is good to see more of this information in the medical research.

There is a study a reference a lot from Plos One in my presentations demonstrating this association. In a 2014 study, researchers at Lund University published research findings on the role of the intestinal barrier in MS. Scientists have previously shown that probiotics could provide a certain amount of protection against MS. However, they questioned whether the intestinal barrier was affected, which led to their examination of inflammatory cells and processes in the intestine. As a result, they saw structural changes in the gastrointestinal mucosa of the small intestine and an increase in inflammatory T-cells. In addition, they saw a reduction in regulatory T-cells (immunosuppressive cells). These changes are often linked to inflammatory bowel diseases. In summary, they concluded that future drugs to treat MS should not only focus on the central nervous system, but also on repairing and restoring the intestinal barrier.

The gastrointestinal tract is 80% of our immune system. Whenever you have inflammation present, the tight junctions and intestinal mucosa can become damaged compromising the lining of the GI tract. Then toxic byproducts in the digestive tract can be absorbed into the bloodstream forming immune complexes which eventually affect numerous systems throughout the body causing inflammation, food sensitivities and autoimmune disorders.
According to this new study in Scientific Reports, the research team confirmed that relapsing remitting multiple sclerosis (RRMS) patients do have a distinct microbiome different from healthy individuals with certain gut microbes showing decreased or increased abundance in RRMS patients compared to controls. The analysis of bacterial diversity showed no difference between total RRMS patients and healthy controls. With that being said, RRMS patients with active disease showed decreased abundance compared to patients in remission and controls. This decreased abundance in RRMS patients with active disease suggests an important role of the gut microbiota in disease exacerbation. This study further supports previous research indicating that MS patients have dysbiosis of gastrointestinal microbiome.

These two studies are a perfect examples between the big disconnect between medical research and the practice of traditional medicine when it comes to the management of chronic disorders.

Gut bacteria has been identified as an important environmental factor in overall health and all autoimmune disease. Patients may need anti-microbials, botanicals, enzymes, prebiotics, and probiotics to optimize the gastrointestinal environment.

All practitioners treating patients with autoimmune disorders should consider a comprehensive digestive stool analysis for these individuals, which modern research supports. There are several other factors that play a role in autoimmunity such as, gluten intolerance, food sensitivities, gastrointestinal infections, hormone imbalances, heavy metal toxicity, and nutrient deficiencies (ie. vitamin D, magnesium, EFAs). These environmental influences filtered through genetic predisposition are fundamental factors in the expression of disease, and a successful treatment approach must include investigation into these factors.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Jun Chen, Nicholas Chia, Krishna R. Kalari, Janet Z. Yao, Martina Novotna, M. Mateo Paz Soldan, David H. Luckey, Eric V. Marietta, Patricio R. Jeraldo, Xianfeng Chen, Brian G. Weinshenker, Moses Rodriguez, Orhun H. Kantarci, Heidi Nelson, Joseph A. Murray, Ashutosh K. Mangalam. Multiple sclerosis patients have a distinct gut microbiota compared to healthy controls. Scientific Reports, 2016; 6: 28484 DOI: 10.1038/srep28484

N-acetyl-cysteine may improve Parkinson’s disease according to new study

Parkinson’s disease is a debilitating neurodegenerative disorder that affects more than one million Americans each year, a figure expected to rise due to aging populations. The main characteristic feature of Parkinson’s disease is the progressive destruction of dopamine-producing cells in the substantia nigra region of the brain where dopamine is made. This loss of dopamine production affects the communication between the brain and the body causing muscle rigidity and tremors.

Present treatments for Parkinson’s disease are limited to replacing dopamine in the brain as well as specific medications designed to slow the progression of the disease. Recently, researchers have demonstrated the role of oxidative stress and its impact on the brain in the Parkinson’s disease process. This oxidative stress lowers glutathione levels resulting in an increased demand for glutathione to help reduce the oxidative damage to the neurons.

According to a new study published last week in PLOS ONE, researchers from Thomas Jefferson University demonstrated a potential benefit of n-acetylcysteine (NAC) in patients with Parkinson’s disease. The study showed that patients receiving NAC improved both mental and physical abilities with brain imaging studies that tracked the levels of dopamine.

This demonstrates that NAC may have a unique physiological effect on the brain that alters the disease process and improves the function of dopamine neurons and offers a new approach for managing patients with Parkinson’s disease.

In this study, patients with Parkinson’s were divided into two groups. One group received a combination of oral and intravenous (IV) NAC for three month period. These patients received 50mg/kg NAC intravenously once per week and 600mg of oral NAC twice daily on the non-IV days. The other group received only their standard Parkinson’s treatment. Patients were evaluated by standard clinical measures including the Unified Parkinson’s Disease Rating Scale (UPDRS) and a brain scan (DaTscan SPECT imaging), which measures the amount of dopamine transporter in the basal ganglia. The patients receiving NAC had improvements of 4-9% in dopamine transporter binding as well as 13% in their UPDRS score.

Glutathione is an important antioxidant which has been found to be depleted in the brain of Parkinson’s disease patients. In addition, the extent of glutathione depletion appears to mirror the severity of the disease and is the earliest known indicator of degeneration. The brain has difficulty handling significant amounts of oxidative stress due to the presence of polyunsaturated fatty acids and low levels of antioxidants such as glutathione. In conclusion, providing antioxidant support with NAC or glutathione can provide a beneficial effect in Parkinson’s disease patients as well as other neurodegenerative disorders.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Daniel A. Monti, George Zabrecky, Daniel Kremens, Tsao-Wei Liang, Nancy A. Wintering, Jingli Cai, Xiatao Wei, Anthony J. Bazzan, Li Zhong, Brendan Bowen, Charles M. Intenzo, Lorraine Iacovitti, Andrew B. Newberg. N-Acetyl Cysteine May Support Dopamine Neurons in Parkinson’s Disease: Preliminary Clinical and Cell Line Data. PLOS ONE, 2016; 11 (6): e0157602 DOI: 10.1371/journal.pone.0157602

New study demonstrates success of low FODMAP diet in IBS sufferers

Irritable bowel syndrome (IBS) can be debilitating causing cramping, abdominal pain, bloating, gas, diarrhea and constipation. IBS can affect and one’s work, sleep and relationships.

According to a recent clinical trial published in Gastroenterology, researchers at University of Michigan’s Health System demonstrated that a low FODMAP (Fermentable Oligo-Di-Monosaccharides and Polyols) significantly helped those with IBS. This study measured the degree of relief from a low FODMAP diet and demonstrated improvement in symptoms as well as an increased quality of life in patients with IBS. This diet excludes many compounds found in wheat, certain fruits and vegetables, garlic, onions and sugar substitutes.

Most treatments rely on medications which are usually ineffective and have numerous side effects. A Low-FODMAP diet is not a new treatment. Most integrative doctors already incorporate a low FODMAP diet for these patients, however, many of the dietary recommendations have not been backed by clinical trials. This just further reinforces these recommendations.

Over a 6 week period, dietitians educated and tracked the progress of over than 90 IBS patients. Approximately 50% of the participants followed a low FODMAP diet and the remainder were a control group consisting of portion control and eliminating commons irritants such as caffeine and alcohol.

As a result, over 50% of the patients on the low FODMAP diet had major improvement of their abdominal pain, compared with only 20% of the control group. There was also additional improvement of bloating, diarrhea and stool urgency.

It is common knowledge that diet is the most effective means to returning balance within the gastrointestinal system. One may need a combination of botanicals, enzymes, and probiotics to optimize the gastrointestinal environment. Certain diagnostic tests may also be beneficial, including stool testing as well as food antibody testing.

The gastrointestinal tract is considered to be the body’s ‘second brain,’ it is made up of a self-contained, complex network of neurons, neurotransmitters, and proteins embedded in the lining of the GI system. It is responsible for all aspects of the digestive process, from the esophagus to the stomach and small and large intestines and may be responsible for IBS symptoms.

There are other nutrients that can support patient with IBS. For example. Perilla frutescens is an herb native to Eastern Asia that demonstrates antispasmodic, prokinetic, and anti-inflammtory effects, which help normalize and promote health bowel function and provide relief from GI symptoms. In addition, there are some specific researched strains of Saccharomyces cerevisiae that have been shown to reduce digestive discomfort and abdominal pain in individuals with IBS.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Shanti L. Eswaran, William D. Chey, Kenya Jackson, Sivaram G. Pillai, Samuel W. Chey, Theresa Han-Markey. 821 A Low FODMAP Diet Improves Quality of Life, Reduces Activity Impairment, and Improves Sleep Quality in Patients With Irritable Bowel Syndrome and Diarrhea: Results From a U.S. Randomized, Controlled Trial. Gastroenterology, 2016; 150 (4): S172 DOI: 10.1016/S0016-5085(16)30665-5

New study demonstrates how the gut bacteria causes obesity

According to a new study published in Nature, a research team from Yale has identified the mechanism in which gut dysbiosis leads to obesity. Previous research has demonstrated the association of the gut microbiome with metabolic markers and type II diabetes. Obesity is linked to changes in the gut bacteria, however, this mechanism was unclear.

In a previous study researchers discovered that one of the short chain fatty acids (SCFAs), acetate, stimulated the secretion of insulin in mice. When they compared acetate to other SCFAs, they discovered higher acetate levels in those that consumed a high fat diet. They also saw that acetate stimulated insulin secretion by beta cells in the pancreas, but this mechanism was not clear.

Interestingly, when acetate was then injected directly into the brain, it caused an increased release of insulin stimulating the parasympathetic nervous system. As a result, the increased acetate stimulates the beta cells of the pancreas to secrete more insulin in response to glucose. This also stimulates the secretion of gastrin and ghrelin causing an increase in food intake.

To establish a causal relationship between the gut microbiota and increased insulin, the research team transferred fecal matter from one group of mice to another. As a result, they observed similar changes in the gut microbiota with acetate levels and insulin.

In summary, this research demonstrates an association of alterations in the gut microbiota as a result of dietary changes leading to an increased acetate production. Furthermore, the increased acetate leads to increased food intake causing metabolic syndrome, insulin resistance, and obesity.

The research team suggests this mechanism may have played a role in evolution by stimulating animals to fatten up in times of food scarcity.

I was also a probiotic workshop at Yale last March and I remember one of the presentations from Max Nueuwdrop, MD, PHD, an internist and endocrinologist, from Amsterdam. He went into detail on the microbiota and metabolism. He showed how butyrate, a SCFA, improved insulin resistance and brown fat activation. In general, low short chain fatty acids (SCFAs) are associated with low diversity and abundance of the commensal bacteria. We typically want to see high levels of butyrate and not acetate. When patients introduce probotics and increase their dietary fiber intake by consuming fruits and vegetables, the beneficial bacteria butyrate, and SCFAs increase.

Probiotics help encourage microbial diversity, especially if the probiotic supplement is of mixed species. In ecological terms, it is more stable to have diverse populations in any ecosystem. The same is true for the gastrointestinal microbiome.

This also bring up the importance of stool testing in patients with metabolic syndrome and diabetes and just looking at facing glucose, insulin, A1c, and lipid profiles.

Other research has indicated that obesity has a microbial component that alters the caloric extraction from ingested food. For example, If you have more Bacteroidetes, the individual tends to be leaner. High Firmicutes:Bacteroidetes ratios have been known to increase the caloric extraction from food and these individuals tend to be more obese. This also ties together the importance of dietary fiber and weight loss.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Rachel J. Perry, Liang Peng, Natasha A. Barry, Gary W. Cline, Dongyan Zhang, Rebecca L. Cardone, Kitt Falk Petersen, Richard G. Kibbey, Andrew L. Goodman, Gerald I. Shulman. Acetate mediates a microbiome–brain–β-cell axis to promote metabolic syndrome.Nature, 2016; 534 (7606): 213 DOI: 10.1038/nature18309

A diet that mimics fasting reduces multiple sclerosis symptoms according to new study

Multiple sclerosis (MS) affects an estimated 350,000 Americans. Symptoms can range from fatigue, weakness visual problems to paralysis. According to a new study published last Thursday in Cell Reports, research suggests a diet that mimics the effects of fasting may reduce the symptoms of multiple sclerosis.

Researchers discovered that a fasting-mimicking diet triggers the killing of autoimmune cells by the production of cortisone. As a result, this leads to the production of healthy new cells.

This new study included mice and human patients who have multiple sclerosis. For the first part of the study, results demonstrated that the fasting-mimicking diet reduced disease symptoms in all mice with all autoimmune disease with a complete recovery in 20% of the mice. As a result, increased levels of corticosterone, a reduction in the inflammatory cytokines, improvements in T cells as well regeneration of the myelin were seen.

Furthermore, researchers also checked the safety and efficacy of the diet on people who have multiple sclerosis through a pilot study including 60 participants with MS. Eighteen patients were put on the fasting-mimicking diet for a seven day cycle and then on a Mediterranean diet for the following six months. In addition, twelve patients were on a controlled diet, and the remaining 18 participants were instructed to follow a ketogenic diet.

Those who followed a fasting mimicking diet cycle followed by the Mediterranean diet and those on a ketogenic diet noted improvements in their quality of life and improvements in their overall health.

The results of this study look optimistic as part of an effective treatment for those suffering from MS and other autoimmune disorders.

I also shared last week several key nutrients such as curcumin, n-acetyl-glucosamine, and ParActin that have the synergistic ability to modulate cytokine and chemokine production as well as balance Th-1 and Th-2 responses.

In addition, as with all autoimmune disorders it is important to optimize vitamin D and address intestinal barrier dysfunction. There was a study published in September 2014 in Plos One in which researchers published new research findings on the role of the intestinal barrier in the autoimmune disease MS. The researchers stated, “they believe that future drugs to treat MS should not only focus on the central nervous system, but also on repairing and restoring the intestinal barrier. They hope for the development of a better treatment that looks at the intestinal barrier as a new therapeutic target.”

Dietary approaches provide the most effective means to returning balance and dysfunction with the gastrointestinal system. Patients may need antimicrobials, botanicals, enzymes, prebiotics, probiotics, and glutamine to optimize the gastrointestinal environment. Integrative health care practitioners can offer hope to these patients. Diagnostic considerations include a comprehensive digestive stool analysis, organic acid testing, food antibody testing, as well as gluten sensitivity testing or elimination of gluten from the diet.

Vitamin D also plays a significant role in autoimmunity. Research has demonstrated that the highest levels of inflammatory inhibition occurs at 50 ng/ml. Optimal vitamin D levels are typically achieved anywhere from 4000 – 10,000 IU daily.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: In Young Choi et al. A Diet Mimicking Fasting Promotes Regeneration and Reduces Autoimmunity and Multiple Sclerosis Symptoms. Cell Reports, May 2016 DOI: 10.1016/j.celrep.2016.05.009

The underlying mechanisms that lead to psoriasis

Psoriasis is an inflammatory skin condition that is characterized by itchy, scaly skin plaques. The exact cause of psoriasis is unknown, however, more and more evidence suggests that the immune system is chronically stimulated causing an overproduction of cytokines that maintains an inflammatory environment.

According to a new study published in the journal International Immunology, researchers have discovered more evidence that a cytokine called IL-17A is especially critical in in the pathogenesis of psoriasis.

In this study, researchers cultured normal keratinocytes with a mixture of six different cytokines known to be involved in psoriasis. As a result, they found that it caused the expression of psoriasis-related genes. The research team identified a group of psoriasis-related genes in keratinocytes that are regulated by IL-17A. One of these genes in particular, called NFKBIZ, was found to have a significant role in the IL-17A pathway. This gene encodes a protein that plays a well-known role in regulating the body’s immune response to infection.

What appears to happen with most autoimmune conditions is there are multiple triggers chronically stimulating the immune system over a long period of time in multiple ways and our immune system gets into overloaded, overwhelmed state and loses its ability to function.

If we know what causes the immune system to attack itself and we know some of the triggers for what causes a malfunction in the immune system, we can successful treat these conditions.

There are different autoimmune diseases within all specialties and all of these are looked at differently, however, they all have the same common triggers. Therefore, we can take a similar approach in treating all autoimmune conditions.

Nutrients to consider

There are only a few natural products that have demonstrated the wide range of protective properties as curcumin. It provides anti-inflammatory properties and antioxidant effects that modulate cytokine and chemokine production and as a result balances the Th-1 and Th-2 T helper cells further downstream.

Glucosamine is a derivative of glucose which can be converted in cells to N-acetyl glucosamine (GlcNAc). This novel form of glucosamine has demonstrated that it acts as an immunosuppressive agent through a variety of mechanisms. Glucosamine can suppress the activation of T-cells and dendritic cells which are two crucial cells involved in the immune response. In one study when GlcNAc was used in children with chronic inflammatory bowel disease, biopsies revealed histological improvements as well as restoration of the epithelial barrier (i.e., repairing leaky-gut).

ParActin is a branded botanical that have very unique immune modulating properties. It is a standardized special extract of Andrographis. In low doses (25-30mg) it actually acts as an immune stimulant, but at higher doses (150-500mg) it activates the peroxisome proliferator activated receptor gamma (PPARγ) nuclear receptor. When activated, it not only stimulates the expression of genes involved in energy homeostasis, but also key regulators of the immune and inflammatory responses.

By Michael Jurgelewicz, DC, DACBN, DCBCN

Source: Muromoto R, Hirao T, Tawa K, Hirashima K, Kon S, Kitai Y, Matsuda T. IL-17A plays a central role in the expression of psoriasis signature genes through the induction of IκB-ζ in keratinocytes. International Immunology. March 3, 2016.

New mechanism of acid reflux damage discovered by researchers

GERD, acid reflux, and functional medicineAccording to a new study published 3 days ago in The Journal of the American Medical Association, researchers found that the damage of the esophagus in gastroesophageal reflux disease (GERD) to be cytokine mediated due to inflammation and not caused directly by the acid in the stomach.

For almost a century, it has been assumed that damage to the lining of the esophagus is caused by the hydrochloric acid of the stomach. According to researchers at UT Southwestern Medical Center and the Dallas VA Medical Center, this damage to the esophageal lining is occurring through an inflammatory response by cytokines.
This new information will probably not change the traditional approach to treating GERD in the near future but it may shift to targeting the cytokines and inflammation in the future which is really causing the damage to the esophagus.

This research builds on previous work in mice demonstrating that it takes several weeks from the time stomach acid is introduced into the esophagus before damage occurs. If the damage from HCL, it should develop immediately.
It’s interesting because alternative healthcare providers have been addressing this inflammation by supporting their patients with natural anti-inflammatory botanicals like deglycyrrhizinated licorice (DGL) to help with dyspepsia and symptoms associated with GERD, which has been recognized for its anti-ulcer, anti-inflammatory and healing effects on the esophageal lining (when using a chewable) and gastric mucosa. DGL is a mucilaginous herb that coats and soothes inflamed gastric and intestinal tissue.

Pharmaceutical interventions may provide symptom management but they do not correct many of the underlying factors and have side effects. Lifestyle changes and nutritional support are usually sufficient to address acid reflux. Patients should consider eat smaller portions at meals. In addition, avoid laying down after meals and avoid eating before bed. Also, alcohol and specific foods can trigger symptoms.

We need to address the underlying causes of these symptoms such as a weak lower esophageal sphincter, impaired digestion (ie. hypochlorhyrdria, enzyme insufficiency), food sensitivities, hiatal hernia, bacterial or fungal imbalance, and lifestyle (ie. stress, poor diet, poor sleep habits)

Although these medications may help with the symptoms, proton pump inhibitors may not be the solution. Recent previous studies have linked PPIs to chronic kidney disease as cardiovascular disease and an increase risk of a heart attack. PPIs can also lead to other problems such as small intestinal bacterial overgrowth (SIBO).

Nutritional supplements may be needed to improve your digestive function such as probiotics and glutamine. Deglycyrrhiizinated licorice (DGL) is well established as an anti-ulcer and mucosal healing botanical and is soothing and protecting to the gastric mucosa and mucous membranes lining the digestive tract.

Helicoacter pylori is a major cause of gastritis. Mastic gum, methylmethionesulfonium, zinc-carnosine and vitamin C address both eradication of H. pylori and the healing and protection of inflamed mucosal tissue.

An alternative approach is typically more effective than what is provided by proton pump inhibitors and does not have side effects or other complications that can be associated with them, such mineral deficiencies, bacterial infections, and dysbiosis .

By Michael Jurgelewicz, DC, DACBN, DCBCN

Source: Kerry B. Dunbar, Agoston T. Agoston, Robert D. Odze, Xiaofang Huo, Thai H. Pham, Daisha J. Cipher, Donald O. Castell, Robert M. Genta, Rhonda F. Souza, Stuart J. Spechler. Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes. JAMA, 2016; 315 (19): 2104 DOI: 10.1001/jama.2016.5657

Delayed reporting of concussions may lead to prolonged post-concussion symptoms

nutritional supplements for concussionAccording to a study published in this month’s Journal of Athletic Training, athletes who wait to report a concussion may experience prolonged recovery times. Researchers determined that athletes who delay post-concussion treatment missed close to one more week of activity than those who received immediate treatment.

Athletes who do not receive immediate treatment are at risk for further damage to the brain and will most likely take much longer to recover. Previous research has also supported this theory that intense physical activity during this vulnerable time immediately after a concussion can be detrimental.

This University of Florida study consisted of 97 male and female athletes participating in football, basketball, lacrosse, soccer, gymnastics, swimming, diving, volleyball, and track and field who were diagnosed with a sport-related concussion between 2008 and 2015. Fifty of the participants did not immediately report their concussion symptoms.

The researchers discovered that athletes who delayed reporting a concussion took an average of five more days to receive medical clearance to return to their activity.

Unfortunately, many athletes naively believe that concussion symptoms will go away, or they are apprehensive to report a concussion because they do not want to be sidelined. This study demonstrates the obvious: if an athlete waits to report a concussion, it will take longer to return to their activity.

Earlier this year I shared a study from the Journal of Pediatrics that examined the effects of post-concussion symptoms on ice hockey players of different ages. It demonstrated that the younger players had a significantly increased risk of prolonged post-concussion symptoms than older players. These findings suggest that adolescents may have longer recoveries from concussions than adults.

Similar results were also seen in a previous study I shared two years ago in The American Journal of Sports Medicine. All of these studies further highlight the significance of concussion in athletes, as well as the importance of awareness of this condition.

The traumatic forces involved in concussion and in those with post-concussion syndrome have been shown to result in a decrease of glucose use by the brain and changes in cerebral blood flow.  

Medical treatments for post-concussion symptoms have consisted mainly of opiates for headaches, antidepressants, anti-nausea and anti-vertigo meds, stimulants, and various other medications to increase neurotransmitter levels.

Nutrient Considerations

Glycerophosphocholine (GPC) is a form of choline that has been shown to help protect and repair damaged brain cells. It has been used to prevent damage to brain cells after blood flow, and thus oxygen, has been cut off to those cells.  

GPC supports the brain’s ability to recover after traumatic brain injuries and helps reduce the symptoms associated with concussion and post-concussion syndrome. In one particular study, twenty-three patients who suffered from concussions and cerebral contusions were given GPC for a three month period. At the end of the study, ninety-six percent of the patients’ mental faculties had improved significantly.

Other brain supportive nutrients to consider include acetyl-l- carnitine, inositol, phosphatidylserine, fish oil, krill oil, and MCT oil.

By Michael Jurgelewicz, DC, DACBN, DCBCN

Source: Asken, B, Bauer, R, et al. “Playing Through It”: Delayed Reporting and Removal From Athletic Activity After Concussion Predicts Prolonged Recovery. Journal of Athletic Training, doi:10.4085/1062-6050- 51.5.02, published online May 2016.