July 16, 2018

Magnesium supplementation improves insulin sensitivity and glucose control

According to a new study published last month in Pharmocological Research, researchers demonstrate magnesium supplementation significantly improves HOMA-IR index and fasting glucose.
Over the past several decades diabetes has become a growing epidemic and it’s a fact that more than 50% of Americans are magnesium deficient. I cannot emphasis enough the importance of magnesium deficiency as a serious and common health problem. Magnesium plays a key role in more than 350 enzymes in the body. It is involved in virtually every metabolic process occurring in the body. Magnesium is the second most abundant intracellular cation and a cofactor involved in the modulation of glucose transport. In addition, a magnesium deficiency interferes with the tyrosine-kinase activity of the insulin receptor as well as increases intracellular calcium concentration which is associated with impaired insulin sensitivity, so it makes sense that a magnesium deficiency could play a significant role in the development of insulin resistance, metabolic syndrome, and type 2 diabetes.

This review consisted of 1,362 individuals from 21 RCTs including 684 and 678 individuals into the magnesium and control groups from studies published between 1992 and 2015. The range of magnesium supplementation was from 1 to 6 months and the doses ranged from 300 mg to 600 mg of magnesium per day. The impact of magnesium supplementation on plasma concentrations of glucose, HbA1c and insulin, and HOMA-IR were assessed.

The results of the meta-analysis demonstrated that magnesium supplementation for greater than 3 months significantly improves the HOMA-IR index as well as fasting glucose in both diabetic and non-diabetic individuals.

How much magnesium is enough? Unfortunately, we do not have a great way to measure magnesium status. For example, serum magnesium represents only 1% of magnesium stores. Magnesium is homeostatically controlled in the serum and measuring serum magnesium levels provides many false negatives. By the time your serum is low, you are very deficient as the body cannot maintain the serum magnesium levels. Serum magnesium is not the answer. Red blood cell magnesium is definitely better and can be done by most labs and all functional medicine labs. I test RBC magnesium levels on all my patients and it’s surprising to see how many patients that are deficient.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Simental-Mendia L et al. A systematic review and meta-analysis of randomized controlled trials on the effects of magnesium supplementation on insulin sensitivity and glucose control. Pharmocological Research. 2016 Sept; 111:272-82. doi:10.1016/j.phrs.2016.06.019.

Chemical exposure has been linked to low levels of vitamin D

This study investigated data from 4,667 adults between 2005 and 2010. EDC exposure was measured by a urine analysis. The researchers found that individuals who were exposed to larger amounts of phthalates had lower levels of vitamin D in the bloodstream than the those who were exposed to smaller amounts of the EDCs. This link was strongest seen in women. It is possible that EDCs alter vitamin D through some of the same mechanisms that they use to impact other hormones in the body.

We live in an ever-increasing toxic environment. We are exposed to According to a new study published Tuesday in the Journal of Clinical Endocrinology & Metabolism, researchers discovered a link between chemical exposure and reduced serum vitamin D levels.

Endocrine disrupting chemicals (EDCs) have been known to cause adverse health effects such as diabetes and obesity by interfering with hormones in the body. There is currently more evidence than ever before. It is a fact that EDCs disrupt hormones in a manner that harms human health. Hundreds of studies have confirmed over and over again
EDCs are found in everyday products and throughout the environment. There are more than 85,000 manufactured chemicals. Many of these chemicals mimic, block or interfere with the body’s natural hormones and as a result, EDCs alter the way cells proliferate and develop.

Examples of EDCs:
• Bisphenol A (BPA)- found in food can linings and cash register receipts.
• Phthalates – found in plastics (PVC products, vinyl shower curtains) and cosmetics (perfumes, nail polish, lotion)
• Flame retardants, solvents, lubricants (PCBs, PBBs, and PBDEs)
• Pesticides (sprayed on conventional fruits and vegetables), insecticides.
• Heavy Metals: cadmium, lead, arsenic, mercury

Everyone is exposed to endocrine-disrupting chemicals, so the connection of these chemicals impacting vitamin D levels have a significant impact on our health. Vitamin D plays a significant role in musculoskeletal, immune and cardiovascular health as well as diabetes and cancer.

pesticides, herbicides, chemical solvents, xenobiotics, and industrial chemicals of all kinds that we get exposed through the food we eat, the water we drink and the air we breathe. These toxins accumulate in our body and contribute to the total toxic load that can cause a variety of health problems.
We need to do their best to minimize further exposure. We also have to keep in mind that our indoor environment is often more toxic than our outdoor environment.

Tip to Help Avoid EDCs:
• Eat organic produce (join your local CSA)
• Buy free-range, organic meats to reduce exposure from added hormones and pesticides.
• Buy products available in glass containers rather than plastic or cans when possible.
• Cookware: Replace non-stick pans with glass, ceramic, or cast iron.
• Drink filtered water
• Use a shower head with a filter
• Use household products that are fragrance-free and free of phthalates and BPA.

There is also significant evidence on the importance of diet and nutritional supplementation in maintaining detoxification pathways.

Nutritional Support for Detoxification
• Milk Thistle is one of the most protective herbs for the liver with hundreds of studies that confirm its protective properties.

• N-Acetyl Cysteine- supports phase II detoxification and precursor to glutathione

• Calcium D-Glucarate- aids in liver detoxification through the glucuronidation pathway. Xenobiotics, environmental toxins, and excess estrogens are cleared through this pathway.

• EGCg- the most extensively studied green tea polyphenol. Green tea also supports detoxification by enhancing the glucuronidation pathway in addition to modulating blood glucose, and its antioxidant and cancer protective properties.

• A Detoxification Program

Exposure to endocrine-disrupting chemicals are virtually impossible to avoid. We need to do our best to limit our exposure and make lifestyle and nutritional choices to properly detoxifying these chemicals.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Lauren E. Johns, Kelly K. Ferguson, John D. Meeker.Relationships Between Urinary Phthalate Metabolite and Bisphenol A Concentrations and Vitamin D Levels in U.S. Adults: National Health and Nutrition Examination Survey (NHANES), 2005–2010. The Journal of Clinical Endocrinology & Metabolism, 2016; jc.2016-2134 DOI: 10.1210/jc.2016-2134

Infant microbiome predicts allergies and asthma later in life

According to a new study published on Monday in Nature Medicine, researchers link the gut microbiome of 1 month old infants to an increased risk of allergies and asthma later in life. This paper identifies that imbalances in the gut microbiome in at-risk infants causes immune dysfunction which causes a hyperactive immune system.

Many studies have linked the early exposure to beneficial microbes in the environment to numerous health benefits. I previously shared a study was published last year the journal Clinical & Experimental Allergy that revealed infants with a lower diversity of gut bacteria at three months of age are at a higher risk to become sensitized to foods such as milk, egg or peanut by the time they reach one year of age. In addition, infants who developed food allergies also had a dysbiosis specifically associated with the bacteria, Enterobacteriaceae and Bacteroidaceae

Recently, researchers at the University of British Columbia reported that 3 month old infants had low levels of four key types of gut bacteria that was significantly more likely to show symptoms of asthma at their first birthdays than infants with normal levels of these bacteria.

In this study, researchers collected stool samples from the infants. Based the team’s 2 and 4 year follow-up data, the size of this at-risk group was consistent with the rate of allergic asthma in the general population and the microbial diversity analysis demonstrated that these infants were missing specific beneficial bacteria and also had high levels of specific opportunistic bacteria.

They also identified that a healthy microbiome contains a wide range of molecules that can reduce inflammation and keep the immune system in check. In contrast, these key anti-inflammatory molecules were not present in the at-risk infants.

We have co-evolved with microbes over the past several decades but our lifestyles have changed dramatically reducing our exposure to these microbes.

There are several variables that may contribute to the infant’s gut microbiome at this early age. Breastfeeding, vaginal births and pets in the home during the first year of life all are associated with protective effects against asthma and allergies. Cesarean delivery may affect the early diversity of intestinal bacteria. The gastrointestinal tract of infants becomes colonized immediately after birth with environmental microorganisms mainly from the mother. The intestinal microbiota of infants delivered by cesarean delivery appears to have less diversity and is characterized by an absence of Bifidobacteria species than the microbiota of vaginally delivered infants. In addition, mothers using formula instead of breast milk is another factor. Breast milk is an early stimulator of the intestinal flora and lacking this dietary support may be a contribution to food sensitization. In these circumstances, a probiotic may be considered.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Kei E Fujimura, Alexandra R Sitarik, Suzanne Havstad, Din L Lin, Sophia Levan, Douglas Fadrosh, Ariane R Panzer, Brandon LaMere, Elze Rackaityte, Nicholas W Lukacs, Ganesa Wegienka, Homer A Boushey, Dennis R Ownby, Edward M Zoratti, Albert M Levin, Christine C Johnson, Susan V Lynch. Neonatal gut microbiota associates with childhood multisensitized atopy and T cell differentiation. Nature Medicine, 2016; DOI: 10.1038/nm.4176

New study demonstrates vitamin D reduces asthma attacks

Asthma has become more common in the last several years. Many patients have managed their asthma with medication and avoiding environmental triggers.

According to a new review published 4 days ago, taking a vitamin D supplement in addition to standard asthma medication can reduce severe asthma attacks.

Low serum vitamin D levels have been linked to an increased risk of asthma. In this review, researchers found 7 trials and 2 studies including 1,093 patients which conducted over 6 to 12 months. The researchers found that vitamin D supplementation reduced the risk of severe asthma attacks requiring hospital admission as wells as reduced the need for steroid tablets.

It is important to note that the vitamin D did not improve lung function or day-to-day asthma symptoms but significantly reduced the risk of severe asthma attacks without side effects.

There was a previous study published 2 years ago that I shared from the journal Allergy which demonstrated that Vitamin D could help manage asthma attacks. Researchers analyzed the medical records of approximately four million members of Clalit Health Services, Israel’s largest health care provider. The Vitamin D levels of 307,900 people were measured between 2008 and 2012. Asthma patients with a Vitamin D deficiency were 25% more likely than other asthmatics to have had at least one flare-up in the recent past.

We know vitamin D has significant immunomodulatory effects and it has been shown to have an effect on asthma.

These results demonstrate the link between Vitamin D and asthma and the beneficial effects of Vitamin D in reducing exacerbations. Asthma patients who experience recurrent exacerbations should have their Vitamin D levels checked and supplement when necessary. Increasing Vitamin D levels is something we can easily do to improve the patients’ quality of life.

While most of the Vitamin D in our bodies comes from exposure to the sun, most of us need to obtain Vitamin D from other sources. The majority of us are deficient and there are several reasons for that. Many people avoid the sun due to the dangers of overexposure. In addition, most of us spend so much time inside under fluorescent lights and away from natural light. Also, depending on what latitude you are at and the time of year, you may not be able to get adequate vitamin D from the sun. For those people that spend a lot of time in the sun, most have eighty percent of their bodies covered preventing optimal Vitamin D absorption.

Other nutrients to consider to relax the airways and provide anti-inflammatory properties include magnesium, vitamin C, and fish oil.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Adrian R Martineau, Christopher J Cates, Mitsuyoshi Urashima, Megan Jensen, Alex P Griffiths, Ulugbek Nurmatov, Aziz Sheikh, Chris J Griffiths. Vitamin D for the management of asthma. Cochrane Library, 2016 DOI:10.1002/14651858.CD011511.pub2

New study demonstrates omega-3 fatty acids improve outcomes from traumatic brain injury

The treatment of concussions and traumatic brain injury (TBI) is a clinical challenge. Medical treatments for post-concussion symptoms have consisted mainly of opiates for headaches, anti-depressants, anti-nauseas, anti-vertigo, stimulants, and other medications to increase neurotransmitter levels.

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.

Previous studies have failed to identify an effective treatment in controlling aspects of neuroprotection, neuroinflammation, and neuroregeneration. A new study published last month in the Journal of the American College of Nutrition showed that the aggressive intake of omega-3 fatty acids was beneficial to TBI, concussion, and post-concussion syndrome patients.

Research suggests that early treatment of high dose omega-3 fatty acids can improve outcomes from traumatic brain injury. The article reviews preclinical research as well as 3 brain injury case studies which demonstrated the safety and tolerability in patients who sustained life-threatening brain injuries and recovered with the supplementation of omega-3 fatty acids.

The brain needs to be saturated with high doses of omega-3 fatty acids in order for the brain to heal. If these individuals do not have an optimal supply of EPA and DHA, healing will likely be impaired. In addition, there is no negative impact supporting these patients with optimal nutrition to regain as much function as possible.

Other Nutrient Considerations

Glycerophosphocholine (GPC) has been used to prevent damage to brain cells after blood flow, and thus oxygen, has been cut off to those cells. GPC also supports the brain’s ability to recover after traumatic brain injuries and reduce the symptoms associated with concussion and post-concussion syndrome. GPC is a form of choline that has been shown to protect and repair damaged brain cells1.

In another 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 significantly2.

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

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Michael D. Lewis. Concussions, Traumatic Brain Injury, and the Innovative Use of Omega-3s. Journal of the American College of Nutrition, 2016; 35 (5): 469 DOI: 10.1080/07315724.2016.1150796

Sleep and its impact on memory and learning

There were two interesting studies published this past week on sleep and its effects on memory and learning this past week. Sleep disturbance is a common problem in our everyday lifestyle and it has significant consequences on overall health, wellbeing, and brain function.

How we feel when we wake up has a lot to do with what happens while we were sleeping. Sleep helps our brain function properly, improves learning, and protects our mental and physical health. Lack of sleep also contributes to weight gain, how our body reacts to insulin, our immune response, and hormone dysfunction.

In the first study, researchers from the Netherlands and Pennsylvania have discovered a component of how the lack of sleep negatively impacts memory.

This animal study published in eLife demonstrated that five hours of sleep deprivation leads to a loss of connectivity between neurons in the hippocampus. This specific region of the brain is associated with learning and memory.

We all know adequate sleep is essential for overall health and sleep issues will exacerbate all chronic disorders. Previous research demonstrate the role of sleep and memory but this study shows that it impairs hippocampal function. The results indicate sleep deprivation significantly reduces the length and density of the dendrites of the neurons in the hippocampus.
They then repeated this sleep-loss experiment but left the mice to sleep undisturbed for 3 hours afterwards. This period is sufficient to restore deficits caused by lack of sleep. The effects of the 5 hour sleep deprivation in the mice were reversed. This demonstrates the importance of the nervous system’s ability to adapt to sleep loss and that these neuronal connections can be restored with several hours of recovery sleep. During this time these individuals are remodeling their brain.

A second study published in Psychological Science revealed how naps in between study sessions may make it easier to recall what you studied and relearn what you’ve forgotten even 6 months later. The improved memory from sleeping between sessions seemed to last over time. Follow-up data showed the sleep group outperformed their peers on the recall test 1 week later and this benefit was still noticeable 6 months later.

These results suggest that alternating study sessions with sleep might be an easy and effective way to remember information over longer periods of time.

Addressing sleep disturbances can very challenging with patients in practice. One product does not work for everyone. We all have our own biochemical individuality and there can be different underlying causes to an individual’s sleep issue. A patient can have a nutrient deficiency or hormone dysfunction. One person may have trouble falling asleep whereas another can’t stay asleep. Also, one botanical may have the opposite effect and stimulate a patient or another product may cause drowsiness. We also need to keep in mind, if we are recommending a product for a child or during pregnancy, we may want to avoid certain botanicals, neurotransmitters, and hormones.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Robbert Havekes, Alan J Park, Jennifer C Tudor, Vincent G Luczak, Rolf T Hansen, Sarah L Ferri, Vibeke M Bruinenberg, Shane G Poplawski, Jonathan P Day, Sara J Aton, Kasia Radwańska, Peter Meerlo, Miles D Houslay, George S Baillie, Ted Abel. Sleep deprivation causes memory deficits by negatively impacting neuronal connectivity in hippocampal area CA1. eLife, 2016; 5 DOI: 10.7554/eLife.13424

Source: S. Mazza, E. Gerbier, M.-P. Gustin, Z. Kasikci, O. Koenig, T. C. Toppino, M. Magnin. Relearn Faster and Retain Longer: Along With Practice, Sleep Makes Perfect. Psychological Science, 2016; DOI:10.1177/0956797616659930

New study reinforces the importance of diet and exercise in the prevention of Alzheimer’s

In a recent study published in the American Journal of Geriatric Psychiatry researchers at UCLA demonstrated the importance of a healthy diet and regular exercise and its impact on reducing amyloid plaque build-ups that are associated with Alzheimer’s disease.

In the study, 44 adults ranging from 40 to 85 years of age with mild memory changes had PET scans to measure the level of plaque and tangles in the brain. Researchers also obtained information on exercise activity, BMI, and other lifestyle factors.

The study found that exercise, a Mediterranean diet, and a healthy BMI were all associated with lower levels of plaques and tangles on the brain scans.

Previous studies have linked a healthy lifestyle to delays in the onset of Alzheimer’s but this study is the first to demonstrate how lifestyle factors directly influence abnormal proteins in people with slight memory loss who have not been diagnosed with dementia. In addition, these factors have also been shown to reduce shrinking of the brain and lower rates of atrophy in individuals with Alzheimer’s.

This study reinforces the importance of diet and exercise in the prevention of Alzheimer’s disease.

Previous research has showed us the association between diabetes and Alzheimers. A study published earlier this year in the Journal of Alzheimer’s Disease compared decades of research on diabetes and Alzheimer’s disease.

In addition to diet and exercise there are also several nutrients to consider. A study published in September in the journal, Neurology, demonstrated that resveratrol stabilized amyloid-beta40 (Abeta40) in patients with mild to moderate Alzheimer’s disease. This biomarker declines when the disease progresses.

Another study published last year in JAMA Neurology demonstrated a significant association between vitamin D insufficiency and cognitive decline specifically seen Alzheimer’s disease and dementia.
B vitamins and omega-3 fatty acids are also essential nutrients involved in numerous metabolic processes that play a significant role in cognitive health. There was an interesting study published in January in the Journal of Alzheimer’s Disease. Researchers found a link between Omega-3 levels, homocysteine, and brain atrophy rates. Homocysteine plays a role in regulating phospholipid metabolism and omega-3 distribution by the methionine cycle. As a result, B vitamins are essential for the synthesis of phospholipids. This study demonstrated when omega-3 levels are in an upper normal range, B vitamins slow cognitive decline and brain atrophy.

Glutathione is also essential for neurodegenerative disease. This powerful antioxidant has been found to be depleted in the brain of neurodegenerative disorders. 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 all neurodegenerative disorders.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Merril, D et al. Modifiable Risk Factors and Brain Positron Emission Tomography Measures of Amyloid and Tau in Nondemented Adults with Memory Complaints. American Journal of Geriatric Psychiatry published May 13 2006.

Low Vitamin D associated with increased risk of cognitive decline according to new study

According to a new study published in the Journal of Gerontology last month, researchers at Duke-NUS Medical School (Duke-NUS) and Duke University have associated low vitamin D levels with an increased risk of cognitive decline in the elderly.

The results reinforce the importance of identifying vitamin D insufficiency among the elderly.

Low vitamin D levels were associated with significantly faster rates of decline in memory and executive function performance.

Last year I shared a study published in JAMA Neurology where researchers demonstrated a significant association between vitamin D insufficiency and cognitive decline specifically seen Alzheimer’s disease and dementia.

Research continues to show the significant role vitamin D plays in our overall health, however, the current research also demonstrates its significant role in maintaining healthy brain function.
This study including 1,202 participants greater than 60 years of age is the first large-scale study in Asia to study the association between vitamin D status and risk of cognitive decline and impairment in the elderly. Their baseline vitamin D levels were measured at the start of the study, and their cognitive abilities were assessed over a 2 year period.

As a result, individuals with lower vitamin D levels at the beginning of the study were about twice as likely to display significant cognitive decline over time. In addition, low vitamin D levels at baseline also increased the risk of future cognitive impairment.

This research reinforces that vitamin D protects against neuron damage and its effects on cognitive decline.

Vitamin D deficiency is a common problem that could easily addressed and that has many other health consequences. Sun exposure is the ideal source of vitamin D, but the reality is most require supplementation. The majority of us are deficient and there are several reasons for that. Many people avoid the sun due to the dangers of overexposure. In addition, most of us spend so much time inside under fluorescent lights and away from natural light. Also, depending on what latitude you are at and the time of year, you may not be able to get adequate vitamin D from the sun. In in some locations this may be most of the year. For those people that spend a lot of time in the sun, most have the majority of their bodies covered and/or using sunscreen preventing optimal Vitamin D absorption.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: David B. Matchar, Choy-Lye Chei, Zhao-Xue Yin, Victoria Koh, Bibhas Chakraborty, Xiao-Ming Shi, Yi Zeng. Vitamin D Levels and the Risk of Cognitive Decline in Chinese Elderly People: the Chinese Longitudinal Healthy Longevity Survey. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2016; glw128 DOI:10.1093/gerona/glw128

New study demonstrates fish oils improve heart function post heart attack

According to a new study just published 3 days ago in journal Circulation, high dose fish oil post heart attack improved heart function and reduced scarring.

The heart’s shape and function can be altered after a heart attack, which can lead to heart failure. There are limited things that can improve healing of the heart or prevent adverse remodeling. This study demonstrates the significant role of omega-3-fatty acids in the structure and tissue of the heart.

This study included 360 heart attack survivors. Researchers compared patients taking 4 grams of omega-3 fatty acids daily for six months to those taking a placebo. There was a 5.8% reduction in left ventricular end-systolic volume index (predicts patient outcome and a 5.6% reduction in fibrosis formation in the non-damaged heart muscle of the fish oil group.

The treatment was safe and effective. Both groups received treatment based on guidelines issued by the American College of Cardiology Foundation and the American Heart Association. Blood tests were used to confirm that patients in the omega-3 fatty acids group were compliant to the treatment.

Fish oil supplementation is an essential for cardiovascular health. Some doctors recommend fish oils to improve LDL particle size, lower triglycerides, anti-inflammatory properties, and simply overall health since these fats are essential for normal function of all of our cells.

Heart failure is a major problem post heart attack. These results demonstrate that omega-3 fatty acids improve cardiac remodeling, which allows the heart to contract better and decreases fibrosis in the region that is not damaged.

Other nutrients are also essential for heart failure patients. These are individuals that have a disruption in their metabolic processes and as the heart muscle weakens it cannot meet metabolic demands. Energy nutrients include ribose, CoQ10, and l-carnitine.

Ribose is a key nutrient for quickly restoring cardiac energy stores. It is needed to synthesize adenine nucleotides, certain vitamins, and other important cellular compounds.
CoQ10 plays a central role in the production of ATP and required for muscle contraction and other cellular processes.

Carnitine supports the heart by the delivery of fat to the heart muscle, which is its main fuel source.

In addition, magnesium and potassium should be considered to support all cardiovascular conditions. These nutrients are often depleted in heart failure often by the use of diuretic medications.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Bobak Heydari, Shuaib Abdullah, James V. Pottala, Ravi Shah, Siddique Abbasi, Damien Mandry, Sanjeev A. Francis, Heidi Lumish, Brian B. Ghoshhajra, Udo Hoffmann, Evan Appelbaum, Jiazhuo H. Feng, Ron Blankstein, Michael Steigner, Joseph P. McConnell, William Harris, Elliott M. Antman, Michael Jerosch-Herold, Raymond Y. Kwong. Effect of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial InfarctionClinical Perspective. Circulation, 2016; 134 (5): 378 DOI: 10.1161/CIRCULATIONAHA.115.019949

New study demonstrates the gut brain relationships with irritable bowel syndrome

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

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.

New research published last Friday in the Alimentary Pharmacology & Therapeutics demonstrated that there is a distinct brain-gut pathway (psychological symptoms begin first) as well as a separate gut-brain pathway (gut symptoms begin first). There are several studies that have been done that show this new gut to brain pathway.

In this study, higher levels of anxiety and depression were significant predictors of developing IBS within 1 year. In addition, individuals who did not have elevated levels of anxiety and depression at the start of the study but had documented IBS had significantly higher levels of anxiety and depression after 1 year.

The researchers determined that in 1/3 of patients, a mood disorder precedes IBS and in the other 2/3 of patients, the IBS precedes the mood disorder.

These results reveal how some patients with IBS have a gastrointestinal disorder that may not only explain their gut symptoms but also their psychological symptoms.

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.

According to a recent clinical trial published in Gastroenterology, researchers at University of Michigan’s Health System demonstrated that a low FODMAP diet 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.

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. Also. 5-HTP is a dominant neurotransmitter in the enteric nervous system. It plays an important role in pain perception, sleep patterns, and is important for digestion. 5-HTP also has benefits on reduction of anxiety.

In addition, Saccharomyces boulardii is also great to use in combination for this. S. boulardii has been tested for clinical efficacy in numerous gastrointestinal conditions, including antibiotic-associated diarrhea, Clostridium difficile infection, acute diarrhea, irritable bowel syndrome, traveler’s diarrhea, Crohn’s disease, Ulcerative Colitis, and Helicobacter pylori infections.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: N. A. Koloski, M. Jones, N. J. Talley. Evidence that independent gut-to-brain and brain-to-gut pathways operate in the irritable bowel syndrome and functional dyspepsia: a 1-year population-based prospective study. Alimentary Pharmacology & Therapeutics, 2016; DOI:10.1111/apt.13738