Autoimmune conditions may improve by treating leaky gut

Autoimmune disease is a condition in which immune system attacks his own body by mistake. Normally the immune system protects against germs and viruses. Some common autoimmune conditions include celiac disease, diabetes mellitus type 1, Graves' disease, Hashimoto’s thyroiditis, inflammatory bowel disease, multiple sclerosis, psoriasis, rheumatoid arthritis, and systemic lupus erythematosus.
Autoimmune conditions are linked to genetic conditions, but as well develop when exposed to an environmental trigger. Autoimmune conditions as well are linked to leaky gut.

How to heal leaky gut

A. Remove food allergens:
Gluten. Intestinal permeability is greater in gluten sensitivity and active celiac disease from gliadin exposure [1].
Beta – glucans in barley and oats. Genetically predisposed mice are found to be susceptible to beta glucans. Beta glucans triggered spondylarthrosis, ankylosing spondylitis, psoriatic arthritis, reactive arthritis, Crohn’s disease [2].
Polyunsaturated fat corn oil and alcohol. Polyunsaturated fat from corn oil is an important cofactor in alcohol-associated liver injury. Corn oil leads to increased gut permeability and dysregulation of intestinal and the effect is exacerbated by alcohol compared to saturated fat [3].
Red wine. Consuming moderate daily red wine (1-3 glasses) in individuals with inactive IBD increased intestinal permeability. Alcohol is a potential trigger for inflammatory bowel disease relapse [4].
Consumption of milk containing A1 β-casein worsens gastrointestinal symptoms, increases gastrointestinal transit time, increases serum inflammation markers, lowers total fecal short fatty acids content, compared to A2 β-casein [5]. Goat milk protein is similar to that of breast milk. Goat milk protein primarily contains  mainly as the A2 type casein and it does not produce β-casomorphin-7 (BCM-7). BCM-7 is generated during the process of milk digestion, which may be related to gastrointestinal disturbances [6].

B. Treat gut infections. Numerous infections can cause intestinal permeability.
Candida albicans impairs intestinal mucosal barrier. Candida can switch from the yeast to the hyphal morphology and take advantage of the impaired intestinal mucosal barrier to facilitate its colonization and penetration [7]. Yeast infection improved after treatment with olive leaf extract and probiotics  [8].
Other infections such as H. Pylori, Blastocystis hominis and Giardia increase gut permeability.

C. Be aware for drugs that might cause leaky gut.
Non-steroidal anti-inflammatory drugs (NSAID) such as ibuprophen. A study showed that all NSAIDs increase small intestinal permeability and cause inflammation [9].

Antibiotics are frequently administered orally to treat bacterial infections, but not necessarily for gastrointestinal tract infections. They disrupt the gut microbial community causing dysbiosis and affect intestinal permeability [10].


D. Manage stress.
The finding of a study indicates that chronic stress was associated with decrease in colon epithelial junction protein levels and increase of colon epithelial permeability [11].

E. Food/supplements that heal leaky gut

1. L-glutamine, which is an amino acid that serves as fuel for the cells of the small intestine.  
2. Vitamin A 
3. Zinc 
4. Slippery elm
5. Licorice
6. Marshmallow root 
7. Low gastric acid (stomach acid) can benefit from taking betaine HCL with meals. Gastric acid consists mostly of hydrochloric acid  which activates pepsinogen into the active enzyme pepsin and in turn breaks down proteins.
8. Digestive enzymes that break down protein (proteases), carbohydrates (amylase), and fat (lipase).   
9. Bile salts especially true for those people who have had their gallbladder removed or having problems emulsifying fats.
10. Fibre helps to feed the good bacteria and in addition is important for having regular bowel movements.
11. Take probiotic supplement and consume food that heal the gut lining such as bone broth, cabbage juice, sauerkraut, kimchi, kombucha, kefir, and a good quality source of yogurt. All are good sources of probiotics.
12. Take prebiotic supplement such as inulin. The prebiotic food such as Jerusalem artichokes, asparagus, onions, chicory, bananas and other fruit, and even green tea are important is because they feed the good bacteria such as bifidobacteria and lactobacilli. Those foods also are good sources of short chain fatty acids. Now scientists have found that gut microbiome could be even  the cause of arthritis and joint pain. In one study, obese mice had more harmful bacteria in their gut which caused inflammation. When mice were given prebiotic, like oligofructose not digestible fiber but beneficial for good gut bacteria like Bifidobacteria, decreased inflammation and slowed cartilage breakdown. Oligofructans are present in a number of vegetables and plants such as garlic, leak, onion, bananas. Chicory root is the best source providing 42 g of inulin and 23 g of oligofructose per 100 g [12].

Low dose Naltrexone, choline and vitamin D in autoimmunity. 

Naltraxone is an opiate antagonist, developed in 1960 for treatment of opioid abuse such as heroin. It is an opiate antagonist and block the effect of narcotic by attaching to the opioid receptors. A dose of 30-50 milligram (mg) of Naltrexone is used in opioid overdose. Low dose Naltraxone (LDN) usually is 1.5-4.5 mg per day taken before bed time since the endorphin response is greater at night time There is no unusual side effects except vivid dreams which it may require to lower the dose. Data from one small study suggests that LDN may provide a benefit in terms of clinical and endoscopic response in adult patients with active Crohn's disease [13].

Choline can help in postural orthostatic syndrome and many autoimmune conditions [14].

Vitamin D has a therapeutic value in multiple sclerosis, rheumatoid arthritis, Crohn’s disease, type I diabetes, and systemic lupus erythematosus [15].
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Dr. Kate Marishta MPH, Dip Nutrition
Greenleaf Executive Nutrition and Health-Dublin, IE
Email: greenleafexecutive@gmail.com
Website:www.greenleafexecutive.ml

References

1. Hollon, J. et al (2015) Effect of gliadin on permeability of intestinal biopsy explants from celiac diseases patients and patients with non-celiac gluten sensitivity. Nutrients. Feb 27;7(3):1565-76
2. Ruutu M. et al (2012) β-glucan triggers spondylarthrosis and Crohn's disease-like ileitis in SKG mice. Arthritis Rheumatology.  Jul;64(7):2211-22.
3. Kirpich, IA (2012) The type of dietary fat modulates intestinal tight junction integrity, gut permeability, and hepatic toll-like receptor expression in a mouse model of alcoholic liver disease. Alcoholism Clinical Experiments Research. May; 36(5):835-46
4. Swanson, GR. (2011) Is moderate red wine consumption safe in inactive inflammatory bowel disease. Digestion. 84 (3):238-44
5. Sun, J. et al (2016)Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms of discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows’ milk. Nutrition Journal. April 29; 15: 45.
6. Tae-Hwan Jung et al (2017)Hypoallergenic and Physicochemical Properties of the A2 β-Casein Fraction of Goat Milk. Korean J Food Sci Anim Resour. 2017; 37(6): 940–947.
7. Yan, L. et al (2013) Disruption of the intestinal mucosal barrier in Candida albacans infections. Microbiological Research. Aug 25;168(7):389-95.
8. Rucklidge, JJ. (2013) Could yeast infections impair recovery from mental illness? A case study using micronutrients and olive leaf extract for the treatment of ADHD and depression. Advances in Body-Mind Medicine. Summer; 27(3):14-8
9. Sigthorsson, G. et al (1998) Intestinal permeability and inflammation in patients on NSAIDs. Gut. October; 43(4):506-511
10. Tulstrup MV. et al (2015) Antibiotic treatment affects intestinal permeability and gut microbial composition in wistar rat’s dependent on antibiotic class. PLoS One. December 21;10(12): e0144854. 
11. Zheng G. et al (2013) Corticosterone mediates stress-realted increased intestinal permeability in a region- specific manner. Neurogastroenterology and Motility Feb;25(2):e127-39. 
12. Univ. Rochester Med. Cen.(2018) The bugs in your gut could make your weak in the knees. (Available at : https://www.sciencedaily.com/releases/2018/04/180419100135.htm) [Accessed September 2018]
13. Segal, D.(2014) Low dose naltrexone for induction of remission in Crohn’s disease. Cochrane Database Syst. Rev. Feb 21;(2):CD010410
14. Dobberstein, L. Choline helps POTS,  chronic fatigue, and autoimmune disorders. (Available at: https://www.wellnessresources.com/news/choline-helps-pots-chronic-fatigue-autoimmune-disorders) [Accessed September 2018]
15. Dankers, W. et al (2017) Vitamin D in autoimmunity: Molecular mechanisms and therapeutic potential. Frontier Immunology Jan 20. doi:  10.3389/fimmu.2016.00697.