Gut-Brain Axis: The Future of Modern Medicine
Updated: Nov 9, 2018
As you can probably tell by now, Erin and I are a little obsessed with the gut. It all began at the beginning of last year when we enrolled ourselves into the Institute of Integrative Nutrition following our annual primary care conference. Post conference, we both were convinced that there HAD to be a better way for our patients to heal themselves. A way that did not involve prescribing potentially harmful pharmaceutical drugs or having the generic “you need to change your diet, exercise, and lose weight” conversation. We knew there was a missing component and IIN opened that door for us.
As we began our late-night studies (after being in clinic all day) we came to be intrigued with all things #guthealth. The more we were taught and the more independent research we did on the gut, and its important role in chronic conditions we daily treat (from Alzheimer’s to Parkinson’s Disease, IBS, anxiety, and depression), the more we realized that we wanted to focus our practice on this fascinating organ system. Thus, the birth of Follow Your Gut MDNP in January of this past year and our recent partnership with Amare, an independent product line like no other that specifically targets gut health. Amare’s main focus is a potential hidden organ system (1) that has only been strongly researched within the last 5-10 years—the Gut-Brain Axis (GBX). In this blog post, I want to explain exactly what the GBX is, discuss its importance, and and share why you need to start following YOUR gut.
What the Gut?! (part 2)
First off, what exactly is the gut? One of our first blog posts was about the gut (2) and was followed by two additional posts about gut-friendly supplements (3) and gut-healthy foods and drinks (4). I encourage you to read these prior to reading this blog post, but if you don’t have time you can always refer back to them for supportive information.
The initial blog post about the gut briefly discussed the GBX, aka our 2nd brain. Yes….the gut is considered our 2nd brain and for good reason! Did you know the brain (our central nervous system—CNS) contains about 100 billion neurons (5) while our gut contains anywhere from 200-600 million neurons? Communication travels along different pathways including the Enteric Nervous System (ENS) and Autonomic Nervous System (ANS), mainly via the vagus nerve, one of the largest nerves in our body.
“The vagus nerve is the primary connection between the brain and proximal intestinal tract, sacral parasympathetic nerve fiber connects the distal third colon [and] connection includes the HPA (hypothalamic-pituitary-adrenal axis), which is responsible for regulating stress response and intestinal endocrine cells, secreting neuropeptides and intestinal peptide that act locally and through the vagus nerve and spinal cord afferent or blood brain barrier to act on the brain” (6) (6).
The communication between the gut and the brain travels along with ENS and ANS with the help of neurotransmitters (serotonin, dopamine, norepinephrine etc) and additional chemicals (short-chain fatty acids, secondary bile acids, and tryptophan metabolites) (7) .
“Microbiota can secrete many kinds of neurotransmitters, for example Lactobacillus subspecies can secrete acetylcholine (regulating memory, attention, learning and mood), Candida, Streptococcus, Escherichia coli and Enterococcus can secrete 5-HT [serotonin], and Bacilli and Serratia can secrete dopamine.” (6).
One of the most well-documented neurotransmitters is serotonin. Pretty much everyone has heard of serotonin as many of the popular and widely used antidepressants (Zoloft, Prozac, Celexa, Lexapro, etc) promote an increase in serotonin in the brain. This helps to alleviate symptoms in depressed or anxiety-ridden patients, as there is a known depletion of serotonin in these individuals. Interestingly enough it has been clinically documented that the gut microbiota is quite variable when comparing between depressed patients and non-depressed patients. In one clinical study, two of the most popular gut microbes Lactobacillus and Bifidobacterium have clinically been proven to be lower in patients with major depressive disorder (8) when compared to controls (people without depressive symptoms). Although there is continuing debate about the gut microbiota (the trillion of microbes in our gut), gut microbiome, and the GBX having a large effect on mental health disorders, we are just skimming the surface of something larger than what western medicine has been made to believe.
Chemicals such as short-chain fatty acids (SCFAs) aid in stimulating blood flow to the colon, increasing absorption of fluids and important electrolytes, and healing the mucosal lining of the gut. Dietary fiber is very important in keeping SCFAs levels up as it has been documented that when fiber intake is low there is a known depletion of SCFAs. When SCFAs are deficient the colon doesn’t flow the way it should, nutrients and fluids are not absorbed properly, and the lining of the gut can become inflamed—thereby encouraging leaky gut syndrome. (7).
So what does all of this “science-y” stuff mean? It means that the microbes in our gut have an effect on the important chemicals and communication transmitters that are needed to allow our minds and bodies to function at their optimal levels #LivingYourBestLife. When the GBX is negatively affected it alters our well-being, starting centrally and trickling down to every last nerve fiber in our bodies.
As mentioned above, GBX research didn’t really start taking off until about 10 years ago. This is when the National Institute of Health’s Human Microbiome Project (9) was launched (in 2007) and made news headlines in 2008. However, upon review of the research for this blog post I did find papers dating back to the late 1970’s. So the GBX has been questioned in regards to certain disorders for almost 40 years. Using “gut brain axis” in the subject line of the journal search engine PubMed will give you 1,931 journal studies, reviews, and articles from this past year alone!
Disruption in the GBX is being shown to alter our moods, causing anxiety and depression (10) (11) (6) (12), be a possible precursor for neurodegenerative disorders such as Parkinson’s disease (13) (14), Multiple Sclerosis (15) and Alzheimers (16), have an association with worsening symptoms in patients with Autism Spectrum Disorder (17), be a catalyst for irritable bowel syndrome (18) (19) with constipation, diarrhea, or both, and cause either initial or continuous flare-ups of autoimmune disorders (20). And I literally could attach 500 more studies to this one paragraph alone.
Hopefully you now understand how important your gut and the GBX truly is. To Erin and I, it is scary and fascinating all in one. So how exactly do you keep your GBX healthy and functioning at its optimal level?
It begins with avoidance and/or limitations of the things that can cause inflammation to the gut lining. This can cause something called “Leaky Gut Syndrome” (LGS). With LGS, the tight junctions of the intestinal lining begin to widen (increasing intestinal permeability) and allow toxins and “bad bacteria” to leak out of the small intestines into your blood stream. There are arguments between various types of medical professionals that LGS is just a theory, but Dr. Alessio Fasano (the physician who founded “Zonulin,” the protein that gluten produces and causes intestinal and systemic inflammation—the main reason why we have gluten free menus now!) proved that this “theory” is actually a reality in his paper titled “Zonulin, regulation of tight junctions, and autoimmune diseases.” (21)
Gastrointestinal disorders such as small-intestinal bacterial overgrowth (SIBO), Heliobacter pylori, gastritis, inflammatory bowel disease (IBD), and irritable bowel syndrome (IBS), are the main antagonists of the GBX. Correcting such disorders, whether it be with medications, dietary changes (taking out the food types that “flare” these disorders up), or managing chronic stress, can aid in healing the gut, thereby allowing the good microbes to flourish and start producing the neurotransmitters and chemicals that our brain needs.
Chronic use of antibiotics has been proven to damage the gut lining and can increase feelings of depression (22). We used to only worry about chronic antibiotic causing antibiotic-resistant bacteria, but now it’s being shown that with the inflammation in the gut and disruption of the GBX that antibiotics can cause, other issues like depression, anxiety, and cognitive impairment are arising (23) (24). In one clinical study, it was proven that children who had antibiotics in the first year of life actually showed more behavioral issues and depressive symptoms than those who did not. The authors concluded that the use of antibiotics within the first year of life for minor illnesses should be questioned. Now, don’t get me wrong—antibiotics do have their time and place. But unfortunately, with providers prescribing Z-paks left, right, and center without taking the time to fully educate their patients that 80-90% of upper respiratory infections are viral, people are beginning to feel the after-effects of antibiotic overuse.
As a nation, our diet truly does suck! Driven by refined/processed carbs, bad fats, sugars, and additives, all being within the reach of a drive-thru, it’s no wonder our guts are completely off track. Diet has been shown to aid in healing the gut and improving the GBX in Parkinson’s disease (13), mood disorders (25), and Alzheimer’s disease (26). Weaning off of the foods that antagonize the gut and replacing them with good fats, moderate amount of lean proteins, fresh organic fruits and vegetables, and adequate hydration (along with other modalities that may be specific for you and your health condition) can aid in healing the gut. Healing allows for the good microbes to replenish and overcome the bad microbes, thereby leading to the replenishment of those important neurotransmitters and chemicals. If you refer back to some of our previous blog posts (Clean Eating, Gut Healthy Food & Drinks, Prebiotics, Collagen Peptides, Avocado, Benefits of Kombucha, Fats, Superfoods, Gluten, Healthy Snacks) you will get some guidance on which direction your diet should take.
“Obesity is one of the most rapidly escalating epidemics faced by global public-health systems” (27). Not only is chronic inflammation terrible for the heart, brain, and kidneys, it can wreck havoc on the gut. Disruption of the GBX in chronic inflammation could be because the inflammatory process “may lead to neuro-inflammation and could [it] be due to the activation of components of innate immunity like Toll-like receptors (TLRs) and increased intestinal permeability (known as a leaky gut).” (27) This type of inflammation has also been associated with Alzheimer’s Disease and depression. Imbalance of gut microbiota due to obesity can increase the risk of developing plaque in the artery walls and can elevate blood pressure (28), thereby increasing inflammation and disturbing the GBX.
Lastly, chronic, uncontrolled stress is something that unfortunately is becoming a norm in our every day lives. I can honestly say I am one of those people who have to find many outlets to handle the stressors of the day. Being a full-time working nurse practitioner, the mother of two girls, and trying to be an attentive and supportive wife to my firefighter husband of almost 12 years, along with the other commitments that I put upon myself, life can be extremely overwhelming! Through a lot of self-development (which is continuous!) and healing my GBX, I am striving to manage my stress in a peaceful and therapeutic way. But I’m human and it gets out of my control sometimes. Chronic stress can be harmful, especially to the GBX. Not only does it disrupt the mind and the stress response system, it completely throws off the gut microbiota. One study showed that “chronic restraint stress disturbed the gut microbiota, inducing microbiota–gut–brain axis dysfunction including decreased hippocampus 5-HT [serotonin] content, reduced BDNF (brain-derived neurotrophic factor) mRNA expression, increased plasma stress hormone levels, declined circulatory IL-10 levels, and abnormal gut microbiota, resulting in depression.” (29).
As you can see, the GBX is more than just your stomach giving you “a gut feeling,” even though that feeling truly is real! There are potentially detrimental effects the GBX can have on your mind and your body, which contribute to a less than desired quality of life.
As I mentioned before, we have recently partnered with Amare, a company like no other and aligns with our mission and all things #guthealth. So, naturally when they approached us to become wellness partners (and after very careful review) we knew this was a company we could truly stand by. Their products focus on the GBX primarily, and allow for healing: mind, body and soul.
There has been a ton information thrown your way with this blog post and I tried my best to condense down as much as possible. With a subject like the GBX and the revolution of modern medicine finally accepting that this is the wave of the future, I had to hold back a lot more information. But if you want to know more, please don’t hesitate to contact us via social media or email.
To provide our followers and readers with the tools to listen to their bodies and give it what it needs to thrive in good health. That they are able to be authentic to their true-self and acknowledge their passions and dreams. And for all of us to listen to our intuition and to trust the guidance that it gives us.
We are on this journey with you….so, are you ready to Follow Your Gut?