Digestive Bitters, Gentian and Skullcap in the Evidence-Based Treatment of Indigestion and Heartburn

Digestive Bitters, Gentian and Skullcap in the Evidence-Based Treatment of Indigestion and Heartburn

by | Jan 11, 2021 | Chronic Disease, Digestion, Health, Microbiome, Nutrition

Digestive bitter formulas or tonics, comprised of plants such as gentian, ginger, wormwood, and dandelion, have been traditionally used to support digestive function for millennia. (1) 

Deficient in most modern diets, which lean heavily toward overly sweet or salty foods, digestive bitter herbs and plants were regularly consumed in ancestral diets. Digestive bitters are most effective when taken 10-15 minutes before a meal or with a meal.

For over a century now, two herbs in particular, gentian and skullcap, have been routinely combined and used as an herbal digestive bitter formulation to treat indigestion and heartburn. (2)

The doctor who pioneered this formulation is the late, great naturopathic physician, Dr. O.G. Carroll, said to be the most famous doctor west of the Mississippi in his time, operated a large clinical practice for decades out of Spokane, Washington. Dr. Carroll called his herbal formulation fifty-fifty caps because they were said to be approximately half gentian and half skullcap. (3) 

More can be learned about Dr. Carroll’s legacy, such as the Carroll Food Intolerance Method, at The Carroll Institute of Healing. 

It is a well-known fact that gastroesophageal reflux disease (GERD) is strongly associated with a condition called hypochlorhydria, wherein the pH of the stomach, which normally is around 1.5 to 3.5, is too high and so the stomach acid, responsible for activating a cascade of enzymatic and hormonal activity in the gut, is abnormally low. (4) 

It can be argued that modern diets tend to prolong acid suppression and lead to hypochlorhydria, impairing vitamin B12, calcium, and iron absorption, as well as leading to increased infectious risks over the long term. Also, it has been hypothesized that the intraluminal environment is altered and small intestinal bacterial overgrowth (SIBO) is promoted. As a result of SIBO, excessive fermentation occurs and leads to symptoms such as bloating, abdominal discomfort, and diarrhea. (5)

Evidence abounds that the lower esophageal sphincter will loosen and open if the acidic environment of the GI tract is not sufficient, hence, the acidic contents of the gut will reflux up into the esophagus and cause the symptoms of heartburn. (6)

The Science of Digestive Bitters

Scientists are split as to the mechanism of digestive bitters: a cephalic elicited vagal response involving the enteric nervous system versus a purely local response in the gastrointestinal tract. The truth is that it’s both. (7)

Our human genome contains 29 bitter taste receptors (T2Rs), which are responsible for all bitter ligands and stimulated when ingesting bitter foods, transferring information from our vagus nerve to our digestive organs and promoting an optimal pH in the gut. (8) In mouse models, bitter compounds have been shown to activate the T2Rs and stimulate the secretion of the hunger hormone ghrelin, which makes us feel satiated. (9)

Gentian

The herb, gentian (Gentiana lutea), also known as bitter root, is known to help keep the pH in the gut optimal as well as upregulate gut function and the ability to break down foodstuff entering the gut. (10)

As a result, enzymatic activity fires on all cylinders in the gut and adequate secretion delivers appropriate catabolic activity, facilitating breakdown and absorption. The microflora stays balanced, as well, disallowing pathogenic bacteria to take hold and engender dysbiosis. Conditions such as fungal overgrowth and ulcers associated with H. pylori bacteria overgrowth would be much less likely to occur. (11, 12)

Bitter glycoside compounds, such as secoiridoid monoterpenes, are what give gentian its bitter taste, but it also contains triterpenoids, xanthones, and other constituents. (13)

Gentian has analgesic, anti-inflammatory, and antioxidant effects. The root of gentian is used more commonly than the bark in herbal remedies. Gentian has been used for digestive disorders, such as loss of appetite, bloating, diarrhea, fullness, flatulence, and acid reflux. It has also been used for alleviating fever as well as preventing muscle spasms.

Skullcap

The herb, skullcap (Scutellaria laterifllora), soothes the digestive lining of the gut and supports gut healing, operating as a nervine, thereby calming the nervous system and helping to regulate the gut-brain axis as well as the vagus nerve connecting the brain to the gut. (14)

Skullcap possesses anxiolytic, sedative, anti-inflammatory, and antispasmodic properties. Skullcap contains flavonoids, lignins, resins, and tannins. (15)

Takeaway

As a naturopathic physician, digestive bitters are my first line of treatment, as we start with getting gut function improved. One of my favorite bitter tonics is gentian and skullcap digestive capsules.

Remember to consult your naturopathic doctor, or your integrative medicine practitioner, regarding the role that digestive bitters can play in your health, as there may be contraindications to adding them to your regimen.

Resources:

  1. McMullen MK, Whitehouse JM, Towell A. Bitters: Time for a New Paradigm. Evid Based Complement Alternat Med. 2015;2015:670504. doi: 10.1155/2015/670504. Epub 2015 May 14. PMID: 26074998; PMCID: PMC4446506. https://pubmed-ncbi-nlm-nih-gov.liboff.ohsu.edu/26074998/
  2. Editor1. (2015, December 17). The Carroll Food Intolerance Evaluation and Its Applications. Retrieved January 11, 2021, from https://ndnr.com/autoimmuneallergy-medicine/the-carroll-food-intolerance-evaluation-and-its-applications/
  3. Zap Indigestion with #50 Capsules. (n.d.). Retrieved January 11, 2021, from https://www.holistichealthpc.com/blog/zap-indigestion-with-50-capsules
  4. Kellerman R, Kintanar T. Gastroesophageal Reflux Disease. Prim Care. 2017 Dec;44(4):561-573. doi: 10.1016/j.pop.2017.07.001. Epub 2017 Oct 5. PMID: 29132520.
  5. Surdea-Blaga T, Negrutiu DE, Palage M, Dumitrascu DL. Food and Gastroesophageal Reflux Disease. Curr Med Chem. 2019;26(19):3497-3511. doi: 10.2174/0929867324666170515123807. PMID: 28521699.
  6. Reebs, D., & *, N. (2018, June 19). The Myth of GERD: It’s Not the Acid, Stupid! Dr. Ben Reebs. Retrieved January 11, 2021, from https://www.drreebs.com/the-myth-of-gerd-its-not-the-acid-stupid/
  7. McMullen MK, Whitehouse JM, Towell A. Bitters: Time for a New Paradigm. Evid Based Complement Alternat Med. 2015;2015:670504. doi: 10.1155/2015/670504. Epub 2015 May 14. PMID: 26074998; PMCID: PMC4446506. https://pubmed-ncbi-nlm-nih-gov.liboff.ohsu.edu/26074998/
  8. Bloxham CJ, Foster SR, Thomas WG. A Bitter Taste in Your Heart. Front Physiol. 2020 May 8;11:431. doi: 10.3389/fphys.2020.00431. PMID: 32457649; PMCID: PMC7225360.
  9. Janssen S, Laermans J, Verhulst PJ, Thijs T, Tack J, Depoortere I. Bitter taste receptors and α-gustducin regulate the secretion of ghrelin with functional effects on food intake and gastric emptying. Proc Natl Acad Sci U S A. 2011 Feb 1;108(5):2094-9. doi: 10.1073/pnas.1011508108. Epub 2011 Jan 18. PMID: 21245306; PMCID: PMC3033292.
  10. Levy, J. (2019, September 10). The Ancient Herb that Aids Digestion, Wound Healing & More. Retrieved January 11, 2021, from https://draxe.com/nutrition/gentian/
  11. Beasley DE, Koltz AM, Lambert JE, Fierer N, Dunn RR. The Evolution of Stomach Acidity and Its Relevance to the Human Microbiome. PLoS One. 2015 Jul 29;10(7):e0134116. doi: 10.1371/journal.pone.0134116. PMID: 26222383; PMCID: PMC4519257.
  12. Sarker SA, Ahmed T, Brüssow H. Hunger and microbiology: is a low gastric acid-induced bacterial overgrowth in the small intestine a contributor to malnutrition in developing countries? Microb Biotechnol. 2017 Sep;10(5):1025-1030. doi: 10.1111/1751-7915.12780. Epub 2017 Jul 17. PMID: 28714103; PMCID: PMC5609274.
  13. Mirzaee F, Hosseini A, Jouybari HB, Davoodi A, Azadbakht M. Medicinal, biological and phytochemical properties of Gentiana species. J Tradit Complement Med. 2017 Jan 28;7(4):400-408. doi: 10.1016/j.jtcme.2016.12.013. PMID: 29034186; PMCID: PMC5634738.
  14. Awad R, Arnason JT, Trudeau V, Bergeron C, Budzinski JW, Foster BC, Merali Z. Phytochemical and biological analysis of skullcap (Scutellaria lateriflora L.): a medicinal plant with anxiolytic properties. Phytomedicine. 2003 Nov;10(8):640-9. doi: 10.1078/0944-7113-00374. PMID: 14692724.
  15. Shang X, He X, He X, Li M, Zhang R, Fan P, Zhang Q, Jia Z. The genus Scutellaria an ethnopharmacological and phytochemical review. J Ethnopharmacol. 2010 Mar 24;128(2):279-313. doi: 10.1016/j.jep.2010.01.006. Epub 2010 Jan 11. PMID: 20064593.
Your Gut Is Not A Black Box, But Here Are Six Difficult-To-Stomach Facts

Your Gut Is Not A Black Box, But Here Are Six Difficult-To-Stomach Facts

by | Jan 4, 2021 | Chronic Disease, Digestion, Health, Microbiome

Over 2,500 years ago the so-called founder of modern medicine, Hippocrates, said that all disease begins in the gut. And evidence shows us that he was right.

While an ever-expanding body of research indicates just how chronically sick our guts can make us, this doesn’t mean that the gut necessarily holds all of the answers to everything that we do not understand. 

A kind of black box to which we can open Pandora’s box…

Or does it?

The Gut Microbiome as Pathogen Protector

The gastrointestinal tract (GIT), in other words, the gut, is the largest interface between the human organism and the outer environment, deeply involved in maintaining our health. 

A giant panoply of microorganisms whose composition directly impacts our epithelial barrier and gut immune system functions is hosted in the lumen (membrane) of the gut and in the upper mucus layer.

Our health status is influenced by these microorganisms. 

For example, probiotics (good bacteria which confirm health benefits to us), can increase macrophage and natural killer cell activity, modulate immunoglobulin or cytokine secretions, as well as indirectly enhance the gut epithelial barrier, alter mucus secretion, and competitively exclude pathogenic bacteria from taking hold. (1)

Correlation, So What About Causation?

Every scientist knows that correlation does not equal causation, yet somehow that can be a difficult concept to remember to stomach at all.

It’s all correlation until somebody gets hurt, right? Cause-effect relationships between pathology and the microbiome are not well established, ad infinitum. It’s a story on repeat when it comes to health and wellness.

And then, bam! We have ourselves a mechanism of action, where the real stuff happens. Where we can dig in. Where there might be a patentable drug mechanism of action lurking in the shadows, and where there may be the ability to obtain research grant funding and warranting further research to confirm the as-of-yet unconfirmed.

For the last two decades or so we’ve heard endlessly about the microbiome and the gut-brain axis. 

But your gut is not a black box. Just because it can make us extremely sick doesn’t mean that it’s necessarily responsible for all of the things that we do not understand right now.

Fact #1: 70% Of Your Immune System Is Housed In Your Gut

Depending on who you talk to, anywhere from 60 to 80 percent of our immune cells reside in our gut. 

Not only immune cells, but approximately 100 trillion gut bacteria also reside there, comprising our intestinal microflora which can take care of pathogens as well as become pathogenic. (2)

When the Pathogen Monster Can Become Pathogenic

Basically, our immune system is inside our body, and bacteria live outside our body—or are they inside our body, and our body is outside? 

These two layers have a life-long conversation, during which millions of antibodies are generated and secreted by cells lining the gut. Our body’s homeostasis and our immunostasis go hand-in-hand.

Hence, if your gut is messed up, you just might get sick a lot more often, and you also just might be liable to get a chronic disease.

For example, the intestinal microbiota serves as a protective mediator during pneumococcal pneumonia, enhancing primary alveolar macrophage function. (3) Patients with diverticular disease have depleted anti-inflammatory microbiota associated with mucosal macrophage infiltration. (4)

Multiple pathologies are associated with dysbiosis or unbalanced gut microflora, as host susceptibility to infections, autoimmune disease, chronic disease, and even cancer, becomes heightened. (5)

Dysbiosis What???

Dysbiosis, most prominent in the digestive tract, is the condition of having microbial imbalances on or within the human organism. It can also occur on any surface or mucus membrane, such as skin, sinus, nose, lung, ear, nail, eye, or vagina.

Dysbiosis, of which dysbacteriosis is a subtype, is not so much about the germ as it is about the effect that the germ (or microbe) can have on a susceptible host. In other words, dysbiosis is about a relationship between host and microbe. (6)

Studies abound showing links between Parkinson’s disease and pathogenic bacteria, as well as the myriad associations between IBS and SIBO, and between SIBO and a host of other chronic diseases. (7, 8)

Fact #2: Probiotics Can Make Some People Sick

Interestingly, most so-called dairy free probiotics contain dairy in them, yet dairy is the most common food sensitivity in the world. (9)

Labels usually read “dairy free,” but the fact is often that a dairy culture medium has merely been washed off and regulations do not require the labeling of such. 

The reason is that most modern starter cultures originate from lactic acid bacteria that originally constituted milk microflora. The lactic acid live active culture is not considered to be dairy related because after the medium has been washed off it does not contain any milk or milk protein. (10)

Hence, many vegan or dairy-free labeled commercial probiotics may contain some tiny amount of dairy derivatives and make a person who is dairy sensitive or intolerant less healthy and produce symptoms, such as gas, bloating, and congestion, consistent with their epigenetics and constitution.

Probiotics obviously represent a powerful tool in order to reestablish homeostasis and promote gut health, but only if they are 100% dairy free for those who are sensitive to dairy derivatives.

This can occur not only via the innate and adaptive immunity, but through other mechanisms: intestinal epithelium permeability regulation, mucus secretion, and competitive antimicrobial compound secretion.

For example, three probiotics that have been shown to be 100% dairy free are Ayush 100B, MegaSporeBiotic, and Therbiotic.

Fact #3: 90% Of Your Serotonin Is Made In Your Gut

90% of our serotonin is made in the gut and can cross the blood-brain barrier. (11) Serotonin is known as the happiness neurotransmitter, and it’s also required in learning and attention.

Hence, it doesn’t take a rocket scientist to deduce that if your gut is messed up, you’ll be more likely to experience anxiety and depression, as well as symptoms of attention deficit disorder.

Fact #4: Psychobiome Aside, There May Be A Microbiome in Our Brain

New research has been coming out that we may even have good (or bad?) bacteria in our brain. (12) We have been finding more and more information about the psychobiome lately, that is, the gut bacteria that may impact how we think and feel. But what about the brain microbiome, now indicated in preliminary research findings? (13, 14)

Fact #5: The Gut Makes A Lot of Critically Important Nutrients

Not only is our microflora responsible for generating Vitamin K, essential to blood coagulation and bone metabolism, but it also plays a role in the production of the eight water soluble B vitamins, namely biotin, cobalamin, folate, niacin, pantothenate, pyridoxine, riboflavin, and thiamin, required for methylation and detoxification pathways. (15)

Therefore, it stands to reason that if our gut is messed up, we may quickly become deficient in key minerals and nutrients to generally get things done in our bodies, such as metabolism, methylation, and detoxification.

Fact #6: You Can Change Your Microbiome Composition In Just One Day

It’s a fact that it only takes one day to completely change our microbiome. This can be done by what you eat, or by a dose of antibiotics. (16) Hence, be mindful of what you’re putting into your gut!

What’s Gut Got to Do, Got to Do with It?

The moral of the story is that you may not need a black box warning to discover that what you put in you will likely get out, in the long run, when it comes to gut health and living a life free of chronic disease.

However, the gut is not a black box because we know that it is where much of chronic disease first begins, to paraphrase Hippocrates.

Nurture your microbiome, nurture your psychobiome, support homeostasis and immunostasis, and keep dysbacteriosis at bay. 

Study the science of nutrition’s black box warnings and know that even though the gut may appear to be a black box at best and a Pandora’s box at worst, it’s neither. By understanding more, you can begin to nurture your microbiome and your psychobiome, support homeostasis and immunostasis, and keep dysbacteriosis at bay.

Resources:

  1. La Fata G, Weber P, Mohajeri MH. Probiotics and the Gut Immune System: Indirect Regulation. Probiotics Antimicrob Proteins. 2018 Mar;10(1):11-21. doi: 10.1007/s12602-017-9322-6. PMID: 28861741; PMCID: PMC5801397.
  2. Ahluwalia B, Magnusson MK, Öhman L. Mucosal immune system of the gastrointestinal tract: maintaining balance between the good and the bad. Scand J Gastroenterol. 2017 Nov;52(11):1185-1193. doi: 10.1080/00365521.2017.1349173. Epub 2017 Jul 12. PMID: 28697651.
  3. Schuijt TJ, Lankelma JM, Scicluna BP, de Sousa e Melo F, Roelofs JJ, de Boer JD, Hoogendijk AJ, de Beer R, de Vos A, Belzer C, de Vos WM, van der Poll T, Wiersinga WJ. The gut microbiota plays a protective role in the host defence against pneumococcal pneumonia. Gut. 2016 Apr;65(4):575-83. doi: 10.1136/gutjnl-2015-309728. Epub 2015 Oct 28. PMID: 26511795; PMCID: PMC4819612.
  4. Barbara G, Scaioli E, Barbaro MR, Biagi E, Laghi L, Cremon C, Marasco G, Colecchia A, Picone G, Salfi N, Capozzi F, Brigidi P, Festi D. Gut microbiota, metabolome and immune signatures in patients with uncomplicated diverticular disease. Gut. 2017 Jul;66(7):1252-1261. doi: 10.1136/gutjnl-2016-312377. Epub 2016 Sep 12. PMID: 27618836.
  5. Lazar V, Ditu LM, Pircalabioru GG, Gheorghe I, Curutiu C, Holban AM, Picu A, Petcu L, Chifiriuc MC. Aspects of Gut Microbiota and Immune System Interactions in Infectious Diseases, Immunopathology, and Cancer. Front Immunol. 2018 Aug 15;9:1830. doi: 10.3389/fimmu.2018.01830. PMID: 30158926; PMCID: PMC6104162.
  6. Martinez KB, Leone V, Chang EB. Western diets, gut dysbiosis, and metabolic diseases: Are they linked? Gut Microbes. 2017 Mar 4;8(2):130-142. doi: 10.1080/19490976.2016.1270811. Epub 2017 Jan 6. PMID: 28059614; PMCID: PMC5390820.
  7. Sun MF, Shen YQ. Dysbiosis of gut microbiota and microbial metabolites in Parkinson’s Disease. Ageing Res Rev. 2018 Aug;45:53-61. doi: 10.1016/j.arr.2018.04.004. Epub 2018 Apr 26. PMID: 29705121.
  8. Borghini R, Donato G, Alvaro D, Picarelli A. New insights in IBS-like disorders: Pandora’s box has been opened; a review. Gastroenterol Hepatol Bed Bench. 2017 Spring;10(2):79-89. PMID: 28702130; PMCID: PMC5495893.
  9. Sarao LK, Arora M. Probiotics, prebiotics, and microencapsulation: A review. Crit Rev Food Sci Nutr. 2017 Jan 22;57(2):344-371. doi: 10.1080/10408398.2014.887055. PMID: 25848935.
  10. Deng Y, Misselwitz B, Dai N, Fox M. Lactose Intolerance in Adults: Biological Mechanism and Dietary Management. Nutrients. 2015 Sep 18;7(9):8020-35. doi: 10.3390/nu7095380. PMID: 26393648; PMCID: PMC4586575.
  11. Yano JM, Yu K, Donaldson GP, Shastri GG, Ann P, Ma L, Nagler CR, Ismagilov RF, Mazmanian SK, Hsiao EY. Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell. 2015 Apr 9;161(2):264-76. doi: 10.1016/j.cell.2015.02.047. Erratum in: Cell. 2015 Sep 24;163:258. PMID: 25860609; PMCID: PMC4393509.
  12. Matarazzo I, Toniato E, Robuffo I. Psychobiome Feeding Mind: Polyphenolics in Depression and Anxiety. Curr Top Med Chem. 2018;18(24):2108-2115. doi: 10.2174/1568026619666181210151348. PMID: 30526463.
  13. Says:, Jami Carpenter, Zhao says: Mari Luque Says: Ramesh Chaudhary says: and Name *. “Bacteria May Live Naturally inside the Human Brain,” November 27, 2018. http://sitn.hms.harvard.edu/flash/2018/bacteria-may-live-naturally-inside-human-brain/.
  14. Pennisi E. Meet the psychobiome. Science. 2020 May 8;368(6491):570-573. doi: 10.1126/science.368.6491.570. PMID: 32381701.
  15. Ramakrishna BS. Role of the gut microbiota in human nutrition and metabolism. J Gastroenterol Hepatol. 2013 Dec;28 Suppl 4:9-17. doi: 10.1111/jgh.12294. PMID: 24251697.
  16. Le Bastard Q, Al-Ghalith GA, Grégoire M, Chapelet G, Javaudin F, Dailly E, Batard E, Knights D, Montassier E. Systematic review: human gut dysbiosis induced by non-antibiotic prescription medications. Aliment Pharmacol Ther. 2018 Feb;47(3):332-345. doi: 10.1111/apt.14451. Epub 2017 Dec 5. PMID: 29205415.
Zinc and The Metabolism of Alcohol

Zinc and The Metabolism of Alcohol

by | Jul 17, 2018 | Chronic Disease, Digestion, Health, Minerals, Nutrition

It’s well known that vitamin C, B complex vitamins, glutathione, and N-acetyl Cysteine (NAC) play a large role in alcohol metabolism, but zinc is rarely mentioned. However, zinc is actually a requisite cofactor in the metabolism of alcohol. (1) Zinc has not been studied extensively as a treatment for alcoholism, though alcoholics are usually zinc deficient and suffer from conditions which may benefit from zinc supplementation, such as low sperm counts and rosacea.

The body’s main enzyme for alcohol metabolism, alcohol dehydrogenase (ADH), actually contains zinc at its catalytic site. Zinc is now considered a novel therapeutic approach to alcohol liver disease (ALD). (2) ADH exists in decreased amounts in women, which contributes to less “first-pass metabolism,” and may in part explain why women are more susceptible to alcohol intoxication.

Zinc, an essential trace element, goes hand-in-hand with protein intake; in other words, poor protein intake correlates with poor zinc status. (3) Some symptoms of zinc deficiency include poor growth, infertility, skin disease, and impaired immune function.

The Epidemic of Chronic Alcoholism

Did you know that 50% of the world’s population drinks alcohol, and 5% to 10% have chronic alcoholism? In fact, over 3% of all deaths worldwide are due to alcohol. (4)

Ethanol

Ethanol is the natural product of sugar fermentation by yeasts. According to the USDA, one standard drink contains about half an ounce of ethanol. This is the equivalent of a light 12 oz beer, a 5 oz pour of wine, or 1.5 oz of an 80-proof distilled liquor. Ethanol is found in many household products, such as mouthwash, perfume, and cooking extracts.

The Metabolism of Alcohol

Alcohol is biotransformed to acetaldehyde by three main enzyme systems in the liver. (5)

  1. The first and main system lies in the cytosol of hepatocytes, where alcohol dehydrogenase (ADH) transforms ethanol to acetaldehyde. As mentioned, the ADHs are actually are actually a class of zinc enzymes!
  2. The second involves CYPs which oxidize ethanol in the microsomes of cells, known as the microsomal ethanol-oxidizing system (MEOS). Microsomes are basically fragments of hepatocellular endoplasmic reticulum.
  3. The third involves catalase in the peroxisomes, which acts upon hydrogen peroxide as substrate, metabolizing no more than 5% of all liver ethanol.

Ethanol crosses cell membranes, about 80% of its absorption occurring in the duodenum and 20% in the stomach itself. Peak blood ethanol levels are reached approximately 30 to 90 minutes after a meal. (6) Once ethanol reaches the blood, its taken up mainly by hepatocytes replete with ample quantities of ADH. ADH, however, is also available in the mucosa of the gut.

Zinc Status as a Biomarker of Chronic Alcoholism

Studies looking at evidence of the association of zinc metabolism and alcohol-associated disorders, such as those involving the liver, brain, lung, gut, and even fetal alcohol syndrome, suggest that zinc status should be used as a biomarker for alcohol abuse. (7,8) While it has been confirmed that alcohol induces autophagy in mice, a recent animal study found that adequate zinc intake is required for autophagy. (9)

Conclusion

Given that the body’s main enzyme system responsible for metabolizing alcohol in the liver is zinc-based, there appears to be enough evidence to warrant further studies in zinc supplementation for alcohol-induced diseases.

Resources

  1. Alcohol dehydrogenase. Egyptian Journal of Medical Human Genetics.
    https://www.sciencedirect.com/topics/neuroscience/alcohol-dehydrogenase. Accessed July 17, 2018.
  2. Kharbanda K, Ronis M, Shearn C, et al. Role of Nutrition in Alcoholic Liver Disease: Summary of the Symposium at the ESBRA 2017 Congress. Biomolecules. 2018;8(2):16. doi:10.3390/biom8020016.
  3. Gibson RS. A Historical Review of Progress in the Assessment of Dietary Zinc Intake as an Indicator of Population Zinc Status. Advances in Nutrition. 2012;3(6):772-782. doi:10.3945/an.112.002287.
  4. Alcohol. World Health Organization. http://www.who.int/substance_abuse/facts/alcohol/en/. Published May 12, 2014. Accessed July 17, 2018.
  5. Alcohol Metabolism: An Update. National Institute on Alcohol Abuse and Alcoholism. https://pubs.niaaa.nih.gov/publications/aa72/aa72.htm. Accessed July 17, 2018.
  6. Mitchell MC, Teigen EL, Ramchandani VA. Absorption and Peak Blood Alcohol Concentration After Drinking Beer, Wine, or Spirits. Alcoholism: Clinical and Experimental Research. 2014;38(5):1200-1204. doi:10.1111/acer.12355.
  7. McClain CJ, Su LC. Zinc deficiency in the alcoholic: a review. Alcohol Clin Exp Res 1983;7:5-10.
  8. Skalny AV, Skalnaya MG, Grabeklis AR, Skalnaya AA, Tinkov AA. Zinc deficiency as a mediator of toxic effects of alcohol abuse. European Journal of Nutrition. 2017. doi:10.1007/s00394-017-1584-y.
  9. Liuzzi JP, Narayanan V, Doan H, Yoo C. Effect of zinc intake on hepatic autophagy during acute alcohol intoxication. BioMetals. 2018;31(2):217-232. doi:10.1007/s10534-018-0077-7.
The Coffee Conundrum: A Proposed Life-Lengthening Mechanism

The Coffee Conundrum: A Proposed Life-Lengthening Mechanism

by | Jul 3, 2018 | Digestion, Health, Longevity

A growing body of research demonstrates an association between coffee drinking and a host of health benefits. Just this week, a new study showed premature death decreased by as much as 16% in those who consume 6 to 7 daily cups of coffee. (1) In 2017, the American Heart Association presented preliminary research showing a lowered risk of stroke and heart failure in coffee consumers (2), while decrease in risk of dementia, by as much as 65% in late age, has been well-established. (3,4)

Relying mainly on observational studies, there are many proposed mechanisms by which coffee may increase longevity and protect against cognitive decline, such as antioxidant capacity, increased insulin sensitivity, and the anti-inflammatory effects of blocking adenosine receptors in the brain. (5,6) This article will explore a potential mechanism which is little talked about, accounting for the gut-brain axis which links emotional and cognitive areas of the brain with intestinal functions.

Coffee Increases Gastric Acid (HCl) Secretion in the Gut

Coffee, both caffeinated and decaffeinated (7,8), increases the production of the hormone gastrin in the gut (9), the prime regulator of gastric acid (HCl) secretion. Specialized endocrine cells (G cells) release gastrin into circulation after a meal.

The G cells are tightly regulated by two hormones: gastrin releasing peptide (GRP), which exerts stimulatory effects in the gut and is countered by the inhibitory effects of somatostatin. The release of gastrin is controlled by a negative feedback loop whereby fasting and increased stomach acid will inhibit it and a high gastric pH will stimulate its secretion.

This may partially explain why long-term proton pump inhibitor (PPI) takers often have chronically elevated serum gastrin levels. PPIs inhibit the H+/K+-ATPase system found in gastric parietal cells, thereby suppressing gastrin levels, which will eventually cause the body to respond to stimulate the release of gastrin to maintain homeostasis.

The hormone gastrin increases stomach motility and gastric emptying. Nutrient absorption is only possible when stomach acid levels are at their proper levels. One study indicates that bitter taste signaling occurring in the gastric parietal cells plays a role in the release of gastrin. (10)

Coffee May Help Optimize Digestion and Nutrient Absorption, Especially as We Age

Low stomach acid (hypochlorhydria) is more common in the elderly (11). Is it possible that coffee’s life-lengthening health benefits are in part due to its effect on gastric parietal cells, helping to maintain optimal pH levels and a healthy microbiome, as well as optimize digestion and nutrient absorption. This may very well be the main reason that coffee consumption, no matter in what form, increases longevity. Unfortunately, more observational studies will not give us the answer.

 

  1. Loftfield E, Cornelis MC, Caporaso N, Yu K, Sinha R, Freedman N. Association of Coffee Drinking With Mortality by Genetic Variation in Caffeine MetabolismFindings From the UK Biobank. JAMA Intern Med. Published online July 02, 2018. doi:10.1001/jamainternmed.2018.2425
  2. Drinking coffee may be associated with reduced risk of heart failure and stroke. Late-onset asthma linked to increased heart disease, stroke risk | American Heart Association. https://newsroom.heart.org/news/drinking-coffee-may-be-associated-with-reduced-risk-of-heart-failure-and-stroke. Accessed July 3, 2018.
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  4. Panza F, Solfrizzi V, Barulli MR, et al. Coffee, tea, and caffeine consumption and prevention of late-life cognitive decline and dementia: A systematic review. The journal of nutrition, health & aging. 2014;19(3):313-328. doi:10.1007/s12603-014-0563-8.
  5. Eskelinen MH, Kivipelto M. Caffeine as a Protective Factor in Dementia and Alzheimers Disease. Journal of Alzheimers Disease. 2010;20(s1). doi:10.3233/jad-2010-1404.
  6. Chiu GS, Chatterjee D, Darmody PT, et al. Hypoxia/Reoxygenation Impairs Memory Formation via Adenosine-Dependent Activation of Caspase 1. Journal of Neuroscience. 2012;32(40):13945-13955. doi:10.1523/jneurosci.0704-12.2012.
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8 Secrets to Biohacking Your Gut

8 Secrets to Biohacking Your Gut

by | Jun 26, 2018 | Diet, Digestion, Health, Nutrition

There’s an old adage that while chiropractic doctors specialize in the spine, naturopathic doctors specialize in the gut. Working with what Dr. Henri Lindlahr, M.D., calls “nature’s laws” and grounded in the natural sciences, here are what I call 8 Secrets to Biohacking Your Gut, and they all involve the letter ‘P.’

1. Purification. Another name for purification is detoxification. There’s an old word for toxicity in the blood, toxemia, which according to Henri Lindlahr, M.D., one of the founders of naturopathic medicine, is caused by the violations of nature’s laws, and is equivalent with disease. (1) In this article, we may gloss over some of these laws, but if you want to learn more about them, check out The Naturopathic Medicine Institute.

Toxemia, aka accumulated “waste matter, morbid materials, and poisons,” must be removed by the organs of elimination, known as emunctories, lest their unchecked accumulation of toxicity lead to various manifestations of chronic disease. According to traditional naturopathic medicine, the five main emunctories are:

  • Liver
  • Gastrointestinal tract
  • Genitourinary tract
  • Lungs
  • Skin

According to traditional naturopathy, toxemia can be primarily reduced via sweat (skin), solid waste (intestines), liquid waste (kidney and urinary bladder), and gaseous waste (lungs). Interestingly, one feature these five emunctories share in common is ample epithelial tissue, which in part serves a defense function immunologically. (2) In the skin, epithelium connects via ducts to sweat glands, a type of exocrine gland which can remove pthalates, BPA, and even toxic metals from the body.

Biohack 1: Take a 40 minute infrared sauna, followed by a cold shower, at least once a week. An interesting aside: Did you know there’s a longitudinal study showing that there’s a significant association between sauna bathing and the reduction of cardiovascular disease and all-cause mortality. (3)

2. Pura Vida. This is the opposite of la vida loca, which induces stress. We know the expression of pura vida as the law of the land in Costa Rica, but at it’s core it really means living a pure life by reducing one’s exposure, as much as possible, to toxic substances, environments, and even thoughts. And yes, this means getting rid of processed sugar and industrial vegetable oils, because of the inflammatory byproducts they produce in our bodies. Because of epigenetics, as expounded upon by the likes of molecular biologist Bruce Lipton, we now know that we literally are what we eat, breathe, and think, and of course, as we follow food chains, we are what we eat ate, too.

Pura vida speaks for itself, but for illustrative purposes I’d like to briefly talk about the effects of stress on the gut. We have microvilli which comprise the brush border and extend into the lumen of our small intestine, responsible for nutrient absorption from our food breakdown. (4) Sloughed every seven days, these microvilli contain arteriovenous (AV) connections which provide necessary blood supply when closed, but in times of stress, the hormones epinephrine and norepinephrine open the AV connections and the microvilli lose their blood supply as blood is shunted away from the gut (think fight or flight). As a result, the microvilli cannot survive and lose their absorptive surface, temporarily inducing malabsorption. This is particularly pronounced after, for example, a severe stress-inducing trauma, such as a car accident, as it may take two or three days for the dead microvilli to slough and fully regenerate. It can be said then that chronic stress will induce chronic malabsorption and/or malnutrition.

We all know about “rest and digest,” which occurs when the parasympathetic nervous system is activated and we are not pumping out cortisol and adrenaline into our bloodstreams. It is just this relaxing state that we need to cultivate in order for pura vida to truly take hold in our lives, so that our digestion and nutrient absorption is optimized.

Biohack 2: When you’re feeling particularly toxic or maybe you’ve binged on that pizza and beer that you’d been craving, or maybe you’re traveling for business and can’t help but eat less nutrient-dense food along the way, keep some activated charcoal or digestive enzymes on hand.

3. Probiotics. 70% of our immune cells reside in the gut (5), and the highest density all-natural, bacterial ecosystem in the world is inhabited by our 100-trilliion celled gut microbiome. Our gut bacteria ferment fiber or collagen protein in the colon, producing short-chain fatty acids (SCFA), which are the main source of energy for superficial colonic cells. The most common (and famous) SCFA is butryic acid, which densely resides in grass-fed butter, such as Kerrygold.

Studies have shown that glucose tolerance is affected by our gut bacteria independent of weight. (6,7) And unhealthy bacteria can cause leaky gut, which has been linked to type 1 DM, IBD, celiac disease, MS, and even asthma; more common conditions linked to an unhealthy microbiome include acne, rosacea, stomachaches, headaches, and fatigue. (8,9,10)

It’s well established that allergies and asthma are illnesses most likely caused by diminished gut function and a compromised microbiome. (11) Oh, and your gut microbiota make vitamin B12 (12), an essential nutrient for making red blood cells, proper neurological function, and DNA synthesis. And 75% of your vitamin K is produced in the microbiome, which helps our blood clot and can keep us from bleeding excessively.

When talking dosage of commercial probiotics, the number of live organisms are known as “colony forming units,” or CFU’s. In most people, 5 to 10 billion viable CFU’s of L. acidophilus or B. bifidum cells daily will suffice. (Pizzorno, Textbook of Natural Medicine – 13)

Biohack 3: Take a probiotic daily, and eat fermented, probiotic-rich foods.

4. Prebiotics. Prebiotics are nondigestible food ingredients that help promote beneficial intestinal microbiomic growth, in particular fiber compounds. Like other high-fiber foods, prebiotic substances pass through the upper GI, remaining undigested until they arrive in the colon. Prebiotics are rich in foods such as garlic and onions, Jerusalem artichokes, jicama, chicory root, and even dandelion greens. In the colon, prebiotic compounds are fermented microbiomically.

The most famous type of fiber prebiotic are oligosaccharides, but when researchers refer to fiber, they also mean fructo-oligosaccharides, polysaccharides, and even inulin. Some carbs rich in prebiotics include sweet potatoes, carrots (I prefer the non-orange ones, which have a lower glycemic load, such as polyphenol purple! We’ll talk more about the power of purple soon!), squash, and asparagus. Then, there are also the resistant starches, so named because they are resistant to digestion, which further promote fermentation and help produce SCFAs like butyrate. Some resistant starches include banana flour, plaintain flour, and raw potato starch.

Biohack 4: Eat prebiotic-rich foods, such as those listed above.

5. Purple Polyphenols. Many plants contain naturally-occurring polyphenolic compounds: fruits, veggies, coffee, tea, and even

wine. But only about 10% of polyphenols are absorbed in the small intestine, while the rest end up in the colon to be degraded to metabolic byproducts by our gut bacteria (14). Research shows a symbiotic relationship between polyphenols and our gut microbiome, making a plant-rich diet even more important. (15) Polyphenols can even act prebiotically, to increase
Lactobacillus and Bifidobacteria. While dark leafy greens are perhaps the most polyphenolic, other polyphenol-rich foods include purple foods such as Concord grapes, black mission figs, prunes, plums, blueberries, and blackberries, as well as coffee and chocolate, and some spices. Oh, and polyphenols increase the presence of good bacteria such as Bacteroidetes, as opposed to the more so-called “bad” bacteria, such as Firmicutes. (16)

Biohack 5: Eat purple polyphenols, such as those listed above!

6. Proline and lysine. Did you know that in the lumen (inner part or tube) of your gut, the amino acids proline and lysine are hydroxylated (a fancy chemical word for the addition of an -OH group to a molecule), with the help of the cofactor Vitamin C, to make collagen?! (17) Pretty amazing, right? It means these nutrients are essential for gut tissue regeneration, which is occurring 24/7. Other nutrients required include L-glutamine and butyric acid.

Oh, and a couple of excellent demulcent herbs that aid in gut healing are slippery elm (Ulmus rubra), deglycyrrhizinated licorice (Glycyrrhiza glabra or DGL), and marshmallow root (Althaea officinalis). 

Another interesting tidbit: Vitamin C is a strong antioxidant, particularly in lowering antioxidant stress in the gut. (18) Apparently Eskimos got plenty of proline and lysine, as seal and whale contain high amounts, but we should probably hold off on eating them.

Biohack 6: Eat plenty of seaweed (an incredibly rich source of proline and lysine).

7. pH (or Proper Stomach Acid). It is essential that our gut is maintained within a highly acidic, proper pH range of 1.5 (fasting) to 3.5 (full stomach of food). Did you know that over 90% of our endogenous serotonin is made in our gut, indicating that “gut feelings” are no joke. (19) Actually, the serotonin made in the brain is a slightly different isomer than the serotonin made in the enteric nervous system, though serotonin influencing drugs, such as SSRI’s, can impact gut function as well. The gut-brain axis oversees everything from satiety, food intake, and glucose regulation, to insulin secretion and sensitivity, and bone metabolism. (20)

Biohack 7: Because studies have shown that stomach acid decreases with age, some natural means to stimulate the production of stomach acid, thereby improving fat breakdown and protein digestion, include betaine HCl and digestive bitters.

8. Purpose and the Solar Plexus. Okay, so here’s the woo-woo biohack. Did you know that according to the Tibetans, the solar

plexus chakra is where fire of the will in the individual is said to be localized? Interestingly, this is also where the fires of digestion roar. So, it can be said that being aligned with our life purpose will also optimize our gastrointestinal gusto. I know it’s kind of a stretch, for which there is no randomized controlled trial, but your gut’s stretch receptors will thank you. 🙂

Biohack 8: Deep belly breathing, regularly, on 4 to 8 counts at a time, can not only stimulate the will to action, but the fires of digestion.

Recapping 8 Gut Biohacks

So, to recount the 8 P’s for biohacking the gut: Purify, live Pura Vida, eat a probiotic-, prebiotic-, polyphenol-, and proline- and lysine-rich diet, maintain proper pH or stomach acid, and find and live your life purpose, thereby firing your solar plexus on all cylinders. And make it #naturopathic.

By the way, consult your doctor first if you are considering trying any of these therapies. In no way does this blog consist of medical advice.

Resources:
1. Lindlahr, Henry 1862-1924., “Nature cure: philosophy and practice based on the unity of disease and cure” (1922). Naturopathic Medicine Historical Collection.
2. Janeway C. Immunobiology: the immune system in health and disease. London: Harcourt Brace & Company; 1999.
3. Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association Between Sauna Bathing and Fatal Cardiovascular and All-Cause Mortality Events. JAMA Internal Medicine. 2015;175(4):542.
4. Tortora GJ, Derrickson B. Principles of anatomy and physiology. New York: Wiley; 2006.
5. Vighi, G., Marcucci, F., Sensi, L., Di Cara, G. and Frati, F. (2008), Allergy and the gastrointestinal system. Clinical & Experimental Immunology, 153: 3–6.
6. Musso G, Gambino R, Cassader M. Obesity, Diabetes, and Gut Microbiota: The hygiene hypothesis expanded? Diabetes Care. 2010;33(10):2277-2284.
7. gshatyan L, Kashtanova D, Popenko A, et al. Gut microbiota and diet in patients with various glucose tolerance. Endocrine Abstracts. 2016.
8. Campbell AW. Autoimmunity and the Gut. Autoimmune Diseases. 2014;2014:152428.
9. Gonzalez A, Hyde E, Sangwan N, Gilbert JA, Viirre E, Knight R. 2016. Migraines are correlated with higher levels of nitrate-, nitrite-, and nitric oxide-reducing oral microbes in the American Gut Project Cohort. mSystems 1(5):e00105-16.
10. Mosca A, Leclerc M and Hugot JP (2016) Gut Microbiota Diversity and Human Diseases: Should We Reintroduce Key Predators in Our Ecosystem? Front. Microbiol. 7:455.
11. Riiser A. The human microbiome, asthma, and allergy. Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology. 2015;11:35.
12. Degnan PH, Taga ME, Goodman AL. Vitamin B12 as a modulator of gut microbial ecology. Cell metabolism. 2014;20(5):769-778.
13. Pizzorno JE, Murray MT. Textbook of natural medicine. St. Louis, MO: Elsevier/Churchill Livingstone; 2013.
14. Tomás-Barberán F. Interaction of polyphenols with gut microbiota: Role in human health. Planta Medica. 2014;80(16).
15. Duda-Chodak A, Tarko T, Satora P, Sroka P. Interaction of dietary compounds, especially polyphenols, with the intestinal microbiota: a review. European Journal of Nutrition. 2015;54(3):325-341.
16. Rastmanesh R. High polyphenol, low probiotic diet for weight loss because of intestinal microbiota interaction. Chemico-Biological Interactions. 2011;189(1-2):1-8.
17. Murad S, Grove D, Lindberg KA, Reynolds G, Sivarajah A, Pinnell SR. Regulation of collagen synthesis by ascorbic acid. Proceedings of the National Academy of Sciences of the United States of America. 1981;78(5):2879-2882.
18. Alzoghaibi MA. Concepts of oxidative stress and antioxidant defense in Crohn’s disease. World Journal of Gastroenterology : WJG. 2013;19(39):6540-6547.
19. Yano JM, Yu K, Donaldson GP, et al. Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell. 2015;161(2):264-276.
20. Heijboer, A. C., Pijl, H., Van den Hoek, A. M., Havekes, L. M., Romijn, J. A. and Corssmit, E. P. M. (2006), Gut–Brain Axis: Regulation of Glucose Metabolism. Journal of Neuroendocrinology, 18: 883–894.

What do you think? I’d love to hear your thoughts!