Anti-Inflammatory Diet

All health care starts with diet. My recommendations for a healthy diet are here:
Anti-Inflammatory Diet and Lifestyle.
There are over 190 articles on diet, inflammation and disease on this blog
(find topics using search [upper left] or index [lower right]), and
more articles by Prof. Ayers on Suite101 .

Friday, December 31, 2010

Honey, Hydrophobicity and Biofilms

A reader (Jay Bryant) recently pointed out a PNAS article on the structure of a bacterial enzyme that uses sucrose to make the glucan matrix of dental biofilms.  This article released a cascade of associations in my mind and illustrated why honey does not contribute to dental plaques, but is antimicrobial and aids wound healing.  People forget that sugars combine both hydrophilic and hydrophobic properties, and thereby act as soaps.
The starting point of the chemical versatility of carbohydrates is the inability of the central portion of a sugar ring structure to form hydrogen bonds.  Each sugar is made of  a linear chain of carbon atoms with each carbon linked also to a hydrogen and a hydroxyl.  Only the hydroxyl can participate in hydrogen bonds, so each carbon has a hydrophilic side (bonds with water to make hydrogen bonds) and a hydrophobic side (that makes van der Waals bonds with other hydrophobic molecules.)  The sugars circularize and the rings have faces that are predominantly hydrophobic and perimeters with hydroxyls that are hydrophilic.  Polysaccharides (long chains of sugars), such as cellulose, can sometimes form long fibers that form a hydrophobic context for hydrogen bonds between the hydroxyls of adjacent polymers.  These cellulose fibers are very resistant to chemical or biological attack and accumulate as the most abundant biological molecules on Earth.
The PNAS article provides another example of how protein enzymes interact with carbohydrates, in this case sucrose and a polymer of glucose.  Typical weak bonds between the amino acid residues of proteins and other molecules are hydrogen, ionic or van der Waals bonds with energies of a couple of kcals/mol.  In contrast, the bonding of the hydrophobic face of a sugar to the hydrophobic face of an hydrophobic amino acid, e.g. tryptophan, phenylalanine, histidine, lysine or arginine, releases more than ten kcals/mol of energy.  Thus, the structure of the bacterial enzyme that makes biofilm glucan chains from dietary sucrose, the sucrose is bound to the enzyme on the face of a prominent tryptophan.  Examination of enzymes that bind to polysaccharides will show a series of tryptophans arrayed across the surface of the enzymes with spacing appropriate to bind to the individual sugars of the polysaccharide.
Biofilms are communities of multiple species of bacteria held together by a polysaccharide matrix.  In the case of dental plaque, the polysaccharide is made of glucose links, whereas many other matrix polysaccharides are negatively charged and held together by positively charged metal ions.  The bacteria bind to the polysaccharides using protein receptors that exploit the display of hydrophobic binding sites of the polysaccharides.  It takes energy to make polysaccharides and the dental plaque bacteria use the energy already expended in the formation of sucrose to produce a polymer of glucose, an alpha-glucan, and free fructose.  Thus, sucrose is essential in forming this type of biofilm and without this sugar, the dental plaque cannot form.  Milk lactose, or glucose would be a more appropriate sweetener.  Unfortunately, high fructose corn syrup would be a poor substitute, because of the high liver toxicity of the fructose (it causes fatty liver, just like alcohol) and very high activity in forming advanced glycation end products (AGEs), which contribute to the symptoms of  diabetics.
Honey seems to be magical, because at low concentrations the sugars present in honey  (mostly glucose and fructose, and not sucrose) are nutrients for bacteria, but at high concentrations honey is anti-bacterial and useful as a wound treatment.  I think that the explanation for its antimicrobial activity is that sugars are amphipathic, that is they have both hydrophilic and hydrophobic properties, just like soap, and at high concentrations they kill bacteria, just as soaps at high concentrations kill bacteria.  In fact, the gentle soaplike properties of sugars are exploited experimentally to dissolve proteins that are normally embedded in cellular membranes.  This explanation predicts that corn syrup, which can also be used to form very stable soap bubbles, should also be useful in wound healing.


Anonymous said...

Dr. Ayers. Welcome back to blogging and thank you so much for the generous sharing of your knowledge. All best wishes for 2011. Thank you so much.

Nigel Kinbrum said...

Ah, there you are! Cheers, Nige.

Ed said...

Dr Ayers, you say that at high concentrations, honey is antimicrobial. What does this mean in a practical sense? I figure that if I put a dollop of honey on a wound, that would seem like a "high concentration" and perform as an antimicrobial. But what if I'm mixing a teaspoon of honey into tea? That strikes me as low concentration, and likely to NOT be antimicrobial.

Another example is, say, 20 grams of table sugar in a pint of cream, vs 24 grams of honey. About the same amount of carbohydrate. At that seemingly low concentration, will the honey behave differently than the sugar?

A second question is perhaps broader. When a food is considered to have antimicrobial properties, is that good, bad, or "it depends?" Does ingesting honey cause the deaths of microbes in my digestive system? It strikes me as a silly thought, but when you attach "antimicrobial" to honey, it makes me wonder.

Thank you for posting, your thoughts are always stimulating.

Lisa said...

Dr. Ayers - So glad you are back. I have read that it has to be raw honey used on wounds, not processed supermarket-type honey. Are you discussing all honey or raw honey? Happy New Year!

Anne said...

Welcome back and Happy New Year!

I have heard xylitol breaks up biofilms. Does it also destroy the bacteria? Does it work in a similar way as honey?

María said...

Feliz año Dr. Gracias por su labor

Jorge said...

Welcome Back Dr. Ayers, and thanks for the post.

Stipetic said...

Nice to see you posting again, Dr. Ayers.

Hi Lisa,

Since I've already done a bit of research on this, I'll just state that the honey used medically is raw honey, either totally untreated or treated with gama-irradiation to kill off potential clostridial spores.

One of the main antibiotic elements of honey is its ability to produce hydrogen peroxide. It is recommended that honey should not be heated above 37°C to prevent the inactivation of glucose oxidase, which is an essential enzyme in the formation of hydrogen peroxide. However, to get the honey out of the combs, it's sometimes necessary to do this at temperatures of 39°C, but this does not seem to affect the antibacterial activity adversely.

Gamma irridiation also does not affect the antibacterial properties of the honey.

Finally, keep in mind that not all honey has significant antibacterial activity. It all depends on what flowers (pollen) the bees feed off of.

Hope this saves Dr. Ayers a bit of time.

Mrs. Ed said...

Honey is a favorite in our home. It is also very easy to digest for someone with a damaged gi it makes baked goods nice and moist, even our almond flour goodies. I have used raw honey on fire ant stings and they go away in 24 hours.

Have a great New Year!! I think I've read all your older posts, so it was nice to see a new one.

Jack said...

Well, Active Manuka Honey has quite a reputation for having very strong antimicrobial properties. Dr Ayers may remember a while back me asking about GERD and heartburn in association with H.pylori.

After trying multiple ideas with respect to diet and specific food intake/avoidance, I found some solid research that many people have experienced excellent results using active manuka honey to ward off heartburn (among many other ailments)

Here is a link with some good info:
Active Manuka Honey

So I bought a jar of 16+ UMF (a fairly high activity rating) and have been taking a couple spoons daily for about 2 weeks now. I can say that it has made a huge improvement in my heartburn symptoms and some days I feel basically completely cured of it. It may take a couple months of use. I'm still taking it, but so far I am shocked that such an easy, natural, and delicious remedy actually existed. From my [limited] understanding the activity in the honey combats H.Pylori directly, but also helps with gut flora.

Given Dr Ayers info here, it makes even more sense now. I wonder if there is any connection with the change in digestive hydrogen and H.pylori as a result of consuming the honey.

-Jack Kronk

Anonymous said...

Dr. Ayers
Good to see you are back, missed your blog. I second the question by Anne re xylitol. I've experienced some improvement in gum disease using xylitol gum but cannot be certain that it is a significant factor as I used other interventions as well.

Dr. Art Ayers said...

Xylitol is a five-carbon molecule with a -CH2-OH on the end instead of the six carbon glucose that ends with a -CH=O, which forms ring structures. That means that xylitol, even though it binds to receptors to make it sweet, is going to be metabolized differently from glucose and the fructose from sucrose or honey.

So, xylitol is sweet, does not raise blood sugar, cannot participate directly in dental plaque/biofilm production, and can't form advanced glycation end products. Gut flora will adjust to metabolize xylitol, but I can't predict the impact on the gluten intolerance/autoimmune components of gum disease. These properties make xylitol attractive to avoid the dental plaque and fructose toxicity problems of sucrose.

Xylitol will act differently than honey, although they both will not participate in biofilm glucan production.

Thanks for the comments/questions.

Dr. Art Ayers said...

Hi Nige.
It is also nice to hear from you and I notice that your Mom has some good days when you can sneak her some protein and saturated fats for breakfast.

Your comment also reminded me of a nagging discussion we had some years ago relative to what happens to extra dietary fats/oils that aren't absorbed in the small intestines. A reader observed that he didn't have oily poos even when he drank large quantities of olive oil.

I think that the answer is that excess fats, proteins and carbs that pass into the colon are just treated the same way as soluble fiber. They are food for flora. The gut flora will adapt in composition to what routinely reaches the colon. Gut flora will convert the fats to secreted shorter fatty acids and hydrogen. That is analogous to dumping high energy electrons to produce fermentation acids.

This also brings up another complicating component to the calories in and calories out discussions. Changes in gut flora will alter the extent to which soluble fiber is digested to short chain fatty acids that are consumed as intestinal nutrients. Hence, with adapted gut flora, soluble fiber is a partially digested carb rather than a poo component.

Antibiotics are used in cattle food lots to alter gut flora and change fat accumulation.

Hope to hear from you soon.

basha said...

I have started to read your blog--think I got to it through reading some article in the NY Times, and then following links until I found your blog--and have a lot of experience with rejuvenation from eating no grains and sugars diet, actually eating only animal protein, vegetables, both raw and cooked, olive oil and butter, and some fruit--and have realized a much better quality of life, 40-lb weight loss, improvement in various ailments--shrinking of varicose veins, disapperance of plantar faciitis, much higher energy level, and my dentist says that the plaque on my teeth is much more easily removed, although I do not use honey in this phase of my life--one of many sweeteners I stay away from, the only one I use is stevia, both in the processed form, and grow it myself and dry the leaves. I came to eating this way after recognizing an addiction to sugar that I tried to deny my whole life, but finally had to throw in the towel, and now I feel like a new person at age 64, being off the sugar and grains for three years. So I am interested in many different ways to increase vitality and health, have been investingating Weston A. Price website, among others, and drinking raw milk, and learning how to ferment vegetables as well. I find your writing very interesting and am passing that on to some family members with various ailments, such as celiac, psoriasis, rosacea, type-1 and 2 diabetes, among other things, although so far none of those were my problems, but I felt I was headed in that direction. Thanks for all you do.

basha said...

I have started to read your blog--think I got to it through reading some article in the NY Times, and then following links until I found your blog--and have a lot of experience with rejuvenation from eating no grains and sugars diet, actually eating only animal protein, vegetables, both raw and cooked, olive oil and butter, and some fruit--and have realized a much better quality of life, 40-lb weight loss, improvement in various ailments--shrinking of varicose veins, disapperance of plantar faciitis, much higher energy level, and my dentist says that the plaque on my teeth is much more easily removed, although I do not use honey in this phase of my life--one of many sweeteners I stay away from, the only one I use is stevia, both in the processed form, and grow it myself and dry the leaves. I came to eating this way after recognizing an addiction to sugar that I tried to deny my whole life, but finally had to throw in the towel, and now I feel like a new person at age 64, being off the sugar and grains for three years. So I am interested in many different ways to increase vitality and health, have been investingating Weston A. Price website, among others, and drinking raw milk, and learning how to ferment vegetables as well. I find your writing very interesting and am passing that on to some family members with various ailments, such as celiac, psoriasis, rosacea, type-1 and 2 diabetes, among other things, although so far none of those were my problems, but I felt I was headed in that direction. Thanks for all you do.

Medjoub said...

Dr Ayers-

To what extent can dietary honey be a part of an anti-inflammatory diet? Obviously too much risks fructose toxicity, just as with fruits. The WAPF, et al, champion raw honey's antimicrobial properties and trace nutrients, but your analysis seems to relate more to the sugars themselves...

This brings to mind Chris Masterjohn's thoughts on honey fructose --

I find myself growing increasingly confused about just how much fructose a body can tolerate without disease, or just how much starch (from potatoes, not grains) is tolerable without disease.

Thanks for your always interesting posts --

basha said...

I apologize for posting twice, sort of confused about the process here.

Nigel Kinbrum said...

Hi again.

By an amazing coincidence, I've just been speaking to Jay Bryant for the best part of an hour (once I start, I can't stop!). Fascinating stuff!

Cheers, Nige.

Anonymous said...

"Gut flora will convert the fats to secreted shorter fatty acids and hydrogen."

in a series of articles about FIAF in "hyperlipid", i've read that gut flora cannot use fat for energy, can it?

David said...

Dr. Ayers,

I just ran across this article today and I thought you would find it interesting. Perhaps it will go mainstream soon? Ha. Unlikely, but the "do-it-yourself" concept is intriguing...

The Enema of Your Enemy is Your Friend: Fecal transplants could be a cheap and effective treatment for gastrointestinal disorders

Conscious Life said...

Hi Dr Ayers, Thanks for the informative post! While studies have found honey to be beneficial in wound healing, there's little research on whether honey is anti-inflammatory after it's being ingested. There are some debate about this. Some people feel that since honey is largely made up of fructose, it's inflammatory. What are your views? Thanks in advance!

Anonymous said...

Dear Dr. Ayers:
This is a fascinating blog. I have a question for you. I can't find your email address. What is the best way to reach you directly?

MasK said...

Hello Dr Ayers,
what do you know about erythromelalgia? I have the symptoms (sudden burning hands, feets, ears, face or chest with big swollen veins), and I wonder if this could be related to poor intestinal health, as I have leaky gut syndrome (high IgG counts to some foods), and symptoms of low flora levels).
Do you think it can be fixed?
Thank you.

Anonymous said...

Hi Dr. Ayers,
I've read that fermentation of carbohydrates in the colon can stimulate cell proliferation and could thus be a cancer risk.

So I am a bit worried about the supposed benefit of inulin and pectin, even though these studies are about mice...

"In conclusion, both types of resistant carbohydrates (wheat bran and apple pomace) increased polyp number and tumour burden and this was associated with elevated epithelial cell proliferation and crypt fission.".

Is crypt fission a good thing?

Look at these other studies:

"The results showed that inulin significantly increased the number (by 20%) and especially the size (by 44%) of adenomas in the small intestine".


Pensive said...

Honey isn't just dextrose and glucose. It also has levulose which is a long burning sugar and honey doesn't result in sugar spikes.

Honey sugars not only gives energy, but creates an energy that can be used to form new tissues in the body. Honey contains amino acids and minerals needed for the fomation of enzymes. It has biological ferments that are active in energy release. The mineral content of honey is shotgunned for a variety of uses: copper, iron and manganese are helpful in oxidation within the cell as well as being necessary for haemoglobin formulations. Honey also has silica, chlorine, calcium, potassion, sodium, phosphorus, sulfur and magnesium.

The mineral content of honey depends on the flower base from which it comes. All honeys have a degree of vitamin C because all flowers have vitamin C in their nectar.

Honey contains vitamin B-1, B2, vitamin C, pantothenic acid, pyridoxine, and nicotinic acid. Weight for weight, it contains more of these than either fruit of vegetables, and has another advantage. Whereas spinach loses 50 percent of vitamin C in one day after it is picked, honey maintains vitamin C and all other nutrients indefinitely, so long as it's not "cooked".

Honey caps which are cut off before the honey is removed from the comb has the highest levels of all these nutrients, and can be eaten as they are, or the honey pressed out and used.

Honey is not only a perfect "food" medicinally, internally and externally, it's THE food which nourishes a queen bee egg, and produces.... a fully formed functioning bee.

Honey, and eggs are "the" two complete foods in that regard. While the quantities of nutrients are tiny, at a cellular level, particularly topically, they would be enough. And they are available in a form which nanotechnologists would be proud of.

In terms of human use, honey has far more to offer humans than contemporary medicine limits it to.

The darker the honey, the more the concentrations of vitamin C and certain minerals like manganese, silica, iron and copper. Manuka honey is sometimes almost BLACK, and contains very high levels of many nutrients which are necessary for healing. The minerals in honey depend not just on the flower type, but the soil the plants are grown on. Don’t expect to find minerals in honey made from sucrose-syrup.

There is more that could be said about honey composition, and there is considerable debate about constituents, but this is enough for now.

Healing from honey, doesn't necessarily mean "anti-bacterial" just because contemporary medicine assumes that's all that happens. It is very possible that honey is giving the cells nutrients the cell needs, just in the way that the queen bee eggs use honey to build all the elements for a bee.

We will know more about honey definitively, if and when (more likely never )contemporary medicine does decent research on honey, based on expansive thinking, broadened their assumptions and using far better methodology.

Pensive said...

At David re fecal transplants.

This has been done several times, and articles have been written on it.

But I'l wager one ironic thought - that perhaps the day a naturopath does something like this, or comes up with a treatment with a similar Eeeuuw factor.... or prescribes pigworms to "cure" autism, is the day they will be tossed in the slammer.

Jimmy Moore said...

Hey Dr. Ayers! I'd love to have you on my "Livin' La Vida Low-Carb Show" podcast sometime....please e-mail me at if you are interested so we can put you on the schedule. THANKS for your consideration!

Anonymous said...

Hi, All of this is pretty much over my a typical mom I am now searching for anwswers now that I have a daugther who is suffereing from allergies. I have read a lot of what you have written reguarding allergies, and was wondering if you could give any suggestions.
I have a child with severe Peanut (CAP Rast test for IGE is 96) and severe Egg white allergy (CAP Rast 26), and allergic to egg yolk (CAP Rast 4). She also gets hives for what I think are phyisical reasons (scratching/dermagraphism)and possibly the cold (cold urticaria). What got me thinking was that her chronic hives started when she was 2 after she had been on Augmention for 2 weeks for the second time. She has probably taken antibiotics 10 or more times (she is now 7). I am concerned that her gut flora is really poor and she will continue to get additional allergies.
If it were your child, what would you do? Is there any promising reaseach that might help her? Any help/suggestions would be greatly appreciated. Thank you!

Dr. Art Ayers said...

You are correct in associating allergies with antibiotic use. There is very little research on the cause of allergies, but my view is that they start as a combination of inflammation and compromised immunological tolerance resulting from disruption of the gut flora of the colon.

This all means that most people develop allergies because of an inflammatory diet and antibiotic use. Both of these lead to abnormal bacterial growth in the gut, and since the immune system develops in response to those gut bacteria, the result is an immune system that produces antibodies to innocuous proteins in food or even self antibodies in autoimmune diseases.

The choice is to continue typical medical approaches that just avoid the allergens and suppress symptoms with medication. The result will be just more allergens added to the list of sensitivity. The alternative is to rebuild the lacking suppressive parts of the immune system and eliminate the allergies (and eventual autoimmune diseases) over time by a healthy anti-inflammatory diet such as I recommend, combined with rebuilding lost gut bacteria.

Probiotics are a quick fix for about 10% of the lacking bacterial species. Most of the lacking bacteria must be acquired by eating fresh vegetables with clinging live bacteria. Many bacteria are also recruited for the gut from contact with people and animals. Thus, hand washing is OK for decreasing exposure to flu viruses, but it also stops the spread of healthy bacteria needed for normal immune system development.

Cleanliness is next to sickliness. Start composting and have your whole family get involved in gardening and mud fights. You also would benefit from having a dog that spends time digging up bones. Kissing is also very healthy.

Also remember that food "allergies" are usually food intolerances that are caused by lacking the bacteria needed to digest plant polysaccharides. In most cases, these intolerances are best overcome by persistent eating of the food with associated bacteria. For example, most people eliminate lactose intolerance by simply eating live yogurt for a couple of weeks. It is usually that simple, but both the food and new bacteria are needed for a normal gut bacterial community of hundreds of different bacterial species.

Let me know how you do.

María said...

Dr. ¿podemos incluir la miel en una dieta antiinflamatoria? Gracias

Anonymous said...

Dr. Ayers,

Your article further increases my love for honey! My comment below is unrelated to honey, however, to to the possibility that biofilms might be involved in biliary tract infection.

My wife, Pat,has been bothered for many years with right quadrant pain in the vicinity of the gallbladder which on occasion prompts a doctor to prescribe an abdominal ultrasound to check for gallstones. The results of her most recent ultrasound was negative, like all the others, and the doctor's solution to Pat's pain was to prescribe acid blockers. More recently, another gastroenterologist is talking about gallbladder removal even though there are no visible gallstones. Pat will have a hida scan next week which might show something.

Pat has undergone four rounds of antibiotics in the last year which caused sever digestive problems that brought about unwanted weight loss. It seems likely that the antibiotics would set her up for biofilm problems.

I came across an interesting study in Germany about biliary tract candidiasis which found candida infection in 54 of 123 patients (44%). Candidiasis had been suspected in only 7 of the 123 patients. The candida infection was determined from samples obtained by endoscopy. The high percentage of candida infected patients is apparently far greater than expected. (I suppose all of the patient's biliary tracts were infected with something.)

Elsewhere I read that stents are commonly used to open up blocked biliary tracts, but they generally clog up, with biofilms I assume, within four to five months. This problem has yet to be solved.

It seems to me that biofilms may be the cause of biliary tract infections that cause blockage that in turn could cause "gallbladder pain" in the absence of gallstones. This appears to be a very common problem.

I would like to now your thoughts on the matter.

Dr. Art Ayers said...

Jack C,
I just did a cursory read of a couple of sites where people have posted similar symptoms. Surgical removal of the gall bladder does not seem consistent with the findings of an apparently normal gall bladder by ultrasound and over active ejection. Surgery does seem to solve the problem and the otherwise normal gall bladder shows signs of chronic inflammation. I am not an M.D. and these are just my impression.

It seems to me that this is another case of an autoimmune disease with the surface of the gall bladder and ducts as the target and hence the inflammation. I expect that part of the symptom problems is the neutralization of the inhibitor of pancreatic proteases that is the target of the autoimmune attack.

A common trigger for the autoimmunity is antibiotic treatment that wipes out the gut flora of the colon that are involved in normal development of the immune tolerance system of cells that suppress autoimmune disease. The quick cure would be a fecal transplant similar to that used for C. difficil infections. The transplant of normal gut bacteria would restart the suppressive part of the immune system. As you can see elsewhere on this site, fixing the suppressive immune system with repair of gut flora using diet is doable, but slow.

I would expect this type of autoimmune problem to also respond to treatment of the inflammation. An anti-inflammatory diet, such as I recommend on this blog, should be part of the long term solution, but I would also expect anti-inflammatory steroid treatment to work.

Let me know what happens.

Anonymous said...

Dr. Ayers

A little puzzle here after many years of healing but still seem to be missing some pieces.

Briefly, Ive been told I have rosacea, not rosacea, dermititus, yeast etc etc. Bottom line my face is chronically inflamed and more recently I can pick flakes of skin of at will. If not for coconut oil I could not leave my house.

Borderline crippling. Ive done every diet known to man. Most recently Iv spent many years at zero carb. Still no healing. Threw in some yams a few month back and had what seemed like healing for about a week. Then back to flaking.

I read through your blog and started taking some D3 as well as sauerkraut and leeks. Ive always had garlic and some onions throughout.

Not too long ago I saturated myself with raw milk and broke out full body eczema. Very pleasant. For the first time in 8 years I went to see a derm/doc and was prescribed prednisone, steroid cream and doxycycline hyclate. In 3 days I was good as new. In a week the inflammation had left my face and for the first time in about 7 years I could walk around not staring at my shoes. I stopped the steroids after a week and continued the antibiotic and my face continued to look "normal."

Within 2 days of stopping the antibiotic my face was inflamed. Within a week of stopping I could fill a glass with skin flakes from my face. WOrse than ever.

My diet is raw yogurt, grass fed meat, garlic, onion, leeks, some ACV (pectin), coconut cream from thailand and some yams. I also have bone broth (gelatin) that I drink each night. Ive been doing the probiotics and VIt D3 with all this. I get all the exercise and sun I could ever need.

I know you dont treat but if you were in my shoes......

Did I simply stop the antibiotics too soon? Therefore the badguys regrouped stronger...Is it a chronic infection I need to deal with....

I have seemingly perfect digestion (even when taking the antibiotic). When going all meat/fat I had months of pure liquid stool, but figured this was OK. Im now at hourly coconut oil coatings. Used to be just in the morning to get me through the day.

Im well versed in the "dieoff" theories, however my dieoff (off and on)seems to be lasting now 5 years. Whats the deal?

Thanks Bill

Dr. Art Ayers said...

All of your symptoms can be explained by an inflammatory attack of your facial skin by your immune system. That is very loosely defined as rosacea. Inhibiting facial inflammation with steroids or killing the cells of your immune system by using antibiotics to kill gut bacteria needed for the normal development of normal T cells of the immune system, can block rosacea symptoms sometimes.

If you stop the steroids or let your normal immune system start to regrow by stopping antibiotics, then symptoms of rosacea will return.

What you need to do is grow a normal bacterial community of some 150 different species in your intestines. Probiotics can support the aggressive half that can contribute to attacking your facial skin as well as part of the immune system that suppresses attacks. Soil bacteria clinging to uncooked vegetables supply the other hundred needed species.

If you read the rest of my articles, you will also see that many of the needed bacteria grow on the unusual polysaccharides, soluble fiber, present in plant materials. Compost containing thousands of different bacterial species that can utilize all plant molecules provides the normal source of the bacteria than can be domesticated in human guts.

Also find that normal bowel stools are formed from packed gut bacteria and not from undigested fiber. If you had a healthy gut, then you would produce normal, well-formed stools when you eat a variety of different foods, e.g. paleo: meat/eggs/fish/dairy with plenty of different veggies.

You were eating most of the right foods, but they didn't make you healthy, because you didn't have the needed gut bacteria to digest the food properly. Those same bacteria are also needed to trigger the development in the gut of aggressive and suppressive cells of the immune system. If the aggressive and suppressive parts are out of balance, you get diseases such as rosacea.

You might also check out the possibility of a fecal transplant as a quick fix. You cannot regain normal immune system function while taking antibiotics.

Let me know what works.

María said...

Buenas noches Dr.
Necesito su ayuda. Mi médico me ha dicho que no tome más glucosamina porque tiene efectos secundarios cardiacos y renales.
Llevo un año con dolor lumbar y pierna debido a la discopatía y ahora no sé que tomar para poder mejorar los discos intervertebrales. Yo sigo tomando glucosamina pero sin el permiso de mi médico. También estoy tomando colágeno en polvo, ¿qué le parece?¿Es verdad que esto puede regenerar los discos? ¿Qué otra cosa puedo hacer para soportar el dolor? Estoy desesperada, por favor dígame que puedo tomar o hacer. Gracias

Andrés said...

Buenas noches Dr. Hace poco tiempo me diagnosticaron proctitis o colitis ulcerosa. Necesito orientación en la dieta que debo seguir. Los médicos no dan importancia a la dieta y sólo me han recomendado un tratamiento farmacológico. Por favor, sería tan amable de darme unas pautas a seguir para que los síntomas remitan y para que la enfermedad no progrese? Muchas gracias por su labor

Mrs. Ed said...

I thought you might find this interesting. Rush University in Chicago is currently enrolling people with Crohn's disease for a study on the Specific Carbohydrate Diet. They want to see if gut flora can be manipulated by diet. The SCD is a no grain, no lactose and ultra low starch diet. It also uses only honey and fruits for sweeteners. here's the link:

Carmen said...

Dr. ¿qué le pasa? últimamente no tenemos noticias suyas. Espero que esté bien, un saludo

Anonymous said...

To remove biofilm and replace with good bacteria, how many days should we give the whole process? Say I use digestive enzymes, pectin, and fermented food. Thanks!

Dr. Art Ayers said...

Changes in gut flora are based on the persistence/tenacity of the problem bacteria and fungi in biofilms, nutrients in food to support the 150 different species of healthy gut bacteria, and access to the perhaps 50 different species of bacteria that are missing. In some people, e.g. lactose intolerant, only a couple of different species of bacteria are missing and eating live yogurt for a couple of weeks will eliminate the intolerance. Others, e.g. with Crohn's inflammatory bowel disease, are missing half of the health gut bacteria and will require careful changes in diet and systematic access to new bacteria.

The answer is that it may take weeks to years. A quick fix would be a fecal transplant to flood your gut with a healthy established community of gut flora that is already trained to grow on a healthy anti-inflammatory diet.

Ed said...

Dr Ayers, do you think a fecal transplant would be wise after a round of chemotherapy with cisplatin? More broadly I'm wondering what your thoughts are on improving tolerance and recovery of chemotherapy, above and beyond eating an anti-inflammatory diet.

Dr. Art Ayers said...

Cisplatin appears to me to attack solid tumors by complexing with DNA, blocking mitosis and causing apoptosis in rapidly dividing cells, i.e. cancer. The result is lots of collateral damage before clearance via the kidneys. This would also produce lots of systemic inflammation and ROS.

Cancer seems to require the conditions attacked by the anti-inflammatory diet, e.g. NFkB activation, compromised immune system. So the AID is an obvious support for recovering from Cisplatin and cancer. You might also look into support for ROS damage (vit.C, NAC, B12).

I am not familiar with the other supportive components of the chemotherapy (antibiotics?), but would expect them to compromise your gut flora. The question is whether having your damaged gut work with a damaged gut flora is better than flushing out the existing gut flora and replacing it with a healthy gut flora from someone else. My guess is that a healthy foreign gut flora would be more supportive of both your damaged gut, your damaged immune system and the rest of your damaged organs. The healthy gut flora would also be less susceptible to new pathogens than your current, damaged flora and help with absorbance of nutrients/vitamins/mineral.

I can only speculate. Let me know how you do.

Anonymous said...

How long should we give to remove all biofilm and bad bacteria with digestive enzymes and pectin?

Carmen said...

Dr. ¿Qué es mejor para la artrosis y la regeneración del cartílago, la glucosamina, condroitina o el cartílago de tiburón? Por favor ayúdeme, gracias

Anonymous said...

Does honey in high enough concentrations kill both good and bad bacteria?

Steve said...

Hi Dr. Ayers!
Been missing your fantastic posts, this is a major "go-to" site for me to keep trying to digest all the info.
Regarding lectins and glutens entry into the blood stream, I was on the look out for this a while ago and you mentioned you didnt think they did or werent sure of their path into circulation. A recent post by Chris Masterjohn on:
discussed these ideas about the gluten and zonulin connection, which seems to be all well and good for the paleo community but challenges the idea the gluten by itself causes leaky gut. The implication is the biodiversity of the gut flora and I would assume the make up of biofilms an individual has as well. Now we are getting somewhere....
Have you seen a few recent articles on wheat and gut flora, or Chris's post and would you care to take some time out of your busy schedule for your interpretation of events?
Thanks, and appreciate your time.


Anonymous said...

Hello Dr. Ayers,

First time commentor though I have been reading your blog for a while.

I have PCOS and a diet so far that does not go with PCOS- think lots of carbs - particularly sugar.

I have to be on Metformin and lets just say that it is simply something that I cnanot tolerate so far. I get lots of gas and loose stools often in a day even when I take just half of the precribed 1500 mg dose. For example, I took one tab two days ago with food after a couple of onth break and am still feeling the side effects.

M question is - is manifestation of such extreme side effects a sign on imbalanced gut flora? If it is, is there something I can do it fix it asap?

Thanks in advance.

Denise said...


Perhaps you just need to switch to another brand of Metformin.

Read this and see if it helps:


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