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 .

Saturday, August 22, 2015

Common Medicines Make Superbugs, Not Prescription Antibiotics

Careless prescriptions and cattle fattening antibiotics are blamed for the rise of superbugs resistant to everything in the hospital arsenal, but that’s all wrong.  Antibiotics fail, because we are all abusing common medicines that also have powerful antibiotic activity.  All painkillers, anti-inflammatories, statins, antidepressants, and the whole list of common pharmaceuticals are the problem.  We simply use too many drugs.

Common drugs should also be labeled as antibiotics, because they kill the sensitive bacteria in your gut and leave behind just the resistant bacteria.  Unfortunately, the genetic mutations that make your gut bacteria resistant to drugs, also provide resistance to antibiotics needed to stop infections and that broad resistance to antibiotics can spread to pathogens that then become the dreaded superbugs.

Here are the simple facts that I have discussed at length in another post:
  • Statins were antibiotics that were repurposed to lower LDL, “bad cholesterol.”
  • Aspirin was an antibiotic that was shown to relieve pain and inflammation.
  • Metformin was an antibiotic that later proved useful for treatment of diabetes.
  • Many chemotherapy drugs are antibiotics developed for cancer treatment.
  • Diuretics were antibiotics that indirectly reduce blood pressure.
  • Antidepressants, such as Prozac, Zoloft, etc. are antibiotics.

Common Drugs Are Actually Antibiotics
Most pharmaceuticals are derived from phytochemicals, a.k.a antioxidants, adapted in plants to kill microorganisms, i.e. as natural antibiotics.  It is not surprising that drugs = antibiotics.  What is surprising is that people assume that if antibiotics are labeled with some other activity, that they cease to be antibiotics.  All drugs are also antibiotics and that is why a major side effect of most medicines is upset gut bacteria.

Overuse of Common Drugs Produces Superbugs
Simply put, common medicines you swallow, kill bacteria in your bowels.  Some bacteria survive and are called “drug resistant.”  Bacteria accumulate resistances to several different kinds of drugs and are called “multidrug resistant.”  As might be expected, hospitals are the breeding grounds for multidrug resistant, mutant bacteria of all different types.  Unfortunately, anyone who takes several types of medications is also a source for multidrug resistant bacteria, so nursing homes are the most frequent sources of superbugs that cause outbreaks of hospital infections.

The Only Way to Stop Superbugs is to Use Less Drugs
The bottom line is that even if doctors start to use antibiotics more rationally and antibiotic use in agriculture is eliminated, superbugs will still be a big problem, because they will be produced by excessive use of common drugs, i.e. those found on the shelves of drug stores and supermarkets, as well as prescribed by doctors.  


The only solution to the superbug problem is to reduce pharmaceutical use by 99%.

104 comments:

Gretchen said...

I'm curious. When was metformin developed as an antibiotic? Goat's rue, the original biguanide, has been used to treat diabetes since the Middle Ages, when people were not aware that bacteria existed.

Dr. Art Ayers said...

Hi Gretchen,
I didn't say that it was developed as an antibiotic. I just surmised, that consistent with recent studies, Metformin was known to be an antibiotic. It and the original biguanides were present in plants as phytoalexins. The point is that Metformin and other common drugs have sufficient antibiotic activity to select for bacterial resistance. No one is looking for Metformin resistance on multi drug resistance plasmids. I contend that common drugs provide the selection pressure for superbugs.

I am not disputing that traditional herbal remedies are sometimes efficacious, or that phytochemicals can have profound physiological activity. I am merely stating the obvious that phytochemicals provided plants with selective advantage via their biological activity as antibiotics. Repurposing phytoalexins as medicines, does not change the fact that they are first and foremost potent antibiotics that in turn apply selection pressure on bacteria favoring resistant mutants. Moreover, the physiological impact of many drugs depends on alteration of gut microbiota, consistent with the priority of impact as antibiotics.

Thanks for your comments.

Gretchen said...

It was the word "later" that led to my question.

John said...

Hi there Art,

I've personally begun to doubt the idea that antibiotic use is thing that creates antibiotic resistant superbugs. If it's anything, I believe it's a secondary cause.

I think a much bigger issue in regards to antibiotic resistance is the rise of iron levels. Iron intakes in the USA are double what they were 60 years ago, thanks to misguided iron fortification of grains. And thanks to being more sedentary and a number of other factors, people generally excrete less iron than they used to, and so it tends to build up in the body.

What does this have to do with antibiotic resistance? Well, back in 1952, E.D. Weinberg discovered that iron had the ability to completely neutralize tetracycline. On top of this, combining antibiotics with iron chelators like desferal makes them much more effective.

Has anyone in the lab ever used antibiotics to create an antibiotic resistant superbug? If they haven't, I think looking at iron and iron reduction could "magically" make antibiotics much more effective in the coming years.

Anonymous said...

Dr. Art,

We may avoid using prescriptions and over-the-counter medications, but wouldn’t some herbal supplements have the same antibiotic effect?

Lori

Gretchen said...

They've found antibiotic resistance in isolated South American tribes with almost no contact with westerners.

http://www.natureworldnews.com/articles/14191/20150420/scientists-discover-antibiotic-resistance-genes-in-south-american-tribe.htm

yulotid said...

Don't forget Erythromycin as a pro-kinetic agent. I took that for a few months before I found Domperidone. And this (Gastroparesis) all started within hours of a dose of Keflex while traveling. I know first hand, this is not quackery.

Dr. Art Ayers said...

Lori,
Herbal remedies don't produce antibiotic resistance, because the natural antibiotics, phytoalexins are present as a mixture of several antibiotics. Resistance normally develops by exposure of large numbers of bacteria to a single pure antibiotic, e.g. as in the typical use of prescription antibiotics or pharmaceuticals. In most cases the antibiotic target is a bacterial enzyme. The mutation frequency during bacterial DNA synthesis is about one in a million, so in about a billion bacteria, several will have mutations in the target gene that will render the mutant gene resistant to the antibiotic. Plants use at least a half-dozen phytoalexins at once, so the chance of having one bacterium with all of the needed mutations is small.

The bottom line is that purified phytoalexins, i.e. drugs, cause bacterial resistance, but herbal supplements can only shift the populations around in the same way that eating vegetables does. If you persist in using the same mixture of phytoalexins/herbs, then your gut microbiota will gradually adjust.

Thanks for the questions.

Dr. Art Ayers said...

Yulotid,
I don't understand your point. Are you just claiming that phytoalexins have biological activity? Are you claiming that phytoalexins are both antibiotics and impact human tissue? I agree. All drugs have many side effects. First and foremost is disrupting gut microbiota, i.e. as antibiotics.

Dr. Art Ayers said...

Gretchen,
I don't find it surprising that people not exposed to pharmaceuticals have antibiotic resistance genes in their gut microbiome. All plant pathogens have genes coding for enzymes that provide tolerance to the phytoalexins of their host plant. The presence of antibiotic resistance genes merely means that plants with phytoalexins chemically related to the test antibiotics, are present in the diet of the people with the naive gut microbiome. This is related to seaweed eating populations having gut bacteria with the enzyme needed to digest sulfated algal polysaccharides. The enzyme was from marine bacteria that feed on seaweed.

I think that this observation of preexistence of antibiotic resistance genes is consistent with the origin of antibiotics/drugs as phytoalexins.

Thanks for your comment.

Dr. Art Ayers said...

John,
I don't think that iron is a significant confounder in the development of disease resistance.

It is trivial to select for antibiotic/drug resistance in the lab. I did it dozens of times and it used to be a typical laboratory exercise for high school students.

More recent experiments have demonstrated that treating gut microbiota with an antibiotic will select for resistance and orchestrate the transfer of the new resistance gene to preexisting drug resistance plasmids that are the foundation of superbugs.

So, Iron is important, but doesn't explain the details of multiple drug resistant superbugs.

Thanks for the comments.

Gretchen said...

My thoughts were that antibiotic resistance is not simply the result of human activities, so doing or not doing X or Y will never get rid of antibiotic resistance, as some people (not you, obviously) think, but the human activities can accelerate a process that is already there. Sort of like enzymes.

And if good bacteria became more antibiotic resistant, that would be a good thing (for us).





solomani said...

Hi Dr. is there a way to check if medicine X was originally an antibiotic?

Dr. Art Ayers said...

Gretchen,
It is most certainly a bad thing for "good bacteria" to develop antibiotic resistance, because gut biofilms enhance horizontal transfer of DNA between species. That is why there is blurring of species and the species concept among gut microbiota. This means, as has been observed, that treatment with a new antibiotic will select for new antibiotic resistance genes and transfer the new resistance to existing multiple resistance plasmids. Presence of antibiotic resistance genes anywhere in the gut microbiome provides access to both pathogens and commensals.

The antibiotic activity of commonly used drugs maintains multiple drug resistance plasmids in the general population. Reduced use of all pharmaceuticals will reduce the reservoir of resistance genes in the general public and hospitals.

Thanks for your continuing interest.

Dr. Art Ayers said...

Solomani,
The antibiotic activity of common medicines is not typically discussed or provided by the pharmaceutical industry. Several recent conferences have presented studies of the potential use of all groups of modern drugs as new antibiotics. All classifications of drugs that I have seen have been found in recent studies to have antibiotic activities similar to labeled antibiotics. I think that it is reasonable to assume that all medicines have antibiotic activity on some of your gut microbiota. Many drugs, including antibiotics, may be essential for specific medical conditions, so it is wise to use them with care. Thought must be given on how to repair the gut microbiota (beyond the simplistic use of probiotics) after short term drug use.

Health is essentially a healthy diet matched to an adapted gut microbiota. Everything else is minor.

Diet alone cannot produce health.

An adapted gut microbiota can make even extreme carnivore (low carb paleo) or herbivore (vegan) diets healthy.

Thanks for the question.

Anonymous said...

Dr. Ayers,

Why is it so easy for healthy babies to inoculate "adult" flora at only a few years of age?They don't need pro-biotic capsules, ferments, FMTs, etc. They simply just touch, crawl and eat. After an adult damages ones flora via antibiotics - fixing this becomes difficult even with the above remedies. Also, it seems young children are more likely to overcome allergies/intolerances "naturally" by just being kids. The obvious may be because of more exposure outdoors but I know a lot of adults with allergies/skin conditions/digestive complaints who have "dirty" jobs and aren't overly hygienic.

I "outgrew" a bad shrimp allergy (hives when consumed) by the time I became a teenager with zero treatment. Just playing outside as we used to do everyday as children.

Seems now (30 years old), the approach is significantly less effective even with the help of vegetable ferments and completely avoiding pharmaceuticals.


Your post are always interesting.
Thanks.


-Dan

Dr. Art Ayers said...

Dan,
It seems to me that damaging gut microbiota takes more than just antibiotics or hyperhygiene or starvation for prebiotic fiber, i.e. processed foods. It is the combination of several attacks on microbiota. In contrast, toddler gut development is just the opposite of these attacks, i.e. active recruitment, on top of a newborn gut microbiota based on lactobacilli and policed by breastfeeding. Modern practices also corrupt toddlerhood gut development by Caesarean birthrates of 30%, representing 90% excess, and extraordinarily `inappropriate use of formula during the first two years.

So, I would say that today, in developed and even in developing countries, gut microbiota are under attack and it is surprising that some people still remain healthy. We have to recognize that the gut/microbe interaction is robust, but it is being pushed to its Darwinian limits of compensation to a healthy diet/microbiome interaction.

A high priority for medicine is to produce simple approaches for a healthy, adapted gut microbiome. Unfortunately, I think the impetus will be to produce expensive drugs to manipulate gut microbiota. It would be so cheap and easy to broadcast health by incorporating free sources of gut microbiota for repair. Maybe that is a project for the Gates Foundation.

Thanks for your comments/questions.

Gretchen said...

"It is most certainly a bad thing for "good bacteria" to develop antibiotic resistance, because gut biofilms enhance horizontal transfer of DNA between species."

Thanks. That makes sense, but I didn't think of it.

raphi said...

Hi Prof Ayers,

2 separate points

1) "gut biofilms enhance horizontal transfer of DNA between species. That is why there is blurring of species and the species concept among gut microbiota" ==> I've harped on this idea for a while now. It seems to me that the implications for just how much of a problem this is for constructing a 'healthy human gut microbiota profile' is underestimated.

Could it even partly explain why Bifido in the Hadza isn't correlated with benefit vs the correlated benefits seen in the Italian cohort?

2) "An adapted gut microbiota can make even extreme carnivore (low carb paleo) or herbivore (vegan) diets healthy." ==> It is safe to say vegan diets are evolutionarily mismatched and push their adherents towards nutrient deficiencies, ergo they're certainly not healthy. Now, can a certain gut microbiota composition make a bad diet (aka vegan) diet less harmful? Plausibly yes. Although to what meaningful extent I do not know. We know bacteria can poop out K2 & other micronutrients but the quantities needed for health - not just survival - suggest that having them pre-formed in food is by far our best bet. This is not generalizable to all micronutrients but it seems to hold true for the majority so far.

A highly carnivorous diet (not exclusively so) is not 'extreme' for humans & other hominids. In fact, such a diet is strongly supported by isotopic evidence. See Richard & Trinkauss 2009 http://www.pnas.org/content/106/38/16034.abstract.

solomani said...

Hi Doctor,
Thanks for the reply. The reason I ask is because I have recently noticed two things as someone who has suffered from ulcerative proctitis for 25 years.

1) Soil based probiotics have a direct impact on the severity of the symptoms reducing them to the point where I can cut back on medicine.

2) Whenever I have probiotics the same day I have an oral medicine - a mesalazine based anti-inflamtory - I notice the effectiveness of the probiotic decreases.

So was wondering why that was when your article popped into my mailbox. Not saying that is the case - am not sure - but its a lead.

Thanks,
Michael aka Solomani

Dr. Art Ayers said...

raphi,
I think that food need only supply macronutrients, minerals and prebiotics. Healthy, adapted microbiota can provide vitamins. It may be expedient to provide vitamins, but supplements should not be necessary.

By extreme, I only mean all meat vs. all plant. I was not referencing historical evolutionary adaptations, but merely stating that both meat and plants contain prebiotic fiber, e.g. glycosaminoglycans, to feed essential gut microbiota. Problems arise when there is inadequate exposure to microbiota needed for adaptation to the diet -- some species of bacteria are missing.

Thank you for your comments.

wolbachia said...

Health is essentially a healthy diet matched to an adapted gut microbiota. Everything else is minor.

Diet alone cannot produce health.

In a nutshell, these two powerful declarations say it all.

Thank you Dr Ayers for your well conceived theories. Like most environmental and ecological theories, research proving the obvious human gut ecology link against the drugs produced by the pharmaceutical industry may prove to be futile.

Gretchen said...

"Health is essentially a healthy diet matched to . . ."

The problem is that "a healthy diet" means different things to different people.

IsamarDesigns said...

Dr. Ayers,

I just discovered your blog today. Thank you for taking the time to put so much information in one place. I am curious about your thoughts on the use of birth control pills in women and the effects they have on the gut colony. I was diagnosed with IBS shortly after beginning a regimen of birth control pills and have found very little information about whether they affect the gut or not. I tried to look for anything birth control pill related on your blog, but haven't found anything yet...I still have so much to read and learn here.

Thank you for any insight you may provide on this matter.

Heather

wolbachia said...

Health is essentially a healthy diet matched to an adapted gut microbiota. Everything else is minor.

Diet alone cannot produce health.

In a nutshell, these two powerful declarations say it all.

Thank you Dr Ayers for your well conceived theories. Like most environmental and ecological theories, research proving the obvious human gut ecology link against the drugs produced by the pharmaceutical industry may prove to be futile.

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Dr. Art Ayers said...

Gretchen,
When I say a healthy diet, I am speaking very broadly and sweeping from paleo low carb to vegan, as long as it excludes processed foods deficient in prebiotic fiber, seed oils high in omega-6 fatty acids and sugars/purified starch. It is very basically protein and fat macronutrients, plus prebiotic fiber to feed gut microbiota. That seems to me to be a very broad definition of healthy.

The major point is that nutrition typically ignores the essential role of gut microbiota that must be adapted to whatever diet is used. A paleo diet matched with vegan gut microbiota or vice versa is unhealthy. Health is determined by the degree to which the gut microbiota is adapted to the diet. Evaluating diets in the absence of adapted gut microbiota is nonsense. Most modern diets are not matched by adapted gut microbiota and are a priori unhealthy. Modern lifestyles that eliminate casual contact with soil bacteria, expose the gut to numerous antibiotics/drugs, lack prebiotic fiber to feed gut microbiota and produce chronic inflammation, prevent a healthy relationship with our diets.

The medical industry has failed to provide a simple approach to adapted gut microbiota and blocked rapid development of broad, safe, cheap approaches such as fecal transplants. Functional solutions will probably come from developing countries that are not dominated by pharmaceutical industries.

Gretchen said...

> When I say a healthy diet, I am speaking very broadly and sweeping from paleo low carb to vegan, as long as it excludes processed foods deficient in prebiotic fiber, seed oils high in omega-6 fatty acids and sugars/purified starch. It is very basically protein and fat macronutrients, plus prebiotic fiber to feed gut microbiota. That seems to me to be a very broad definition of healthy.

I agree, but Dean Ornish would have a very different definition of a healthy diet. That's why I think we should avoid the term without clarification. It's like "complex carbohydrates," a meaningless term unless you define it.

> The major point is that nutrition typically ignores the essential role of gut microbiota that must be adapted to whatever diet is used.

Again, I agree. I raise sheep, and you have to be careful not to suddenly change their diet, especially not giving them a lot of grain when they haven't had much, or they'll keel over. There's something called "overeating disease" that can kill your largest, hungriest lambs if they get into the grain bin or if you suddenly increase their grain ration. Of course they're ruminants, but the basic premise is the same

I live on a so-called farm and inhale manure particles when I'm shoveling out the barn. I'm a very lazy housekeeper, and if I drop something on the floor, even if I've just been out to the barn, I'll just pick it up and eat it. My water comes from a spring and includes some surface water runoff. I'm pretty healthy. But I still have diabetes.

I've seen more and more standard medical sources refer to gut bacteria, so you're obviously on to something.

gretchen

Anonymous said...

I've just discovered your blog. I care a lot about health and have been brought up in a very health-conscious and anti-medicine environment, however I really had no idea that all drugs should be considered antibiotics. It makes sense and it reassures me that my instinct not to fill my kids with paracetamol etc is correct. However, I take from your tone that you'd probably think I'm an idiot for not knowing this already. I think there's a really powerful message in here and there are many people who would welcome this knowledge if it were packaged in a more inclusive and open format. Anyway I hope I haven't offended you, I just feel very strongly about getting powerful health messages out in the open and it's often too easy for sceptics to dismiss them based on the tone of voice of the writer. I wish you all the best.

Dr. Art Ayers said...

Anonymous,
I apologize for conveying a disrespectful tone to my general audience. I am only expressing frustration with the routine deceit and predatory nature of the medical industry and my own inability, as a scientist, to see through the obfuscation. I am an authority on phytochemicals/phytoalexins and knowledgeable of the history of antibiotics and pharmaceuticals, and yet I failed to see that companies systematically repurposed plant-based antibiotics as common medicines. The witch hunt for abusers of designated antibiotics is a hoax. Most recenty, the pharmaceutical companies have gone beyond the absurd to sponsor research to study re-re-purposing medicines as new sources of antibiotics!

I was trying to be annoyingly clear. To sound the alarm of my recent awareness. Sorry, that I just came across as testy.

solomani said...

Doc, I tend to think it's more likely incompetence over malice for these pharmas.

Peter Dietrich said...

Dr Ayers,

Do you know if synthetic thyroid hormone like levothryoxine has antibiotic action?

Curious,

Peter

Dr. Art Ayers said...

Peter,
I wouldn't worry about the antibiotic activity of synthetic thyroid hormone, since any antibiotic activity will just cause your gut bacteria to adjust, they will become resistant. That's no big deal. You just don't want to do it casually, because it is easier than figuring out why the hormone are low. Doctors are typically more interested in treatment than cures.

Most thyroid supplements are used to compensate for autoimmune attack on the thyroid gland initiated as a spillover of celiac disease. Thus, the initial immune attack in the gut is initiated by inflammation and gut flora damage that mutes immune tolerance. Most doctors are unaware that autoimmune disease spreads from organ to organ with a gradual shift in the antigen targets that are common to different organs, e.g. transglutaminase shared by gut, thyroid, hair follicles, etc. Thus, a more reasonable approach to thyroid hormone deficiency or excess, would be to reduce aggravation of celiac inflammation and renew gut T reg production mediated by gut bacteria. The initial cause was probably antibiotic treatment many years prior to the thyroid symptoms.

I hope this is helpful.

Peter Dietrich said...

Dr. Ayers,

Thank you for your response. I was diagnosed with Grave's Disease (hyperthyroidism) and given radioactive iodine to eliminate my thyroid hormone production, which is unfortunate. Thus I take levothyroxine every day. I also have IBS (diarrhea type) which began almost exactly at the same time of the thyroid dysfunction. I was curious if the antibiotic activity of the levothyroxine was contributing to the IBS.

However if I understand your work, it seems that the cure for both conditions is likely the same approach: an anti-inflammatory diet and fixing the gut flora. While I may be stuck on the thyroid meds forever, I'm hoping to beat the IBS.

Best,

Peter

Dr. Art Ayers said...

Peter,
As I indicated before, your hyperthyroidism would typically result as a consequence of celiac and could have been cured by avoiding grains and fixing your gut flora to provide immune tolerance.

You are in a very common situation that requires medical therapy for what appears to me to be an unnecessary, but medically lucrative intervention. Fortunately, your maintenance is relatively cheap, but you are still left with your initial problem of autoimmune diseases that started with your undiagnosed celiac. You will continue to spawn new autoimmune symptoms until you fix your gut floral

Unfortunately, the medical industry is actively avoiding the development of simple diet/lifestyle approaches to gut flora repair, and hopes to provide patentable alternatives that lead to profitable therapies.

I think that you can start to fix your gut flora and repair your immune system as you indicate, by an Anti-Inflammatory Diet (avoiding grain for your celiac), prebiotic fiber and recruiting new bacteria for your gut flora. I suggest that you badger Tim Steele, et al. at Vegetable Pharm and Free the Animal, until they hack their way to general solutions for repair of gut flora. Many of those people had similar health issues and have fixed them.

Thanks for your comments and questions.



Peter Dietrich said...

Thank you Dr. Ayers, you've been more than helpful!

Peter

Kay Dee said...

Dr. Ayers,

in my experience people that have antibodies against TPO and/or Tireoglobulin in their blood, often they have NOT antibodies against Transglutaminase.

In those cases where's the trigger?

Dr. Art Ayers said...

Kay Dee,
Autoimmunity is dynamic. I think that the autoimmune attack on the thyroid started as a spillover from the anti-transglutaminase attack of celiac. Once the thyroid tissue was exposed, the newly available thyroid antigens were exposed to the tolerance-compromised immune system and a new set of autoantigens dominated. Anti-TPO just shows that the autoimmune attack on the thyroid is years old.

Cure for autoimmune thyroid disease involves avoiding celiac aggravation, lowering sources of inflammation and fixing the gut/tolerance problem. Just adjusting thyroid hormones will permit further progression of autoimmune diseases.

Thanks for the questions.

solomani said...

I'm curious doctor what your view of things like ulcerative colitis is - autoimmune response to gluten? I thought this was the case as I have ulcerative proctitis and for more than a decade I could see a direct link between grain, in particular wheat, on my symptoms. However recently I am not seeing any consistency between diet and symptoms. Though overall my symptoms have improved diet doesn't seem so directly related. It's been a head scratcher for me the last 12 months trying to "troubleshoot" it.

Dr. Art Ayers said...

Solomani,
My initial thoughts on ulcerative colitis is that it is an autoimmune disease distinct from celiac and gluten intolerance, though celiac could lead to ulcerative colitis. The antigen targets for UC are diverse and include many of the nuclear proteins that would be expected to result from neutrophils releasing NETS containing DNA and associated proteins. The associated proteins are nuclear proteins that bind to nucleic acids via basic (+) amino acids that enhance presentation to the immune system.

The bottom line is that UC results in the loss of a larger fraction of the 200 species of gut bacteria, so diet and dairy probiotics may provide benefits, but not a cure. You need to replace 10X more species of bacteria at one time and do it persistently, i.e. fecal transplants have good success at providing a cure. With fecal transplants over weeks or months and a diet adapted to the transplants, it should be possible to cure UC with relative ease and reasonable expense.

I hope this explanation is helpful.

Kay Dee said...

Dr. Ayers,

I can’t understard this point: how can Celiacs disappear without Gluten avoidance?
Example: my mother have Hashimoto from 20 years (anti Tiroglobulin/TPO Antibodies); she always kept eating gluten in large amount.
Today she have always anti Tiroglobulin/TPO Antibodies and she have NOT (anti Transglutaminase Antibodies.

Thanks for your patience.

solomani said...

Hi Dr, yes its helpful and would explain why large dosages of pill based probiotics - like Elixia and the like - improves the condition and symptoms. But does not cure it at all.

aqdrk said...

Well, for one, Metformin introduces bile acids in the colon by shutting down their reabsorption in the ileum. That's already sufficient antibiotic activity. But I believe that in non- and pre-diabetic patients with gut flora imbalance that could possibly be a potent short-term (1-3 months) tool to repair the damaged gut lining. That is also a tool to allow antibiotics such as Rifaxmin to do their job in the colon, since it needs bile to dissolve. It's all about how you use this. In my opinion, Metformin could be a valuable tool in the early stages of the war to shift gut flora back to healthy balance.

Gretchen said...

There's some evidence (1 report) that metformin works in the colon.

http://www.eurekalert.org/pub_releases/2015-08/uonc-ddm081715.php

Anonymous said...

Hi Doc!

Great post as always.

I would really like to hear your thoughts on mold illness. I strongly suspect that one of the main reasons I haven't been able to heal my gut (done fermented veggies, diet changes, and pretty much everything else you suggest on the site) and overcome my health issues is that my house is contaminated with toxic mold.

Do you think mold exposure and mycotoxins in our environment (home, workplace, etc.) are something to be concerned about and/or that it can block repair of gut flora? Perhaps people with a damaged gut microbiota, and hence, a compromised immune system, are more susceptible to mold toxins (?)

Really hoping for a reply (or maybe even a small blog post on the topic (?)) as I think this is something a lot of people wonder about.

Dr. Art Ayers said...

Gretchen,
I would say that most drugs act via action on the gut microbiome, so metformin acting primarily in the lower gut is no surprise. That fact that gut dysbiosis is common would predict that many drugs would have high individual variability of action, and that is what is observed. Statins are an example. Statins have barely detectable impact on heart disease, even though they are very effective in lowering LDL, but statins have easily measured side effects. Since statins have substantial antibiotic activity, any heart/vascular benefit is probably as antibiotics and the steroid impact is irrelevant.

Mathew Arnold said...

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JSNoelle said...

Dr. Ayers,

I just tested very high in D-Lactate in a urine test. From what I understand, this means that I have an overgrowth of certain bacteria in my gut but I'm having trouble figuring out what I need to do to fix this. Anytime I eat dairy or carbs I have a worsening of brain fog, fatigue, anxiety and depression. I feel like I am in a drunken stupor most of the time. I have encephalopathy as well. What would you recommend? I feel a little bit better after I go carb free for a few days but I know its not going to be enough to get better. I would really appreciate your insight. I don't have a shorten bowel either.

Thank you,

Noelle

Green said...

Hi Noelle

I have the same condition as you. SIBO (small intestinal bacterial overgrowth) causes the symptons. I have understood that it is very hard to cure, I mean, where are the success stories? Gut dysbiosis has gone too far to be solved with simple answers.

JSNoelle said...

Hi Green,

How did you find out that you have SIBO and what treatments have you tried? I asked my GI doctor about my test results(she didn't order the test, it was through another doctor) and she had no idea what it meant and had never heard of the test. You think after seeing that someone has 25x more d-lactate than normal she would have had an idea since its her specialty.

I have come across some success stories but I don't know if they are long term or not. I think in order to have success you really have to completely change your diet long term which is very hard to most people to stick to. I think most people just take a short course of antibiotics and don't get results from that. You are right, it is so complicated.

Hope you find some relief,

Noelle

Green said...

@ Noelle

I don´t have any official diagnosis. When i eat (prebiotic)fiber or foods containing D-lactate producing bacteria strains (e.g from kefir or sauerkraut) I get exactly same symptons as you.

Fermented products used to be fine but this all started when I ate too much Natto (soy beans fermented by Bacillus subtilis). That strain somehow hit the last nail on the coffin I guess. (Prior to this all I had also got couple autoimmune diseases)

If you Noelle consume those fermented products I think you should at least consider stop doing so.

The fiber is problematic too, I am very careful with prebiotic fibers.


The thing is:

Treating SEVERE gut dysbiosis is a Catch22

-Soluble fibers and resistant starch are feeded to nonexistent good strains and to more pathogenic bacteria (or overabundant symbiotic bacteria) in your colon (or small intestine). Thus, symptons only get worsened.

-But If you don´t eat fibers, you starve some symbiotic strains that are left.

What strains person x should increase, what decrease. How and in what order. Each case is partially unique.

Gut composition is so complex with all the strains, their DNA, host DNA, bacteria interactions, their metabolites etc.

Ed said...

Hi Dr Art,

I was wondering what you thought about MAP (Mycobacterium avium paratuberculosis) being a key root cause of ulcerative colitis and Crohn's disease, as discussed by John Brisson?

http://fixyourgut.com/map-cause-crohns-disease-ulcerative-colitis/

Wow, googling a bit suggests that MAP may be related to a number of chronic diseases - Blau syndrome, type 1 diabetes, Hashimoto thyroiditis, and multiple sclerosis. Freaky!

http://www.ncbi.nlm.nih.gov/pubmed/25788897

And further (I know this is too much, but it's too interesting...)

http://crohnsmapvaccine.com/pdfs/ACDP-MAP-and-Crohns.pdf

Ed said...

Yo Dr Art - I just had a thought - you should write this up for the medical hypothesis journal.

Anonymous said...

Dr ayers
be rberine a plant alkaloid is promoted for health.....especially ampk activation and lipid lowering.
however I am concerned about antibiotic effect and gut biome disruption. Perhaps no better than statin?

Hap, MD

Dr. Art Ayers said...

Hap,
My impression from reading the biomedical literature is that statins are not very effective in lowering the risk of cardiovascular disease compared to many other approaches to lower inflammation. Statins effectively lower lipids, but I am not convinced that lipid lowering makes sense for diseases initiated by inflammation. Statins, berberine and metformin all have antibiotic impact on gut microbiota, but statins have the most severe side effects that seem to me to far outweigh their slight benefit. It seems to me that gut microbiota can adapt to drugs, but drugs of all types are overused by a ridiculous factor of perhaps a hundred fold. From an antibiotic resistance perspective, I think that we should learn from plants and only use drugs in combination and never chronically. This approach would necessitate a new focus on cures vs. chronic treatment.

Thanks for the questions.

Anonymous said...

Dear Dr Ayers

Statin lowering of LDL does have some beneficial effect on atherosclerosis, but we are finding that it's anti inflammatory effect through various signaling and inhibition of NFkB, TNF a, il-6 by direct action is probably more important. there may also be effects on selectins and other adhesion molecules related to endothelial dysfunction. I went off my atorvastatin due to adverse effects, preferring now to stay with low dose aspirin, CoQ10, K2, and low dose naloxone....which also has inhibitory effects on inflammation via the mu opioid receptors on macrophages and microglia. Folate will also inhibit ROS via Nadhp ase pathways. Strange because activated macrophages in atheroma express membrane receptors for Folate receptor Beta while normal monocytes do not. We need to learn how to interfere with lipid peroxidation because oxLDL is the culprit which initiates the inflammatory cascade.

I took Metformin for many years due to the reports of cancer chemoprevention and found it very beneficial to lipid profile....which I tested every year. One of these days I will "weigh in" on certain medical literature related to new finding about metformin affects in colon, strangely and inadvertently identified in FDG PET scans (I am a radiologist), and of course t he AMPK activation.

Clearly, Chinese used Berberine for antimicrobial effect and berberine potentiates the antimicrobial affect of many antifungal and bacterial drugs. Its all in Wikipedia I still wonder about the benefits versus the drawbacks.

the problem with atherogenesis is that once we get "wise" to the negative affect of our lifestyles and/or food choices, hygiene, and drug effects, the process is already well underway, if that is hand dealt. Endothelial dysfunction is the earliest changes in the process and primarily silent. So the vast majority already have atherosclerotic disease which makes the question of prevention untenable and "cure" problematic. Have to move on to the next level in the disease process and hope for arrest or reversal, which is possible. But it is even worse in clinical cardiology because the first sign of CAD in half the patients is a fatal heart attack....ooops. Monotherapy, as you have suggested, is a cul de sac in multifactorial diseases of chronic abuse or senescence. It does require some consideration of drug combinations.

Hap MD

Anonymous said...

I would like to clarify a few potential misleading statements or even errors of my previous comment.

naloxone.....seems to have anti-inflammatory effect on both circulating or localized macrophages that is "non opiod" which is poorly understood and mediated differently. But...I will accept the mu receptor hypothesis as still valid.

AFIK we do not know exactly why activated macrophages express substantially increased FR beta receptors. This is further complicated by the notion of polarized macrophages as well as a number of different macrophage phenotypes (which can be changed by signaling from one the same macrophage) that are considered proinflammatory and anti inflammatory. I have questioned experts in the field since I am working on a folate receptor conjugate that can be used to externally image macrophages in atheroma , potentially stratifying fibrous from vulnerable plaques. They do not know why FR beta is expressed or whether someone on folate supplemation is exacerbating or reducing risk. Cold folate will partially block the affinity of receptors for conjugated folate used in imaging. However, FR beta is considered a Trojan horse for the introduction of drugs for diagnosis and therapy of macrophage laden plaques. The kind that want to cause big trouble. I read that folate also affects the production of ROS in plaques through a NADPH ase pathway. I would leave that to the biochemist to expound as something else for folate to be doing in addition to a cofactor in DNA synthesis.

Lastly, it is misleading to say oxLDL activates monocytes, although this is conventional wisdom. Research shows they can be activated in the presence of LDL if other processes are present.

Oh yeah....I will owe you all some explanation of how metformin affects the interpretation of PET scans in colon and why that is.

Hap

Anonymous said...

Hi Dr Ayers,

Found your wonderful blog several weeks ago. Thank you for taking the time to explain so much. Having dysbiosis for over 10 yrs and with constipation I can relate to a lot of what you say. too many antibiotics for uti's gut never the same

My vit d is very low but have a hard time taking it It gives me the jitters tried taking 400 iu and still feel jittery once with coffee I felt so shaky I have taken with eggs or yoghurt but still have same effect.

Anyone know what this means and if I can do something that would not make this happen?

Thanks
Joann

Charlene said...

My daughter has been on a Weston A. Price diet for 5 years for a crippling rheumatoid arthritis: avoidance of processed foods and seed oils; emphasis on raw milk, cream, butter, wild seafood, grass fed meats, organ meats, eggs, kimchee, fermented cod liver oil and butter oil. Avoidance of all medications. The diet has allowed her to go from being bedridden with pain for a year, to eventually returning to college, graduating, getting a full-time job and living her life fully.

However, she still struggles with some stiffness in her joints. She has been reading about gut microbiome and decided to try high dose soil-based probiotics - without changing anything else in her diet. What she experienced was alarming swelling in her joints. So much so that she thought her disease was progressing again. It took her a few weeks to recognize that the cause of the swelling might be the probiotics. She stopped taking them and within 2 days the swelling in her joints went down - even more reduced than before taking the probiotic. In other words, a noticeable improvement.

But now the question is: what should she do? Should she cycle probiotics on/off and maybe enter another inflammatory phase hoping it will reduce when she stops the probiotic? What might be happening in the gut with all those microbes that an introduction of probiotic pills would trigger more swelling, only to have the swelling reduce significantly once the probiotic is stopped? Have any of those organisms colonized her gut?

I'd appreciate any insight you can offer. Thanks so much for your blog.

Charlene

Dr. Art Ayers said...

Charlene,
I think that your diet sounds fine except for what you left out: prebiotic/soluble fiber from vegetables. We need fat and protein, and our gut bacteria and fungi need prebiotic fiber, e.g. resistant starch, inulin, pectin, veg. beta glucans. So, if you were short on prebiotic fiber, your gut bacteria could not produce all the vitamins you need.

Different species of gut bacteria determine development of either the aggressive or suppressive halves of the immune system. Autoimmune diseases are caused by loss, typically by antibiotic use, of the species of bacteria in the gut that stimulate the development of the immune cells, Tregs, that control immune attack on pathogens. Loss of that control results in attack on body tissues that are inflamed, e.g. the start of arthritis. Attack on joints results in pain and stiffness. Reducing dietary sources of inflammation will reduce the magnitude of the attack and symptoms, but the immune system will not heal until the gut bacterial community is repaired by reintroducing the missing bacteria needed for the development of the suppressive immune system.

You daughter still has symptoms of inflammation, and inflammation blocks the production of vitamin D in the skin. Hence, your daughter would typically also be deficient in vitamin D, which will also encourage inflammation. So serum vit.D needs to be measured, appropriately supplemented and then retested to make sure the deficiency has been remedied (high normal range). It is also important to avoid other sources of chronic inflammation, e.g. dental infections.

Large amounts of probiotics should provide a temporary fix for the immune system and a return of both the aggressive and suppressive parts of the immune system. So your daughter's immune system may have been mostly fixed by the probiotics, but a difficulty of the suppressive immune system from the gut, is that the suppression is specific for antigens presented in the gut. Unfortunately, some of the autoimmune antigens in the joints showing symptoms of immune attack, may not be present in the gut to initiate a suppression of attack on those antigens. The result would be a renewed aggressive attack on the joints following probiotics.

The answer may be the use of prebiotic fiber, especially resistant starch, along with meat acting as a source of joint proteins.

I have written several articles on repair of gut flora. Please read up on reducing hygiene and picking up new bacteria from the environment/raw veggies. Also note that most gut bacteria are obtained from other people, so make sure that the rest of the people around your daughter have healthy gut bacteria, i.e. do not have autoimmune symptoms.

Thanks for your questions. Let me know it my suggestions are helpful.

Gretchen said...

Another paper on metformin and gut microbiota. This suggests that the effect is beneficial.

http://www.eurekalert.org/pub_releases/2015-12/uoct-nri120215.php

I confess I haven't tracked down the original paper in Nature.

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Natasha said...

Dear Dr. Ayers,

I don't see my comment about the T-reg research yet. I emailed Dr. Bluestone and had an immediate response. He said that the immune treatment is being handled by an outside company: http://www.caladrius.com/

Perhaps I need to make my comment again. They are researching taking T-regs from "recently" diagnosed T1D. Growing them in the lab, and then infusing them back. They say that the effect was for a year.

Here is the "news" version:
http://www.telegraph.co.uk/news/science/science-news/12016532/End-of-daily-injections-for-diabetes-as-scientists-restore-insulin-production.html

The research is being conducted by Dr. Bluestone (UCSF).
http://profiles.ucsf.edu/jeffrey.bluestone

Here is his lab: http://bluestonelab.ucsf.edu/

Thanks,
Natasha

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Ab said...

Hi Dr Ayers,


I would like to have you write an article for our website so that more people get to know the insights u have presented here and benefit from it.

Am willing to compensate for ur time. Please get in touch thru my email attached with this comment if u feel that's possible.

regards,
Ab

Charlene said...

Dr. Ayers,

Thanks for your suggestions on fine-tuning my daughter's diet for rheumatoid arthritis. She does eat salads and potatoes, so I believe she is providing some of the prebiotic components needed for a healthy flora/fauna. She is not overly hygienic, but she is not around dogs so does not have a lot of exposure to dirt.

I've made note of your comment about vitamin D deficiency and am purchasing a UV-b desk lamp for her - hopefully that will stimulate vitamin D production for her. Recent reports about fermented cod liver oil suggests that that food source for vitamin D may not be adequate.

I was thinking about what you said about the lack of joint antigens in the gut and that being the reason the suppressive immune system has not reduced her inflammation. In my search for UV phototherapy options, I ran into information about UV blood irradiation. I know it sounds kookie, but the man who discovered this therapy - Niels Finsen - won a Nobel prize in medicine in 1903 for figuring out that taking a small sample of blood from a patient, shining UV light on it briefly, and then sending it back into the patient produces an auto-vaccine that was effective for healing lupus. Other doctors up until 1940s launched a serious campaign against infectious disease, cancer, auto-immune disease using this therapy and found it effective.

My daughter lives in California where there are some doctors using UV Blood Irradiation.. I've suggested she try it. If she does try it, I will let you know the outcome.

Dr. Art Ayers said...

Charlene,
I don't understand your approach to vitD supplementation. As I see it, chronic inflammation, as exemplified in arthritis, shuts off vitD production by solar UV in the skin. That means that using a UV-B lamp will do nothing. It doesn't matter how much UV is applied to the skin of someone with chronic inflammation -- their skin can't use UV to produce vitD.

I don't know why someone would use cod liver oil as an inconvenient source of vitD, when capsules of known vitD content are cheaply available.

VitD supplements, at high doses, can be used to suppress inflammation sufficiently to reestablish solar skin production of vitD, but that should be done under a doctor's supervision. Test, supplement, retest. Studies show that most doctors do not understand vitD production and just wrongly assume that the mdr for vitD is adequate. As a result, most people under a doctor's supervision for vitD deficiency remain deficient after supplementation.

I don't feel comfortable with the blood UV irradiation protocols. It seems to be poorly studied and makes no scientific sense to me. A quick search brings it up on medical scams.

Let me know of your daughter's progress.

shishir patwa said...

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Thanks

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Charlene said...

Hi Dr. Ayers,

I do admit uncertainty about vitamin D supplementation. I've read that high-dose vitamin D supplementation - esp. D2 - can lead to soft tissue calcification (heart attacks?) and that there are many forms of vitamin D -not just D2 and D3 - that are best taken in concert as from food sources. Vitamin D taken at high levels can cause toxic effects which are mitigated by vitamin A & K2 (which is why the Weston A. Price foundation recommends cod liver oil along with high vitamin butter oil - the former has A & D, the latter contains K2).

http://www.westonaprice.org/health-topics/abcs-of-nutrition/on-the-trail-of-the-elusive-x-factor-a-sixty-two-year-old-mystery-finally-solved/#interactions

I had not heard that chronic inflammation shuts down vitamin D production from sunshine, I wonder what the mechanism for that would be.

Although this is from a site for Dummies, it gives a table for how much sunshine gives you 1,000 IU of vitamin D.
http://www.dummies.com/how-to/content/how-much-sun-do-you-need-to-make-vitamin-d.html
Considering that a serving of fermented cod liver oil only gives 1000 IU of vitamin D, it seems sun exposure esp. during summer is much more efficient - and enjoyable. We don't get much sun in winter in northern hemisphere, so I was wondering if UV lamps might be a reasonable substitute.

Not sure about the quality of this study, but the abstract suggests that UV-A helps relieve symptoms of rheumatoid arthritis.
http://www.ncbi.nlm.nih.gov/pubmed/3440328

Yes, I am aware that Google and Wikipedia don't give credence to UV blood irradiation. But, I'm not ready to give Google and Wikipedia much credence as a source of unbiased, non-Big Pharma-influenced health information. Dr. William Campbell Douglass, MD, seemed to take his Hippocratic oath of "Do No Harm" seriously, and he wrote "Into the Light" which documents the use of UBI. He was quite an enthusiast. But, I understand the need for caution. And, I agree, more current research on this would be helpful.

Thank you, Dr. Ayers, for raising these questions. Really helps to have someone to brainstorm with.

Charlene





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Anonymous said...

http://www.eurekalert.org/pub

Dr Ayers,

thought you might like link above goes along with what you have said re tregs


Joann

Brown Ada said...

The patients themselves, professionals as well as the drug design centers should pay attention to this matter. Only with the combined effort, can less related side effects will occur to people.

Bennett said...

I guess Joann was referring to this:

http://www.eurekalert.org/pub_releases/2015-11/uoc--ift112415.php

Natasha also posted about this above

Tregs are isolated, expanded and infused back into the patients to treat autoimmune disease (Type 1 Diabetes in this case)


Any comments, Dr.Ayers?

Allison Warren said...

AMAZING! I have taken several of these drugs and had no idea they were originally antibiotics! No wonder I have had periods where I lacked immunity to everything. Thank you for the post!

Aaron Grey said...

Hi, can I contact you through your email? I've something to share that might interest you.

Aaron
aarongrey112 gmail.com

kay Dee said...

https://www.sciencedaily.com/releases/2008/01/080125223302.htm

DR. Ayers, what about this article?

Anonymous said...

This all sounds well and politically correct as you certainly are but you could never in a million years have the guts to deal with problems all through the history of the world when there were no "drugs" and where hundreds of millions of people died all the while eating biome rich organic food.

Anonymous said...

should say "...of people died from diseases and widespread outbreaks"

Gregory R.H. said...

Good day Dr. Ayers. Why don't you post anymore? Hope everything is alright with you!

Greg

Dr. Art Ayers said...

Greg,
I have few good excuses: distraction with some of my own research and trying to put together ideas with too many missing pieces.

Thanks for your concern, but I am fine. Merely perplexed with big picture explanations of allergy and autoimmunity.

Dr. Art Ayers said...

kay Dee,
I am familiar with the work on vitamin D participating in disease. Vit.D is after all a steroid hormone with a cytoplasmic receptor that acts as a transcription factor. Healthy people with a healthy adapted gut flora do not benefit from any vitamin supplements. Thinking that we obtain meaningful amounts of vitamin D from food, seems silly to me. Also the impact of inflammation on solar production of vitamin D is ignored. It is very complex and there is minimal new research.

Anonymous said...

Dr Ayers,

Glad you are doing fine. Only found this blog several months ago. Appreciate all your efforts.

Would you know why vitamin d supps would cause jitteriness? Even at low dose. My d is very low and need to supplement
and am having a hard time with it. its creeping me out. Feeling like Im harming myself I do take with food such as eggs or
yoghurt.
Thanks in advance

Joann

Kay D. Mitochondrial said...


Dr Ayers,

below the Barry Sears suggestions on his last article - obviously I would enjoy your impression ...

"
Polyphenols Dramatically Improve Colon’s Bacterial Composition
This second article demonstrated the ability of polyphenols to dramatically improve the bacterial composition of the colon. (See study from Diabetes Journal.)
Since the colon is virtually devoid of oxygen, any trace of oxygen coming from our human side of the gut barrier may destroy important bacterial strains for which oxygen is toxic. One of these is known as A. muciniphila.
This particular microbe appears to one of the “best of the best” microbes in the colon’s ecosystem as it not only heals a leaky gut, but also reverses weight gain as well as stimulating satiety.
One of the great mysteries of polyphenols is that while only very small amounts ever enter into the bloodstream, they somehow can generate profound health benefits. This study suggested an intriguing new possibility that polyphenols can change the microbe composition by acting as the ultimate anti-oxidant to remove any remaining traces of oxygen that may have leaked into the colon. As a result, high levels of supplemental polyphenols demonstrated a dramatic increase in the levels of A. muciniphila in the gut along with a corresponding decrease in inflammation, reduction in body fat, and regaining of blood sugar control in the body. By decreasing the oxygen content in the alien world of the colon, the oxygen-rich world of the body was dramatically improved.
"

Dr. Art Ayers said...

Kay D. Mito,

Thanks for the chance to shout about plant polyphenolics, aka phytoalexins.

"Polyphenolic" and "antioxidant" refer to a group of plant secondary metabolites, produced from either the amino acid phenylalanine or from lipid precursors that yield terpenoids. The adaptive advantage of these chemicals to the plants that produce them is that they are bioactive, i.e. they bind to biological molecules such as proteins/ enzymes. Phytoalexins disrupt biological processes to kill microorganisms that are problems for plants, plant pathogens.

Plant polyphenols/phytalexins are natural antibiotics and are typical sources for the development of pharmaceuticals. That is why pharmaceuticals are also very good antibiotics.

It seems silly to me that it is concluded that adding polyphenolics are altering gut flora by lowering colon oxygen levels. There is no evidence presented to support that idea. All they show is that microbiota composition changes when polyphenolics are added to the diet. One should expect that the polyphenolics are still active as antibiotics and that these phytoalexins kill bacteria and alter gut microbiota. Some of the gut microbiota are more tolerant to those particular phytoalexins and their numbers increase. One would not expect the overall numbers to decrease, but just their relative numbers should change. That is what was observed.

Those polyphenolics will also not act quickly on oxygen. The oxygen level in the mucin layer inhabited by A. muciniphila adjacent to the colon cells will be regulated by oxygen leaking from the colon cells and consumption of oxygen by nearby bacteria. The changes in bacterial levels and the physiological impact due to polyphenols can all be explained as a result of changes in the microbiota metabolism due to phytoalexin impact on gut microbiota.

Dr. Art Ayers said...

Anon
Jitteriness with vit.D

First off, vit.D deficiency is not normal and has a cause, typically chronic inflammation. I cannot divine your particular cause, but can try to explain typical situations.

Most of the people that I know who respond with symptoms to vit.D supplements, suffer from SIBO and that is also the cause of their chronic inflammation.

There are numerous cures for SIBO that involve decreasing nutrients to feed the bacteria in the small intestines, and repairing the bacteria in the colon. Improving acid production in the stomach and using dietary plant polyphenolics to reduce SIBO are also helpful.

It sounds to me that you would benefit from a typical paleo diet of meat/fish/eggs and plenty of low starch vegetables.

Personally, if I had your symptoms, I would just buy a copy of Tim Steele's "The Potato Hack," and start eating boiled potatoes until all of my symptoms went away. You could monitor progress by occasionally taking a low dose of vit.D and checking your jitters. If you can't tolerate the potatoes, then you need a more extreme repair of your gut flora.

Let me know if this helps.

Anonymous said...

Dr Ayers,

Thank you for that. Yes I do have gut problems IBS is what GI doc called it over 10 yrs ago I knew what happened Antibiotics
for UTI's and since I could not use some anti's was given Floxin several times Eventually my gut didn't return to what it was before I have "coped" I take probiotics every day for all these yrs It helps but no fix
Couple yrs back I had tooth root canal infection which then had to take Clindamycin That one was weird after one week My stool didn't look the same very small almost pellet size and color like chocolate then a strange taste in back of throat
which eventually subsided.
Paleo is great except for the constipation. Then I resort to spaghetti or oatmeal or eggplant to get movement
Most of my symptoms are lower and usually are the next day

Having new symptom of itchy bumps that derm telling me bug bites which they are not

I didn't connect the dots that Vit d and jittery would be connected to my gut

No problem with potatoes Ill get the book and try it use to have dairy problems but not anymore. Raw and fermented is a big deal ….takes almost a week to recoup and I don't look too good either pale and sick My family usually think I have a stomach flu and they are nurses! not their fault, symptoms are odd

Well, I didn't mean to rant I'm so sick of thinking and talking about it I forget ….its my new normal not so new anymore


Thank you for listening

Joann

Dr. Art Ayers said...

Joann,
I would be surprised if you were not also taking PPIs for acid reflux, since SIBO causes acid reflux and PPIs cause SIBO. Typically, people are give antibiotics that kill the gut flora and SIBO and IBS start up. Then they are given PPIs for the associated acid reflux and the PPIs lower acid and facilitate more bacterial growth in the small intestines.

Many people in your situation with a total killing of gut microbiota and resultant constipation, also develop rosacea from the SIBO.

The simplest/safest solution is a fecal transplant with plenty of dietary soluble fiber to which the donor's microbiota was adapted. That would just take a couple of weeks under a doctor's supervision.

Otherwise, introducing a hundred new species of bacteria, which were killed off by your antibiotic treatments, is a hit or miss proposition. Your only sources are bacteria your environment and food. Since your gut flora didn't recover after the antibiotics, there must be few bacteria available in your environment and few remaining on your food. You need to have an extended family with kids that play in the mud, pets that have access to the outdoors and food fresh/minimally washed from the garden. Excess hygiene is your enemy. Health is contagious, but not for the isolated. You would not have this problem, if you had dirt floors with a "pot hole" at the head of the dinner table.

Let me know how it goes.

Anonymous said...

Dr Ayers,

I so agree with everything you said. I asked my daughter about a donation for a fecal transplant few yrs ago. at that time
she hadn't heard of it. She recently said one of her patients family members said the patient had an implant and was cured
But of course that was for c diff.
I don't take any meds. no ppi's Having a bad day today ….wonder what I ate yesterday……is about how it goes
Yes, I understand about the need for "unclean" food. That was one of the things you wrote about in your blog. And I knew you knew what is going on with this mess I got myself into.
After several years I figured out since every time I took an anti I could eat anything without a problem. It took about a month
to get horrible symptoms….bloating, intermittent diarrhea etc to the point where I wouldn't eat or only ate soup and an egg
then after 6 months I was almost "normal". In my craziness I devised a cope which was to never eat anything uncooked no salads, no fruits. for 6 months no dairy take probiotics and be careful not to introduce any bacteria since I figured I don't have the "good guys" to compete with the "bad guys" Then I would Take a chance to see what I could tolerate
Double edge sword!
From what I know the fecal implant is only available for Cdiff patients that do not respond to meds.
I do have dogs I was in an extended family environment Not now my kids are on their own

You are the only person that understands what I'm talking about. it seems weird, almost lol

Joann going to try the potato hack

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navillus said...

Hi Art,
I have been following you for about 4+ years. I recently did a 3 day potato hack to see if it would help with my RA inflammation. I experienced more aches during the 3 days. Fourth day when I returned to my regular diet which still included some RS potatoes the aches got a bit better. I am not a true believer in the herxheimer effect. I have been eating cooked/cooled potatoes a la Tim Steele prior to starting the potato hack. So I don't think it was something new I was introducing to my system. Is it a process and maybe I should try again. I certainly don't need to lose weight (5'3" and 107 lbs).

An another question on RA... what is your opinion of the Boron deficiency for RA sufferers. I have read where some have used borax in a diluted concentration or even dipped their fingers into borax and taken it straight as such. Thanks for your help!
Marybeth

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Hi Art,
One more try,what's your take on LDN for autoimmune diseases? Hope you will answer!
Thanks

Anonymous said...

I miss your posts, Dr. Ayers. Do you plan to start up again?

-Nate

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Anonymous said...

In two months it will be a whole year without a post!
Your posts made my perseption of life, health and daily activiies change 180ยบ.
I'm kind of sad wandering wether you won't write anymore...

Kay D. Mitochondrial said...

Exactly the same

Anonymous said...

And I also miss your posts, Dr. Ayers. I hope you realize the positive influence you have had on many people. We appreciate it.

Lori

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Prof. Ayers,

you absolute HAVE to read the article below, written by Barry Sears on Alzheimer/amyloid/inflammation

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Hope I will soon enjoy you comment.

K.

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Anonymous said...

Dr. Ayers, I hope your are doing well, I miss your informative and scientific posts about inflammation. Have you heard anything new about Atopic dermatitis (Eczema)?

Anonymous said...

Hi Dr. Ayers, I'd like to ask your opinion on chaga tea which is said or even proven to be antimicrobial. If it really is antimicrobial, is that good or bad? Does it kill beneficial bacteria, too?

I'd be really thankful for an answer.