Let’s jump into another edition of Health News Reviews! Today we will discuss gluten and brain fog, stomach autoimmunity, ketogenic diets and performance, probiotics and depression, probiotics and diabetes, sun exposure and gluten intolerance, and more…
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Paleo f(x) (Microbiota Tests) … 00:00:50
Probiotics & Type 2 Diabetes … 00:05:50
Gluten-Sensitivities & Living-Location … 00:13:52
Probiotics & Fecal Microbiota … 00:15:55
Probiotics & Depression … 00:19:05
Dr. Ruscio Resources … 00:21:12
Maternal Vitamin D Deficiency … 00:22:12
Ketogenic Diet & Physical Fitness … 00:22:53
Anti-Parietal Cell Antibodies … 00:25:49
(click gray Topics bar above to expand and see full outline/time stamp)
Low-FODMAP Diet … 00:29:38
Low-FODMAP Efficacy with IBS … 00:31:00
Gut-Brain & Alcohol Dependence … 00:31:40
Celiac Disease – Brain Fog … 00:33:50
Episode Wrap-up … 00:36:14
Download Episode (Right click on link and ‘Save As’)
- Effects of Probiotic Supplements in Patients with Type 2 Diabetes: A Meta-Analysis of Randomized-Controlled Trials
(click green Links bar above to expand and see all links/references)
- the Future of Functional Medicine Review
- Lower Prevalence of Celiac Disease and Gluten-Related Disorders in Persons Living in Southern vs Northern Latitudes of the United States
- Alterations in Fecal Microbiota Composition by Probiotic Supplementation in Healthy Adults: A Systematic Review of Randomized Controlled Trials
- The Effects of Probiotics on Depressive Symptoms in Humans: A Systematic Review
- Does Maternal Vitamin D Deficiency Increase the Risk of Preterm Birth: A Meta-Analysis of Observational Studies
- Impact of a 6-Week Non-Energy-Restricted Ketogenic Diet on Physical Fitness, Body Composition, and Biochemical Parameters in Healthy Adults
- Anti-parietal Cell Antibodies – Diagnostic Significance
- How to Institute the Low-FODMAP Diet
- The Evidence Base for Efficacy of the Low FODMAP Diet in Irritable Bowel Syndrome: Is It Ready for Prime Time as a First-Line Therapy?
- The Link Between Inflammation, Bugs, the Intestine and the Brain in Alcohol Dependence
- Gluten-Induced Cognitive Impairment (“Brain Fog”) in Coeliac Disease
Health News Reviews – Updates On: Gluten and Brain Fog, Stomach Autoimmunity, Ketogenic Diets and Performance, Probiotics and Depression, Probiotics and Diabetes, and Sun Exposure and Gluten Intolerance
Dr. Michael Ruscio: Hey, everyone! Welcome to Dr. Ruscio Radio. This is Dr. Ruscio.
Paleo f(x) (Microbiota Tests)
Let’s jump into another edition of health news updates. But before we do, I wanted to make a couple notes regarding Paleo f(x) this year, because at the time of this recording, I just got back. And there was a couple of things that I wanted to share, not much, but a few.
One thing that was really nice to see—I sat on the “What Your Microbiota is Telling Your Gut” panel on Friday. It was Dr. David Perlmutter, myself, Dr. Josh Axe, Dr. Grace Liu, and Dr. Will Cole—and it was nice to see that, generally speaking, it seems that the aggregate opinion of the panel has shifted to recognize that some of the microbiota tests, that are interesting for research purposes and an important part of the data gathering process like American Gut and uBiome and other tests that give you essentially a detailed mapping of your microbiota, are not clinically relevant.
I felt like I was the only one saying that last year. Maybe not the only one, but I felt like an outlier saying that last year. And this year, it seems like people were also getting onboard with that. So that was very comforting to see. Although, it was disheartening that even though that point was made at least twice clearly on the panel, once by Dr. Perlmutter and once by myself, when we got to the question section at the end of the panel, there were two questions that were directly in violation of understanding that, which were essentially, “I have low actinobacteria. What can I do about that?” It’s just like, “Gosh, we just explained how you don’t need to custom treat your microbiota. And that there’s, that’s not a good idea.”
So sometimes, admittedly, it is disheartening when you take time to explain something to someone, and it’s like it went right in one ear and out the other. And I think it points to this common desire, which is to find the one thing that you have to address. You look at a lab report. Everything looks good, except for this one thing. So if you can improve this one thing, you’re going to get healthier. But again, just because something on a lab flags high or low, it doesn’t mean that that actually means anything. And that that finding is tied to any kind of intervention. So we made that point clearly on the panel. But some people still seem to not have fully digested that concept. So maybe, okay, maybe we need a few repetitions to totally let that sink in.
That was really the main thing. I did not admittedly go to many of the lectures. I just had too much going on with chatting with people, but definitely some interesting stuff going forward. There has been a very nice welcoming of the gut work that I’ve been doing by many people. And it’s been really nice to see, if I may just be a bit candid here. Gosh, how do I say this? So I look at it like you can make an argument for your approach to gut health that’s built upon kindling, which are just little bits of paper that burn quickly and brightly, but then fade out fast.
And I’ve seen some people with approaches like this that were very well marketable, meaning they were interesting. But I knew that they weren’t clinically sound because I had been going with a different approach of, I guess like a log, which takes a while to light, but then has a slow, consistent burn, and is more of what you want. You want slow, consistent results or an approach that is solid. I guess.
So what’s been interesting to see is that there’s really been a nice embracing of the gut approach that I’ve been bringing to the table. And so I’m very happy with that. Admittedly, it’s very gratifying and validating to see. While some of the concepts I advocate aren’t super sexy in terms of, “Here is the next miracle bacteria that we can get swept away in,” even in spite of that, I think people are starting to realize that this cost-effective approach, this gut-first approach, this practical approach based upon clinical literature and not interesting speculation based upon mechanism or what have you, is actually quite a bit more sound. It’s producing results.
And there’s definitely a few, I guess, big names in the Paleo movement who had good results with some of the recommendations that I’ve been making. And I wanted to say thank you for that. So it’s nice to see that this stuff is really getting, I think, the attention that it deserves, and really because it works. And it works because it’s based upon clinical information. So that was nice. So I’ll stop tooting my own horn here. And we can get on to some of the research literature. Okay.
Probiotics & Type 2 Diabetes
The first study, “Effects of Probiotic Supplements in Patients with Type 2 Diabetes: A Meta-Analysis of Randomized-Controlled Trials,” so our highest level of scientific evidence. Twelve trials involving 770 participants were enrolled. Now, here’s essentially what the reductions that were found were.
So maybe to take a step back, probiotics may be able to help with metabolism. But we want to be careful in quantifying how much will a probiotic help with metabolism, right. And this gets down to the message that I’ve been advocating for a while. We can conclude, and media snippets will oftentimes say, “The probiotic that can, you know, help with your weight loss or the missing bacteria, that’s the cure to your diabetes,” because of one study that showed improvement in the blood glucose. But the improvement in the blood glucose was like two points, right. So if your fasting blood glucose, which shouldn’t be maybe above 99, goes from 103 to 101, that’s nothing, right. And that may have been statistically significant, meaning the numbers weren’t due to chance, but not necessarily enough to be clinically meaningful.
And so I say that so when we look at these numbers we want to look at these numbers specifically so that we can get a good opinion, an aggregate opinion, when we analyze all the data, “Okay, probiotics, diabetes, what’s the effect?” So fasting blood glucose, in this case, 11 point reduction. So that’s not bad. That’s enough to be meaningful. It’s only slightly meaningful. But that’s meaningful. Also, keep in mind that this was in a group of type 2 diabetics. So these people are definitely going to be able to respond well. It’s like someone who is very overweight. They have a lot of room for improvement with weight loss. These are diabetics. They have a lot of room for improvement with blood sugar regulation, so 11 points.
Serum insulin concentration decreased by two points. So I’d say similar, meaningful, but only mildly meaningful. And there was no significant reduction on hemoglobin A1c, which was interesting because you would think because of the anti-inflammatory effects of probiotics that that may have had a positive impact on hemoglobin A1c. So hemoglobin A1c is a 60 to 90 day average of your blood sugar. But that can be falsely elevated if someone has inflammation.
Now, what may have been the issue here is the length of follow-up of these studies, on average, may not have been sufficient to allow enough time for the hemoglobin A1c to be impacted. So if these were eight-week trials, that may not have been enough. And I actually don’t know, off the top of my head, what the average length of the trials were. I’m assuming at least a month, probably more like two to three months.
So there was also significant effects on lowering total cholesterol, which was lowered by eight points. Triglycerides, which was lowered by 22 points. Both of those I think are…The triglycerides are more significant than the cholesterol. But both are mildly meaningful, in my opinion. And there was also an elevation in HDL. There was no change in LDL in this reading.
Now, one of their ways of…And I was just writing about this actually for an upcoming edition of the Future of Functional Medicine Review clinical newsletter. One of the ways that probiotics lower cholesterol is by the probiotics actually deconjugating bile or breaking apart bile. And when that happens, your intestines can’t reabsorb and reuse the bile. So your liver has to make more bile. And when your liver makes bile, it uses cholesterol. So you lower cholesterol because you’re using more of it to make bile. This is why certain bile binders have been shown to lower cholesterol. Anything that binds bile or sucks bile out of your system, so to speak, will require your liver to produce more bile. And that requires cholesterol to do so. And that’s how there’s cholesterol-lowering. So that’s something interesting there.
Now, a couple of other things there that are important. The results showed multispecies probiotics had a stronger reducing effect than did single strains. Okay. And they also showed that a duration of over eight weeks would be more impactful than under eight weeks. So this definitely suggests that the follow-up, as I was mentioning earlier, is probably at least eight weeks in some of these studies, so that last point important—multi-species probiotics.
The reason I mention that is because sometimes again, we get swept into this model of thinking, “I pooped in the cup. And it said I was low in this strain of bacteria. So I should find a probiotic that has just that strain of bacteria.” And that is absolute crap in terms of a concept. There has been no study, to my knowledge, showing that stool test predicts responsiveness to probiotics—very, very important. There was one, I think, nutritionist—maybe she was an acupuncturist—who asked that question at the end of the panel as a part of the Q&A.
And it’s disheartening that people are being fed this line of information. I don’t know by who. Or maybe, they’re just trying the inferences on their own that what you see on the stool test is going to tell you what probiotics you need. And that’s not the case. We want to look at the interventional trials, and try to look at conditions, and see if we can get a slight guidance, in terms of, what conditions may respond best to what probiotics. But we’re not looking at these probiotics in your stool via a stool test predicatively in terms of telling us what probiotics you’re going to respond best to. So here, it just looks pretty simple. Multi-species probiotics have a better effect.
I also want to say this quickly, that while I’m not a huge advocate of prebiotics, not because I have anything against prebiotics—they never did anything wrong to me—but when you look at the reactions, they’re more prone to cause reactions in many people with sensitive digestion, so I’m a bit cautious with them. I also think that clinically, the utility have been grossly overstated by microbiota enthusiasts. But the one area where they show the most benefit, and I read about this in the book, is with blood sugar, with decreasing blood sugar.
There have been some studies—and I may be slightly off here in my
numbers—but some studies showing as high as 50 to 60 point reductions in fasting-blood glucose using prebiotics. However, the doses were about, I believe they’re about, gosh, 50 grams per day. I’m sorry, 20, 20 grams per day. So usually, you see at least 100 milligrams—I’m sorry, 1,000 milligrams or one gram in a prebiotic supplement.
So if we go all the way up from one gram, three to five grams may be the dose that most people tolerate and don’t have negative reactions to. So it’s like the safest dose where you get some benefit, but not much detriment. These studies used 20 grams. And the researchers commented that there’s a pretty high incidence of side effects in these patients. Gastrointestinal side effects that is. So this can be a therapy that can be impressive for lowering blood glucose, but at the cost of potentially causing some GI side effects.
Gluten-Sensitivities & Living-Location
Next study. “Lower Prevalence of Celiac Disease and Gluten-Related Disorders in Persons Living in Southern vs Northern Latitudes of the United States.” So to quote, “In this population, a higher portion of persons living in a latitude above 35º”—so that’s like the Mediterranean-ish region of the globe—so “above 35º have a greater incidence of celiac disease and/or avoid gluten than persons living south of this latitude. This was found to be independent of race, ethnicity, socioeconomic status, or body mass index.”
So the theory behind this is that people that live in darker areas that have less exposure to sun may have more autoimmune conditions because of the impact of sunshine, and therefore, the vitamin D and other health benefits vectored by sunshine on the immune system. Now, this may not be an airtight case because sometimes what you see is a higher density of Westernized societies in the more northern latitudes. So I wouldn’t say it’s a bulletproof case that has no points of refute, but I also think we’ve clearly seen that vitamin D can be helpful for autoimmune conditions. So what does this mean for you?
It means get some sun exposure, and don’t be overly fearful of the sun. And we’ve talked about this in other posts, and videos, and podcasts, and what have you. But there is definitely evidence that sunshine, all things considered, does more for your health than takes away from your health. And sunshine seems to have no impact, and maybe even a slight protective effect against some skin cancers, but definitely has a protective effect against other types of cancers that are more common and more deadly than skin cancer. Okay.
Probiotics & Fecal Microbiota
“Alterations in Fecal Microbiota Composition by Probiotic Supplementation in Healthy Adults: A Systematic Review of Randomized Controlled Trials.” So essentially, this study is looking to see what effect do probiotics have on the microbiome. Seven trials were included in the investigation. And the data quality was found to be high. Now, they observed no effects on the fecal microbiota composition in terms of alpha diversity, richness, or evenness. And there was one study that found that probiotic supplementation improved the structure of the bacterial community in terms of beta diversity when compared to placebo.
So does this tell us a whole lot? In my opinion, no. It’s more so to illustrate that there’s still a lot we’re learning about the microbiota, which is why I continually make the caution that we want to be very careful with microbiota tests that give you the whole map out of your gut microbiota and your diversity scores, because we’re still figuring a lot of this out. We’ve discussed many studies that have shown positive, clear positive clinical benefit from probiotics. Not to say everyone is going to do well in them, and some people may not have reactions. But clearly, there is a wealth of data showing that probiotics can be helpful.
Now, what’s counterintuitive here is that if diversity is so important for you, then why do we see the compound of probiotics, which have been shown to have so much benefit, have no effect on diversity? It may be because of the way the microbiota was quantified in the study. There’s definitely variation in the way that these can be quantified and how diversity is scored, the methodology that is used. So there’s a lot there that we still don’t know.
And what that translates to—another way of saying that is the microbiota stuff, to use a broad term—testing, interpretation, correlation—is preclinical. It’s academic. And that may be one of the reasons why we see here that at least this fairly well-performed systematic review of randomized controlled trials of probiotics did not show a significant impact in terms of favorably impacting diversity.
There have been other studies that have shown that probiotics do improve diversity. And there have been other studies showing that probiotics can help the microbiota rebound more quickly after antibiotic administration. But this may trump those studies because this is a systematic review. So instead of looking at one study, this aggregate finding shows us that there may not be a huge impact of/or from probiotics on the microbiota. But we still know that the probiotics that we’ve talked about in terms of clinical trials for clinical conditions show a lot of benefits. So another reinforcement of why I’m cautious with how much we take away from these academic microbiota tests.
Probiotics & Depression
“The Effects of Probiotics on Depressive Symptoms in Humans: A Systematic Review.” Ten studies met the criteria and were analyzed for effects on mood, anxiety, and cognition. Five studies assess mood. Seven studies assess anxiety. And three studies assess cognition. To quote, “The majority of the studies found positive results on all measures of depressive symptoms; however, the strain of probiotic, the dosing, and duration of treatment varied widely.”
Now, you can look at that in one of two ways. Here’s how I look at that. The strain, the dose, and the duration doesn’t matter that much because irrespective of there being different strain, dose, and duration, there was still found to be significant impact on depression, anxiety, and cognition. So again, there is one of two ways you can generally approach healthcare medicine, or your personal health research, or your personal health plan. You can look to make things more complicated, or you can look to make things more simple, or simpler or simplified. Sorry.
So in this case, we see here, I think, a pretty good piece of evidence that shows that we can make this simplified. We don’t have to be trying to go through painstaking results to find the miracle bacteria. In fact, one of the things that was a bit frustrating, or not frustrating, disheartening about some of the questions at Paleo f(x), is people were still thinking about this one bacteria that was low on a stool test or on my microbiota test or my American Gut test. And how can I adjust that? And it’s like, “God, you look at all these studies. How many studies do we need to see that show none of these were done based upon people’s testing? These were just giving people, who had certain symptoms, probiotics. And we found that many different forms of probiotics were effective.”
Dr. Ruscio Resources
Hey, everyone, in case you’re someone who is in need of help or would like to learn more, I just wanted to take a moment to let you know what resources are available. For those who would like to become a patient, you can find all the information at DrRuscio.com/GetHelp.
For those who are looking for more of a self-help approach and/or to learn more about the gut and the microbiota, you can request to be notified when my print book becomes available at DrRuscio.com/GutBook. You can also get a copy of my free 25-page gut health e-book there.
And finally, if you’re a healthcare practitioner looking to learn more about my functional medicine approach, you can visit DrRuscio.com/Review. All of these pages are at the DrRuscio.com URL, which is D-R-R-U-S-C-I-O.com, then slash either “Get help,” “Gut book,” or “Review.” Okay. Back to the show.
Maternal Vitamin D Deficiency
“Does Maternal Vitamin D Deficiency Increase the Risk of Preterm Birth: A Meta-Analysis of Observational Studies.” Pregnant women with vitamin D deficiency during pregnancy have an increased risk of preterm birth. So certainly, something to keep a look out for. If you are pregnant, trying to get pregnant, then make sure that your vitamin D levels are at least above, this study found, underneath 20. So you want to be above 20. And I would say forward to 50 nanograms per milliliter would be a safe area of the range to shoot for.
Ketogenic Diet & Physical Fitness
Okay, next study, “Impact of a 6-Week Non-Energy-Restricted Ketogenic Diet on Physical Fitness, Body Composition, and Biochemical Parameters in Healthy Adults.” So they’re going to put someone on a ketogenic, and they’re not going to calorie restrict them. And they’re going to see how they perform. They detected a mildly negative impact on physical performance in terms of endurance capacity, peak power. And the athletes were faster to exhaustion.
So there was no major…And let me just read the quote here. “Our findings lead us to assume that a ketogenic diet does not impact physical fitness in a clinically relevant manner that would impair activities of daily living and aerobic training. However, a ketogenic diet may be a matter of concern in competitive athletes.” So it’s something to keep in mind there. If you’re a ketogenic, you may want to reconsider that if you’re a high-level athlete.
Now, for the rest of us, what does this mean? Well, one thing is if these people were what is called keto-adapted, meaning they were in ketosis for longer and their metabolism had a chance to adapt to that, maybe they wouldn’t have seen these negative changes. Okay, that’s one thing to consider.
The thing I think is more salient is sometimes when we say low-carb, people think ketogenic diet. And there’s a big difference between those two. A low-carb diet is a diet where you’re going to restrict, in my mind, excessive levels of carbohydrate intake and focus mostly on vegetables, maybe a little bit of fruit, and a little bit of starch, but mostly vegetables.
A ketogenic diet, there’s a big difference between a lower-carb diet and a ketogenic diet. And to give you some specifics: a low-carb diet may be anywhere around 100 to 150-ish grams of carb a day, but a ketogenic diet, you’re going to get down to like 30 to 50. And just that movement from 1 to 150 down to 30 or 50, really results in you being able to have a little bit of carbs in a day. You can have one fruit. Or you can have a little bit of rice. Or you can have whatever. You can have a little bit of that. It’s enough to get some carbs into the system and not make you feel totally deprived.
But then, when you go down to a ketogenic diet, all those things go out the window. And it becomes much more difficult. So it’s important, I think, that when we say, “lower-carb diet,” we don’t mean ketogenic diet, because the ketogenic diet or ketosis is going to be hard for you to comply with, and may not be necessary for most people. Other than those who have pretty frank metabolic impairments like being frankly overweight or a diabetic, and then a short-term application of the ketogenic diet may be a good place to start and then doing some experimentation from there.
Anti-Parietal Cell Antibodies
“Anti-parietal Cell Antibodies – Diagnostic Significance.” What are anti-parietal cell antibodies? Well, they are antibodies to the parietal cells in the stomach. And the parietal cells in the stomach produce hydrochloric acid. Now, up to 40% of those who have Hashimoto’s thyroid autoimmunity may have these antibodies. And really, if you have any autoimmune condition, you’re at an increased risk for these antibodies.
But I also want to be careful, because that is often said. And it, I think, freaks people out into thinking that they have a strikingly high chance of having all these other autoimmune conditions and maybe get scared—because they have thyroid autoimmunity, which is like the most common thyroid condition—that they’re going to come down with something that’s much more rare, like multiple sclerosis. And we just have to be careful.
And actually, Chris Kresser and I were having a discussion about this over some really delicious barbecue in Austin, which is just because someone experience a tripling of their risk, if that risk was .8 to begin with, then that tripling is not highly impactful, or highly significant, or a cause for alarm. And I know we’ve talked about this on the podcast before. Now, that being said. It has been shown that 20% to 40% of those with Hashimoto’s, for example, will have these anti-parietal cell antibodies.
So just a couple of notes here from the studies. These antibodies are more prevalent in the blood of patients with type 1 diabetes, autoimmune thyroid disease, vitiligo, and celiacs. And they recommend that people with autoimmune diseases should be closely screened for these antibodies. And the other issue is that the issue can develop over a long period of time. And it can promote the damage of the stomach to the point where people will become hypochlorhydric.
Now, what do you do in terms of treatment? Well, there’s some debate regarding if H. pylori eradication can help with that. And according to this paper, about 20% of people with these antibodies are also found to have H. pylori. And there are some evidence showing that the treatment of H. pylori can improve these antibodies. And there’s other evidence showing that the treatment of H. pylori will do nothing for these antibodies. So it’s certainly worth looking into and addressing H. pylori if it’s present. But it’s not a guarantee.
There have been two, maybe three clinical trials. I know at least two that were performed in the 80s on a gluten-free diet. And it did not have any effect. “Ah! What?!” Yeah, I’m sorry. It didn’t have any effect. So maybe there’s other stuff that we have to do, like the two studies done in Japan that have shown that the administration of vitamin B-12 has been able to arrest these antibodies. I think this is one of the most overlooked areas of the autoimmune crowd.
And if I can just be a bit candid, I’m referring to the autoimmune crowd that does a robust amount of autoimmune testing only to tell you to take like a handful of antioxidants and go gluten-free harder, and harder, and harder. Even though a lot of the autoimmunity tests have not been shown to be clinically valid, a lot of them are missing this because I see patients who have gone to these doctors. And they scare the bejeezus out of these people, and have them live like nuns. And they don’t, in some cases, get any better.
And I’ve never heard anyone being recommended the vitamin B-12 therapy for these parietal cell antibodies, which probably have some of the best clinical data behind them. So I think some of the educators over there need to remove their heads from a certain orifice of their body, and start incorporating this in to their teaching. Okay, so before I piss anybody else off, let’s move on to the next study.
“How to Institute the Low-FODMAP Diet.” So this is a simple study on the low FODMAP. So it should be applied strictly for an initial period of four to six weeks. And then, if it doesn’t work, one should look into other issues that may be driving the symptoms or may be leading to the non-responsive. And these are things like SIBO, amongst others. However, this paper does conclude that this should be effective for the vast majority of people. After that initial strict period of four to six weeks, the goal should then be a relaxed FODMAP diet, where one reintroduces foods and eats foods that are higher in FODMAP or restricted on the diet to tolerance.
And I think that’s important to mention. I know we’ve discussed this before in the past, but a diet isn’t necessarily meant to be followed super strictly forever. It’s used as a tool to help guide awareness about foods that may be problematic, also to help with healing in the short-term. And then, in the long-term, we always want to be trying to move to the broadest diet possible.
Low-FODMAP Efficacy with IBS
And in another FODMAP study, “The Evidence Base for Efficacy of the Low FODMAP Diet in Irritable Bowel Syndrome: Is It Ready for Prime Time as a First-Line Therapy?” And to quote, “In conclusion, clinical trials and observational studies support the notion that a dietician-led low FODMAP diet is ready for prime time and should be considered as a first-line therapy for patients with IBS where the use of a restrictive diet is appropriate.” So we’re seeing some pretty compelling evidence here regarding the utility of the low FODMAP diet.
Gut-Brain & Alcohol Dependence
Okay, just a couple more studies here. “The Link Between Inflammation, Bugs, the Intestine and the Brain in Alcohol Dependence.” Essentially, what this study shows is the gut-brain connection. And they essentially discussed how chronic and excessive alcohol consumption…And let me just stop for a minute and say this does not mean that you can’t go out to dinner on Saturday night with your girlfriends and get a little cray-cray and have a few drinks. Okay. That is fine. We’re talking about alcoholism level of alcohol intake. We’re not talking about moderate and occasional use. So let me just be clear in saying that so that the overzealous of us out there don’t go off the rails with this.
But alcoholism level alcohol intake will lead to a fairly substantial leaky gut. This allows bacteria into the bloodstream. This then increases inflammation. And the inflammation can also cause neuroinflammation, which can lead to mood alterations. So this just shows the very profound gut-brain connection.
A couple of other things I should mention there. Routinely, I see patients that have things like brain fog, and depression, and what have you, improve when we improve the health of their gut. That probably goes without saying. The other thing that also happens is people’s alcohol intolerance improves, which I’m actually happy to see because again, I don’t believe in making people live like health nuts in order to be healthy. I think the whole point about becoming healthy is so that you can be robust and go out and do stuff and enjoy your life.
And so I’m happy to see that people have increased alcohol tolerance, as their gut health improves, so that they can enjoy those indulgences whenever they arise. Part of the reason for that may be the gut in this whole pathway we just discussed. Part of that may also be the liver, because everything in the gut drains into the liver. So leaky gut, you’re probably going to have an overtaxed liver. And that’s going to make it harder for you to be able to tolerate alcohol.
Celiac Disease – Brain Fog
Okay, the final study here, “Gluten-Induced Cognitive Impairment (“Brain Fog”) in Coeliac Disease.” So essentially, we’re starting to see this brain fog term be more so recognized, and I’m happy to see that. And just a few quotes here. “These mild degradations of cognitive functions, referred to as ‘brain fog,’ are yet to be formally recognized as a medical or psychological condition. However, subtle tests of cognitive function are measurable in untreated patients with coeliac disease and improve over the first 12 months’ therapy with a gluten-free diet. Such deficits also occur in patients with Crohn’s disease, particularly in association with systemic inflammatory activity. Thus, cognitive impairments associated with brain fog are psychologically and neurologically real and improve with adherence to a gluten-free diet.”
So in summary, we can measure brain fog and quantify that. And we do see improvement of that in the gluten-free diet. And we also see when people have inflammation, namely as in Crohn’s disease in their intestines, that also correlates with brain fog. So we’re starting to see that brain fog is a real thing, and that there are ways that it can be treated.
And, of course, that makes sense. You may have gathered that I’m big into looking at symptoms as a way of predicting the potential therapies that may be needed or to predict what may be going on in someone internally, instead of just looking solely at lab tests. So I believe in treating the person, not the lab tests, or ideally treating both.
In this case, when someone says they have brain fog, I am certain there is some type of neurological problem that is present. And now we’re saying that, yes, these things seem to be scientifically quantified. And then, when we do things like a gluten-free diet for those who are gluten sensitive and the brain fog improves, these tests that measure the cognitive impairment also improve. So we’re seeing that brain fog is becoming a legitimate concept.
Episode Wrap Up
Okay, that it is for this edition of Health News Reviews. I hope you guys are getting a lot out of this. Also, remember that if you’re a healthcare provider or you’re trying to sharpen your clinical skills or even if you’re a lay person who is really interested, The Future of Functional Medicine Review Clinical Newsletter has been super helpful for the clinicians and doctors that have been reading it thus far.
But I think not everyone is still on the same page in terms of what that is. It’s a monthly newsletter written exclusively for clinicians or health enthusiasts who want to get prescriptive with all of this stuff that we talk about. And there is one case study a month. There’s three to five research studies that are summarized a month. There is one practice tip. And there is practitioner question of the month. So, so far, it has been great in terms of the feedback that we have gotten.
But I have had a few, actually a few doctors who are patients at the clinic. And they said, “So, tell me what that is again.” And so maybe I wasn’t clear enough in some of the materials that we put out to describe it. And I’m planning on doing something else, too. Maybe like a screen recording to help people see what this actually is. But essentially, it’s a multi-section newsletter that’s meant to take this information that we discuss and really bring it to another level of clinical applicability and clinical detail.
So if you haven’t checked it out, check it out. You can access the January edition, the full January edition, completely free if you go to DrRuscio.com/review.
All right, guys. We’ll talk to you next time.
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What do you think? I would like to hear your thoughts or experience with this.
Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.