microbiome

Drugs for Ulcers; Extreme Dangers of Long-Term Use

April 23, 2016 by James Bogash

Ulcer drugs and your micrrobiome — Adobe Stock / freshidea

If you’ve got a bleeding ulcer, drugs that block acid like Nexium, Prilosec and Aciphex can save your life. Even if that ulcer is caused by your daily anti-inflammatory.

However, for the remaining 99% of the time that acid-blocking drugs are used, they can wreak havoc.

You see, the body digests….and it does everything else. When it comes to digestion, stomach acid is the lynchpin. The key. The big daddy.

Stop the production of stomach acid, and you open up the Mother of all Pandora’s boxes. Stomach acid does not just participate in digestion, it STARTS it. Among many other things. Here is just a small sample of what stomach acid does in the human body:

The most obvious function is the digestion of proteins.
Most other digestive enzymes are produced in an inactive form (otherwise the enzymes would digest the very glands they are made in). Stomach acid activates these enzymes so they can work.
The pH of the stomach has to be low enough to tell the pancreas to release bicarbonate. Stomach acid ensures this happens. Without it, the pH of the contents released from the stomach (chyme) stay acidic and can damage the entire length of the intestinal tract.
Stomach acid turns on certain anti-cancer compounds in foods (like indole-3-carbinol in cruciferous veggies).
Stomach acid is needed to absorb certain compounds like iron and B12.

There’s one other little ditty that stomach acid does. There are very few microorganisms that can survive a pH of 2 or 3. In other words, stomach acid sterilizes most things that try to make it through the stomach.

That means that if you do not have enough stomach acid because you are, say…taking Nexium…, bacteria will begin to grow in regions of the intestine that are not supposed to have bacteria growing in them. The technical term for this is small intestine bacterial overgrowth (or SIBO, for short).

And if you want to pick something that can totally screw up your health, SIBO is a good first choice. Having bacteria growing where it is not supposed to be begins to damage the lining of the small intestine, allowing things to get into your body that are not supposed to. This can create massive amounts of inflammation everywhere, even in the brain.

Just in case you think I’m making this up, researchers in this particular study looked at the gut flora of the lower intestinal tract (microbiome) of 1827 healthy twins to see if proton pump inhibitor (PPI) use had any negative effects.

Here’s what they found in those PPI users:

There was a lower number of normal gut bacteria (commensals).
There was a lower microbial diversity (the “mark of death” when it comes to a healthy gut).
There were a higher number bacterial from the oral cavity (again indicating that these bacterial are not getting killed off in the stomach), with a special mention of the Streptococcaceae family.

The list I gave earlier is really bad enough when it comes to destroying your health. But when you add in a disruption to the microbiome, the sky’s the limit to how much damage long-term use is to your health.

And just what is “long-term?” If you read the safety labels, then anything over 3 months is completely out of context of what these drugs are designed for. That does not mean that I haven’t seen patients on these for DECADES. THAT is a disaster waiting to happen.

But what about all those patients out there that make too much stomach acid and need these drugs?

I will go out on a limb and state that almost NO ONE who has reflux or gastritis makes too much stomach acid. Quite frankly, short of a gastrin-producing tumor, it just doesn’t happen. As a matter of fact, with stress and with aging, stomach acid production goes down. It gets to the point where some 40% of women over 50 are not producing any stomach acid AT ALL (achlorhydria).

I’m not saying that stomach acid getting where it’s not supposed to be is a good thing, because it’s not. What I am saying is that stomach acid is not the problem. Usually, the problem is just the opposite. I can’t tell you how many times I’ve given digestive support to patients with gastritis or reflux and their symptoms went away.

Kind of ironic that this approach to totally opposed to the mainstream medical approach and yet seems to work very well.

All without destroying your microbiome and your long term health. What a bargain.

Pneumonia and Antibiotics? Surprisingly Bad Mix

March 26, 2016 by James Bogash

It never ceases to amaze me how much mainstream medicine has moved away from understanding and supporting normal physiology.

There was just a commentary in the Journal of the American Medical Association (JAMA) on primary prevention of atherosclerotic coronary heart disease. (in English: the article was about how to prevent a first heart attack)

I went into the article thinking it was going to cover lifestyle and targeted supplementation that has been shown, in medical research over the course of decades, to strongly prevent heart disease. Nope. The ENTIRE commentary was about how to determine when doctors should medicate with statins.

Sad, sad, sad state of affairs.

Vaccination is another aspect of mainstream medicine that has gone way off the deep end. There are now strong recommendations to vaccinate all young children (girls and boys) with Gardasil for HPV. This is NOT a cervical cancer vaccine and it has NOT, as of the date of this writing, been shown to lower the rates of cervical cancer. Yes, this is correct. It has been shown to lower the rates of higher grade lesions of the cervix, but not actual cervical cancer. Medicine has taken a big leap here in saying that it protects against cervical cancer–this fallacy of using surrogate endpoints has fallen flat on its face many, many times before.

But wait! It gets worse…

What if one of the most common medical treatments actually derails something that is more effective than vaccination for a common condition. To twist this even further, what if the medical intervention is one that is the go-to treatment for the condition that a particular vaccine is designed for?

Regular readers already have an idea that I’m talking about the use of antibiotics wiping out normal, protective bacterial flora that does amazing things for your health.

Specifically, I’m talking about the use of antibiotics for pneumococcal pneumonia (Streptococcus pneumoniae). The type of pneumonia that medicine pushes the Prevnar vaccine throughout the entire lifespan, from infants to seniors.

This particular study puts all of this into perspective. In it, researchers looked at how the GUT bacteria could protect against LUNG infections. Here’s the specifics:

It is well accepted that the gut microbiota supports BODYWIDE immune response.
Researchers wiped out the gut microbiota of mice and then infected them with S. pneumoniae.
When the gut microbiota was wiped out, there was more bacterial spread into the body, more, organ damage and higher death rates.
When the bacteria was wiped out, the immune cells in the lung did not respond as strongly to bacterial debris (LPS and lipoteichoic acid) and the white blood cells had less ability to destroy the invading bacteria (phagocytosis).
When a fecal transplant was done (yeah—sounds like something I’d sign up for…), bacterial counts in the lungs dropped back down to normal.
After the fecal transplant, the immune system calmed down as well (TNF-α and IL-10).

In summary, the gut bacteria played a very, very strong role in fighting off Streptococcal pneumoniae infections in the lung.

Think about this. Having a healthy microbiome in your gut plays a role in fighting off bacterial infections in the lung. This means that the use of antibiotics for a bacterial pneumonia will PREDISPOSE YOU FOR FUTURE INFECTIONS by decimating your gut microbiome.

Staggering.

The mainstream medical approach to “preventing” pneumonia is to give the Prevnar vaccination (which I’ve written about how the potential pitfalls of this vaccination that can be read by clicking here). With the the same hand, your primary care doctor or pulmonologist will not hesitate to give you antibiotics to combat any number of infections, bacterial, viral or otherwise.

So what does this mean if you’re seemingly getting respiratory infections every time the wind changes direction? I would suggest you bombard your immune system with positive karma the second you’ve got the slightest indication of an infection. Vitamin C (at high doses—not 500 mg), vitamin D, vitamin A, no refined carbs and exercise (yes—exercise—raises your core body temp and helps your immune system fight off the infection better). And NO antibiotics unless you’re on your death bed with a fever of 104.

Over time (years, actually), your gut microbiome will recover to the point where it can help you fight infections in other areas of the body. If not, and you continue to use antibiotics at the drop of a dime, your immune system will NEVER stand on its own.

Never.

Want to Lose Weight?? Enlist the Help of a Friend

February 11, 2016 by James Bogash

Microbiome and brown fat — vlorzor / Dollar Photo Club

What if I told you that you could lose weight without doing a darn thing, so long as you had some help from a friend?

Sounds like an ad for the newest wonder supplement for weight loss. Get this great new weight loss product for $3 (just pay $59.95 for shipping and handling) with a money back guarantee (not including the S & H).

But no. This is something far more legit (and free, by the way…).

But first, we need to review the different types of body fat. And not just the unwanted fat that hangs around your middle and organs and increases your risk of all those nasty chronic diseases. There are three types of body fat:

White fat–the bad stuff that does nothing but sit there and cause problems
Brown fat–fat that burns calories like crazy to produce heat; as close to the answer for weight gain that the human body has
Beige fat–an in-between state of fat as it transitions from useless white fat to the desirable brown fat

Until recently, scientists thought the brown fat was only present in babies and bats. As humans age, they lose brown fat, never to get back those heat-generating, calorie-burning fat cells.

Or, at least that’s what we thought. Turns out that we can actually “brown” our white fat cells, changing the makeup of the fat cell so that it begins to burn calories to generate heat. On the flip side, certain lifestyle choices have been shown to lower the amount of brown fat. Some of these are very simple to implement. Most notable of these is the use of artificial sweeteners (just in case you’re STILL using them to lose weight, this little factoid should wake you up). I’ve covered many of these factors in a previous article that can be read by clicking here.

The one factor that I need to review in the context of this blog article has to do with exposure to cooler temps. In a small study, volunteers who were exposed to cooler temps (60 degrees F) for 6 hours per day increased his or her brown fat by a respectable 37% in 10 short days.

Pretty cool. It certainly makes sense for our bodies to raise the internal thermostat (so to speak) when exposed to short term cold. It’s about adaptation. But how exactly does this happen? This group of researchers turned to mice to get a better grip on how this happens.

And the results are pretty surprising.

In this particular study, researchers exposed mice to slowly colder temps over the course of a month and watched how the mice’s bodies responded. But they ALSO kept an eye on the bacteria in the gut. Here’s what they found:

The cold exposure led to a dramatic shift of the bacteria in the gut (microbiome).
The cold mice developed more brown and beige fat, lost weight and had lower diabetes markers.
Here’s the shocking part–transplantation of the cold mice microbiome into germ-free mice LED TO THESE SAME POSITIVE CHANGES.
But before all of you living in the frigid tundra of Minnesota, prolonged cold led to adaptive changes–the gut actually enlarged to make sure it could grab even more calories to support the brown fat burning calories (increasing intestinal, villi, and microvilli lengths).

To make this even more interesting, the researchers were able to pinpoint a particular bacteria, Akkermansia muciniphila, as having the most potent effect. Which may not be surprising–I have covered this bacteria before in its ability to fight off diabetes and its relationship with well-trained athletes.

Back to my opening statement. Yes, you can lose weight during next to nothing. All you have to do is find a friend to freeze his or her butt off for 10 days and then do a fecal transplant from your cold-adapted friend.

Better be a pretty good friend….

Info on Heart Failure Your Cardiologist Probably Doesn’t Know

January 10, 2016 by James Bogash

Prevent heart disease — McCarony/Dollar Photo Club

Heart disease remains the biggest killer in the Western world. This is despite billions of dollars pumped into this condition.

Billions of dollars into research, drug development, drug use and cardiology procedures. And yet, all we have to show for it is a slight reduction in deaths from heart disease, but an increasing number of people living with heart disease.

What this tells me is that we are getting better at keeping people alive who have had a heart attack, but we still suck at doing anything to keep people from getting there in the first place. Most cardiologists and primary care doctors would point to the statin class of drugs as the singlemost important discovery in cardiologist ever.

Which pretty much explains why we’re in the mess we’re in because statins pretty much suck at preventing heart disease. Period. (in case you think this isn’t true, I’d invite you to read through my 100+ page eBook on cholesterol and we can talk after that…)

One thing we HAVE discovered from all the billions of dollars that have gone into cardiovascular research is that heart disease is almost 100% preventable.

Yup.

Seems hard to reconcile that the #1 killer in the Western world is almost entirely preventable. All we need to do is exercise more and eat better.

Except that it’s not quite that simple.

At the surface, yes, healthy dietary choices, not smoking and exercising regularly will eliminate a huge chunk of heart disease in this country. Then there’s the specifics, things like:

Short burst aerobic exercise instead of merely walking 30 minutes a day
More healthy fats (monounsaturated, omega-3) instead of trans and omega-6 fats
Managing stress
Avoiding refined carbohydrates and eat more whole grains
Avoiding toxic environmental chemical exposure like BPA

But sometimes the answers are far more complex. And way beyond the realm of the average cardiologist.

You see, the human body has never respected the artificial boundaries of medical specialties that we have created. The examples of neurology crossing into gastroenterology, endocrinology crossing into cardiology and obstetrics crossing into psychology are all over the place.

This particular article is no different. In it, researchers looked at 60 stable patients with mild CHF (half with NYHA functional class I to II) and moderate to severe CHF (half with NYHA functional class III to IV) and evaluated the composition of the inhabitants of the gut. Here’s what they found when these heart failure patients were compared to normal patients:

The entire heart failure population had massive quantities of pathogenic bacteria and Candida.

You can bet these findings will be the key topic of discussion at the next joint Cardiovascular / Gastroenterology convention.

(Yeah, don’t hold your breath waiting for the invite to this event…)

But seriously, these are some VERY striking differences between the heart failure patients and the normal participants. The question is whether the changes in the gut were the cause or the result of the chronic heart failure.

As with everything, the answer likely lies somewhere in between. We already have strong evidence that the bacteria in the gut contribute to obesity and diabetes. It would not be a big stretch to link bad bacteria balance in the gut with the later development of heart disease.

Personally, I’ll keep an eye on the research as it comes out over the next few years linking the gut bacteria and heart disease. In the meantime, I would do everything possible to make sure I’m living a lifestyle that is consistent with a healthy bacterial flora in the gut as well as avoiding antibiotics in all but the most life-threatening situations.

Your heart will must likely thank you for it.

Taking Drugs for Cholesterol Issues? Maybe Medication Started the Problem

October 31, 2015 by James Bogash

Cholesterol myth — Your microbiome and your cholesterol

Cholesterol lowering drugs seem to have lost some of their luster. Can’t say I’m disappointed about that little tidbit.

Due to staggeringly successful marketing efforts on the part of the drug companies (most notably Pfizer for Lipitor), drugs to lower cholesterol became one of the most successful drugs ever produced. Unfortunately, this had little effect on patient health because of the truly dismal benefits of the statin class of drugs.

One percent improvement. Yup. That’s about all you can expect from taking a statin drug to lower your cholesterol. Pretty much sucks no matter how you look at it.

The cholesterol story has become quite interesting in the past few years. It took some very large studies to put the minimal benefits of statin drugs into perspective, especially in light of the risk of diabetes from this class of drugs.

I think the findings that statins increased the risk of diabetes (ironically, especially in those who were at lower risk in the first place) has finally opened medicine to the idea that this class of drugs is not the miracle drug we once thought it was.

To see how far it’s come, the most recent cardiovascular disease prevention guidelines do NOT include cholesterol as a risk factor nor are there recommendations to limit dietary cholesterol intake.

My how far we’ve come.

Still frustrating, however, when you consider that these recommendations NEVER should’ve been present in the first place. It’s like medicine is just now waking up to the idea that the “statins to lower high cholesterol” approach is just not a good idea.

I’m not saying that high cholesterol is a goal we should shoot for. Quite the opposite. It’s just that cholesterol is just one risk factor among many and putting on blinders to look just at total cholesterol is a bad idea. To give you an idea of how crazy the idea of using a drug to single-mindedly lower cholesterol is, this particular study should do the trick. You see, cholesterol levels are merely a reflection of the health of the body. That means that literally hundreds of factors will work together to create the numbers that you see on your blood test.

These numbers can include total cholesterol, LDL cholesterol (generally “bad”), HDL cholesterol (generally “good”), triglycerides (lower is better), Lp (a) (lower is better), Apo B (lower is better) and VLDL (lower is better). Diet, exercise, stress levels, supplements and environmental exposures can all affect your lipids levels. But according to the results of this study, there may be another factor affecting your levels that your doctor is likely not aware of.

The bacteria in your gut.

Yup. As if we didn’t already link the bacteria in your gut to pretty much every other aspect of health. Now we can chalk up your lipid levels on the list. Here’s the specifics of the study:

The gut bacteria was evaluated in 893 subjects, with an average 238 different types of bacteria per individual (ranged from 44 to 355).
As seen in just about every other study looking at the microbiome, higher diversity (as measured by Shannon’s diversity index) led to better lipid values.
Higher diversity was linked to lower BMI.
Higher diversity was linked to lower trigylcerides.
High diversity was linked to higher HDL levels.

The study went into FAR more detail than this as far as the relationship between specific bacterial species, BMI and lipids, but suffice it to say that the results were consistent with prior studies on this same subject.

So what does this mean? It means that someone, somewhere is going to try to financially capitalize on this relationship. You can bet this will be along the lines of fecal transplants (and now for the collective “yuck…”), which is already well on its way to being an acceptable treatment for C. diff infections.

To me, this means that diversity is key. I have said this time and time again and always relate it back to antibiotic use in all but the most life-threatening situations.

Antibiotics WIPE OUT DIVERSITY and it takes years to recover, if ever. IF EVER. I can not state this more strongly—if you are the type of person who runs out and gets an antibiotic prescription for acne, sinus infections, urinary tract infections, sore throats, ear infections or upper respiratory tract infections (ALL of these have very little evidence of effectiveness and can be better managed naturally), even if it is only once every few years, you are absolutely, positively, destroying the diversity in your gut and with it, your long term health.

Thinking that you are OK after antibiotics by just following up with probiotics for a week or two is old school. Taking probiotics is just the first 100 yards of a marathon. But if you can point me to a probiotic with 200+ strains that will survive through to GI tract to the lower regions of the intestines, I’ll revise my thinking on this issue.

Until then, avoid antibiotics unless you are on your deathbed with a fever of 106.

Why Are There Bacteria in Our Intestinal Tract?

September 4, 2015 by James Bogash

This concept, beyond all others, seems to be incredibly difficult for mainstream medicine to grasp. We continue to use antibiotics like candy with no thought whatsoever to the destruction of a bacterial presence that has been hundreds of thousands of years in the development.

In hunter-gatherer days, our exposure to soil dwelling bacteria was very common, and their presence in our gut became mutually beneficial. The list of things that our bacterial flora do for us is virtually endless, as evidenced by the labeling of this bacterial population as another organ system on par with the liver. This particular article reviews the origins of the bacteria in our gut.

In today’s society, the first exposure to healthy bacteria is via the birth canal and then with breastfeeding.

But what if mom has EVER been on antibiotics? Scraps that idea.

What if the baby is put on antibiotics early in life and the pediatrician is unaware that the bacteria needs to be replaced?

Is Soy as Bad for Us as “They” Say?

September 3, 2015 by James Bogash

You know, I read A LOT of medical literature. Finding negative health effects of soy is actually quite difficult.

The evidence on the health of soy is overwhelmingly positive. There are still oncologists telling their breast cancer patients to avoid soy, despite the fact that it DOUBLES survival rates. Of course, we are talking about organic (i.e. non-GMO) and unprocessed (no “soy burgers” or “soy dogs” or “TVP”).

The other complicating factor that needs to be understood about soy is that, for the full benefits to be obtained, we need to have the right blend of good bacteria in our gut to convert the isoflavones to their aglycone form, thus getting the most benefits from the soy intake. This particular small study further confirms this, finding that the ability of soy to lower cholesterol was greater when prebiotics (fiber that can aid the growth of healthy bacteria) were added into the diet.

Devastating Arthritis in Children Starts at the Pediatrician

August 13, 2015 by James Bogash

antibiotic use and juvenile arthritis — dalaprod / Dollar Photo Club

Arthritis in the typical 50 or 60 year old is not a surprise, but when it strikes our children it’s something to be heavily concerned about.

In general, arthritis that strikes our kids is going to fall into the auto-immune type where the immune system has turned in on itself, attacking the joints of your children when the immune system should otherwise know better. The most common version of this is juvenile rheumatoid arthritis or juvenile idiopathic arthritis, but it doesn’t really matter what you call it–your child will experience pain that children should not experience.

Even worse, this early joint destruction is going to create a major issue years down the line, setting up children for more pain and disability as they age. It is likely that these children will also have a later increased risk of heart disease. All in all, not a good picture.

At this heart of all of this is a whacked out immune system. You see, we have two main branches of the immune system–the cell-mediated Type 1 (I refer to this arm as the “attack dogs” – they attack anything that tries to invade your body) and humoral mediated Type 2 (I refer to these as the “guard dogs” – they try to keep everything from getting into the body in the first place.

Balance is key here. You want your immune system to attack things that it should (like a bacteria or virus) and NOT attack things it shouldn’t be attacking (joints, thyroid, adrenal, DNA, connective tissue, etc…). We ALL have some degree of immunity. Our immune systems aren’t perfect–there are mistakes that occur, but a healthy functioning immune system keeps this autoimmune attack under control.

This proper balance is set up very early in life. And if we don’t get it right in the first few years of life, the will be a near-lifetime battle to keep the immune system in check.

And there are some very, very, critically important things that happen (or don’t) to our little ones that will screw up immune balance for a lifetime. Way up at the top of the list is antibiotic use.

Antibiotic use. Not even overuse. Just USE.

Yes–that seemingly benign treatment that pediatricians STILL hand out like candy absolutely decimates immune balance from the get-go. I have said it before and I will say it again (and again and again):

There is nothing more devastating to the long term immune, gastrointestinal and neurological health of your child than exposing him or her to antibiotics in the first few years of life. The first 2 years is likely the most critical, but exposure at any time during childhood can have an effect.

And all of this would not be so bad if antibiotics were used appropriately. That means as narrow-spectrum as possible (sniper rifle instead of cannon) and only used when absolutely necessary. As in life-threatening. Despite decades now of an attempt by researchers and guidelines to get doctors to stop the overuse of antibiotics. Despite marketing efforts geared towards getting the message to patients. Despite all of this, doctors can’t seem to resist writing prescriptions for conditions like ear infections, upper respiratory infections and pharyngitis (including Strep throat).

And all along, the battle cry is “antibiotic resistance.” Sad that the destruction of the microbiome is only now, almost a century later, being viewed as a consequence of antibiotic use.

All of this brings us to this particular article. In it, researchers looked at the association of antibiotic use in children with juvenile arthritis. Here’s what they found:

ANY antibiotic exposure was led to a scary 210% increased risk of a child developing juvenile idiopathic arthritis.
This risk went up with more courses of antibiotics, jumping to an increased risk of 300% with over 5 antibiotic courses.
The risk was strongest when those kids developed arthritis within one year of taking antibiotics.
It was NOT the infection itself (the risk did not change based on the number or type of infections).
To drive the idea that it was NOT the infection itself, those children who had antibiotic-treated upper respiratory tract infections were more strongly at risk for arthritis than untreated upper respiratory tract infections.

This is serious. This is not about antibiotic resistance of thinking that antibiotics are needed for that sore throat. This is about a near-permanent disruption of the delicate balance of the immune system in a child.

And this study does not stand alone. Strong links with other autoimmune conditions like Crohn’s disease and ulcerative colitis are also known. Overall, it is very, very clear that antibiotics are in no way benign. Rather, they begin the process of the destruction of proper immune balance. Even a single course is enough to tip the scales. And don’t think for a minute that following up with probiotics will wipe out the bad effects of the antibiotics. I firmly believe that it takes years of dedication to rebuild the microbiome after a single course of antibiotics.

That’s some serious stuff.