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Mark Hyman, MD

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5 Steps to Kill Hidden Bugs in Your Gut That Make You Sick

Posted: 09/25/10 03:00 PM ET

Doctors are trained to identify diseases by where they are located. If you have asthma, it's considered a lung problem; if you have rheumatoid arthritis, it must be a joint problem; if you have acne, doctors see it as a skin problem; if you are overweight, you must have a metabolism problem; if you have allergies, immune imbalance is blamed. Doctors who understand health this way are both right and wrong. Sometimes the causes of your symptoms do have some relationship to their location, but that's far from the whole story.

As we come to understand disease in the 21st century, our old ways of defining illness based on symptoms is not very useful. Instead by understanding the origins of disease and the way in which the body operates as one whole, integrated ecosystem we now know that symptoms appearing in one area of the body may be caused by imbalances in an entirely different system.

If your skin is bad or you have allergies, can't seem to lose weight, suffer from an autoimmune disease or allergies, struggle with fibromyalgia, or have recurring headaches, the real reason may be that your gut is unhealthy. This may be true even if you have NEVER had any digestive complaints.

There are many other possible imbalances in your body's operating system that may drive illness as well. These include problems with hormones, immune function, detoxification, energy production and more. But for now let's take a deeper look at the gut and why it may be at the root of your chronic symptoms.

Symptoms Throughout the Body are Resolved by Treating the Gut

Many today do have digestive problems including reflux or heartburn, irritable bowel, bloating, constipation, diarrhea and colitis. In fact, belly problems account for over 200 million doctor's visits and billions in health care costs annually. But gut problems cause disease far beyond the gut. In medical school I learned that patients with colitis could also have inflamed joints and eyes, and that patients with liver failure could be cured of delirium by taking antibiotics that killed the toxin-producing bacteria in their gut. Could it be that when things are not quite right down below it affects the health of our entire body and many diseases we haven't linked before to imbalances in the digestive system?

The answer is a resounding yes. Normalizing gut function is one of the most important things I do for patients, and it's so simple. The "side effects" of treating the gut are quite extraordinary. My patients find relief from allergies, acne, arthritis, headaches, autoimmune disease, depression, attention deficit, and more--often after years or decades of suffering. Here are a few examples of the results I have achieved by addressing imbalances in the function and flora of the gut:

• A 58-year-old woman with many years of worsening allergies, asthma, and sinusitis who was on frequent antibiotics and didn't respond to any of the usual therapies was cured by eliminating a worm she harbored in her gut called Strongyloides.

• A 52-year-old woman who suffered with daily headaches and frequent migraines for years, found relief by clearing out the overgrowth of bad bugs in her small intestine with a new non-absorbed antibiotic called Xifaxin.

• A six-year-old-girl with severe behavioral problems including violence, disruptive behavior in school, and depression was treated for bacterial yeast overgrowth, and in less than 10 days her behavioral issues and depression were resolved.

• A three-year-old boy with autism started talking after treating a parasite called Giardia in his gut.

These are not miracle cures, but common results that occur when you normalize gut function and flora through improved diet, increased fiber intake, daily probiotic supplementation, enzyme therapy, the use of nutrients that repair the gut lining, and the direct treatment of bad bugs in the gut with herbs or medication.

A number of recent studies have made all these seemingly strange reversals in symptoms understandable. Let's review them.

Research Linking Gut Flora and Inflammation to Chronic Illness

Scientists compared gut flora or bacteria from children in Florence, Italy who ate a diet high in meat, fat, and sugar to children from a West African village in Burkina Faso who ate beans, whole grains, vegetables, and nuts.(i) The bugs in the guts of the African children were healthier, more diverse, better at regulating inflammation and infection, and better at extracting energy from fiber. The bugs in the guts of the Italian children produced by-products that create inflammation; promote allergy, asthma, and autoimmunity; and lead to obesity.

Why is this important?

In the West our increased use of vaccinations and antibiotics and enhancements in hygiene have lead to health improvements for many. Yet these same factors have dramatically changed the ecosystem of bugs in our gut, and this has a broad impact on health that is still largely unrecognized.

There are trillions of bacteria in your gut and they collectively contain at least 100 times as many genes as you do. The bacterial DNA in your gut outnumbers your own DNA by a very large margin. This bacterial DNA controls immune function, regulates digestion and intestinal function, protects against infections, and even produces vitamins and nutrients.

When the balance of bacteria in your gut is optimal this DNA works for you to great effect. For example, some good bacteria produce short chain fatty acids. These healthy fats reduce inflammation and modulate your immune system. Bad bugs, on the other hand, produce fats that promote allergy and asthma, eczema and inflammation throughout your body.(ii)

Another recent study found that the bacterial fingerprint of gut flora of autistic children differs dramatically from healthy children.(iii) Simply by looking at the byproducts of their intestinal bacteria (which are excreted in the urine--a test I do regularly in my practice called organic acids testing), researchers could distinguish between autistic and normal children.

Think about this: Problems with gut flora are linked to autism. Can bacteria in the gut actually affect the brain? They can. Toxins, metabolic by-products, and inflammatory molecules produced by these unfriendly bacteria can all adversely impact the brain. I explore the links between gut function and brain function in much greater detail in my book, The UltraMind Solution.

Autoimmune diseases are also linked to changes in gut flora. A recent study showed that children who use antibiotics for acne may alter normal flora, and this, in turn, can trigger changes that lead to autoimmune disease such as inflammatory bowel disease or colitis.(iv)

The connections between gut flora and system-wide health don't stop there. A recent study in the New England Journal of Medicine found that you could cure or prevent delirium and brain fog in patients with liver failure by giving them an antibiotic called Xifaxan to clear out bugs that produce toxins their poor livers couldn't detoxify.(v) Toxins from bacteria were making them insane and foggy. Remove the bacteria that produce the toxins, and their symptoms clear up practically overnight.

Other similar studies have found that clearing out overgrowth of bad bugs with a non-absorbed antibiotic can be an effective treatment for restless leg syndrome (vi) and fibromyalgia. (vii)

Even obesity has been linked to changes in our gut ecosystem that are the result of a high-fat, processed, inflammatory diet. Bad bugs produce toxins called lipopolysaccardies (LPS) that trigger inflammation and insulin resistance or pre-diabetes and thus promote weight gain.(viii)

It seems remarkable, but the little critters living inside of you have been linked to everything from autism to obesity, from allergy to autoimmunity, from fibromyalgia to restless leg syndrome, from delirium to eczema to asthma. In fact the links between chronic illness and gut bacteria keep growing every day.

So what can you do to keep your gut flora balanced, your gut healthy, and thus overcome or avoid these health problems?

Five Steps to a Healthy Gut (and a Healthy Body!)

Follow these five simple steps to begin rebalancing your gut flora.

1. Eat a fiber-rich, whole foods diet--it should be rich in beans, nuts, seeds, whole grains, fruits, and vegetables--all of which feed good bugs.

2. Limit sugar, processed foods, animal fats, and animal protein--these provide food for unhealthy bugs.

3. Avoid the use of antibiotics, acid blockers, and anti-inflammatories--they change gut flora for the worse.

4. Take probiotics daily--these healthy, friendly flora can improve your digestive health and reduce inflammation and allergy.

5. Consider specialized testing--such as organic acid testing, stool testing (new tests can look at the DNA of the bacteria in your gut), and others to help assess your gut function. You will likely have to work with a functional medicine practitioner to effective test and treat imbalances in your gut.

And if you have a chronic illness, even if you don't have digestive symptoms, you might want to consider what is living inside your gut. Tending to the garden within can be the answer to many seemingly unrelated health problems.

To your good health,

Mark Hyman, MD

Mark Hyman, M.D. is a practicing physician, founder of The UltraWellness Center, a four-time New York Times bestselling author, and an international leader in the field of Functional Medicine. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on YouTube, become a fan on Facebook, and subscribe to his newsletter.

References

(i) De Filippo, C., Cavalieri, D., Di Paola, M., et al. 2010. Impact of diet in shaping gut microbiota revealed by a comparative study in children from Europe and rural Africa. Proc Natl Acad Sci USA. 107(33): 14691-6

(ii) Sandin, A., Bråbäck, L., Norin, E., and B. Björkstén. 2009. Faecal short chain fatty acid pattern and allergy in early childhood. Acta Paediatr. 98(5): 823-7.

(iii) Yap, I.K., Angley, M., Veselkov, K.A., et al. 2010. Urinary metabolic phenotyping differentiates children with autism from their unaffected siblings and age-matched controls. J Proteome Res. 9(6): 2996-3004.

(iv) Margolis, D.J., Fanelli, M., Hoffstad, O., and J.D. Lewis. 2010. Potential association between the oral tetracycline class of antimicrobials used to treat acne and inflammatory bowel disease. Am J Gastroenterol. Aug 10 epub in advance of publication.

(v) Bass, N.M., Mullen, K.D., Sanyal, A., et al. 2010. Rifaximin treatment in hepatic encephalopathy. N Engl J Med. 362(12): 1071-81.

(vi) Weinstock, L.B., Fern, S.E., and S.P. Duntley. 2008. Restless legs syndrome in patients with irritable bowel syndrome: response to small intestinal bacterial overgrowth therapy. Dig Dis Sci. 53(5): 1252-6.

(vii) Pimentel, M., Wallace, D., Hallegua, D., et al. 2004. A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing. Ann Rheum Dis. 63(4): 450-2.

(viii) Cani, P.D., Amar, J., Iglesias, M.A., et al. 2007. Metabolic endotoxemia initiates obesity and insulin resistance. Diabetes. 56(7): 1761-72.

 
 
 

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Doctors are trained to identify diseases by where they are located. If you have asthma, it's considered a lung problem; if you have rheumatoid arthritis, it must be a joint problem; if you have ...
Doctors are trained to identify diseases by where they are located. If you have asthma, it's considered a lung problem; if you have rheumatoid arthritis, it must be a joint problem; if you have ...
 
 
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04:43 PM on 10/06/2010
Your post is exactly what I have tried to tell doctors years ago when I got suddenly ill from a water damaged building. First I had sever uticaria, then they did the steroids, antiobiotics, allergy testing. Next came the sinus surgery and chemical sensitivities. I tested the home and there were many dangerous molds and yeasts. I was allergic to candida albicans. Even the asthma meds tell you to rinse because you can get thrush. I kept asking the doctors to test my tongue and finally my ENT did and it was candida albicans. Couldn't get much help back then. Did diflican for 8 months. One doctor said yeast won't hurt you, just get a job. Others refused to read literature. I am on the low sugar low carb diet and just over 100 lbs. I did the diet years ago also and lost a lot of weight. Now I can feel lumps on my belly but no insurance. I had the best insurance back then. So I do the diet on my own and if I cheat I do get the itchy and bumbs on my trunk of my belly. And everything I read it can kill you if left unchecked. What a shame that people don't listen and the doctors are not trained, or it is out of their realm of expertise. I love reading you info. And I have read for 12 years and have met people all over the world dealing with this. Thank you. Linda
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smilinggreenmom
03:50 PM on 10/04/2010
Been there - done t his whole thing and I can tell you absolutely first hand that probiotics have changed our life! Most importantly, they have changed our little boy's life! He had severe eczema and food intolerance since he was a baby and no one had any suggestions on how to treat him or make him better except for a few powerful scary drugs such as steroids. We knew we wanted something that would be good for him and that would help - and when we were told about Belly Boost probiotics, we jumped at the chance to try them. They have been amazing and an answer to our family's prayers because he began to look so much better within a short amount of time. He looks and feels great now and we are believers that probiotics hold many possibilities for better health. Here is more about our story if anyone is interested: http://smilinggreenmom.com/2009/10/ethan/
04:08 PM on 09/30/2010
I think a lot of people are reading too much into this article - he's just summarizing a lot of recent medical and biological research that shows that our gut flora has much more influence on our body's health, status and behaviour than anybody ever realized until recent years.
it's nothing more than that - of course we should still take antibiotics, when necessary.
it's just a new perspective on the way our bodies work.
08:17 AM on 10/17/2010
You are putting Dr. Hyman down because he isn't reporting on fresh research. If it is so old news, then why are so many doctors ignoring the evidence? My own doctor doesn't believe any of this. When I try to tell him about how I have eliminated diabetes II symptoms, lowered cholesterol, lowered blood pressure, cleared skin, darker hair, reduced varicose veins, etc., using the recommendations from Dr Hyman's books, he says that you can't believe everything you read. A calorie is a calorie he says. So, it is important for Dr. Hyman to keep hammering on this subject. Thank you, Dr. Hyman!!!!
10:17 PM on 10/17/2010
If everyone had a decent dose of high quality colostrum first thing in the morning, it would eliminate the need for many people to take antibiotics. The passive transfer of immunity for so many pathogen (including various staph and strep infections, coronavirus, rotovirus, influenza and assorted food poisoning) is reason enough to take it, but add to that the latest research on peptides and their relationship to our immune systems and that seals the deal.

BenH may think that this knowledge is recent, but our ancestors knew this several thousand years ago, as confirmed by analysis of archeological digs around the world. They may not have had the scientific tools that we do, but they had a better diet.

We need live (bioactive) foods in our diets and high quality colostrum is one such food.
12:54 PM on 09/30/2010
Left unchecked, the immune system becomes suppressed and inflammation and yeast begin to have a party and you become fatigued, foggy brain, develop allergies, food sensitivities, IBS, sluggish liver, MS, cancer, migraines..etc.. the list goes on. The bottom line here is you don't develop cancer because you lacked having chemotherapy in your system any more than getting a headache because you lacked having an aspirin. You will take the aspirin to tamper the symptoms so you can go about your day but the real reason was never addressed (Dehydration? hormones? food allergies? or toxins?) The condition mentioned above of gastroparesis involves a structural weakness in the vagus nerve which contracts to move food through and can be caused by stomache surgery or diabetes. Dr. Hyman is referring to the condition of an imbalance in the gut flora and all the negative health fall out from that. If you give the body the right tools to which it recognizes, your system can do amazing things to heal itself. Drugs will never do that- drugs just manipulate. FIX the clitch!!!!!!
12:53 PM on 09/30/2010
Oh Please! Is it not becoming apparent to the populace (of which I am a part of) that it seems the majority of Allopathic Doctors are becoming nothing more than just glorified pharmaceutical reps with M.D. licenses!! We are the only country that allows those ridiculous drug pushing commercials to air. I think you will find that most drugs started out with a plant or herb base, but because you can't patent an herb or supplement- you can't make money!! So they have to synthetically re-invent it to patent and sell it! Oh, and you get the benefit of 20 side effects to boot! It's called chemical manipulation of symptoms. This does not treat the underlying cause. Fix the clitch! And by the way , Dr. Hyman is in great company with many other well known and documented Doctors of like minds and practice. Dr. Andrew Weil or Dr. Oz ring a bell? Or the backgrounds and substantial clinical studies of the Mayo Clinic or John Hopkins anyone?? And bugs, parasites, worms, bad bacteria all mean the same thing for the body that's hosting these invaders- there is an imbalance in the gut that effects your digestion, assimilation of nutrients and ability to detox normaly. cont..
11:26 AM on 09/30/2010
Interesting
10:04 AM on 09/30/2010
I would say my "gut is unhealthy", but that's because I have gastroparesis. Mark Hyman's advice for a healthy gut is to "eat fiber-rich, whole foods", which is the EXACT OPPOSITE of any treatment advice given to me by my doctors. Mark, I think you generalize a little too much. The world isn't as simple as you think.

@mozartian, high fiber diets in people with gastroparesis can form bezoars: http://www.healthsystem.virginia.edu/internet/digestive-health/nutrition/gastroparesisdiettips.pdf

Sorry for such a self-centered post.. I'm sure there's people out there with problems other than gastroparesis.
04:39 AM on 09/30/2010
I see from the comments that the PR firms hired by big Pharma are working on overdrive.

Dismissing the articles findings is one thing but what is so dangerous about the advice being given: eat fiber? limit sugar? take probiotics e.g. yogurt? limit antibiotics?

What on earth is dangerous about any of this advice?
02:00 AM on 09/30/2010
The other half of the equation, and the one that everyone seems to miss, is what happens AFTER the gut. Our toilets are killing us, literally. Humans are biologically designed to squat to eliminate. Sitting keeps the body from expelling ALL the waste material present at any given time. Straining to eliminate results in hemorrhoids, rectal sphincter problems, and sometimes, even heart attacks. The waste material left behind festers, causing diverticulitis, appendicitis, colon cancer, and other lower-gut maladies.

Squatting also securely seals the ileocecal valve between the colon and the small intestine. In the conventional sitting position, this valve is unsupported and often leaks during evacuation, contaminating the small intestine.

Asian and African countries have much lower rates of these sorts of problems, at least in communities where squat toilets are still commonly used. Communities that use mostly Western-style toilets quickly pick up our levels of those diseases.

Women who use squat toilets often have fewer problems giving birth as well; nature intends a squat for that process too, but most Western women are too fat, not flexible enough, or have muscles that "won't go that way" to squat for the birthing process, which opens the pelvic outlet by 30%.

I really wish that healers who wish to address our profoundly disabling gut issues would address this part of the story as well. It is necessary to do so for FULL healing. http://www.naturesplatform.com/health_benefits.html
01:43 AM on 09/30/2010
Bad medicine, badly written. Scary parasites, infections, then advise no antibiotics, while several cures involve antibiotics. Pfft..
Oh - and theres books to buy. Oh yeah.
01:33 PM on 09/29/2010
Wow. I'm a big fan of Huffpost but really would have thought this stuff would be filtered a little better. The least reliable type of data in medicine is the type given above...anecdotal stories and retrospective trials. They have been dis-proven over and over. I am sure there is a link to diet and a number of chronic diseases, but this data doesn't say anything meaningful about that. For example, the title "Research Linking Gut Flora..." can be very misleading. Hopefully people understand the enormous difference between association and causality but I fear some readers may not and will therefore erroneously assume that because two things were found happening at the same time (feeling better with having some bacteria in the gut) means that they are somehow related. Please give me a randomized controlled trial or at least temper your statements a little.
09:04 PM on 09/29/2010
Please conduct that randomized control trial. I have frequent gut pain, I can't lose weight regardless of vegetarian diet, I have all kinds of headaches, and having a solid poop is a rare gift. I can't eat a bit of garlic or I get extremely painful noxious gas for 24 hours. For several years I would get hives from drinking tea, but that has stopped now. I still get cluster headaches (with blotchy eye bleeding) from eating turmeric. I have tried to ask doctors to look at my poop to figure out if I have parasites or what, but they generally turn up their nose because it is too unpleasant to think about. One gave me an intestinal CT scan at great cost to my insurance and said "nope, you don't have cancer, so go home." Please help me! I am so tired of hosing out the insides. I can't hold an office job because I have to spend over an hour in the bathroom every $#@!ing morning.
12:43 AM on 09/30/2010
You have right to demand the stool test from your doctor. Lab can do that in a day…It would give you some answers to problems you are having. For your frequent and persistent bathroom visits – best solution is probiotic. And lots of it.
I had a similar issues for a long time until homeopathic md recommended VSL-3…….saved me! Available on line only, ( maybe in some pharmacies) and it is quite expensive…….but it is worth every penny. You mix one packet with water and drink it after every bowel movement……after few days you will see the difference. There are few other but less potent probiotics available in your pharmacy. (Align). Activia is very good for maintenance but you need something much stronger for a while, You will see the difference after week or two of strong probiotics. Lot of your problems will just fade away. Another recommended item should be in your daily diet is Kefir. Taste like diluted plain yogurt. Take cup a day. Available in health food stores and it is very inexpensive. Google the name to see more descriptions for all those items,
They will help you stabilize and normalize your beneficial intestinal and stomach bacteria and after a while you will see lot of symptoms just fade away…..good luck!
02:03 AM on 09/30/2010
Use a squat toilet! It will resolve most of these problems within a month. Here's something that can adapt your regular toilet easily and without embarrassment: http://www.naturesplatform.com/all_products.html
http://www.naturesplatform.com/health_benefits.html
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11:04 AM on 09/29/2010
reminds me of that commercial......ACTIVIA!
11:04 AM on 09/29/2010
This article is about as accurate as it gets. My testimonial proves it at http://www.feelingnormalagain.com and my video blog site will seek to educate people on just how important your digestion really is at http://www.yourhealthtruth.com. Keep up the great work doc! Let's partner up if you would like.
10:25 AM on 09/29/2010
Your hypothesis about Autistic children and gut flora is slightly flawed and not complete. You stated only the hypothesis that gut flora causes brain changes. But, autism also affects gut flora. For example for my own autistic child this would be caused by the fact that she will only eat a few foods, much more limited than the usual American diet. So it is a self reinforcing cycle.

I do agree with you in that I do believe that eating better is a path to clearer thinking. I have seen several times that when I eat a healthy diet for losing weight that my thinking clears and my energy level rises.

But these benefits in themselves have not enough to alter my eating behavior permanently. I returned to my old patterns. I am overweight and my energy is thus lower.

Just writing this does give motivation today to put down the cheesburger and pick up some nuts and beans.
08:48 AM on 09/29/2010
I have fibromyalgia and an autoimmune disease controlled through exercise and medication. During bad spells, I long for a cure, which is what Dr. Hyman seems to be offering. His advice seems compelling and simple enough. But I've tried taking probiotics. I noticed no difference in any of my symptoms. How much do I need to take? How long will it take before I notice improvement? If I don't feel better, is that because it's not working or because I'm having a flare up for another reason, or because I also need to stop eating gluten? And what about Dr. Teitelbaum's advice to take several dozen supplements and half a gallon of guaifenesin every day? Or Dr. Brown's work showing that antibiotics actually cure autoimmune conditions rather than contributing to them as you suggest? They both also have plenty of anecdotal evidence and a few studies to support their claims. I would gladly seek treatment by any of these doctors if possible; I don't doubt their intentions or skill. But their treatments can be difficult in practice and expensive, my doctor's don't believe in them, and insurance does not cover them. I would waste a lot of time and money trying to figure out which of these unproven and ill-defined approaches works for me. We need research to back up the claims and establish an effective treatment protocol. That takes time to build up. Do the research, and educate other doctors so they can help patients.
shuffleoff
...but not to buffalo!
10:38 AM on 09/29/2010
You have your first fan Denise Keller...great post.
11:07 AM on 09/29/2010
Trust me Denise, this guy knows what he is talking about. Read my testimonial at http://www.feelingnormalagain.com. The digestive system is a complicated organ, but rest assured, that most diseases stem from having problems there. You may also look into performing a liver/gallbladder flush.