Dr Alex Vasquez explains the mitochondrial link

52 Pages·2014·13.38 MB·English

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The magazine for
complementary and
alternative medicine
professionals
DECEMBER 2014 £6
Functional
Inflammology:
Dr Alex Vasquez
explains the
mitochondrial link
Beating
Fuss about folate: Alzheimer’s: the
is folic acid safe? MEND system
proves it can
B12: works like be done
magic – if you get
the form right Outstanding,
inspiring: meet
Stress supplements: our CAM Award
practitioners’ guide winners
PLUS
How to steer the brain/gut conversation (cid:31) In Practice (cid:31) Women’s fertility needs
selenium (cid:31) PCOS linked to leaky gut (cid:31) When oats are toxic (cid:31) Latest news and research
cover.indd 1 24/11/2014 08:10
Pg 2 - Schwabe Pharma FPC.indd 1 24/11/2014 11:02
IN THIS ISSUE
The magazine for complementary
@CAMmagUK
and alternative medicine professionals
www.cam-mag.com
contents
editor’snote

DECEMBER 2014
We all need
inspiration –
here’s yours!
If you’re coming to the end of a hard year, let alone a hard week,
let our CAM Award winners inspire you.
Our awards are essentially about recognition from peers. But
we’ve been getting more and more nominations from patients who 20 16
have been given their lives back by CAM practitioners. Maybe it’s a
sign of the times, but people seem to be suffering more and more
at the hands of the conventional medical system. cover story
Imagine what life is like for a 15-year-old schoolgirl who has not
been able to control her bowel. When a CAM practitioner takes on M 20 Functional Infl ammology: Dr Alex Vasquez
a case that has foiled umpteen consultants and multiple hospitals, explains the mitochondrial link
O
including the likes of Guy’s and Great Ormond Street, for years,
you might not give much for her chances. You’ll love the outcome C features
in our Awards report, starting on page 4. .
G
You might also not have given much credence to a dining 14 Beating Alzheimer’s: the MEND system
room table outfi t whose intention was to provide low-cost CAM A proves it can be done. Editor Simon Martin
treatments in a community that wasn’t exactly crying out for them. M picks the research paper of the year
Who could have known that 30 years later, this is now one of the
16 Folate, folic acid and 5-methyltetrahydrofolate:
UK’s biggest natural health centres, operating out of a former -
M confusion and controversy. Functional medicine
cottage hospital with 21 practitioners and 1,400 people a week
masterclass, with Ben Brown, ND
coming through the doors? A
And who knew that a career-change teacher would qualify from 34 Practitioners’ Guide to Stress Supplements
C
her nutritional therapy course with a blog-based business that
47 CAMstudent: Justin Lusty on the importance of
already has 11,000 Facebook followers? W.
specialising
There’s more inspiration this month from our unoffi cial CAM
Award winner Prof Dale Bredesen. We’ve elected his paper on W 48 In Practice
Alzheimer’s the Outstanding Research of the Year. Get to this • “Listen very keenly and make no
W assumptions” – Lisanne Davidson
on page 14 – it’s the same story, only bigger: where orthodox
• Vitamin B12: almost the “magic potion”
medicine and the pharmaceutical industry fails patients, a
– Anne Pemberton
therapeutic system based on functional medicine principles E
seems to have the answer. N
Alzheimer’s is like other chronic diseases – it is complex. You’re regulars
I
dealing with “network-based imbalances”, as Bredesen describes L
it. “And so you really have to hit them at multiple places. But when N 4 News
• Outstanding, inspiring: meet our
you do that, you see striking effects.”
O CAM Award winners
Yet AZ research is blindly focused on a single cause and a
• Britain’s obese in denial about their weight
single, pharmaceutical billion-dollar bullet. As Bredesen and
D • How to steer the brain/gut conversation
colleague Varghese John commented in a 2013 paper: “…of the
over 40 ongoing Phase 1, Phase 2 and Phase 3 clinical trials N 12 New releases
for Alzheimer’s disease, virtually all involve monotherapeutic • Bio-Kult launches Winter Wellness campaign
A
approaches.” • Your options for the “new” B12

Maybe, Bredesen’s MEND system, addressing a truly dreaded E • A new resource on the scene
disease, will fi nally change medicine for good. V
18 CAM Conferences: new for 2015
Simon Martin, Editor I
L 25 CAM Awards: is it your turn?

■ And talking of inspiration…we’re chuffed to announce W 40 Listings: your natural health and CPD directory
“recognition” for two regular CAM writers who do a lot of work for 44 Research update
O
us behind the scenes: naturopath Ben Brown, ND, has agreed to • Women’s fertility needs selenium too
become a contributing editor alongside Mike Ash and Niki Gratrix; N • When milk is a killer
and kinesiologist and hypnotherapist Rebecca Smith has offi cially • The zonulin-PCOS link
taken on the role of section editor for In Practice, which we’re
expanding to include case histories and news from your clinics.
cam DECEMBER 2014 3
conts.indd 3 24/11/2014 11:29
cAM news

Outstanding, inspiring:
2014
our 2014 winners
From a multi-practitioner centre that first This was only one of many stories
opened in 1984 to an osteopath treating gut provided by Karen’s patients. We tend to
problems that have baffled NHS specialists, pigeon-hole osteopathy as being for back
to an outstanding student who already has pain, but here is someone succeeding in our
a business with 11,000 Facebook followers, favourite CAM area – the gut.
the CAM Awards sponsored by Protexin have Making a difference
unearthed some unusually inspiring stories. The need for an alternative
Sponsors Protexin said: “The awards
This case and others struck a real chord
represent everything that is great about this
OUTsTAndInG PRAcTIce: with our judges, since it so clearly backs
industry and really recognise influential
Karen Brewer our stand that we desperately need practitioners who have gone the extra mile.
One of those, that helped clinch practitioners able and willing to provide real The outstanding practice award celebrates
the Outstanding Practice award alternative treatment, not just treatment that hard work, innovation and determination.
for Registered Osteopath Karen Brewer, was “complements” orthodox medicine. This is at The outstanding contribution to the
that of a 15-year-old patient, born premature the heart of CAM: where do people go when community award praises those who bring
CAM to their local area, something as
and a lifelong sufferer with an undiagnosed all else fails?
an industry we are all trying to achieve.
bowel condition, who was passed from Imagine what that alternative treatment
The student award praises those who do
hospital to hospital with no success, finally has meant, in particular, to a 15-year-old girl
something amazing while studying to make
released after 90 in-patient stays and who previously was unable to control her the world a healthier place.
47 anaesthetics, who went on to have a bowel movements. “Here at Protexin we recognise that the
colostomy – reversed two and a half years Karen herself says: “My diagnostic work all practitioners do is very important,
ago – which is when the trouble really started. approach and osteopathic treatment is as they are the ones who drive the industry
forward and make a real difference. We
Her mother writes: “It was only a matter of very different from those practising in our
want to help in making that difference, and
weeks before things started to go back to area, and it has allowed me to treat more
we aim to equip every practitioner with the
the way they were. She was in constant pain, complicated and unusual injuries and
resources needed to give the most current
with no medication being able to successfully conditions not generally known to be treated and up-to-date advice. As such, we were very
manage her bowel movements. by osteopaths. Many of my patients have seen proud to be sponsors.”
“Karen heard of her case and offered to doctors, consultants and other therapists
try to help. She saw my daughter for ten without success, and have come to me vital Nutrition Cookbook.
treatments, which she provided free of through recommendation by existing patients, Sally Wisbey, featured in our October
charge as she was just keen to help her. exasperated, having tried ‘everything’ and got In Practice section, is a CNM graduate in
Within two sessions she started to improve, no relief.” naturopathic nutrition.
both her bowel movements and also her skin, Highly commended:
which was always covered in a rash due to Jane Mcclenaghan OUTsTAndInG cOnTRIBUTIOn
the toxins in her body. and sally wisbey TO THe cOMMUnITy: The
“She now has regular bowel movements Unusually, we had to Letchworth centre for Healthy
and for the first time in her life actually gets give two practitioners Living
Jane Mcclenaghan (left), and
the sensation of needing to go to the toilet. sally wisbey Highly Commended “We began in a Letchworth dining room,
After nearly 15 years of top doctors from accolades in the Outstanding Practice where for six months we provided a
Guys to Great Ormond Street drawing a blank category. low-cost complement to conventional
and having no idea how to help her, it has Jane McClenaghan is an ION-trained health care: a qualified doctor, trained in
been nothing short of a miracle the success registered nutritional therapist who practises homeopathy, offered patients non-drug-
that Karen has achieved. My daughter has a in Belfast and is also the founder of vital based treatment. Clearly meeting a deep
normal life for the first time ever, and we owe Nutrition, which focuses heavily on educating public need, we flourished and expanded to
this to Karen.” about healthy eating; she is the author of the include a broader team of clinicians, as well
cam
edITOR sIMOn MARTIn BSc (Hons) e: [email protected] www.cam-mag.com
is published for qualified
practitioners of complementary and alternative cOnTRIBUTInG edITORs MIKE ASH, BSc (Hons), DO, ND, F DipION; BEN BROWN, ND; NIKI GRATRIX, BA (Hons), Dip ION
medicine ISSN 1475-9403 secTIOn edITOR REBECCA SMITH sUB-edITOR AMY ROBINSON e: [email protected] t: 01279 810077
GROUP sALes MAnAGeR ABIGAIL MORRIS e: [email protected] t: 01279 810093 sALes eXecUTIVe FIONA
Published by Target Publishing Ltd, CHRISTODOULIDES e: [email protected] t: 01279 810071 PROdUcTIOn HANNAH WADE e: hannah.wade@target
The Old Dairy, Hudsons Farm, publishing.com t: 01279 810076 desIGn CLARE HOLLAND AdMInIsTRATIOn/dIsTRIBUTIOn ALEXANDRA OUTLAW
Fieldgate Lane, Ugley Green, Bishops
Stortford CM22 6HJ t: 01279 816300 f: 01279 816496 e: [email protected] t: 01279 810064 AccOUnTs LORRAINE EvANS e: [email protected]
e: [email protected] www.targetpublishing.com t: 01279 810092 MAnAGInG dIRecTOR DAvID CANN e: [email protected] t: 01279 816300
Some material may be speculative and/or not in agreement with current medical practice. Information in CAM is provided for professional education and debate and is not intended to be used by non-medically qualified readers as a
substitute for, or basis of, medical treatment. Copyright of articles remains with individual authors. All rights reserved. No article may be reproduced in any form, printed or electronically, without wriiten consent of the author and
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4 cam deceMBeR 2014
news.indd 4 24/11/2014 10:21
cAM news
for the holistic care of cancer patients in
the UK”, says Roberta.
This enormous impact on several
communities of course is only part of the
story: the judges were inspired by the
longevity and persistence of the effort.
Right: HRH Prince charles with Letchworth
centre founder and director Roberta Meldrum.
as a programme of classes Highly commended: sarah
which taught people methods stelling
of improving their own health Sarah runs a successful, multi-
and enhancing well-being.” disciplinary Edinburgh practice, but many
Those small beginnings were in 1984. practitioners in Edinburgh and Glasgow
And no, we didn’t have to check the have her to thank for education and
date, because editor Simon Martin was inspiration. One of her nominators put it
in charge of Here’s Health magazine at this way: “She has pretty much educated
the time – and featured the Centre back every practising nutritionist in the
then. Roberta Meldrum, still directing Edinburgh/Glasgow area who has come
things, is justifiably proud to be able to through CNM. Her degree in biochemistry
claim to have “touched the lives of tens has been a blessing for all students who
of thousands of people locally, regionally have studied with her.”
and nationally” in the 30 years since.
“Currently, with a complementary OutstAnding
therapy clinic staffed by 21 practitioners, student: Katharine tate
a counselling service (staffed by 15 To be outstanding in this
qualified counsellors), and more than 70 category, it’s not enough to
weekly classes for adults and children “just” be good academically and clinically;
which teach people ways of taking we’re looking for something extra.
responsibility for their own health, the Katharine Tate is an ION student who
Centre has nearly 1,400 people a week passed with distinction with the highest
using its services.” marks in the year – including the highest
The Centre has low-cost therapy on mark for her business plan, which is
offer and a massive, ongoing community where the story really starts.
outreach that involves local council Thanks to her highly professional and
bodies, schools, the elderly, carers, and cleanly designed blog and website at
babies and young mothers – actually, the thefoodteacher.co.uk, Katharine leaves
list is endless. ION with a Facebook following of 11,000
The judges were also impressed – built in just eight months, and an army
with the way the Centre works with of dedicated fans, especially mothers. Her
conventional health and medical site strapline is: “Combining Education
professionals without frightening them and Nutrition for a Healthy Childhood”.
off. The Centre designed and delivered “Her teaching qualification gives her
a programme of university-accredited unique insights and the professional
courses (including a pioneering two-year credibility to tap into this market”,
diploma) to put CAM across to health said one of her ION supervisors. “She
professionals. It was also responsible for has demonstrated much thought and
design and initial delivery of the CAM creativity in developing packages that
module on the Marie Curie Cancer Care’s she plans to offer to schools. She has
nursing diploma programme. “Many developed a strong brand that has grown
consider this effectively set the blueprint exceptionally fast.”
cAM Awards 2014, sponsored by Protexin
n Outstanding Practice the Letchworth centre for Healthy Living,
Karen Brewer, dO, Balance right Osteopathy, Letchworth garden city, Herts:
chertsey, surrey: www.balance-rite.co.uk. www.letchworthcentre.org.
Highly commended: Jane Mcclenaghan, Highly commended: sarah stelling, Bsc,
dipiOn, Belfast: www.vital-nutrition.co.uk and dipiOn, edinburgh centre of nutrition and
sally Wisbey, dip cnM (nat nutr), London: therapy: www.ecnt.co.uk.
www.sallywisbeynutrition.co.uk. n Outstanding student
n Outstanding cOntriButiOn tO tHe Katharine tate, institute for Optimum
cOMMunity nutrition, Harpenden, Herts:
roberta Meldrum and the 21 practitioners at www.thefoodteacher.com. ➞
www.cam-mag.com cam deceMBeR 2014 5
news.indd 5 24/11/2014 10:21
cAM news
camChat
conventional crops bred for drought
Joanna Maggs is international and low nitrogen soils outperform
technical director at good
Health naturally: www.
goodhealthnaturally.com gMos, reduce poverty
Researchers have created conventionally varieties. In field trials, these have performed
‘‘ bred crops tolerant to drought and low at least as well as existing commercial seeds
Chinese university researchers have shown nitrogen soils that can reduce poverty when the rainfall is adequate, and yielded up
that electro-acupuncture appears to promote in 13 African countries by up to 9%, far to 30% more during drought. It is estimated
angiogenesis, a profoundly important finding for outperforming anything that genetic that it will help reduce the number of people
clinicians helping patients after stroke-induced modification has achieved, says a new report living in poverty in 13 African countries by
cerebral ischaemia. from the Institute of Science in Society. as much as 9%.
“The severe reduction of blood flow to the
Genetic modification has promised major The researchers who bred the new
affected tissue results in a lack of oxygen and
benefits, says I-SIS, “But for the last 20 years, varieties were able to draw on collections in
nutrient transportation, which in turn interferes
GM has singularly failed to convert that a large seed bank run by the International
with intracellular protein synthesis and worsens
potential into reality. Almost all the GM crops Maize and Wheat Improvement Center
ischaemic brain injury, and ultimately leads to
tissue hypoxia and cell death”, the researchers grown have been modified to have one of (CIMMYT) in Mexico City. Some of the
say. two traits: tolerance of glyphosate-based varieties kept there were known to thrive
In their study on rats, the researchers herbicides and the ability to produce a in dry regions, and these were first cross-
monitored changes in regional cerebral blood Bt-toxin that can kill corn and cotton pests. bred to produce varieties that were drought
flow (rCBF) and expressions of angiotensin In the meantime, conventional breeding, tolerant, and then crossed with varieties that
II – the hormone that raises blood pressure by often employing modern techniques such as are already successful in Africa.
vasoconstriction, among other things. They also
marker-assisted breeding, has continued to Researchers at CIMMYT have also been
measured activity at its receptors (AT1R, AT2R).
deliver the goods.” participating in the Improved Maize for
Electro-acupuncture partially suppressed
I-SIS points to a recent report in the African Soils (IMAS) project, which has
occlusion-induced decline of ipsilateral rCBF,
journal Nature. GM and non-GM methods so far developed 21 conventionally bred
and contralateral blood flow was also superior.
Angiotensin II level was remarkably elevated have both been applied to developing varieties, which have yielded up to 1 tonne
immediately after MCAO, but rats given electro- improved varieties of maize – and non-GM per hectare more in nitrogen-poor soils than
acupuncture showed significantly lower levels at has won hands down. existing commercial varieties.
one to three hours, and the value was significantly “If our real goal is to feed the world, we Biswanath Das, a maize researcher at
increased thereafter. should be taking resources away CIMMYT, is quoted in Nature as saying that
At the receptors, electro-acupuncture partially from GM and devoting them to other while “it is important to consider all options”,
inhibited the enhanced expression of AT1R,
agricultural research that is less glamorous- conventional breeding will probably have a
while inducing increased AT2R level. Electro-
sounding but more effective”, they say. greater impact.
acupuncture stimulation also had positive effects
The Drought Tolerant Maize for Africa
on other markers. * Full article can be found on the I-sIs website at
Project has developed 153 new non-GMO www.i-sis.org.uk/Announcingscienceinsociety64.php.
As expected, middle cerebral artery occlusion
induced significant increases in expression of
Angiotensin II and its receptor-mediated signal
More evidence arthritis/pain drugs
pathway. But electro-acupuncture significantly
attenuated the effect and was followed by reduced
contribute to stroke death
vasoconstriction and improved blood supply
in the ischaemic region – ultimately conferring
Commonly prescribed, older drugs for risks of certain arthritic pain relievers and
beneficial effects on cerebral ischaemia.
arthritis and pain may increase the risk death from stroke.”
This is just one of many thousands of
of death from stroke, according to a study Researchers looked at records of 100,243
examples of the benefits electro-acupressure/
acupuncture can provide. It is something that can published in Neurology, the medical journal people hospitalised for a first stroke in
be used by any natural health professional, with of the American Academy of Neurology. Denmark between 2004 and 2012 and
the minimum of training. The drugs examined in the study, called deaths within one month after the stroke.
You can demonstrate on your clients to show COX-2 inhibitors, include older drugs Overall, people who were current users of
its more immediate benefits, which include pain diclofenac, etodolac, nabumeton and COX-2 inhibitors were 19% more likely to die
relief, stress relief and joint flexibility. Clients meloxicam, as well as newer drugs called after stroke than people who did not take
may then follow up by buying from you their own
coxibs, including celecoxib and rofecoxib. the drugs. New users of the older COX-2
hand-held equipment, which is easy to learn, to
COX-2 inhibitors are selective nonsteroidal drugs were 42% more likely to die from
continue use at home.
anti-inflammatory drugs (NSAIDs). The stroke than those who were not taking the
This gives clients a sense of being able to
study also looked at non-selective NSAIDs, drugs. Those taking etodolac were 53%
make a small investment to help themselves,
long-term, with many symptoms or conditions, not which include common pain relievers such more likely to die from stroke.
just for themselves, but for any member of their as ibuprofen and naproxen. The researchers found no link between
family. Electro-acupressure is safe for use for any “While newer versions of these COX- the non-selective NSAIDs and increased
age, for more than 160 conditions and sympto‘ms‘ 2 inhibitors drugs have been pulled off stroke death. Also, the study found no link
(arguably as effective as acupuncture itself, but shelves, older ones are still frequently between chronic use of any of the drugs
without the needles). prescribed,” said study author Morten and stroke mortality.
* Li J et al. Electro-acupuncture improves cerebral blood flow and attenuates
moderate ischemic injury via Angiotensin II its receptors-mediated mechanism Schmidt, MD, of Aarhus University Hospital
in rats. BMC Complementary and Alternative Medicine 2014, 14:441. in Aarhus, Denmark. “Our study provides * schmidt M et al. Preadmission use of nonaspirin
nonsteroidal anti-inflammatory drugs and 30-day stroke
further important evidence solidifying the mortality. neurology 2014, epub nov 5.
6 cam deceMBeR 2014 www.cAM-MAg.coM
news.indd 6 24/11/2014 08:11
CAM news
Britain’s obese in denial about
their weight
A majority of obese people in Britain
would not describe themselves
as “obese”, and many would not
even describe themselves as “very
overweight”, according to a Cancer
Research UK study published in BMJ
Open.
Fewer than 10% of those who are
clinically obese accept they have a
serious weight problem.
In the survey of around 2000 adults,
only 11% of obese women accurately
acknowledged they were “obese”, with
most describing themselves as “very
overweight”, or “just right.”
And among men, only 7% correctly bulging beer bellies and huge behinds,
described themselves as being “obese” so people shy away from these images.
and another 16% as “very overweight”. “But we also asked people whether
Approximately 10% of people knew they felt they were “very overweight”,
the BMI threshold for obesity, and and the majority of those who were
those who did were more likely to obese did not accept this term, either.
define themselves as “obese”. This is a real problem, as it means they
Researchers suggest that as bigger are unlikely to identify with health
sizes become the new “normal,” people messages on the subject of weight.
are less likely to recognise the health “We need to establish better ways
problems associated with their weight. for health professionals to address this
Prof Jane Wardle, co-author and sensitive subject and communicate
director of the Cancer Research UK with people whose health would
Health Behaviour Centre at UCL, said: benefit from positive lifestyle changes.”
“It’s a real worry that people don’t Around 18,000 cases of cancer in
recognise that their weight places the UK each year are linked to being
them in the obese category, because overweight or obese. Excess weight is
it means they aren’t aware they are at known to increase the risk of several
increased risk of a number of health types of cancer, including cancers of
problems, including cancer. the breast in post-menopausal women,
“The term ‘obese’ is often considered bowel, womb, esophagus, pancreas,
derogatory, which may be why so kidney and gallbladder.
many people reject it. Mass media * Johnson F et al. Do weight perceptions among
often illustrate obesity in a way that obese adults in Great Britain match clinical
definitions? Analysis of cross-sectional surveys
people find offensive, with pictures of from 2007 and 2012. BMJ Open, 2014, 4 (11).
CAM’s contributors
Our thanks this month to:
• New CAM contributing editor, naturopath Ben Brown, ND: www.timeforwellness.com.
• Our In Practice featured practitioner Lisanne Davidson, DipION:
www.higherhealthandhealing.co.uk.
• CAM Conferences reporter Ingrid Grasmo, BSc (Hons), who is about to qualify from CNM!
• Natalie Lamb, NT, Dip CNM, mBANT, BA (Hons). Nutritional therapist and technical advisor at
Probiotics International Ltd (Protexin): www.protexin.com.
• CAMstudent columnist Justin Lusty, Dip ION, 2013 CAM Award winner and 2014 ION top student
in the year, director and founder of realstartups.co.uk: [email protected], Twitter
@slimmerhealth and uk.linkedin.com/in/justinlusty.
• Joanna Maggs, international technical director at Good Health Naturally: www.
goodhealthnaturally.com.
• Anne Pemberton, BSc (Hons), PGCE(Autism), RGN, DipION, course director for the MSc nutrition at
the Northern College of Acupuncture: www.nutrimed.co.uk.
• In Practice section editor Rebecca Smith, ASK, CMH, CHyp, PNLP, SQHP:
www.newportcomplementaryhealthclinic.co.uk.
• Author of Functional Inflammology and a host of other textbooks, Dr Alex Vasquez, BSc, DC, ND,
DO, FACN, programme director for the MS in human nutrition and functional medicine at the
University of Western States: www.InflammationMastery.com. ➞
www.CAM-MAg.CoM cam DECEMBER 2014 7
news.indd 7 24/11/2014 08:11
cAM news
The gut and brain are talking: how
do we steer the conversation
towards health?
The final event in the 2014 series of CAM Conferences in collaboration with BANT
(British Association for Applied Nutrition and Nutritional Therapy) and supported by
Platinum sponsors Premier Research Labs (PRL), revealed the latest advances exploring
the connection between the gut and the brain. Ingrid grasmo, BSc (Hons), reports.
The fifth and last of the 2014 CAM anxiety and reduce excess cortisol, which
conferences saw three experts have been linked to symptom reduction
discuss the impact of the gut-brain in IBS and chronic fatigue. Likewise, other
axis for anxiety, IBS and central nervous studies have shown that psychological
system (CNS) health: Charlotte Watts, stress suppresses beneficial bacteria,
DipION, guest lecturer for The Minded resulting in an upregulated hypothalamic-
Institute, consultant nutritional therapist for pituitary-adrenal (HPA) axis that impairs
charlotte watts Ben Brown Umahro cadogan
Ocado and Yoga teacher at Light Centre normal stress responses. This in turn sets
Moorgate; CAM contributing editor Ben up a vicious cycle, said Charlotte, where gut mucosa and smooth muscle that
Brown, ND, founder of Time for Wellness, inflammatory cytokines from the gut reach the CNS via the vagus nerve.
technical director of Viridian Nutrition, triggered in response to stress disrupt brain “Visceral feelings and gut instincts are
lecturer at BCNH and ION; and Umahro neurochemistry and increase susceptibility literally emotional intuitions transferred
Cadogan, adjunct professor of nutrition and to anxiety and depression. These up to your brain via the vagus nerve”, said
functional medicine at University of Western imbalances can adversely affect the HPA Charlotte.
States, USA, and ambassador and lecturer axis, she added, highlighting that post-natal Given that 80% of fibres in the vagus
of our own Functional Sports Nutrition gut microbial colonisation can have long- nerve send information from the GIT
Academy. lasting effects on neural processing that to the brain – using acetylcholine for
may result in poor adaptation to stressors relaxing, rebuilding, healing, learning
The gut-brain axis: uncovering later in life. and memory – it is important to promote
implications for anxiety and stress good vagal tone for encouraging
states Feelings, instincts and the vagus parasympathetic function. “Anxiety is
In a two-part presentation, Charlotte Watts nerve essentially the vagus nerve disengaging”,
explored the impact of the gut-brain axis Charlotte said it is important to get patients she explained. While acetylcholine is an
in anxiety and stress states, emphasising reconnected with how their gut feels, important neurotransmitter in the gut-
the importance of “gut feelings” as valid as anxiety is often expressed physically. brain axis, others include GABA, serotonin,
physical responses. Biochemical signalling Communication of an “anxious bowel” is noradrenaline, dopamine and melatonin.
between the gastrointestinal tract (GIT) and mediated by the enteric nervous system Charlotte noted that gut bacteria are able
the nervous system, aka the gut-brain axis, (ENS), which is able to signal to smooth to both produce and respond to these
often involves intestinal microbiota that are muscle, glands and endocrine cells of the same neurotransmitters that the CNS
able to modulate brain function. Through the GIT, including key CNS regions involved uses to regulate mood and cognition,
effects of key neurotransmitters, emotional in emotion, motivation and cognition. She allowing the brain to respond to feedback
reactions of anxiety can cause GIT distress added that the ENS is able to function from gut microbiota via the vagus
and symptoms of many common digestive autonomously from the CNS, but information nerve. For example, alterations in central
disorders. In addition to targeted nutritional from the CNS influences the GIT. This has GABA receptor expression have been
interventions, helping patients re-connect implications for anxiety states, as gut-to- implicated in the pathogenesis of anxiety
with their gut and understand the influence brain communication is often lost, resulting and depression, which are both highly
of the gut-brain axis on certain symptoms in the brain halting peristalsis in response comorbid with functional bowel disorders.
may help improve outcomes. to stress. Charlotte explained that this Research findings she presented revealed
Recent research findings have shown occurs through efferent ENS neurons that that Lactobacillus rhamnosus reduces
that an individual’s microbiome exerts control gut motility and chemical mediators stress-induced cortisol, and anxiety- and
direct effects on the central nervous system – indeed, anxiety states are often associated depression-related behaviours via the
(CNS), influencing anxiety and depression. with changes in gut motility. On the other vagus nerve. Other neurotransmitters
Different probiotic strains have been shown hand, afferent ENS neurons receive exhibit CNS effects through a similar
to modulate the immune system, decrease information from sensory receptors in the mechanism.
8 cam deceMBeR 2014 www.cAM-MAg.coM
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nutrition for anxiety and stress focusing on the role of digestive
Introducing nutritional therapy dysfunction, gut bacteria imbalances,
approaches for addressing anxiety and food intolerances, poor physical fitness,
stress states via the gut, Charlotte said high-carbohydrate diets and disruptions
that individuals with anxious tendencies in circadian rhythm on IBS symptoms.
often live in a brain-dominant state and Given that the worldwide prevalence
are constantly on sympathetic overdrive. of IBS ranges from 5-15%, effective
This often manifests as stress “going strategies to help manage this
straight to the belly”, and physically increasingly common condition are
expresses itself as tightness in the jaw needed. IBS often extends to other
and head. When healing the gut, it is organs and systems, with people usually
possible that emotions surface, so it is presenting with multiple comorbidities
important to prepare patients and provide that are not necessarily limited to the
adequate support. Relaxation plays an GIT. Disturbances in the GIT of patients
important role in healing and interrupting with IBS are difficult to detect, as they
the vicious cycle. Remaining in a state of are subtle and muscular in nature, and
stress can have direct effects on eating are linked to increased sensitivity of
habits, through the impact of cortisol on the nervous system. The gut-brain axis
leptin, stimulating appetite and a sense plays a key role in the pathophysiology
of need. of IBS, with imbalanced gut microbiota
Key tests for individuals with anxiety being the causative factor for many
and stress include an Adrenal Stress patients. Indeed, stress can exacerbate
Index and comprehensive stool testing, IBS symptoms, while IBS can aggravate
she said. These can help tailor gut anxiety, he said.
protocols to support mood-affecting gut Abnormal microbiota are able to
microbiota and reveal cortisol and DHEA activate the mucosal innate immune
status, with the latter being the key anti- response, which increases epithelial
stress hormone. permeability, activates pain pathways and
Charlotte recommended foods to dysregulates the ENS. This results in a
support gut mucosal health, grain low-grade state of inflammation, further
reduction through a GAPS/Paleo-style driving IBS pathology. Furthermore,
approach, spices for gut calming, healing small intestinal bacterial overgrowth
and antioxidant power, and good sources (SIBO) occurs in 4-64% of patients with
of sulphoraphanes for detoxification IBS and has significant implications for
and collagen production in the gut key nutrient absorption, such as vitamin
wall. Importantly, she stressed that B12 and folic acid, that require a healthy
foods need to feel “safe” to patients and gut flora for absorption. Ben outlined
they need to be fully comfortable with strategies for addressing gut dysbiosis,
recommendations. including a minimally processed
Targeted nutrients she described as plant-based diet high in polyphenols,
helpful included GABA (and associated prebiotics, enteric-coated peppermint oil
co-factors like magnesium, zinc, vitamin and probiotics.
B6 and C) and its precursor glutamine Dysfunction in three key areas of
to help interrupt the anxiety cycle; digestion, such as hypochlorhydria in the
L-theanine for further GABA support; stomach, pancreatic insufficiency and
taurine and its co-factor vitamin B6 bile acid diarrhoea of the gallbladder can
as an inhibitory neurotransmitter; and mimic symptoms of IBS. So it’s important
magnesium – as deficiency has been to become familiar with their clinical
associated with anxiety and HPA axis symptoms, relevant markers and testing
dysregulation (particularly effective (eg low faecal elastase-1 as a marker
if taken alongside vitamin B6). Lastly, for exocrine pancreatic insufficiency).
DHEA levels can be boosted by vitamin Another functional digestive issue
C, magnesium, MSM, shiitake and reishi associated with IBS is impaired gut
mushrooms, rhodiola and activities that motility, with chronic constipation often
raise beta-endorphin levels. masquerading as IBS. This is because
constipation can be severe to the point
Unravelling complexities of overflow occurring as diarrhoea.
of the gIT: getting to the root Asking patients about their symptoms
cause of IBs and showing them the Bristol Stool Chart
Naturopath Benjamin Brown continued
➞
the discussion on the gut-brain axis, ConTInUED on PAgE 10
www.CAM-MAg.CoM cam DECEMBER 2014 9
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➞ can be a better way to identify constipation, that have an impact on the brain. The gut inflammation to reduce the risk of
said Ben, as frequency often varies greatly digestive system should be considered a issues with microglia in the CNS, he noted.
between individuals. For such patients, he sensory organ, he said, as neuroendocrine An important consequence of chronic
recommends a bowel cleanse – consuming messages via the ENS through the vagal gut inflammation was said to be altered
two kiwi fruits per day over four weeks is nerve communicate to the CNS and change serotonin production, shifting metabolism
effective – followed by non-fermentable fibre our moods and even eating behaviours. “If of tryptophan towards kynurenine and
such as milled linseed in water. we do not address the gut, whether people quinolate, the latter acting as an excitatory,
have overt digestive diseases or not, it’s cytotoxic neurotransmitter through its
FODMAPS and gluten going to be very hard to help shift the brain effects on unregulated glutamate release
Common food sensitivities in patients and nervous system back into balance,” he and increased sensitivity of glutamate
with IBS include gluten, dairy, lactose said. receptors. Importantly, conversion to
and fatty foods, but some individuals Umahro noted that approximately 25% quinolate is magnified in the absence
react to the short-chain carbohydrates of individuals living in industrialised of vitamin B6, and adequate glutathione
FODMAPS (fermentable oligosaccharides, societies have what can be described levels are required to control glutamate
disaccharides, monosaccharides and as “amputated gut microflora”. The effect release from astrocytes. Inappropriate
polyols) even when they do not have of gut microbiota on the ENS, autonomic digestion of gluten and casein can create
any gluten. Furthermore, a diet high nervous system (ANS) and CNS highlights opioid-like substances in the presence of
in carbohydrates can trigger IBS- the importance of addressing imbalanced gut inflammation, intestinal permeability
like symptoms, known as intestinal microflora. Probiotics that alter brain or genetic reasons. These interfere with
carbohydrate dyspepsia. He drew attention function (known as psychobiotics), such neurotransmission and cross-react
to the fact that approximately 50% of as select strains of L. Rhamnosus, can against basal ganglia and other neuronal
individuals cannot completely absorb 25g modify the expression of GABA receptors tissues, said Umahro. While abnormal gut
of fructose, which is sufficient to cause in the brain. Umahro also drew attention function can cause significant imbalances
GI distress. Studies reveal that depressive to the impact the gut microbiome has on in neurotransmitter function, it is also
symptoms and GI disturbances in patients brain-derived neurotrophic factor (BDNF) important to consider the impaired nutrient
with fructose malabsorption can be levels. When BDNF levels are low, as in absorption that often occurs alongside this,
significantly improved by a fructose- depression, fewer connections can be made he added. This because many nutrients act
reduced diet over four weeks. While a between neurons, but this can be improved as critical co-factors necessary for healthy
low FODMAPS diet can be effective for with exercise, serotonin and psychotherapy. brain function.
many patients with IBS, Ben said it is a Other gut-derived molecules created by Lastly, Umahro shared a number of useful
restrictive approach that is only targeting microbial fermentation in the gut include biomarkers and tests that can help gain
the symptoms and not the underlying cause, vasoactive amines, short-chain fatty acids greater insight into what may be happening
such as imbalanced gut microflora. such as acetate and propionate, ethanol, in the GIT. These included elastase-1
Lastly, Ben drew attention to the lactate, hydrogen sulfide and both phenols for pancreatic output, faecal fat for bile
importance of circadian rhythms in IBS, with and indoles. He described all of these production, parasites, yeasts (including
research showing that shift workers have as having significant effects on the CNS, culturing, d-arabinitol, serum IgM and
a high incidence of digestive dysfunction impacting mood, pain perception, cognitive IgG and DNA detection), total microbiome
that can be ameliorated by administering and neurological function. diversity, SCFAs, urinary tryptophan
melatonin. Other sources of circadian metabolites, sugar absorption for intestinal
rhythm disruption are light when sleeping, Make sure 5-HTP bypasses permeability, food antibodies, gluteo- and
electronic devices used late in the day, the gut caseomorphins, and markers of enteric tight
and sleep disorders. Physical activity can Key shared neurotransmitters in the gut- junctions.
improve GI health by improving microbial brain axis include serotonin, melatonin, While these tests are important, Umahro
diversity in the GIT and improving co- dopamine, GABA and acetylcholine – the stressed that it is not possible to give
morbid symptoms such as anxiety and majority of which are produced in the patients a “one size fits all” approach to
fatigue. In any case, he concluded that it is ENS. Given their shared effects, Umahro intervention, even among individuals with
critical to identify the cause of IBS and tailor highlighted that 5-HTP will only exert the same pathology.
interventions around this for long-lasting its effects on the brain if administered
results. sublingually to help bypass the gut. • If you missed this conference, or any of the
Overflow of gut serotonin into the others in the series, you can buy the audio,
The gut-brain axis and its key role systemic blood can have adverse effects, video and presentation downloads for £36
inc VAT, and still receive CPD points. Log on
in psychiatric and neurological playing a role in the pathogenesis of
to www.camconferences.co.uk/previous-
disease osteoporosis and autism. In addition to
events/ or telephone [phone].
Functional nutrition lecturer Umahro shared neurotransmitters, both the ENS
• Booking for the 2015 series of CAM
Cadogan gave a comprehensive overview and CNS have shared cell types in the
Conferences in collaboration with BANT is
of the gut-brain axis, its role in psychiatric, form of microglia. Hyperactivity of CNS
open at www.camconferences.com, with
neurological, cognitive and learning microglia by the gut can result in a number new details constantly being added. Latest
disorders, and how to best assess and of adverse effects, including chronic brain news on the next events is on page 18 of
intervene for managing gut problems inflammation. It is therefore key to manage this issue.
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