Gut Bacteria Play a Role in Anorexia and Other Eating Disorders

837 anorexia and gut microbiome

People with eating disorders such as anorexia simply do not experience hunger and satiety in the same way people who have a healthy relationship with food do. New research suggests that the composition of gut bacteria, or the gut microbiome, may play a role in the behavioral aspects of anorexia and eating disorders. For instance, previous research shows a connection between mood disorders such as depression and poor gut microbiome diversity. Less than half of people with eating disorders fully recover, showing that conventional treatments are failing untold numbers of people, the vast majority of them women.

The study showed that patients with anorexia had lower diversity of gut bacteria than healthy individuals. They also found that the less diverse the gut microbiome was the more depression and anxiety patients suffered. The researchers also found that as a patient with anorexia began eating again their gut bacteria diversity was partially restored, which in itself aided in recovery.

Alterations in the gut microbiome can affect how a person’s body functions, how they think, feel, and behave, and how they interact with others.

The gut microbiome is critical not only to regulating mood and behavior, it also plays a vital role in regulating metabolic function, appetite control, and weight.

A better understanding of the role of the gut microbiome in anorexia can help researchers forge new directions in treatment around determining target weight goals, how fast the anorexic patient should gain weight, and what type of diet the anorexic patient should follow to best support the brain’s role in eating disorder behaviors.

The researchers are now investigating whether targeted probiotics could ease the renourishment and refeeding phase of anorexia recovery — many patients struggle with gastric and abdominal distress when reintroducing foods. Customized probiotic therapy could also support the mental and emotional aspects of recovery from an eating disorder.

Gut bacteria targeted in eating disorders

Past research has also shown a link between the gut microbiome and eating disorders, which affect an estimated 5 to 10 percent of the population. A 2015 study from France showed gut bacteria plays a role in eating disorders.

The study looked at mice who had an inflammatory reaction to a protein made by gut bacteria. In essence, the mice responded to these bacteria as if it were an allergy or sensitivity. This immune response caused eating disorders in the mice.

The gut bacteria that triggered this reaction is very similar in structure to a hormone called alpha-Melanocyte-stimulating hormone (a-MSH). a-MSH is a satiety hormone that tells you when to feel full. When the immune system attacks the gut bacteria similar to a-MSH, it also attacks the a-MSH due to their structural similarity. This immune reaction can then dysregulate signals around feeding, energy usage, and anxiety.

When the immune system mistakenly attacks the body

This study is evidence of a “cross-reactive” immune reaction, in which the immune system confuses something in the body with something infectious and attacks both. This is a very common mechanism in autoimmune reactions, such as with Hashimoto’s hypothyroidism, type 1 diabetes, or multiple sclerosis.

The research suggests that some eating disorders may have an immune reaction driving the psychological disorder.

Tips on addressing eating disorders nutritionally

Although eating disorders are highly complicated and require intensive, sometimes multi-faceted therapeutic approaches, it’s still important to be mindful of nutritional strategies to support the brain and the gut microbiome:

Eliminate processed carbs and sugars as they trigger addictive tendencies metabolically.

Keep blood sugar stable to curbing cravings, food obsession, and relentless hunger. You may need to eat small, frequent meals that include protein initially.

Base your diet on plenty of vegetables and a wide, ever changing diversity of vegetables. This will increase the diversity of your gut microbiome, which promotes psychological health and stability.

Supporting your brain chemicals, or neurotransmitters. Neurotransmitters affect your mood, thoughts about yourself, behavior, energy levels, and other aspects of how you feel and function. For instance, you may need serotonin or dopamine support. Serotonin is the neurotransmitter that allows us to feel joy and stave off depression. Dopamine, on the other hand, is necessary to feel self-worth, motivation, and to not experience constant cravings. Both serotonin and dopamine have been shown to play a role in eating disorders. If you have been starving yourself, binging and purging, undereating, or affecting your diet in other ways due to an eating disorder, there is a strong possibility you may be deficient in either one or both of these important neurotransmitters.

Ask my office for more advice on how to support a healthier approach to balanced approach to recovering from eating disorders.

How to Support Your Brain’s Happiness Chemical

836 serotonin basics

Many people take SSRI antidepressants for depression. However, it’s important to ask why you are feeling depression in the first place.

Many important research strides have been made linking chronic inflammation, poor gut health, gut bacteria, and general brain health with depression.

However, we still need healthy serotonin activity, the target of SSRIs, to feel good.

Do you have these symptoms of low serotonin?

  • No longer finding joy, pleasure, or enthusiasm in life
  • Rage and anger
  • Depression
  • Depression related to lack of sunlight
  • No longer enjoy hobbies, favorite foods, friendships, or relationships
  • Unable to sleep deeply or feel rested from sleep
  • Life looks good on paper but doesn’t feel good

Light. The brain depends on sufficient light to manufacture serotonin, so being indoors all the time or in chronically dark or grey weather can affect serotonin activity.

Estrogen. In women an estrogen deficiency can lead to poor serotonin activity. This can explain why some women who are perimenopausal or post-menopausal experience depression.

Although it’s important to use functional medicine to address the cause of low estrogen, such as blood sugar or adrenal imbalances, some perimenopausal or post-menopausal women may still need bioidentical hormone replacement. In these situations, estrogen therapy can deplete the methyl donors necessary for serotonin synthesis, making it important to supplement with them: methyl B-12, SAMe, or MSM (methylsulfonylmethane).

Diet. Some nutritional advice will tell you to address low serotonin activity with foods high in tryptophan, a precursor amino acid to serotonin. However, clinically we really don’t see this work.

Better nutritional advice is to eat a diet that keeps blood sugar stable and does not inflame the gut or the body. This means avoiding sugar and processed carbohydrates, avoiding foods that trigger an immune response, and eating lots of diverse vegetables to foster healthy and diverse gut bacteria.

Blood sugar and gut inflammation. Unstable blood sugar — blood sugar that is either too low or too high — can significantly impact serotonin activity, leading to depression. The same goes for a diet that inflames the gut and the body.

Iron. Additionally, an iron is deficiency can cause low serotonin production. Things that can cause iron deficiency include iron anemia, celiac disease, leaky gut, heavy periods, parasites, over exercising, low stomach acid, hypothyroidism, and uterine fibroids.

Nutritional cofactors for serotonin activity

In addition to iron, nutrients serotonin synthesis requires include P-5-P (pyridoxal-5-phosphate), an active form of B-6, niacin, methyl B-12, folic acid, and magnesium.

Deficiencies in these cofactors are widespread due to how poorly most Americans eat.

Additionally, magnesium deficiencies can arise in those taking diuretics or athletes who over train.

Methyl donors such as methyl B-12 are important for the conversion of the amino acid 5-HTP to serotonin; people who take SSRI antidepressants for long periods of time deplete their methyl donors and P-5-P.

Those considering weaning off SSRIs may need to supplement with these cofactors to cover deficiencies acquired during use of the medication.

Supplements that support serotonin activity

The amino acids 5-HTP or tryptophan are precursors to serotonin. Tryptophan has been shown to more easily cross the blood-brain barrier than 5-HTP. Others prefer 5-HTP because it is only one step away from being converted to serotonin, whereas tryptophan is two steps away. Therefore, 5-HTP has more potential to boost serotonin levels. However, both work and taking both can cover your bases.

Both 5-HTP and tryptophan have been shown to be helpful in addressing depression, persistent nightmares, fibromyalgia, chronic headaches, migraines, and mood disorders.

Botanicals that increase receptor site sensitivity, ensure the breakdown of used serotonin, and provide necessary cofactors for serotonin production include St. John’s wort, SAMe, P-5-P (a form of B-6), niacinamide, magnesium citrate, methyl B-12, and folic acid.

Ask my office how we can help you support your brain serotonin activity so it can help you feel happier and enjoy life more.

Is Chronic Stress Damaging You? Take a Salivary Cortisol Test to Find Out

835 adrenal salivary test

Many of us are too stressed out these days and this can have negative consequences on our bodies and brains, promoting chronic disease and rapid brain degeneration. If you’re concerned about the effects of stress on your body and how to manage it, an adrenal salivary test is an important ally. It can show you whether your stress hormone cortisol is too high or too low and whether this has affected your sleep-wake cycle, or circadian rhythm.

Symptoms of low adrenal hormones

  • Fatigue
  • Slow starter in the mornings
  • Crash in the afternoon
  • Crave sweets, caffeine, or nicotine to keep going
  • Prone to moodiness
  • Become shaky, light-headed, or irritable if go too long without eating
  • Wake up at 3 or 4 a.m.; inability to stay asleep
  • Become dizzy when move from sitting to standing

Symptoms of high adrenal hormones

  • Excess belly fat
  • Insulin resistance (high blood sugar)
  • Trouble falling asleep
  • Wake up not feeling rested
  • Women grow facial hair; men grow breasts
  • Polycystic ovarian syndrome (PCOS).

How to do an adrenal salivary test

To perform the adrenal salivary test, simply collect a small vial of saliva several times throughout the day using the vials in your test kit. The lab will then analyze your saliva for cortisol levels and how much cortisol you produce in the morning, afternoon, and evening. Do not something unusual or stressful on the day of your test.

It’s important to understand that low or high adrenal hormones usually don’t reflect a problem solely with the adrenal glands, two glands that sit atop each kidney and secrete adrenal hormones. Instead, chronic stress affects stress pathways in the brain, which start to dysfunction when stress is chronic.

It isn’t just being too busy, a bad job, a bad relationship, and so forth that cause chronic stress. Lesser known factors of chronic stress can include unstable blood sugar (usually from too many carbs), a chronic infection, leaky gut, or an autoimmune disease. Using second and third adrenal salivary tests allow you to track whether you’re successfully managing your condition; adrenal health should improve as these conditions resolve. If adrenal health does not improve, it means you must keep investigating to find out what is causing the body stress.

Measuring the sleep-wake cycle, or circadian rhythm

A sleep-wake cycle, or circadian rhythm, that is out of whack is one symptom of adrenal stress. If the circadian rhythm is normal, then cortisol is highest in the morning and lowest at night. This is what allows us to feel alert when we wake up and sleepy before bed. Many people with altered circadian rhythms notice they are more awake at night. Or they may notice an energy crash in the afternoon and being wide awake in the middle of the night.

The stages of stress

The adrenal salivary test measures circadian rhythm, the cortisol precursor hormones DHEA and 17 hydroxyprogesterone, and cortisol levels. It can tell you where you fall on the spectrum of adrenal fatigue to high adrenal hormones. People don’t necessarily progress from high adrenal hormone to low; adrenal function can jump back and forth between phases or stay stuck in one phase.

The adrenal salivary test also measures total secretory Ig antibodies, or (SIgA). Low SIgA levels reflect poor and dysfunctional immunity. If your SIgA levels are low, you are more prone to food intolerances, chemical sensitivities, autoimmune disease, infections, and other assaults on the immune system.

Ask my office about functional medicine protocols that can profoundly influence your adrenal health. We will also search for and manage the root causes of your adrenal stress.

Test for Gluten Sensitivity if You Have Hashimoto’s

834 hashimotos and gluten

Numerous studies show a strong link between gluten intolerance and Hashimoto’s disease, an autoimmune disease that attacks the thyroid gland, causing hypothyroidism. This is because gluten has a molecular structure that closely resembles thyroid tissue — gluten sensitivity triggers an attack on the thyroid gland. Gluten (technically, the correct term is gliadin), is the protein found in wheat and wheat-like grains, such as spelt, kamut, rye, barley, triticale, and oats.

One of the immune system’s primary jobs is to protect the body from foreign invaders. Sometimes it may recognize a common food as a dangerous invader. When you eat that food throughout each day this can keep your immune system engaged in constant battle, making it hyper zealous, overly sensitive, and thus prone towards food sensitivities and autoimmunity.

Some people also have celiac disease, disease in which gluten triggers an autoimmune attack against the gut, the skin, or neurological tissue. Gluten sensitivity is more common than celiac disease, however, both show up in higher numbers in people with Hashimoto’s hypothyroidism.

If you have been diagnosed with hypothyroidism you should first test for Hashimoto’s by screening for TPO and TGB antibodies — the majority of hypothyroidism cases are caused by Hashimoto’s.

You should also screen for gluten intolerance or celiac disease given how common these conditions are in patients with Hashimoto’s. Likewise, people who discover they are gluten intolerant or have celiac disease should screen for Hashimoto’s.

It’s important to give up gluten completely if you have Hashimoto’s and gluten intolerance. Cheats and little bites are not ok as they trigger an immune response that ultimately destroys thyroid tissue. Also, it’s important to avoid foods that have been contaminated by gluten. Be careful when in a kitchen where gluten is used, with restaurant food, or with questionable packaged foods.

Cyrex Labs offers testing to identify gluten intolerance. However, sometimes the immune system can be so depleted that it produces too few antibodies to produce a positive test, even though you react to gluten. You can screen for this with a total immunoglobulin test.

However, given the evidence establishing a link between gluten intolerance and Hashimoto’s disease, you may be surprised how much better you feel by simply removing gluten from your diet as a start.

Many people have to remove other foods as well, such as dairy, eggs, or other grains. Following the autoimmune paleo diet for about a month and then reintroducing restricted foods one at a time every 72 hours can help you determine which foods trigger an inflammatory reaction in you.

Many people are able to put their hypothyroid symptoms into remission simply by following a diet that eliminates gluten and other trigger foods. Although autoimmune diseases such as Hashimoto’s can be successfully managed through diet and lifestyle strategies, it’s important to understand they can’t be cured. It’s just a matter of taming the immune system.

Ask my office for ways to manage your autoimmune Hashimoto’s hypothyroid condition.