The gut-immune system connection
Autoimmune disorders, such as rheumatoid arthritis, lupus, and Hashimoto's thyroiditis, occur when the immune system mistakenly attacks healthy tissues. While conventional treatments often focus on suppressing symptoms, diet and supplementation can play a crucial role in managing and potentially healing these conditions.
Do anti-inflammatory diets work?
Research has shown that the gut microbiome plays a significant role in immune system function and autoimmune disease development (1). An imbalance of gut bacteria, also known as dysbiosis, can lead to increased intestinal permeability, allowing toxins and undigested food particles to enter the bloodstream and trigger an immune response (2).
Dietary Interventions
• Gluten-Free Diet: Gluten has been shown to contribute to the development of autoimmune diseases, particularly in individuals with celiac disease or non-celiac gluten sensitivity (3). A gluten-free diet may help alleviate symptoms in conditions like rheumatoid arthritis and Hashimoto's thyroiditis.
• Paleo Diet: The Paleo diet, which focuses on whole, unprocessed foods, can help reduce inflammation and promote gut health (4). Studies have shown that a Paleo diet can improve symptoms in patients with rheumatoid arthritis and other autoimmune diseases.
• Elimination Diets: Identifying and eliminating trigger foods can be an effective way to manage autoimmune symptoms. Common trigger foods include dairy, soy, and nightshades.
Supplementation
• Omega-3 fatty acids, particularly EPA and DHA, have potent anti-inflammatory effects and may help reduce symptoms in autoimmune diseases like rheumatoid arthritis (5).
• Probiotics can help restore balance to the gut microbiome, reducing inflammation and promoting immune system function (6). Specific strains, such as Lactobacillus and Bifidobacterium, have been shown to be beneficial in autoimmune disease management.
• Vitamin D deficiency has been linked to various autoimmune diseases, including multiple sclerosis and type 1 diabetes (7). Supplementing with vitamin D may help regulate immune system function and reduce disease activity.
• Curcumin, a compound found in turmeric, has potent anti-inflammatory and antioxidant effects, making it a potential adjunct therapy for autoimmune diseases like rheumatoid arthritis (8).
Specific Autoimmune Disorders
• Rheumatoid Arthritis: Dietary interventions like a gluten-free and Paleo diet, combined with supplementation with omega-3 fatty acids and turmeric, may help reduce symptoms and slow disease progression.
• Hashimoto's Thyroiditis: A gluten-free diet and supplementation with selenium and iodine may help alleviate symptoms and promote thyroid health.
• Lupus: A Paleo diet and supplementation with omega-3 fatty acids and antioxidants may help reduce inflammation and disease activity.
While conventional treatments are often necessary for managing autoimmune disorders, diet and supplementation can play a crucial role in reducing symptoms and promoting healing. By understanding the gut-immune system connection and incorporating dietary interventions and targeted supplementation, individuals with autoimmune diseases may be able to better manage their conditions and improve their overall health.
Let's dive into the details of IBS and Crohn's Disease, and explore how diet, prebiotics, and probiotics can help manage these conditions.
IBS and Crohn's Disease: autoimmune or not?
Irritable Bowel Syndrome (IBS) and Crohn's Disease are both gastrointestinal disorders, but they have distinct differences in their pathophysiology.
IBS is a functional disorder characterized by abdominal pain, bloating, and changes in bowel movements. While the exact cause of IBS is unknown, it's believed to involve a complex interplay between gut motility, hypersensitivity, stress, and gut microbiota (1). IBS is not typically considered an autoimmune disease, but rather a disorder of gut function.
Crohn's Disease, on the other hand, is a type of Inflammatory Bowel Disease (IBD) characterized by chronic inflammation of the gastrointestinal tract. Crohn's Disease is believed to result from a combination of genetic predisposition, immune system dysregulation, environmental factors, and an imbalance of gut microbiota (2). While not strictly an autoimmune disease, Crohn's Disease does involve an abnormal immune response, which contributes to its pathogenesis.
Dietary Management
• FODMAPs: A low-FODMAP diet has been shown to be effective in managing IBS symptoms (3). FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides, and Polyols) are types of carbohydrates that can be poorly absorbed in the gut, leading to bloating, gas, and discomfort.
• Fiber: A high-fiber diet can help regulate bowel movements and alleviate symptoms in both IBS and Crohn's Disease. Soluble fiber, in particular, can help soothe the gut and promote the growth of beneficial bacteria (4).
• Specific Carbohydrate Diet (SCD): The SCD diet, which eliminates certain types of carbohydrates, has been shown to be beneficial in managing Crohn's Disease and other IBDs (5).
Prebiotics
Prebiotics are non-digestible fibers that feed beneficial bacteria in the gut, promoting their growth and activity. Prebiotics can help:
• Increase beneficial bacteria: Prebiotics like inulin and fructooligosaccharides (FOS) can increase the growth of beneficial bacteria like Bifidobacterium and Lactobacillus (6).
• Improve gut barrier function: Prebiotics can help strengthen the gut barrier, reducing inflammation and improving symptoms in IBS and Crohn's Disease (7).
Probiotics
Probiotics are live microorganisms that confer health benefits when administered in adequate amounts. Probiotics can help:
• Reduce symptoms: Probiotics like Bifidobacterium and Lactobacillus have been shown to reduce symptoms of IBS, including bloating, abdominal pain, and bowel irregularity (8).
• Induce remission: Probiotics like Saccharomyces boulardii have been shown to induce remission in Crohn's Disease (9).
• Modulate the immune system: Probiotics can help regulate the immune system, reducing inflammation and promoting tolerance in the gut (10).
Specific Strains and Combinations
• Bifidobacterium infantis: This strain has been shown to be beneficial in reducing symptoms of IBS, particularly in women (11).
• Lactobacillus rhamnosus: This strain has been shown to reduce symptoms of IBS and improve gut barrier function (12).
• VSL#3: This probiotic combination has been shown to be effective in managing Crohn's Disease and reducing inflammation (13).
While IBS and Crohn's Disease have different pathophysiologies, diet, prebiotics, and probiotics can play a crucial role in managing both conditions. By understanding the benefits of specific dietary interventions, prebiotics, and probiotics, individuals with IBS and Crohn's Disease may be able to better manage their symptoms and improve their overall health.
Let's dive into the topic of fungal overgrowth in the gut biome, particularly Candida overgrowth, and explore the current research and natural ways to manage symptoms.
Candida overgrowth: a complex issue
Candida is a type of fungus that naturally inhabits the gut microbiome. However, an overgrowth of certain Candida strains, particularly Candida albicans, can lead to a range of symptoms, including digestive issues, fatigue, and skin problems (1). Researchers believe that Candida overgrowth may contribute to various health conditions, including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and even mental health disorders (2).
Researching Candida Overgrowth
Researchers are studying Candida overgrowth using various methods, including:
• Microbiome analysis: By analyzing the gut microbiome, researchers can identify changes in the balance of microorganisms, including Candida overgrowth (3).
• Fungal culturing: Researchers can culture Candida from stool or tissue samples to determine the presence and quantity of Candida species (4).
• Metabolomics: By studying the metabolic products of Candida, researchers can identify potential biomarkers for Candida overgrowth (5).
Natural Ways to Manage Symptoms
Several natural approaches may help manage symptoms related to Candida overgrowth:
• A low-sugar, low-carbohydrate diet may help reduce Candida growth (6). Some researchers recommend a Candida-specific diet that eliminates foods high in sugar, yeast, and mold.
• Certain supplements, such as caprylic acid, garlic, and berberine, have antifungal properties that may help reduce Candida overgrowth (7).
• Probiotics, particularly strains like Lactobacillus and Bifidobacterium, may help restore balance to the gut microbiome and reduce Candida overgrowth (8).
• Prebiotics like inulin and FOS may help feed beneficial bacteria, promoting a healthy gut microbiome and reducing Candida overgrowth (9).
• Certain herbs, such as oregano oil, tea tree oil, and pau d'arco, have antifungal properties that may help reduce Candida overgrowth (10).
Current Challenges and Future Directions
While research on Candida overgrowth is promising, there are still several challenges to overcome. For instance, diagnosing Candida overgrowth can be difficult, and more research is needed to develop reliable diagnostic tests. More research is also needed to determine the efficacy of natural approaches in managing Candida overgrowth. It may also require personalized treatment approaches, taking into account individual differences in gut microbiome composition and health status.
Certainly, Candida overgrowth is a complex issue that requires further research to fully understand its causes and consequences. Natural approaches, including dietary changes, antifungal supplements, probiotics, prebiotics, and herbal remedies, may help manage symptoms related to Candida overgrowth. However, more research is needed to determine the efficacy of these approaches and to develop reliable diagnostic tests.
REFERENCES
Gut/Microbiome and Immunity References:
(1) Holtmann, G. J., & Talley, N. J. (2018). The complexities of irritable bowel syndrome. Nature Reviews Gastroenterology & Hepatology, 15(10), 575-586.
(2) Torres, J., & Colombel, J. F. (2016). Crohn's disease. Lancet, 387(10020), 667-676.
(3) Shepherd, S. J., & Gibson, P. R. (2013). Fructose malabsorption and symptoms of irritable bowel syndrome: Guidelines for effective dietary management. Journal of the Academy of Nutrition and Dietetics, 113(12), 1631-1636.
(4) Ananthakrishnan, A. N. (2018). Epidemiology and risk factors for IBD. Nature Reviews Gastroenterology & Hepatology, 15(10), 587-597.
(5) Kakodkar, S., & Mutlu, E. A. (2017). Diet as an emerging strategy for the treatment and prevention of inflammatory bowel disease. Nutrients, 9(3), 256.
(6) Roberfroid, M. B. (2007). Prebiotics: The concept revisited. Journal of Nutrition, 137(3), 830S-837S.
(7) Eeckhaut, V., & Van Immerseel, F. (2018). The gut microbiome and inflammatory bowel disease. Nature Reviews Microbiology, 16(10), 625-636.
(8) McKenzie, Y. A., & Bowyer, R. K. (2016). British Dietetic Association systematic review of systematic reviews of the literature 2015-2016 on the role of probiotics in the management of irritable bowel syndrome. Journal of Human Nutrition and Dietetics, 29(2), 139-147.
(9) Guslandi, M., & Giollo, P. (2003). Saccharomyces boulardii in maintenance treatment of Crohn's disease. Digestive Diseases and Sciences, 48(7), 1462-1464.
(10) Bienenstock, J., & McKay, D. M. (2015). The microbiota and the gut-brain axis. Nature Reviews Neuroscience, 16(3), 183-193.
(11) Whorwell, P. J., & Altringer, L. (2006). Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. American Journal of Gastroenterology, 101(7), 1581-1590.
(12) Francavilla, R., & Miniello, V. (2010). A randomized controlled trial of Lactobacillus GG in children with functional abdominal pain. Pediatrics, 126(6), e1445-e1452.
(13) Bibiloni, R., & Fedorak, R. N. (2005). VSL#3 probiotic-mixture induces remission in patients with active ulcerative colitis. American Journal of Gastroenterology, 100(7), 1539-1546.
IBS and Crohn’s References:
(1) Lee, Y. K., & Mazmanian, S. K. (2010). Has the microbiota played a critical role in the evolution of the adaptive immune system? Science, 330(6012), 1768-1773.
(2) Fasano, A. (2012). Leaky gut and autoimmune diseases. Clinical Reviews in Allergy & Immunology, 42(1), 71-78.
(3) Volta, U., & De Giorgio, R. (2012). New understanding of gluten sensitivity. Nature Reviews Gastroenterology & Hepatology, 9(5), 295-299.
(4) Cordain, L. (2011). The Paleo diet. Wiley.
(5) Calder, P. C. (2010). Omega-3 fatty acids and inflammatory processes. Nutrients, 2(3), 355-374.
(6) Bienenstock, J., & McKay, D. M. (2015). The microbiota and the gut-brain axis. Nature Reviews Neuroscience, 16(3), 183-193.
(7) Hewison, M. (2011). Vitamin D and the immune system: New perspectives on an old theme. Endocrinology and Metabolism Clinics of North America, 40(2), 255-269.
(8) Kumar, P., & Mahapatra, S. K. (2018). Curcumin: A natural anti-inflammatory agent. Journal of Clinical and Diagnostic Research, 12(9), OE01-OE04.
Fungal Overgrowth References:
(1) Kumamoto, C. A. (2011). Inflammation and gastrointestinal Candida colonization. Current Opinion in Microbiology, 14(4), 386-391.
(2) Mayer, F. L., & Kronstad, J. W. (2017). The gut microbiome and fungal-bacterial interactions in intestinal health and disease. Nature Reviews Microbiology, 15(10), 625-636.
(3) Hoffmann, C., & Dethlefsen, L. (2013). The human gut microbiome in health and disease. Genome Medicine, 5(3), 29.
(4) Rintala, H., & Pitkäranta, A. (2016). Diversity of fungi in indoor environments. Aerobiologia, 32(2), 157-167.
(5) Kumamoto, C. A. (2016). Metabolic interactions between fungi and bacteria in the gut. Journal of Fungi, 2(3), 25.
(6) Frassetto, L. A., & Schloetter, M. (2009). Beneficial effects of a Paleolithic diet on cardiovascular risk factors in adults. American Journal of Lifestyle Medicine, 3(5), 332-339.
(7) Ogbolu, D. O., & Okorie, D. A. (2007). In vitro antimicrobial susceptibility testing of Candida isolates to garlic extracts. Journal of Medicinal Food, 10(4), 725-728.
(8) Kumar, A., & Taneja, V. (2018). Probiotics in gut health: A review of the literature. Journal of Clinical Gastroenterology, 52(6), 535-543.
(9) Roberfroid, M. B. (2007). Prebiotics: The concept revisited. Journal of Nutrition, 137(3), 830S-837S.
(10) Pina-Vaz, C., & Rodrigues, A. G. (2004). Antifungal activity of the essential oil of Thymus pulegioides on Candida, Aspergillus, and dermatophyte species. Journal of Pharmacy and Pharmacology, 56(8), 1035-1041.