Tag Archives: Ulcerative Colitis

INCREASED GUT PERMEABILITY – CAUSES & CONSEQUENCES

 

 

leaky-gut-pail-300x235

Those of you who have been following this blog know I’m interested – for personal reasons and also just because it’s fascinating – in how the state of the probiotics in our gut microbiomes affects our health in general.
So this development is of great interest to me:
A different kind of PREbiotic dietary supplement, Good Gut Daily, has recently entered the market. PREbiotics provide the nourishment for our PRObiotics. This kind is polyphenol-based and has  been clinically shown to calm acute digestive symptoms in as little as 30 minutes and enhance immune health. For those of you who, like me, suffer from ongoing digestive health problems and haven’t found a satisfactory solution, the arrival of this new supplement is excellent news.
Polyphenols are naturally occurring compounds found in plants – including fruits, vegetables, tea, coffee, and wine.
I’ll be writing about Good Gut Daily in more depth in an upcoming post but, in the interest of not overwhelming you with information, I thought it useful to do a preliminary post on some of the causes of increased intestinal leakiness so you can see how your GI problems originated and how poor gut health creates major health problems elsewhere in your body.
This post grew out of a phone and email conversations with molecular biologist Rob Wotring, the Chief Scientific Officer at Greenteaspoon. Many thanks, Rob, for sharing some of your wealth of information on how the gut works.

 

 

 

DIGESTION – FROM MOUTH TO ANUS

 

 

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The human digestive tract runs from the mouth at the top to the anus at the other end. Foreign matter (food) is taken in and partially broken down by chewing in the mouth. It then travels down through the esophagus to the stomach and from there into the small and large intestines, where it is selectively digested. During this trip, various phases of digestion take place  and nutrients are extracted and absorbed. The liver, gall bladder and pancreas, organs that aid in the digestive process, are located along the length of the GI tract.
The total length of the GI tract varies from person to person. In an adult male the range is 20 to 40 feet. On average, the small intestine in adults is 22 feet long and the large intestine is 5 feet.
As you can intuit, a lot could go wrong during that long trip – and much of that depends on the quality of what you deliver to your mouth as ‘food’.

 

(Source: sanjosefuncmed.com)

(Source: sanjosefuncmed.com)

 

 

You can see the location of the mucosal layer (called ‘mucous coat’ in the diagram below) and the intestinal villi in this cross section of the human small intestine. The empty space in the center, just below the villi (the spikes you see in the image of a healthy mucosal membrane in the image to the left above),  is called the lumen, the tube in which food travels through the intestines.

 

(Source: MyHumanBody.ca)
(Source: MyHumanBody.ca)

 

 

 

 

 

INCREASED GUT PERMEABILITY – AKA LEAKY GUT

Increased gut permeability – also known as hyper-permeable intestines or “leaky gut” – describes the intestinal lining’s having become more porous than it should be so the process of what is allowed out into the body no longer functions properly.  Larger, undigested food molecules and other bad things (such as yeasts, toxins, and other forms of waste  that normally would continue on and get excreted through the anus) flow freely through these too-large holes in the intestinal lining and enter the bloodstream, where they don’t belong and are treated as dangerous invaders.
The  gut’s mucosal layer is thin, delicate – and very important. This is where our probiotic bacteria live, so degrading it also degrades the strength of our immune systems. The probiotics residing in the gut mucosal layer make up 70-90% of the human immune system.
Damage to the gut’s mucosal layer leads to a whole range of serious problems as the body tries to cope with the invaders being released into the bloodstream. Once this lining has become disturbed, allowing problematic things to flow through it into the blood stream, a cycle of chronic irritation begins, leading to chronic inflammation in the body and a whole series of autoimmune conditions.
For an easy to understand explanation of increased gut permeability, see Leaky Gut Syndrome in Plain English – and How to Fix It. (Reasoner, undated)

 

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Symptoms associated with Leaky Gut Syndrome (Age Management & Hormone Balance Center, 2013)
  • Abdominal Pain (chronic)
  • Bloating
  • Anaphylactoid Reactions
  • Anxiety
  • Gluten Intolerance (celiac)
  • Heartburn
  • Migraines
  • Multiple Chemical Sensitivities
  • Myofascial Pain
  • Poor Exercise Tolerance
  • Poor Memory
  • Recurrent Vaginal Infections
  •  Brittle Nails
  • Swollen Lymph Glands
  • Constipation
  • Liver Dysfunction
  • Abdominal Spasms
  • Chronic Fatigue
  • Constant Hunger Pains
  • Sluggishness
  • Insomnia
  • Excessive Flatulence
  • Shortness of Breath
  • Fears of unknown origin
  • Hemorrhoids
  • Malnutrition
  • Muscle Cramps
  • Muscle Pain
  • Mood Swings
  • Poor Immunity
  • Recurrent Bladder Infections
  • Recurrent Skin Rashes
  • Hair Loss
  • Food Allergies
  • Diarrhea
  • Brain Fatigue
  • Anal Irritation
  • Depleted Appetite
  • Depression

 

 

 

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Here’s a partial list of diseases and conditions associated with increased intestinal permeability (Galland, undated) (Age Management & Hormone Balance Center, 2013):
  • Accelerated Aging
  • Acne
  • AIDS
  • Alcoholism
  • Autism
  • Arthritis
  • Asthma
  • Candidiasis
  • Celiac disease
  • CFIDS
  • Childhood hyperactivity
  • Chronic arthritis/pain treated with NSAIDS
  • Chronic Fatigue Syndrome
  • Cystic fibrosis
  • Chronic hepatitis
  • Colon Cancer
  • Dermatitis
  • Eczema
  • Environmental illness
  • Fibromyalgia
  • Food Allergies & intolerances
  • Giardia
  • Hepatic dysfunction
  • HIV infection
  • Hives
  • Inflammatory bowel disease & syndrome
  • Infectious enterocolitis
  • Liver Dysfunction
  • Malnutrition
  • Multiple food & chemical sensitivies
  • Multiple sclerosis
  • Neoplasia treated with cytotoxic drugs
  • Pancreatic dysfunction & insufficiency
  • Psoriasis
  • Schizophrenia
  • Spondyloarthropathies
  • Ulcerative Colititis
  • Urticaria

 

There are other chronic diseases and conditions we now know are also autoimmune in nature – including allergies, diabetes, lupus, multiple sclorosis, myesthenia gravis, endometriosis, some heart conditions, juvenile arthritis, chronic Lyme disease, myasthenia gravis, PANDAS, PCOS, pernicious anemia, Raynaud’s, restless leg syndrome, rheumatic fever, rheumatoid arthritis, some thyroid disease, vitiligo … and many others. Learn more about AUTOIMMUNE DISORDERS.

chronic-inflammation

 

 

 

Ten years ago the father of integrative medicine, Dr Andrew Weil, offered this definition of leaky gut (Weil, 2005):

Leaky gut syndrome is not generally recognized by conventional physicians, but evidence is accumulating that it is a real condition that affects the lining of the intestines. The theory is that leaky gut syndrome (also called increased intestinal permeability), is the result of damage to the intestinal lining, making it less able to protect the internal environment as well as to filter needed nutrients and other biological substances. As a consequence, some bacteria and their toxins, incompletely digested proteins and fats, and waste not normally absorbed may “leak” out of the intestines into the blood stream. This triggers an autoimmune reaction, which can lead to gastrointestinal problems such as abdominal bloating, excessive gas and cramps, fatigue, food sensitivities, joint pain, skin rashes, and autoimmunity. The cause of this syndrome may be chronic inflammation, food sensitivity, damage from taking large amounts of nonsteroidal anti-inflammatory drugs (NSAIDS), cytotoxic drugs and radiation or certain antibiotics, excessive alcohol consumption, or compromised immunity.

 

Andrew Weil, MD
Andrew Weil, MD

 

 

 

 

FUNCTIONS OF THE INTESTINAL MUCOSAL LAYER (Camp, 2015)

This thin, wet layer lining the intestinal walls serves many important functions:
  1. Determines which nutrients pass through the intestinal walls and into the blood stream
  2. Protects and covers mast cells that contain histamines
  3. Activates enzymes
  4. Secretes antibodies made from the intestinal wall to support immune defenses
  5. Prevents yeast and parasites from adhering to the intestinal wall

 

 

 

All of these factors can lead to breakdown of the tight junctions and leaky gut. NSAIDs are pain relievers like Aspirin, Aleve, Advil, etc. SIBO is an acronym for small intestinal bacterial overgrowth. Additionally, low exercise levels is a stressor under the category of physical stress.  (Source: thevreelandclinic.wordpress.com)
All of these factors can lead to breakdown of the tight junctions and leaky gut. NSAIDs are pain relievers like Aspirin, Aleve, Advil, etc. SIBO is an acronym for small intestinal bacterial overgrowth. Additionally, low exercise levels is a stressor under the category of physical stress. (Source: thevreelandclinic.wordpress.com)

 

 

 

CAUSES OF INCREASED GUT PERMEABILITY

 

 

 

INFECTIONS THAT PENETRATE THE GUT’S MUCOSAL LAYER

Infections (eg, acute viral or bacterial infection, intestinal parasites, HIV, candida, etc)  that damage the integrity of the intestinal mucosal lining are  the most common causes of increased gut permeability. (Galland, undated) (Wotring, 2015)

 

ULCERATIVE COLITIS

(Source: www.healthplexus.net625 × 238Search by image Ulcerative means a loss of the surface lining, and colitis means inflammation of that lining or mucosa. The inflammation is caused by an abnormal invasion ...)
(Source: www.healthplexus.net)

 

Ulcerative means a loss of the surface lining. Colitis means inflammation of the mucosa lining inside the colon’s walls. Ulcerative colitis occurs when the immune system reacts aggressively against the normal bacteria inhabiting the colon – ie, it is an autoimmune process.

 

 

(Source: www.natap.org)
(Source: www.natap.org)

 

 

 

 

AGE

 

(Source: www.soulseeds.com)
(Source: www.soulseeds.com)

 

The gut’s mucosal lining in babies under six months is not yet fully formed. (Wotring, 2015)  Mature intestines are made to allow absorption of appropriate nutrients while also preventing pathogens and toxins from entering the body and causing diseases. In young babies, the barrier function is underdeveloped so large amounts of big molecules get through the gut mucosal layer and enter circulation in the body. This makes infants susceptible to infectious diarrhea, necrotizing enterocolitis (the lining of the intestinal wall dies and the tissue falls off), and allergic gastroenteropathy.
Since intestinal barrier dysfunction is known to predispose the development of intestinal diseases  as well as autoimmune diseases in other parts of the body, it is highly important that infants’ intestinal barriers be allowed to receive the health benefits of breast milk so they mature properly. Illnesses associated with intestinal barrier dysfunction occur more often in adults who were formula-fed as infants than in those who were nursed.  (Anderson et al, 2012)
In the elderly, epithelial stem cells mutate more frequently, leading to thinning of the mucosal lining. GI disorders are a major cause of illness and death for the elderly.  (Saffrey, 2013) (Wotring, 2015)

 

 

 

 

 

REDUCED OXYGEN-CARRYING CONDITIONS

 

Person Using an Inhaler --- Image by © Royalty-Free/Corbis
Image by © Royalty-Free/Corbis
Ailments that reduce the amount of oxygen carried in the blood – eg, anemia, heart conditions, respiratory problems – are associated with increased gut permeability. (Wotring, 2015)
The observation that gut and lung disorders commonly occur together has led GI and respiratory researchers to think they share a common cause. For example, asthmatic flares and seasonal allergic reactions – both autoimmune conditions – are accompanied by inflammation in the digestive tract.
In a 2010 paper appearing in the National Review of Gastroenterology and Hepatology, neurogastroenterologist Nicholas Talley and his colleagues observed that people with asthma and allergic rhinitis have abnormally high levels of eosinophils in both their airways and their intestines. In healthy people, these cells aren’t found in their airways at all.
Eosinophils are specialized cells in the immune system created in the bone marrow. In the mucous membrane lining the stomach, small intestine and colon, their purpose is to prevent pathogenic bugs and toxins from escaping through the gut walls and getting into the body.
In allergies, these eosinophilic cells start growing in the lungs and airways and the ones in the GI tract stop serving their protective function and instead damage the gut’s mucosal lining, allowing toxins to leak through. This increased intestinal permeability has often been documented in asthma patients. (Johnson, 2010)

 

 

 

 

ALCOHOL

 

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Alcohol disrupts the integrity of the gut’s mucosal layer. The disruption can be measured within 30 minutes after alcohol has been consumed. (Wotring, 2015)
Alcohol damages the delicate lining of the stomach and intestinal tract as it passes through, creating increased permeability. This increased porosity permits large, incompletely digested food particles to move through the gut walls directly into the bloodstream, where immune cells regard them as foreign invaders and attack them with specially designed antibodies.
Once these antibodies have been created, they remain in the body on the look out for offending food particles to come along, creating a vicious cycle of autoimmunity: Because the alcoholic’s gut lining has become too permeable, improperly digested particles are always invading and a perpetual allergy-addiction cycle has been created – the immune system is in a state of continual hyper-reactivity.

Several studies have shown that alcoholic patients have an unusually high degree of allergic responses: both to “classic” allergens such as pollen and to various foods. Multiple studies have compared the allergic responses of alcoholics, depressive, and schizophrenic patients, and found that the alcoholic group was significantly more allergic to a variety of food allergens. A similar study compared patients admitted to an inpatient alcoholism hospital with a matched control group of patients with no history or evidence of alcohol abuse who have been admitted to a general hospital for elective surgery. Most alcoholics are allergic to a wide range of foods as well as environmental-mental allergens. Among foods, grains (the primary ingredient of many alcoholic beverages) are highly reactive. It is well known that particular foods and/or certain chemicals-can become an addiction.

– (Occhipinti, 2013)

 

 

 

 

DIETARY EMULSIFIERS

 

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Emulsifiers are chemicals or natural substances that encourage the suspension of one type of liquid in another – as in the oil and water in margarine, shortening, ice cream, salad dressings, and creamy sauces. They are one of the most frequently used type of food additive.
Emulsifiers are added to commercial breads and cakes, icings, frozen desserts, soups, mayonnaise, homogenized milk, whipped toppings, non-dairy creamers, chocolate bars, chew candies, bubble gum, extruded snacks, soft drinks, bottled liquid coffees … and many other processed foods. (FoodAdditivesWorld, 2013)
Emulsifiers are also added to cosmetics, lotions, and some pharmaceuticals for the same reason they’re put into processed foods –  they improve product appearance by preventing ingredients from separating and extend storage life.  (Encyclopedia Britannica, 2015)
The FDA and other regulatory agencies in the US claim there is no evidence that chemical emulsifiers increase the risk of cancer or have other toxic effects in mammals so have ruled they are “generally regarded as safe” (GRAS) for use  in processed foods.

 

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Yet there is evidence that these emulsifiers disturb the colonies of probiotic bacteria living in the colon, increasing the risk of inflammatory bowel diseases and metabolic disorders. (Reardon, 2015)

 

 

(Source: www.scimex.org)
(Source: www.scimex.org)

 

Yet there is evidence that these emulsifiers disturb the colonies of probiotic bacteria living in the colon, increasing the risk of inflammatory bowel diseases and metabolic disorders. (Reardon, 2015)  Anything that can break down fats also breaks down the gut’s mucosal layer. (Wotring, 2015)
Could adding emulsifiers to food products to make them look more appealing and ‘last’ longer possibly be worth ruining our gut linings and increasing our risk for developing one or more autoimmune diseases?

 

(Source: www.huffingtonpost.com)
(Source: www.huffingtonpost.com)

 

See Emulsifiers for more than you might want to know about these food additives.

 

 

 

NSAIDS

 

pain_pill_abuse_addiction

 

Aspirin, ibuprofen and naproxin are common NSAIDs (non-steroidal anti-inflammatory drugs) available OTC for use as pain relievers. NSAIDs are also available at prescription strength.
They are the most widely prescribed medications in the US. 100 million Americans use them regularly to manage pain. ALL NSAIDs cause injury in the GI tract: erosions, ulcers, bleeding and perforations in the stomach and intestines.
An estimated 16,500 Americans die each year from and 100,000 are hospitalized with NSAID-induced complications. (PLx, undated)

 

(Source: www.plxpharma.com)
(Source: www.plxpharma.com)
It takes NSAIDs such as asprin, ibuprofen, Advil, Motrin, Aleve only 15-30 minutes to create lesions in the mucosal layer of the GI tract! (Wotring, 2015)
NSAIDs damage the hormones in your GI tract that protect the gut from becoming inflamed. Chronic use can lead to dire consequences such as intestinal perforations, H. pilori infection, kidney failure, Crohn’s disease, diverticular disease, inflammatory bowel disease. (Alice, 2015) (Camp, 2015)
Japanese researchers found small bowel injuries occurring in 80% of their study participants after only two weeks on aspirin therapy. Other studies have noted GI damage in people on low-dose aspirin therapy taken for cardiovascular protection. (Alice, 2015).

 

 

(Source: physrev.physiology.org)
(Source: physrev.physiology.org)

 

After many decades of promoting an aspirin a day to prevent heart attacks, the FDA has now reversed its position. (Alice, 2015)
The FDA’s website now says:

“FDA has concluded that the data do not support the use of aspirin as a preventive medication by people who have not had a heart attack, stroke or cardiovascular problems, a use that is called ‘primary prevention.’ In such people, the benefit has not been established but risks — such as dangerous bleeding into the brain or stomach — are still present.”

Hopefully this news will change the behavior of the 40 million Americans who take an aspirin every day.
See this WebMD article for more information on both OTC and prescription NSAIDs.

 

 

 

INTENSE EXERCISE

 

exercise-intense1

Many people experience nausea, heartburn, cramping, and diarrhea while exercising – especially during high-intensity exercise.
When the body is at rest, your heart directs 20-25% of its pumped blood  to your digestive tract. While even moderate exercise increases your heart rate and therefore the amount of  blood  being pumped from your heart, the amount of blood flowing to the GI tracts gets decreased by as much as 60-70% and is instead diverted to your muscles, heart, lungs, and brain. Increasing the intensity of your workout reduces the blood flow to the gut even further. This decrease causes those common GI complaints. (Rocky Mountains Health Plans, 2014)
The harder or longer you run or exercise, the less blood gets delivered to your gut, causing digestion to slow. (Powell, 2013)
Runners, cyclists and triathletes tend to get diarrhea after 30-60 minutes of intense exercise. These athletes often put toilet paper inside the seat of their pants to soak up the mess. (Wotring, 2015)

 

 

(Source: www.rmhp.org)
(Source: www.rmhp.org)
Even worse, exercising can damage the gut’s mucosal lining and cause increased gut permeability. The authors of an article in the Journal of the International Society of Sports Nutrition explain how this works:

Among athletes strenuous exercise, dehydration and gastric emptying … delay are the main causes of gastrointestinal (GI) complaints …. A serious underperfusion of the gut often leads to mucosal damage and enhanced permeability so as to hide blood loss, microbiota invasion (or endotoxemia) and food-born allergen absorption (with anaphylaxis)….

Anyone who participates in physical exercise is at risk for injury and illness arising from such activity….

There is a very high prevalence of gastrointestinal (GI) complaints during exercise among long-distance runners, triathletes and athletes involved in other types of strenuous long-lasting exercise. These GI complaints occur because of the redistribution of the blood flow, that is shunted from the viscera to skeletal muscle, heart, lung and brain….

The symptoms are often mild and may not even affect performance. Some of the symptoms, however, can be life-threatening, such as blood loss in feces in the hours following the running presented by some marathoners and long-distance triathletes.

Damage to the gut and impaired gut function is associated with increased of intestinal permeability after a marathon. Moreover, vigorous exercise (jogging, aerobics, dancing, tennis, bicycling, racquetball, swimming, and skiing) facilities allergen absorption from the GI tract, leading to a food-dependent exercise induces anaphylaxis (FDEIA).

(Prado de Oliveira & Burini, 2011

 

 

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HIGH HEAT

 

 

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When the body is in an overheated state, some of the blood that normally flows to the intestines gets diverted to the skin and the temperature inside the intestines increases. (Wotring, 2015)
This combination damages  the intestinal barrier, creating increased intestinal permeability to microbial endotoxins (toxins  present inside a bacterial cell that get released when the cell disintegrates),  leading to endotoxemia (the presence of endotoxins in the blood). (Lambert, 2008)  Severe endotoxemia can lead to shock, hemorhages, and kidney death.

 

finnische-sauna
Be careful when exposing yourself to high heat for extended periods of time (eg, while tanning all day at the beach, taking a long sauna, engaging in intense exercise).

 

 

 

 

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  • In our conversation, Rob Wotring also mentioned these interesting tidbits about the gut:
  • The gut’s mucosal layer is being created all the time. This may explain why your gut – and the rest of you – can feel awful say in the morning and then good some hours later on in the day.
  • Approximately 40% of your energy goes toward producing the mucus barrier.
  • Women are much more susceptible to disruption of the mucosal layer.
  • Progesterone thickens the gut lining.
  • There’s convincing evidence that polyphenol PREbiotics (as in Good Gut Daily) are able to heal damage in the gut lining.

 

 

Now that you’ve read about the importance of your intestines and what can happen if their walls become damaged, here’s another depiction of the four layers of the intestinal lining in all its amazing complexity (University of Leeds, undated):

 

(Source: www.histology.leeds.ac.uk)
(Source: www.histology.leeds.ac.uk)
The innermost layer, the MUCOSA, is made up of three parts:
  1.  A thin EPITHELIAL lining which includes glandular tissue
  2.  An underlying layer of loose connective tissue called the LAMINA          PROPRIA which provides vascular support for the epithelium and often contains mucosal glands. Products of digestion pass into  capillaries here. Lymphoid follicles and plasma cells are also often found here.
  3. And finally, next to the lamina propria, the MUSCULARIS MUCOSA, a thin, double layer of smooth muscle responsible for local movement of the mucosa.
The layer next to the mucosa is the SUBMUCOSA, a loose connective tissue layer containing larger blood vessels, lymphatics, and nerves. It can also contain mucous secreting glands.
The layer outside the submucosa is the MUSCULARIS PROPRIA (EXTERNA). There are usually two sub-layers of smooth muscles in the muscularis propria: An inner circular layer and an outer longitudinal layer. The two layers work together to produce peristalsis ((rhythmic waves of contraction) to move food through the gut.
The outermost layer is the ADVENTIA (OR SEROSA) consisting of loose connective tissues containing blood vessels, lymphatics, and nerves. This layer is covered by the visceral peritoneum.

 

 

And here’s another intestinal cross section so you can see the location of these layers in relation to the central intestinal “tube”, the lumen, where the digesting food is working its way through from the stomach to the anus:

 

 

(Source: www.myvmc.com)
(Source: www.myvmc.com)

 

 

 

 

 

REFERENCES

Age Management & Hormone Balance Center. (2013). Gastrointestinal Repair (Leaky Gut Syndrome). See: http://www.agemanagementmi.com/services/gastrointestinal-repair-leaky-gut-syndrome/

Alice. (2015). FDA Reverses Its Position on Daily Aspirin Use. See: http://www.healthfreedoms.org/fda-reverses-its-position-on-daily-aspirin-use/

Anderson, R.C. et al. (2012). The Role of Intestinal Barrier Function in Early Life in the Development of Colitis. See: http://cdn.intechopen.com/pdfs-wm/25358.pdf

Camp, M. (2015). Digestive Health. See: http://www.drcamphealth.com/digestivehealth.php

CISA. (undated). Emulsifiers. See: http://www.chemistryindustry.biz/emulsifiers.html

Encyclopedia Britannica. (2015). Emulsifier. See: http://www.britannica.com/EBchecked/topic/186305/emulsifier

FoodAdditivesWorld.com. (2013). Emulsifiers. See: http://www.foodadditivesworld.com/emulsifiers.html

Galland, L. (undated). LEAKY GUT SYNDROMES: BREAKING THE VICIOUS CYCLE. See: http://www.mdheal.org/leakygut.htm

Greenteaspoon. (2015). Good Gut Daily website.  See: http://goodgutdaily.com/

Johnson, K. (2010). The Gut-Lung Connection: How Respiratory Disease is Informing Gastrointestinal Research. See: https://katejohnsonmednews.wordpress.com/2010/06/04/the-gut-lung-connection/

Lambert, G. (2008). Intestinal Barrier Dysfunction, Endotoxemia, and Gastrointestinal Symptoms: The ‘Canary in the Coal Mine’ during Exercise-Heat Stress? In Thermoregulation and Human Performance: Physiological and Biological Aspects. (Editor: Marino, F.E.). See: http://www.karger.com/Article/PDF/151550

Occhipinti, M.J. (2013). Alcoholism’s “Leaky Gut” Syndrome. See: http://www.afpafitness.com/research-articles/alcoholisms-leaky-gut-syndrome

PLx. (undated). GI-SAFER NSAID TECHNOLOGY & PRODUCT PIPELINE — WITH PLXGUARD. See: http://www.plxpharma.com/prodDev.htm

Powell, B. (2013). Nagging Nausea. Trail Runner. See: http://www.trailrunnermag.com/health/race-day-nutrition/489-nagging-nausea

Prado de Oliveira, E. & Burin, R.C. (2011). Food-dependent, exercise-induced gastrointestinal distress. Journal of the International Society of Sports Nutrition, 8:12. See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190328/

Reardon, S. (2015). Food preservatives linked to obesity and gut disease: Mouse study suggests that emulsifiers alter gut bacteria, leading to the inflammatory bowel condition colitis. Nature.com. See: http://www.nature.com/news/food-preservatives-linked-to-obesity-and-gut-disease-1.16984

Reasoner, J. (undated). Leaky Gut Syndrome in Plain English – and How to Fix It. See: http://scdlifestyle.com/2010/03/the-scd-diet-and-leaky-gut-syndrome/

Rocky Mountain Health Plans. (2014). Don’t Let Digestion Interfere with Your Workout. See: http://blog.rmhp.org/2014/01/dont-let-digestion-interfere-with-your-workout/

Saffrey, M.J. (2013). Aging of the mammalian gastrointestinal tract: a complex organ system. AGE. See: http://link.springer.com/article/10.1007%2Fs11357-013-9603-2

University of Leeds, Faculty of Biological Sciences. Four Layers of the Gastrointestinal Tract. See: http://www.histology.leeds.ac.uk/oral/GI_layers.php

WebMD. (2015). NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) and Arthritis. See: http://www.webmd.com/osteoarthritis/guide/anti-inflammatory-drugs#1

Weil, A. (2005). What is leaky gut? See: http://www.drweil.com/drw/u/QAA361058/what-is-leaky-gut.html

Wotring, R. (2015). Personal communication.

 

 

 

© Copyright 2015 Joan Rothchild Hardin. All Rights Reserved.

 

DISCLAIMER:  Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.

How Sugar Affects Your Health – 146 Ways

 

 

(Source: glutenfabulous.org)
(Source: glutenfabulous.org)

 

This list of 146 way sugar affects our health – all detrimental – was compiled by Nancy Appleton, PhD from medical journals and other scientific publications. Dr Appleton is a clinical nutritionist and researcher. She is the author of several books, including Lick The Sugar Habit, Stopping Inflammation: Relieving the Cause of Degenerative Diseases, and Suicide by Sugar: A Startling Look at Our #1 National Addiction. Her website is www.nancyappleton.com

 

1. Sugar can suppress the immune system.

2. Sugar upsets the mineral relationships in the body.

3. Sugar can cause hyperactivity, anxiety, difficulty concentrating, and crankiness in children.

4. Sugar can produce a significant rise in triglycerides.

5. Sugar contributes to the reduction in defense against bacterial infection (infectious diseases).

6. Sugar causes a loss of tissue elasticity and function, the more sugar you eat the more elasticity and function you loose.

7. Sugar reduces high density lipoproteins.

8. Sugar leads to chromium deficiency.

9 Sugar leads to cancer of the ovaries.

10. Sugar can increase fasting levels of glucose.

11. Sugar causes copper deficiency.

12. Sugar interferes with absorption of calcium and magnesium.

13. Sugar can weaken eyesight.

14. Sugar raises the level of a neurotransmitters: dopamine, serotonin, and norepinephrine.

15. Sugar can cause hypoglycemia.

16. Sugar can produce an acidic digestive tract.

17. Sugar can cause a rapid rise of adrenaline levels in children.

18. Sugar malabsorption is frequent in patients with functional bowel disease.

19. Sugar can cause premature aging.

20. Sugar can lead to alcoholism.

21. Sugar can cause tooth decay.

22. Sugar contributes to obesity

23. High intake of sugar increases the risk of Crohn’s disease and ulcerative colitis.

24. Sugar can cause changes frequently found in person with gastric or duodenal ulcers.

25. Sugar can cause arthritis.

26. Sugar can cause asthma.

27. Sugar greatly assists the uncontrolled growth of Candida Albicans (yeast infections).

28. Sugar can cause gallstones.

29. Sugar can cause heart disease.

30. Sugar can cause appendicitis.

31. Sugar can cause multiple sclerosis.

32. Sugar can cause hemorrhoids.

33. Sugar can cause varicose veins.

34. Sugar can elevate glucose and insulin responses in oral contraceptive users.

35. Sugar can lead to periodontal disease.

36. Sugar can contribute to osteoporosis.

37. Sugar contributes to saliva acidity.

38. Sugar can cause a decrease in insulin sensitivity.

39. Sugar can lower the amount of Vitamin E (alpha-Tocopherol in the blood.

40. Sugar can decrease growth hormone.

41. Sugar can increase cholesterol.

42. Sugar can increase the systolic blood pressure.

43. Sugar can cause drowsiness and decreased activity in children.

44. High sugar intake increases advanced glycation end products (AGEs)(Sugar bound non-enzymatically to protein)

45. Sugar can interfere with the absorption of protein.

46. Sugar causes food allergies.

47. Sugar can contribute to diabetes.

48. Sugar can cause toxemia during pregnancy.

49. Sugar can contribute to eczema in children.

50. Sugar can cause cardiovascular disease.

51. Sugar can impair the structure of DNA

52. Sugar can change the structure of protein.

53. Sugar can make our skin age by changing the structure of collagen.

54. Sugar can cause cataracts.

55. Sugar can cause emphysema.

56. Sugar can cause atherosclerosis.

57. Sugar can promote an elevation of low density lipoproteins (LDL).

58. High sugar intake can impair the physiological homeostasis of many systems in the body.

59. Sugar lowers the enzymes ability to function.

60. Sugar intake is higher in people with Parkinson’s disease.

61. Sugar can cause a permanent altering the way the proteins act in the body.

62. Sugar can increase the size of the liver by making the liver cells divide.

63. Sugar can increase the amount of liver fat.

64. Sugar can increase kidney size and produce pathological changes in the kidney.

65. Sugar can damage the pancreas.

66. Sugar can increase the body’s fluid retention.

67. Sugar is enemy #1 of the bowel movement.

68. Sugar can cause myopia (nearsightedness).

69. Sugar can compromise the lining of the capillaries.

70. Sugar can make the tendons more brittle.

71. Sugar can cause headaches, including migraine.

72. Sugar plays a role in pancreatic cancer in women.

73. Sugar can adversely affect school children’s grades and cause learning disorders..

74. Sugar can cause an increase in delta, alpha, and theta brain waves.

75. Sugar can cause depression.

76. Sugar increases the risk of gastric cancer.

77. Sugar and cause dyspepsia (indigestion).

78. Sugar can increase your risk of getting gout.

79. Sugar can increase the levels of glucose in an oral glucose tolerance test over the ingestion of complex carbohydrates.

80. Sugar can increase the insulin responses in humans consuming high-sugar diets compared to low sugar diets.

81 High refined sugar diet reduces learning capacity.

82. Sugar can cause less effective functioning of two blood proteins, albumin, and lipoproteins, which may reduce the body’s ability to handle fat and cholesterol.

83. Sugar can contribute to Alzheimer’s disease.

84. Sugar can cause platelet adhesiveness.

85. Sugar can cause hormonal imbalance; some hormones become underactive and others become overactive.

86. Sugar can lead to the formation of kidney stones.

87. Sugar can lead to the hypothalamus to become highly sensitive to a large variety of stimuli.

88. Sugar can lead to dizziness.

89. Diets high in sugar can cause free radicals and oxidative stress.

90. High sucrose diets of subjects with peripheral vascular disease significantly increases platelet adhesion.

91. High sugar diet can lead to biliary tract cancer.

92. Sugar feeds cancer.

93. High sugar consumption of pregnant adolescents is associated with a twofold increased risk for delivering a small-for-gestational-age (SGA) infant.

94. High sugar consumption can lead to substantial decrease in gestation duration among adolescents.

95. Sugar slows food’s travel time through the gastrointestinal tract.

96. Sugar increases the concentration of bile acids in stools and bacterial enzymes in the colon. This can modify bile to produce cancer-causing compounds and colon cancer.

97. Sugar increases estradiol (the most potent form of naturally occurring estrogen) in men.

98. Sugar combines and destroys phosphatase, an enzyme, which makes the process of digestion more difficult.

99. Sugar can be a risk factor of gallbladder cancer.

100. Sugar is an addictive substance.

101. Sugar can be intoxicating, similar to alcohol.

102. Sugar can exacerbate PMS.

103. Sugar given to premature babies can affect the amount of carbon dioxide they produce.

104. Decrease in sugar intake can increase emotional stability.

105. The body changes sugar into 2 to 5 times more fat in the bloodstream than it does starch.

106. The rapid absorption of sugar promotes excessive food intake in obese subjects.

107. Sugar can worsen the symptoms of children with attention deficit hyperactivity disorder (ADHD).

108. Sugar adversely affects urinary electrolyte composition.

109. Sugar can slow down the ability of the adrenal glands to function.

110. Sugar has the potential of inducing abnormal metabolic processes in a normal healthy individual and to promote chronic degenerative diseases.

111.. IVs (intravenous feedings) of sugar water can cut off oxygen to the brain.

112. High sucrose intake could be an important risk factor in lung cancer.

113. Sugar increases the risk of polio.

114. High sugar intake can cause epileptic seizures.

115. Sugar causes high blood pressure in obese people.

116. In Intensive Care Units, limiting sugar saves lives.

117. Sugar may induce cell death.

118. Sugar can increase the amount of food that you eat.

119. In juvenile rehabilitation camps, when children were put on a low sugar diet, there was a 44% drop in antisocial behavior.

120. Sugar can lead to prostate cancer.

121. Sugar dehydrates newborns.

122. Sugar increases the estradiol in young men.

123. Sugar can cause low birth weight babies.

124. Greater consumption of refined sugar is associated with a worse outcome of schizophrenia

125. Sugar can raise homocysteine levels in the blood stream.

126. Sweet food items increase the risk of breast cancer.

127. Sugar is a risk factor in cancer of the small intestine.

128. Sugar may cause laryngeal cancer.

129. Sugar induces salt and water retention.

130. Sugar may contribute to mild memory loss.

131. As sugar increases in the diet of 10 years olds, there is a linear decrease in the intake of many essential nutrients.

132. Sugar can increase the total amount of food consumed.

133. Exposing a newborn to sugar results in a heightened preference for sucrose relative to water at 6 months and 2 years of age.

134. Sugar causes constipation.

135. Sugar causes varicose veins.

136. Sugar can cause brain decay in prediabetic and diabetic women.

137. Sugar can increase the risk of stomach cancer.

138. Sugar can cause metabolic syndrome.

139. Sugar ingestion by pregnant women increases neural tube defects in embryos.

140. Sugar can be a factor in asthma.

141. The higher the sugar consumption the more chances of getting irritable bowel syndrome.

142. Sugar could affect central reward systems.

143. Sugar can cause cancer of the rectum.

144. Sugar can cause endometrial cancer.

145. Sugar can cause renal (kidney) cell carcinoma.

146. Sugar can cause liver tumors.

 

 

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Many thanks to Dr Beth Forgosh, of Discover Chiropractic of Soho, for bringing Dr Appleton’s list to my attention.

 

 

Note added to this post on 12/29/2014:

 

fruit-vs-dessert

 

Suzette Lawrence, MSN, commented that Dr Appleton’s list, above, describes the effects of REFINED sugars:

“This is not the case for natural fruits sugars that are attached to the fiber in the fruit, known as levulose … if absorbed it occurs low in the intestines and is converted to glycogen in the liver and stored there as an emergency energy source.  I agree that the SAD (Standard American Diet) beginning in infancy sets the stage for every disease, and some new ones. Think, GMO beet sugar … ”

From a 2014 article by the Cancer Treatment Centers of America entitled Natural vs. refined sugars – What’s the difference?:

Sugar, in all forms, is a simple carbohydrate that the body converts into glucose and uses for energy. But the effect on the body and your overall health depends on the type of sugar you’re eating, either natural or refined.

We wanted to explore the difference between these sugar types as a follow-up to our post about whether sugar drives the growth of cancer, which has received several comments. We again turned to Julie Baker, Clinical Oncology Dietitian at our hospital outside Atlanta, for her expertise on the issue.

Understanding sugars

Natural sugars are found in fruit as fructose and in dairy products, such as milk and cheese, as lactose. Foods with natural sugar have an important role in the diet of cancer patients and anyone trying to prevent cancer because they provide essential nutrients that keep the body healthy and help prevent disease.

Refined sugar comes from sugar cane or sugar beets, which are processed to extract the sugar. It is typically found as sucrose, which is the combination of glucose and fructose. We use white and brown sugars to sweeten cakes and cookies, coffee, cereal and even fruit. Food manufacturers add chemically produced sugar, typically high-fructose corn syrup, to foods and beverages, including crackers, flavored yogurt, tomato sauce and salad dressing. Low-fat foods are the worst offenders, as manufacturers use sugar to add flavor.

Most of the processed foods we eat add calories and sugar with little nutritional value. In contrast, fruit and unsweetened milk have vitamins and minerals. Milk also has protein and fruit has fiber, both of which keep you feeling full longer.

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2003;133:831S-834S.
143. De Stefani E, Mendilaharsu M, & Deneo-Pellegrini H. Sucrose as a Risk Factor for Cancer of the Colon and Rectum: a Case-control Study in Uruguay. International Journal of Cancer. 1998 Jan 5;75(1):40-4.
144. Levi F, Franceschi S, Negri E, & La Vecchia C. Dietary Factors and the Risk of Endometrial Cancer. Cancer. 1993 Jun 1;71(11):3575-3581.
145. Mellemgaard A. et al. Dietary Risk Factors for Renal Cell Carcinoma in Denmark. European Journal of Cancer. 1996 Apr;32A(4):673-82.
146. Rogers AE, Nields HM, & Newberne PM. Nutritional and Dietary Influences on Liver Tumorigenesis in Mice and Rats. Arch Toxicol Suppl. 1987;10:231-43. Review.

 

 

© Copyright 2014 Joan Rothchild Hardin. All Rights Reserved.

 

DISCLAIMER:  Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.

Follow Up on AO+ Living Bacterial Skin Tonic

Updated 2/25/2016.

 

images-1
I first wrote about AOBiome’s brilliant new approach to skin health and cleanliness in Living Bacterial Skin Tonic – Instead of Soap?! (June 7, 2014).
AO+ Refreshing Cosmetic Mist is a liquid developed by a biotech start up company in Cambridge MA to spray on our bodies in lieu of – or as an adjunct to – taking showers. Showering with most soaps and shampoos kills all the healthy elements of our skin’s microbiome. AOBiome’s new living bacterial skin tonic, made of safe live-cultured Nitrosomonas bacteria, replenishes the biome of microscopic organisms that should live on our skin.
(Source: AOBiome)
(Source: AOBiome)

 

From the AO Biome website:

THE SCIENCE

Skin has a Broad Systemic Impact

A healthy microbiome is necessary for skin to do its work optimally. The human skin microbiome requires Ammonia Oxidizing Bacteria (AOB) to function well.

AOBs Are Everywhere in Nature

In the wild, humans had this on their skin – a mutually beneficial working relationship! AOB in the natural environment regulate our nitrogen metabolism. Unfortunately, AOB on our bodies have been impaired by culture and behavior.

Why Does This Matter?

Modern hygiene has selectively depleted the natural balance of the skin microbiome particularly affecting AOB. By restoring the appropriate AOB levels, we believe a range of human health conditions could be impacted. AOBiome is interested in exploring potential physiologic effects including:

Improving skin architecture
Improving skin architecture
Preventing infection
Preventing infection
Improving vascularization
Improving vascularization

 

 

 

 

 

AOBs: What I'm spraying on my skin daily to improve my skin microbiome
AOBs: What I’m spraying on my skin daily to improve my skin microbiome

 

 

MY EXPERIENCE WITH AO+ SPRAY

After waiting a few months for the company to catch up to demand for their new bacterial spray, my first month’s supply arrived in early September 2014: Four spray bottles nestled inside an elegant box  – one bottle for each week – with clear use instructions. Each bottle contains over 100 sprays to least a week at about 15 sprays/day. The bacteria in the spray will survive about a month at room temperature so the bottle I’m using sits on the bathroom counter. The other bottles are stored in the fridge, where they’ll last for at least six months.

 

 

 

AO+ Refresjomg Cosmetic Mist - live cultured ammonia-oxidizing bacteria (AOB). (Source: www.microbesandme.com)
AO+ Refresjomg Cosmetic Mist – live cultured ammonia-oxidizing bacteria (AOB). (Source: www.microbesandme.com)
I began using the spray on September 7th immediately after toweling off from a shower – only on my arms, neck and chest at first – instead of my usual Jurlique Lavender Body Care Lotion. I showered using Dr. Bronner’s Lavender Soap (bar version) on my feet, crotch, arm pits and lightly on my face. As I was doing before, I’ve continued using Jurlique’s Skin Balancing Face Oil on my face and Erbe’s Orange C Serum around my eyes where the skin is delicate and usually dry.
I’ve also continued washing my hair with Jurlique’s Lavender Conditioner about once weekly. (I’ve got fine, curly hair so shampoo isn’t good for it – too drying. Conditioner does a fine job of cleaning out the dirt and excess oils.)
BTW, all the products mentioned above contain only high quality ingredients and no parabens, estrogen disrupters, carcinogens or other harsh, dangerous chemicals.
I stopped using antiperspirants many years ago once I understood that the body needs to perspire but, not quite ready to retire my deodorant, I’ve continued using my favorite: Tom’s Long Lasting Deodorant (Unscented).
What I noticed right away after that first application was that the skin where I’d applied the AO+ Refreshing Cosmetic Mist smelled like a baby’s skin – a ‘this makes me smile and feel good all over’ scent, not the shitty diaper smell. And after just one application, my skin felt and looked soft, smooth and well-nourished.

 

 

images

After a few days, I started using the bacterial spray on my legs and the tops of my feet too. This skin is usually pretty dry but has become nicely hydrated with the spray.
I tried the spray on my face but didn’t like the tight feeling it produced so returned to using face oil. Interestingly, I’ve never felt it at all on the rest of my body. This seemed to be unique to my face. Perhaps I’ll give it another try on my face.
That first bottle, with the daily use described above, lasted for 20 days – so clearly I wasn’t using 15 sprays/day.
Yesterday, with the second bottle, I started using the spray on my entire body – with the exception of my face, armpits, the parts of my back I can’t reach, and soles of my feet. That probably amounted to 12-15 sprays.
I’m thinking I’ll start using it on my hair too starting tomorrow.
One of the more interesting things that started happening after two weeks of using the spray on my arms is that some patches of seborrheic keratosis began to dry up. I expect they’ll eventually fall off! This is most welcome.

 

An example of a seborrheic keratosis. (Source: www.medicinenet.com)
An example of a seborrheic keratosis. (Source: www.medicinenet.com)

 

Seborrheic keratosis is a benign skin disorder characterized by rough, raised areas resulting from excessive growth of the top layer of skin cells. Mine are a light brown but they can range from light tan to black. They’re odd looking – like they’re just sitting on top of my skin. They’re sometimes referred to as “barnacles of old age.” How delightful. I’ll be glad to see them go.

 

BACTERIA ARE YOUR FRIENDS

(Source: www.microbesandme.com)
(Source: www.microbesandme.com)
The bottom line is that I’m quite happy to be an early user of AO Biome’s AO+ Refreshing Cosmetic Mist and greatly look forward to its being widely available. My hope is that the existence of this product will help educate people to differentiate between USEFUL bacteria and HARMFUL ones instead of viewing all bacteria as dangerous and in need of being destroyed.
I quote Michael Pollan from his wonderful article Some of My Best Friends Are Germs (Pollan, 2013):

As a civilization, we’ve just spent the better part of a century doing our unwitting best to wreck the human-associated microbiota.

 

 

There's a difference between good bacteria and bad bacteria. Nurture your good bacteria instead of trying to kill them off. (Source: naturallyimmune.org)
There’s a difference between good bacteria and bad bacteria. Nurture your good bacteria instead of trying to kill them off. (Source: naturallyimmune.org)

 

I highly recommend perusing AOBiome’s website, facebook and FAQ for more fascinating information on the needs of the skin microbiome and the science behind their product.

 

 

imgres

 

 

 

 

 

GUT/BRAIN/SKIN AXIS (Bowe & Logan, 2011) (Kresser, 2014)

 

I’ve been writing mostly on the gut microbiome on this site. Here’s information on how the skin flora microbiome fits in:

 

 

The trillions of microbes in and on our bodies are key to understanding our health. (Source: organicfitness.com)
The trillions of microbes in and on our bodies are key to understanding our health. (Source: organicfitness.com)

 

70 years ago, dermatologists John H. Stokes and Donald M. Pillsbury proposed a gastrointestinal mechanism for the observed overlap between depression, anxiety and skin conditions, such as acne.
They  hypothesized that emotional states might alter intestinal microflora, increase intestinal permeability and contribute to systemic inflammation. Among the acne remedies they suggested were Lactobacillus acidophilus cultures. Imbalances in the gut microbiota and oral probiotics produce systemic inflammation and oxidative stress, upset glycemic control and tissue lipid content, influence mood  and cause skin conditions such as acne.

 

EVIDENCE OF A  CONNECTION BETWEEN GUT PROBLEMS AND SKIN DISORDERS

 

  • People with acne are also at higher risk for suffering from GI distress, such as constipation, halitosis and gastric reflux.
  • A recent study found that teens with acne and other seborrheic conditions were 37% more likely to have abdominal bloating.
  • People with acne rosacea have been found to be 10 times more likely than healthy controls to have small intestine bacterial overgrowth (SIBO), a condition involving inappropriate growth of bacteria in the small intestine. Correcting their SIBO markedly improved their acne rosacea.
  • 14% of patients with ulcerative colitis and 24% of patients with Crohn’s disease also have skin disorders.
  • Celiac disease sufferers are also apt to have cutaneous manifestations, such as dermatitis herpetiformis (occurs in 1/4 of people with celiac). Celiacs also have increased frequency of oral mucosal lesions, alopecia and vitiligo.
  • A recent study showed that a drug used to treat psoriasis is also effective for Crohn’s.
  • In another study, 56 patients with acne who consumed a Lactobacillus fermented dairy beverage for 12 weeks saw clinical improvement.
  • Pasteurized, unfermented dairy is associated with acne but fermented dairy is not.

 

Scientists are now validating the existence of a gut-brain-skin axis – and recommending oral probiotics to cure and prevent acne and other skin conditions.
Noted practitioner of functional and integrative medicine,  licensed acupuncturist, and health blogger Chris Kresser puts it simply:
                              If you want to heal your skin, you have to heal your gut.
And, as I’ve noted throughout this site, improving your gut flora will reduce chronic inflammation everywhere in the body and keep you from developing allergies, one or more of the many autoimmune conditions and possibly even cancers – or let your body heal if you already have one of these conditions – and also improve your mood.

 

 

 

(Source: www.drchadmorton.com)
Your skin is a direct reflection of your digestive tract. (Source: www.drchadmorton.com)

 

2/25/2016:
In another brilliant move, AO Biome has renamed its skin-microbiome friendly spray mist, shampoo, and cleanser MOTHER DIRT.

 

 

Source: www.persiankittykat.com)
Source: www.persiankittykat.com)

 

 

 

REFERENCES

AOBiome. (2013-2014). facebook.  See:  https://www.facebook.com/AOBiome

AOBiome. (2014). FAQ. See: https://www.aobiome.com/faq

AOBiome. (2014). Pioneering bacterial therapy for the skin. See: https://www.aobiome.com/company

Bowe, W.P. & Logan, A.C.  (2011). Acne vulgaris, probiotics and the gut-brain-skin axis – back to the future? Gut Pathogens, 3: 1. See: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3038963/

Hardin, J.R. (2014). Living Bacterial Skin Tonic – Instead of Soap?! Allergies And Your Gut. See:  http://allergiesandyourgut.com/2014/06/07/living-bacterial-skin-tonic-instead-bathing/

Kresser, C. (2014). The gut-skin connection: how altered gut function affects the skin. See:  http://chriskresser.com/the-gut-skin-connection-how-altered-gut-function-affects-the-skin

Polan, M. (2013). Some of My Best Friends Are Germs. New York Times Magazine, May 15 2013. See:  http://www.nytimes.com/2013/05/19/magazine/say-hello-to-the-100-trillion-bacteria-that-make-up-your-microbiome.html?pagewanted=all&_r=0


© Copyright 2014 Joan Rothchild Hardin. All Rights Reserved.

 

DISCLAIMER:  Nothing on this site or blog is intended to provide medical advice, diagnosis or treatment.