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Healing the Leaky Gut

 

To heal the digestion and the leaky gut, basically seven things are needed—supplement the following divided into 2 or more servings:

            1. The amino acid L-glutamine (1500 mg/day, a maximum for your child would be 3000 mg/day) that also reduces blood and brain ammonia levels. Experiments with various animal models have demonstrated that the provision of glutamine can result in better nitrogen homeostasis, with conservation of skeletal muscle. This leads to better ability to learn, to retain, and to recall. There is also considerable evidence that glutamine can enhance the barrier function of the gut. Furthermore, it is now known that the gut produces large amounts of a vital antioxidant, glutathione, when adequate glutamine is present.

 

Glutamine is the principal metabolic fuel for small intestine enterocytes, lymphocytes, macrophages, and fibroblasts (major players in the immune function). Supplemental use of glutamine increases intestinal villus height, stimulates the gut’s mucosal, cellular proliferation, and maintains mucosal integrity. It also prevents intestinal hyperpermeability and bacterial translocation, which may be involved in sepsis and the development of multiple organ failure—Miller AL, Altern Med Rev, 1999 Aug, 4:4, 239-48.

 

L-glutamine is essential for the synthesis of the mucoproteins present in the mucous secretions of the GI tract. These secretions are responsible for protecting the lining of the GI tract. In addition to protective qualities, L-glutamine administration has been known to actually improve mucosal structure and healing (Arch Surg 1990;125(8):1040-45). The Merck Index reports that cabbage contains vitamin U, the anti-ulcer vitamin, used in “treatment of gastric disorders” (Merck Index, Merck & Co., Rahway, NJ. 1989, p 1581). Some of the healing properties of cabbage may be due to its high L-glutamine content. Cabbage juice suppresses Candida yeast infection (Heinerman, ibid, p56), and is an excellent laxative. Use it to clear impactions of the bowel.

 

Glutamine is often low due to yeast toxins. An adequate amount of this amino acid promotes the production of growth hormone. Just be careful with glutamine. When it converts to glutamate in the intestines this releases ammonia. Excess lysine tends to excess ammonia. If you have low arginine, it will be difficult to eliminate the ammonia. Arginine also promotes the production of growth hormone. It is possible that the bacteria in the gut have lowered the arginine levels. Dr. Braverman mentions a case presented by Stanbury and colleagues from MIT, where the presenting symptom was constipation. The bowel flora contained the bacteria Streptococcus fecalis, a potent source of arginine desaminase. This enzyme converts arginine back to citrulline, and an excess of the enzyme caused a deficiency of arginine in the patient.

 

The net results of Strep infection are depletion of vitamin K, decreased glutathione, arginine, and sulfhydryl protein levels, overstimulation of the immune system, increased TNF alpha (that triggers Tourette's syndrome, facial tics, OCD, and Schizophrenia), potential autoimmune responses, and inflammatory reactions against the GAGs in the GI tract. Supplement these nutrients while struggling with this invader (see suggestions pertaining to TNF elsewhere in this paper.  

 

So, to overcocme leaky gut, start correcting deficiencies of folic acid, B12, zinc, molybdenum, arginine, and the other aminos that help remove ammonia, before trying glutamine. If ammonia is already high, alpha-ketoglutaric acid (alpha-ketoglutarate) might be a better place to start. It will convert to glutamate when it absorbs ammonia. Glutamate then absorbs another ammonia molecule to become glutamine that delivers the unwanted ammonia to the urea cycle leading to the formation of urea that can be passed out through the kidneys. α-ketoglutaric acid is an intermediate in the Krebs cycle, and as such can be degraded to carbon dioxide and water, or transformed into sugars. As an added bonus, alpha-ketoglutarate is needed to convert B6 into its useable coenzyme form, P5P. Glutamate is an excitotoxin so don’t overdo. Get expert guidance on using the aminos, and be very observant when you use them.

            2. Bromelain (200 or more mg/day), a digestive aid and anti-inflammatory often available in item 3. It should not be used with ulcer or gastritis as the protease may eat on the raw flesh. It “thins” the blood; so don’t take it with prescription blood thinners or aspirin.

            3. A digestive aid of pancreatic enzymes, including lipase, amylase, lactase, cellulase, and peptidase, (with ox bile if there is evidence of indigestion of fat). Use enough to correct all observed stomach or bowel irregularities. A good one is GI-Zyme™ by Mannatech™, Kirkman’s EnZym-Complete™ or SpectraZyme™ by Metagenics™ available from www.randallnutritioncenter.com/rcnc2000/spectrazyme.html, or Fern’s Nutrition, 1-800-229-3376. These do not contain ox bile. There are only a couple of possible downsides. If you are taking large, regular doses of aspirin or NSAIDS, these will make your stomach so raw, and your gut so leaky, that the protease could eat on your stomach or gut. To protect the stomach from HCl and protease, drink a large glass of water one-half hour before eating (this will hydrate the mucus lining of the stomach), and take the enzymes with the first part of your meal, unless they are in veggie capsules. These take longer to dissolve. Take them 15 minutes before eating (mix it in a spoon of food for children). Therefore, if taking lots of pain pills, or if you have an ulcer, or severe gastritis, find an enzyme supplement without protease. RGardens, International, “Gamma-Zyme™”, 200 capsules for $30.00, is the only one I know of (Phone 800-700-7767). The use of a supplement of arginine will greatly reduce this stomach and gut damage caused by NSAIDs. NSAIDs also rob you of copper, so care must be used if copper deficient. One can also ask the doctor about prescribing a form combined with copper, or take 4-8 mg copper, depending on the amount of NSAID being used. 

 

Some have found MSM as effective as Tagamet™ or Zantac™ in relieving ulcer pain and heartburn. Remember too, that aspirin or aspirin-containing compounds or anti-inflammatory drugs such as indocin, butazolidin, or cortisone should never be taken when hydrochloric acid is being supplemented. This combination increases the risk of ulcer. Two enzyme tablets at bedtime are reported to usually desensitize you to pollens and things that cause hayfever—and perhaps other allergies. Enzymes introduced in large amounts too quickly can affect the bowel: usually diarrhea, intestinal bloating, peculiar acrid smell of the stool, and, in some cases, itching of the perianal area. Work up to dose slowly, back off if these symptoms persist.

            4. Probiotics: Lactobacillus Acidophilus, Bifido Bifidus—these produce most of the available vitamins B–complex and K, and the fatty acids (butyrate) that the cells in the lining of the gut depend on for their nutrition, and they keep Candida yeast from becoming a problem. Additionally, by producing a substance, Muramil Dipeptide, that activates synthesis of B- and T-lymphocytes, the healthy gut wall is literally infiltrated, jam-packed, with B and T lymphocytes ready to protect the body from any invader. Further, the beneficial flora of the gut synthesize such antiviral substances as interferon, lizocym, and surfactiris that dissolve the membranes of lipid-envelope viruses. Take these on an empty stomach for best results, possibly with a little baking soda water to help them survive the journey. These will not recolonize the gut without some lactic acid; so, if casein free, take some S. boulardii. Supplementing probiotics may be doubly vital when taking magnesium:  Magnesium is a wide-spectrum antibiotic. Good bacteria in the intestines are vital in nature’s plan to prevent diarrhea, but magnesium in the gut can, and usually does, kill them. When taking large amounts of magnesium, use very large amounts of probiotics.

            5. Supplement vitamins A and D [preferably as cod-liver oil (5000 to 10,000 IU vitamin A, 800 to 1200 IU vitamin D. Should you not use CLO, then choose a water-miscible form of vitamin A and a capsule of D3, and the minerals zinc (15-30 mg/day) and copper (in an 8:1 zinc/copper ratio unless testing shows there is high copper already—as it probably will in autism--, but not exceeding five mg copper per day, and do not take them together) in addition to a broad-based, multi-vitamin/mineral supplement Nutrilite™ Food Supplement by Amway™ or, preferably, GlycoBears® chewable multivitamin/mineral by Mannatech™. Zinc reduces intestinal permeability in malnourished children with diarrhea. A lack of copper may cause seizures—Arch Dis Child, 1982;57[9]:716-18. A lowered hematocrit (red blood cell count) can be indicative of lowered blood copper levels (copper induced anemia).

 

A 1977 South African Medical Journal study of vitamin A as therapy for excessive bleeding (bleeding is the leading cause of hysterectomies). The article cited the use of vitamin A over a ten-year period at Johannesburg General Hospital and documented a 92% cure rate! An extreme vegetarian diet, recommended and promoted by many, depletes the body’s stores of vitamin A leading to malnutrition and infection, and bleeding! A search of standard nutrition textbooks confirms that persons with low thyroid function, babies, and young children are unable to convert beta carotene (found in vegetables and used in place of vitamin A in most vitamin pills) into usable vitamin A. Patients with low thyroid often have excess bleeding, and are at extreme risk of unneeded surgery to the reproductive organs. In addition to this, many foods, particularly the soy foods with a high copper, diadzen, and genistein content, are known to depress the thyroid function. The textbooks also state that vitamin A is needed for iron absorption, and the building of blood, but few indeed will direct that vitamin A be taken with iron supplements. Nevertheless, in tests of pregnant women, 68% responded to iron only, while 35% responded to vitamin A only, but 97% responded to a combination of vitamin A and iron ([Lancet, November 27, 1993, pp.1325-1328]. People with underactive thyroids are always vitamin A deficient. They cannot convert beta-carotene to vitamin A because of a lack of iodine (Dr. Michael Cutler, MD), nor can they convert vitamin A to the form usable by the eyes. Without adequate vitamin A they cannot convert the thyroid hormone T4 to T3! Occasionally, you will see a yellow cast to the palms of the hands and bottoms of the feet, or around the eyes and cheeks, due to an inability to handle carotene.

 

The antioxidant, vitamin A is vital to a child’s ability to sleep through the night, to have abundant energy, and to have a strong immune system. Additionally, in South Africa, high death rates following measles vaccine were reduced to virtually zero by injecting 200,000 IU of vitamin A with the vaccine! In an American study, kids who stayed out of trouble got 8,000 IU of vitamin A in their diet, those who were usually in trouble, got 3,000! Grab that CLO! Nevertheless, like zinc, absorbability and individual need for vitamin A can vary widely. If no improvement is seen, keep increasing the daily intake by 10,000 IU per day (every 2 to 4 weeks) until benefits are experienced or until a rough, dry, dirty rash appears around the neck or upper shoulders, or nausea, or headache occurs indicating toxicity. Should this occur, stop the supplement for a few days until these symptoms disappear, then reinstitute the supplement at a lower amount (Dr. Sidney Baker). If needed in these very high amounts, use water-soluble vitamin A as it is far less likely to induce toxicity. Your doctor should monitor this type program. 

 

Additionally, bleeding can be a sign of vitamin K deficiency. This is quite likely in autists because of a failure to eat green vegetables and a lack of friendly bacteria in the gut (they make 80% of our available vitamin K). Vitamin K is more than a blood-clotting vitamin, however. It is a powerful antioxidant, and necessary to vital function. It prevents Arteriosclerosis by preventing hardening (calcification) of the smooth muscle of the arteries and prevents osteoporosis by working with vitamin D in controlling calcium utilization, preventing excessive bone loss. Though it is a fat-soluble vitamin, vitamin K is not stored and must be absorbed on a daily basis. The pancreas contains one of the highest levels where it is involved with sugar regulation and aids in control of hypoglycemic related anxiety attacks. Vitamin K reacts enzymatically with glutamate and calcium to ensure proper placement of calcium where it belongs in bone and teeth. It is a cofactor for the conversion of glutamate to gamma carboxyglutamate. Lack of vitamin K would create a cycle of deregulation in the glutamate/calcium pathway leading to further neurological inflammation. Excess glutamate also leads to release of insulin that res,ults in decreased blood sugar levels. The amount of glucose in the brain regulates the removal of excess glutamate from the synapses; thus, a drop in glucose allows the buildup of toxic glutamate. A supplement of at least one milligram of vitamin K a day for children would be indicated, with 10 mg a day being suggested for adults. Women who took a lot of vitamin D with low vitamin K had double the hip fractures!

 

Dr. Woody McGinnis, MD, USA has this to say about copper: “I think a lot of our behavioral kids are intolerant of even a milligram or two of extra copper, even in the face of high Zinc supplementation. This is contrary to the usual proportional balance we like to strike. I get a serum Copper and a plasma Zinc, and try to keep the ratio less than 1:1.” This intolerance is probably because normal levels of copper are toxic to mercury-poisoned people. High copper is also one indicator of Candida.  Nevertheless, blood, urine, and even hair analysis may not reveal copper toxicity directly. Copper is stored mainly in the brain, liver, and other organs, not in the blood or urine. The detection of copper toxicity can be tricky, even with hair mineral analysis. Some people who have copper overload initially don’t test high in copper because the copper is tightly stored in tissues and hasn’t yet been released into circulation and deposited in the hair. If copper levels are low or normal, copper overload still can be present but hidden. Several indirect indicators on a hair mineral test are also excellent to detect copper imbalance. These include a hair calcium level greater than about 100 mg%, a potassium level less than about 3 mg%, a sodium/potassium ratio less than 2.5:1, a zinc/copper ratio less than 6:1, an elevated mercury level or a copper level less than 1.0 mg%. Severe Zn/Cu imbalance or zinc deficiency is associated with irritability and rages! For more information on determining copper overload through hair mineral analysis, have your health practitioner contact Trace Elements, Inc., at 1-800-824-2314. When copper is high, the patient has cravings for foods that have high copper to zinc ratios such as mushrooms, lobster, crab, canned prawns, cod, oysters, pecans, hazelnuts, sunflower seeds, walnuts, almonds, Brazil nuts, sesame seeds, French fries, brewer’s yeast, chocolate, dried peaches, and liver.

 

Copper binds to pesticides, giving them easier entrance into organisms. “These biotoxins don’t just affect the nervous system. They trigger release of inflammatory agents in the body that can inflame almost any organ and cause multiple-system symptoms.” Biotoxins all do their damage by setting off an “exaggerated inflammatory response” in humans. They hide out in fatty tissues where blood-borne disease-fighters can’t get at them; thus, they trick the body’s immune system into launching attacks against joints, muscles, nerves and brain. (This has come to be called “autoimmune disease” where the body is said to be mistakenly attacking itself.)

“The body can turn off the macrophage cytokine response, so that the achiness, fever, headache, and fatigue of a cold will go away, but there’s no negative feedback that stops the cytokine response from fat cells,” says Shoemaker. “So, the illness doesn’t self-heal.”

Cholestyramine (CSM) is an FDA-approved medication that has been used to safely lower elevated levels of cholesterol for more than 20 years. It isn’t absorbed; if it’s not taken with food, it binds cholesterol, bile salts, and biological toxins from bile in the small intestine, and then the CSM-toxin complex is excreted harmlessly. Shoemaker and Hudnell don’t have definitive answers yet as to exactly how or why CSM clears neurotoxins from the body, but a double-blind, placebo-controlled, cross-over clinical trial of eight, Pfiesteria patients positive for biotoxins showed that those who took a placebo remained ill, but improved following CSM treatment. Data from 30 others he’s gathered since matches the original study data.

Shoemaker says while some patients notice immediate improvements, Lyme disease patients who’ve been sick for more than five years usually require toxin-binding therapy for 4-8 weeks, he says. “Most patients improve in two weeks, some with complete abatement of symptoms, but depending on the amount of toxin in your body, it may take longer.” 

He believes the response of these patients to CSM therapy shows the underlying common theme of neurotoxin-mediated illness, and that the proof that toxins were responsible for the illness is found when patients recover, i.e., have no symptoms following treatment with his protocol.

“The proof of neurotoxin effect comes from watching the biomarkers change with treatment and relapse with re-exposure,” says Shoemaker. “There’s very strong evidence, especially in the Sick Building Syndrome patients.”

Hudnell agrees. “The best evidence that biotoxins are causing the illnesses comes from cases with repeated illness,” says the toxicologist. “When you see patients with chronic illness recover vision as symptoms resolve while being treated with a drug that can do nothing but remove compounds from circulation, then see vision plummet and symptoms return following re-exposure to sources of toxins, and finally, see re-recovery with re-treatment, sometimes for three or four cycles, you become convinced that it’s the toxins causing the illness.”  - Quotes from Ritchie C. Shoemaker, MD and H. Kenneth Hudnell, PhD. – From Neurotoxins, by Patti Schmidt.

Having considered all this and being reminded that these toxins can be positively removed from the body by binding the toxic bile, how can we protect ourselves on a daily basis?

 

Fill up on fiber. Fiber helps everything move smoothly and efficiently through the digestive tract. Fiber promotes healthy flora in the gut and binds and transports excess bile acids and potential inflammation-causing substances out of the body. Fiber-rich meals help contribute to a steady and sustained contribution to blood sugar. All that’s widely recognized, yet in this country our average fiber intake is 10 grams daily, whereas 25 to 30 grams are required for good health. Good high fiber-foods include steamed vegetables, ripe fruits, lentils, black beans, barley, chickpeas, bulgur, brown rice, oatmeal, and whole-grain breads and cereals. Avoid refined and processed items such as white bread, pasta, cornflakes, cookies, candy, and other sweets. Another benefit of fiber-rich foods? They have the advantage of satisfying hunger more effectively, since they are broken down slowly in the digestive system. In contrast, simple and refined sugars (from processed foods and sweets) quickly cause blood sugar spikes... then a crash in energy that leaves you craving something sweet.

 

Glucomannan is a water-soluble fiber that encourages better digestion overall... helps stimulate the conversion of cholesterol to bile acids... and decreases the intestinal absorption of cholesterol and the reabsorption of toxic bile. Take one capsule 30 minutes before lunch and dinner with a large glass of water. Supplement also resveratrol that supports both paths of Phase II detoxification by providing both sulfates and glucuronides.

 

Returning to the subject of vitamin A, an inflammation fighter, in intestinal health: The significance and urgency of building vitamin A is seen in a recent report: “These data indicate that vitamin A is necessary for optimal function in the hippocampus, which we know to be a main seat of learning,” said Salk researcher Sharoni Jacobs, “The study indicates that the detrimental effects of vitamin A deprivation (on learning) are remarkably reversible, which offers hope to the millions of children worldwide with vitamin A-deficient diets.”

            6. Aloe (preferably Ambrotose AO™ that contains Manapol™ and many other saccharides and antioxidants for even better results, or Man-Aloe® Classic (Manapol™) by Mannatech™ for they are the only stabilized, standardized, aloe products available).

            7. Balance flora by use of antifungals and supplement flora with yogurt or a probiotic supplement. Provide fiber, preferably fructo-oligosaccharide to provide an environment for the “good guys” to overcome yeast and other “bad guys”, or other non-gluten fiber. Mannatech’s GI-Pro™ offers a 12-billion count for effective colonization.

            8. Restore adequate sulfate to the body as outlined in the section Phenol-sulfotransferase.

 

When the gut is healed and the digestion restored, bizarre eating habits will cease, and a more balanced dietary will be possible. There are three things to know about glutamine:

            1. It can cause a buzz like excess caffeine—the kid will be hyper, in that case reduce the amount until this disappears. The amount recommended is not likely to do this.

            2. High glutamine readings are seen in subclinical ammonia toxicity. This could be due to a weak detoxification, or to excess protein intake. In the latter case, other amino acids will be high.

            3. Glutamine and arginine are the precursors that, with the help of vitamin B6, produce the amino acid GABA. Perhaps because of this relationship, both glutamine and vitamin B6 have been shown helpful to those suffering epilepsy. A pyridoxine deficiency decreased GABA in the hippocampal area by 32% in female rats. Additionally, according to current research done at NeuroGenesis, low levels of opioids, caused by stress, also result in low levels of GABA. In addition, low levels of opioids are correlated with high dopamine levels and low serotonin levels. Excessive anxiety and panic disorder can be related to GABA imbalances and sugar imbalances. GABA is an inhibitory transmitter that exerts a calming action; however, excess GABA is related to learning difficulties.

 

 

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