Leaky brains? This info is from the School of Applied Functional Medicine & used with permission. If I duplicated info in this handout in my cutting & pasting, just remember, repeat-repeat-repeat to learn.
June 21, 2016 | 8 Comments | SAFM Team I want to introduce you to a client, Mary, who is delightedly free of debilitating, daily anxiety. Great news! Life-changing relief for Mary. But I bet you are going to be surprised to find out what helped her…. If you’ve studied functional medicine concepts even a small bit, you are well familiar with the concept of Leaky Gut, that is enhanced intestinal permeability. This is critical know-how for any practitioner. I’ve written before about just how dangerous it can be for a protective shield that separates one cavity from another in the body to be damaged. (As I’ve shared in prior issues, intestinal permeability is implicated in all autoimmune disease and is believed to be caused by a perfect storm of many factors, including low vitamin D, ongoing NSAID use, and modern wheat exposure.) But what about a leaky brain? Not surprisingly, an effective and appropriately permeable blood-brain barrier (BBB) is critical for neurological health. The brain needs nutrients and oxygen and to rid itself of wastes. However, it can be readily damaged by toxins (e.g. mercury), chronic inflammation, or nutrient imbalance. Research shows that many factors can make the BBB inappropriately permeable, including age, toxic exposure, chronic low-grade inflammation, microvascular disease, Type 2 diabetes, and Alzheimers. Each person’s body is unique, and some individuals are much more vulnerable to this dynamic than others. Neurotransmitter imbalance can be caused by inappropriate amino acids moving from systemic circulation into brain circulation. In the body, glutamine is the most prevalent circulating amino acid; the body even makes its own supply from glutamic
acid. Glutamine is critical for tissue growth and maintenance (especially muscles, which makes it a favorite supplement of bodybuilders). It’s often recommended to help with repairing damaged intestinal villi in cases of leaky gut or celiac disease. The body (including the brain) can readily convert glutamate to glutamine and back again. However, in the brain both glutamine and glutamic acid act as neurotransmitters keeping a highly-controlled, delicate balance between inhibitory action (from glutamine) and excitatory action (from glutamate). A person with a leaky BBB who supplements with high doses of glutamine or glutamic acid can easily become vulnerable to neurological imbalance. Too much glutamic acid (or glutamate) can easily cause one to suffer from too much excitatory stimulation. The result? Anxiety. And often also insomnia, irritability, restlessness, and when acute, a hair trigger sensitivity to anything alarming or disturbing. “Excitotoxic” glutamate overload can also exacerbate ADHD and many other neurological disorders. Mary began suffering from particularly acute anxiety and fear-based obsession. Investigating her complaints carefully, we learned this began about six weeks after beginning a twice-daily dose of l-glutamine to help to heal her food sensitivities and leaky gut. Note this was only 3 grams twice daily. But Mary had also started using a daily whey protein shake (given discovering a food sensitivity to eggs!). Whey protein (esp. if denatured) is particularly high in glutamic acid. Together, this was enough to put Mary is a bad place neurologically. After stopping both of these supplements cold-turkey, Mary was back to normal after about 10 days. To quote her, “Oh my God, it’s like I finally woke up from a two-month nightmare.” We focused instead on using zinc, whole-food protein, and supportive herbs (e.g. aloe, marshmallow root, slippery elm, DGL, quercetin) to help heal her gut lining. Be aware of both the benefits and the risks of food-based supplements that contain denatured or free amino acids. One size does not fit all! Protein powders, lglutamine, collagen, gelatin (esp. if it’s “hydrolyzed”), bouillon/broth… These may be an issue for some clients. I have had other, prior clients find that dairy foods in general bothered them in this way. Most of us know that some individuals are very sensitive neurologically to monosodium glutamate and its many derivatives for this same reason (e.g. anything hydrolyzed or autolyzed or modified, any protein isolate or concentrate, maltodextrin, yeast extract). I have had several clients this past year discover issues like Mary’s. It’s a perfect reminder that each of our clients is unique. Every person can have a unique response to a specific food, herb, supplement, or nutrient. Just because it’s “logical” or “healthy” for one, doesn’t make it so for another. Remember to stay in a mode of ‘beginners’ mind’ and treat each individual client’s symptoms as golden clues. 1. Did healing Mary’s gut help her tolerate glutamate later on? Reply
o
4.1 SAFM Team says: Ah, that’s a great question! The answer is: I don’t know. Given her experience, she didn’t want to be “challenged” with it later on, so she continued her avoidance of glutamine-containing supplements and also intense sources in foods. She did have some food sensitivities which she was able to successfully reintroduce after a 4-6 month elimination. So clearly some immune calming and gut healing took place. In retrospect, I think it was wise for her to avoid fearprovoking choices. Reply
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Maria says:
Thanks Tracy! I appreciate your response. It’s great to learn so much from his site! I do drink coffee and often eat dark chocolate daily. I will cut those out and try having matcha green tea in the morning only. I haven’t tried the NAC and Taurine yet. But I started taking a “sleep spray” that was recommended to me. It has HTP and melatonin (1.5 mg) and some other calming agents. I find it very helpful to quickly fall asleep. But now I am waking up about 2 times a night and usually around 4am (and I find myself hungry). I am thinking maybe low cortisol or blood sugar. I feel like I need to work on adrenals. Eliminating coffee should help with that and I use Rosemary essential oil on my adrenals in the morning. I eat really well for the most part. The melatonin is helping me fall asleep. I wonder if I should cut out the caffeine, try the NAC before bed (or maybe stick to the sleep spray) and also try a snack – like dates and almonds or coconut oil….? For blood sugar balance. Or I can do a test with meltonion for a week and then switch to NAC and see which supplement works for me best. I think cutting out the bone broth has helped too. After reading your post, I started the low dose meltonion and cut out the bone broth and I have slept better in the last week than in a year. Minus waking up during the night – but I also fall asleep quickly again, so it’s probably not even an issue.
Thanks!! Reply o
3.1 SAFM says: Wonderful – good for you! Thanks for sharing. I encourage you to not remain dependent for long on the melatonin. It can be very helpful as triage – to get you get rested and rejuvenated again. But I don’t recommend relying on it. As a hormone, it necessarily affects other hormones. It sounds like your focus on the adrenals could be powerful. Enjoy the journey! <3 Reply
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Maria says:
Wow, this is a really interesting post! I just subscribed to your group and newsletters, etc. I have really liked everything I read so far and learned a bunch already! I am fasinated by this case study and your response, Tracy! For almost a year now, I have been struggling with sleep. Mostly taking 3-4 hours to fall asleep, lots of racing mind and stress by the fact that I can’t fall asleep. Also,.. In this past year, I have been using collagen protein everyday, and also bone broth a few times a week. I wonder if I am also experiencing the glutamine issue (too much of the protein). I kept reading how great it is for skin and healing the gut. But it’s probably not great for my brain! I am going to cut it out completely and also try NAC and taurine before bed… I am curious if that will help me!! Thanks!!! Reply o
2.1
SAFM says: Welcome, Maria! I appreciate your enthusiasm. I agree fully that a 2-3 weeks trial without either the bone broth or the collagen is a great idea and will help you to learn about your unique body. The NAC/Taurine combination will also help to promote more gluamate to GABA conversion which can also be helpful for calming a racing mind at bedtime. Keep in mind also that any caffeine at all in your diet may be part of the problem, especially anything after noon. I have had a few clients find that their poor sleep, however, was even due to the coffee they had at 9:30am. In a few other cases, the dark chocolate they enjoyed at 3pm (much less later) was a major issue. We have varying levels of sensitivity to stimulants, so it pays to consider these as well. Happy Exploring! Reply
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Kathleen Mitchell says:
I have also heard concernâ&#x20AC;&#x2122;s regarding L-Glutmaine fueling certain cancers. Just another thing to consider:) Reply o
1.1 SAFM says: Correct. L-glutamine would definitely be contraindicated in any type of brain or nervous system cancer for the very reasons this post highlights. Thanks for highlighting this.
Leaky Blood Brain Barrier? This topic has come up a lot lately. Can you recommend some articles to gain some general knowledge on this topic?
Thanks! Missy
Tracy's Answer: Great question! Indeed, I expect we will be hearing much more in the coming few years about this dynamic. We are discovering more and more that a "leaky gut" can predispose one for impairment in the blood brain barrier. In a healthy individual, an intact blood-brain barrier helps to guarantee a well-controlled, semi-permeable membrane between the brain and the rest of the systemic body. This is important for a myriad reasons. For example, in the rest of the body, the amino acids glutamine and glutamic acid are the most prevalent ones in the body. In the brain, however, the balance between these two amino acids is very tightly controlled (and fluctuates over time in response to our environment) to keep an appropriate inhibitory or stimulatory neurotransmitter pace in the brain. The integrity of the blood-brain barrier can be harmed by many different factors, just as is the case with integrity of the intestinal barrier function. For example, low Vitamin D, high homocysteine (impaired methylation), secreting high amounts of zonulin in response to the gluten protein (which is the case in those with autoimmune disease), parasitic infection, heavy metal toxicity, having a poor gut microbial balance - that is simply, chronic inflammation. In fact, a leaky gut can cause the systemic inflammation that can then contribute to a "leaky brain". These are some resources (some lay, some more technical) which might be helpful to you:
An overview article by Dr. William Cole which also gives some labwork ideas: http://www.mindbodygreen.com/020800/signs-you-might-have-a-leaky-brain-what-to-do-about-it.html Elevated levels of homocysteine (HCY) have been shown in animal studies to impair the blood-brain barrier. Elevated HCY is evidence of impaired methylation which, as you know, can cause a number of systemic, inflammatory effects: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1895614/ Chris Kresser gives a good detailed overview of some of the dynamics that can contribute to leaky brain: http://chriskresser.com/the-healthy-skeptic-podcast-episode-9/ A quick summary of how having a balanced gut microbial population improves the integrity of the blood-brain barrier (fascinating, huh!?). Yet more validation that so much of disease does begin (or wellness begins!) in the gut: http://www.drperlmutter.com/gut-bacteria-protects-brain/#more-3419 Relatively recent research has highlighted the specific proteins that respond in the brain to chronic inflammation in creating brain barrier permeability: http://www.sciencedaily.com/releases/2014/06/140602104749.htmand http://www.fasebj.org/content/28/6/2551 . For a deeper dive, consider the book "Brain Maker" by Dr. David Perlmutter, author of "Grain Brain"
Leaky brains? June 21, 2016 | 10 Comments | SAFM Team I want to introduce you to a client, Mary, who is delightedly free of debilitating, daily anxiety. Great news! Life-changing relief for Mary. But I bet you are going to be surprised to find out what helped her…. If you’ve studied functional medicine concepts even a small bit, you are well familiar with the concept of Leaky Gut, that is enhanced intestinal permeability. This is critical know-how for any practitioner. I’ve written before about just how dangerous it can be for a protective shield that separates one cavity from another in the body to be damaged. (As I’ve shared in prior issues, intestinal permeability is implicated in all autoimmune disease and is believed to be caused by a perfect storm of many factors, including low vitamin D, ongoing NSAID use, and modern wheat exposure.) But what about a leaky brain? Not surprisingly, an effective and appropriately permeable blood-brain barrier (BBB) is critical for neurological health. The brain needs nutrients and oxygen and to rid itself of wastes. However, it can be readily damaged by toxins (e.g. mercury), chronic inflammation, or nutrient imbalance. Research shows that many factors can make the BBB inappropriately permeable, including age, toxic exposure, chronic low-grade inflammation, microvascular disease, Type 2 diabetes, and Alzheimers. Each person’s body is unique, and some individuals are much more vulnerable to this dynamic than others. Neurotransmitter imbalance can be caused by inappropriate amino acids moving from systemic circulation into brain circulation. In the body, glutamine is the most prevalent circulating amino acid; the body even makes its own supply
from glutamic acid. Glutamine is critical for tissue growth and maintenance (especially muscles, which makes it a favorite supplement of bodybuilders). It’s often recommended to help with repairing damaged intestinal villi in cases of leaky gut or celiac disease. The body (including the brain) can readily convert glutamate to glutamine and back again. However, in the brain both glutamine and glutamic acid act as neurotransmitters keeping a highly-controlled, delicate balance between inhibitory action (from glutamine) and excitatory action (from glutamate). A person with a leaky BBB who supplements with high doses of glutamine or glutamic acid can easily become vulnerable to neurological imbalance. Too much glutamic acid (or glutamate) can easily cause one to suffer from too much excitatory stimulation. The result? Anxiety. And often also insomnia, irritability, restlessness, and when acute, a hair trigger sensitivity to anything alarming or disturbing. “Excitotoxic” glutamate overload can also exacerbate ADHD and many other neurological disorders. Mary began suffering from particularly acute anxiety and fear-based obsession. Investigating her complaints carefully, we learned this began about six weeks after beginning a twice-daily dose of l-glutamine to help to heal her food sensitivities and leaky gut. Note this was only 3 grams twice daily. But Mary had also started using a daily whey protein shake (given discovering a food sensitivity to eggs!). Whey protein (esp. if denatured) is particularly high in glutamic acid. Together, this was enough to put Mary is a bad place neurologically. After stopping both of these supplements cold-turkey, Mary was back to normal after about 10 days. To quote her, “Oh my God, it’s like I finally woke up from a two-month nightmare.” We focused instead on using zinc, whole-food protein, and supportive herbs (e.g. aloe, slippery elm, DGL, quercetin) to help heal her gut lining. Be aware of both the benefits and the risks of food-based supplements that contain denatured or free amino acids. One size does not fit all! Protein powders, l-glutamine, collagen, gelatin (esp. if it’s “hydrolyzed”), bouillon/broth… These may be an issue for some clients. I have had other, prior clients find that dairy foods in general bothered them in this way. Most of us know that some individuals are very sensitive neurologically to monosodium glutamate and its many derivatives for this same reason (e.g. anything hydrolyzed or autolyzed or modified, any protein isolate or concentrate, maltodextrin, yeast extract). I have had several clients this past year discover issues like Mary’s. It’s a perfect reminder that each of our clients is unique. Every person can have a unique response to a specific food, herb, supplement, or nutrient. Just bec ause it’s “logical” or “healthy” for one, doesn’t make it so for another. Remember to stay in a mode of ‘beginners’ mind’ and treat eac h individual client’s symptoms as golden clues.