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DR. MARK’S INTEGRATIVE MEDICINE CABINET: The pharmacy in your kitchen
JACKSON HOLE, WYO - When I was at the Mayo Clinic training with the Internal Medicine Service, we would see patients with chronic autoimmune disease and other clinical syndromes like fibromyalgia and chronic fatigue. I would get my turn for the interview and start asking about nutritional habits: What did you have for breakfast? Do you ever get low blood sugar? Do you ever have to go to the bathroom right after you eat? Do certain foods make you feel congested? Did you have a lot of antibiotics as a child or recently?
And then I would whisper, because it was not accepted as a real clinical term in medicine, “Do you have leaky gut?” At this point the attending physician, who was my mentor, would stop me and ask how could this have anything to do with the patient’s problem. And exactly what kind of alternative medicine was I trying to practice?
Meanwhile, the patient was ecstatic that someone, for the first time in a dozen consults, was asking all the right questions. Most doctors have medical intuition and know when something feels right. So I had to walk around whispering the term “leaky gut” to my colleagues in training. However, when working with Dr. Andrew Weil, we could have a rational discussion about how nutrition may be a possible trigger.
Now we can shout it out loud as a recent article in the New England Journal of Medicine is talking about leaky gut and autoimmune disease. The problem is it’s 20 years too late.
Leaky gut refers to the confusion in the immune system caused by the absorption of food. This is not a “food allergy,” which is more like the child at school who can’t eat nuts, as he has an instant histamine reaction and breaks out in hives or anaphylaxis and needs epinephrine or an Epipen. This is real and is very scary and I feel our schools do an excellent job identifying and meeting the needs for these boys and girls.
What we are talking about with leaky gut is delayed hidden food sensitivity. That may take one hour or up to three days to manifest, making it very difficult to identify. As food is digested, our small intestine, with an absorption layer the size of a doubles tennis court, has a protective immune surveillance system that watches for proteins (foods, bugs or toxins) that try to cross and enter the circulation, which is our barrier of defense from the outside world.
For some of us, the immune system attacks specific food proteins and causes a delayed flu-like reaction as it tries to process this immune-protein complex. However, the tricky part is this flu-like reaction is different for everyone and different in the same person for different foods. So for you it may be why your energy is low the next day, your sleep is poor, your joints hurt more, you may be more irritable, your digestion is off, you have those pesky little bumps on the back of your arms, your acne is worse or your menstrual cycle seems particularly bad that month for no reason.
Here is where gluten is an especially bad player as the 20 or so new chromosomes added to create the new short wheat has also created a unique molecule that drives this inflammatory response and is highly allergenic. Celiac is the disease of gluten, and it affects one in 100, making it one of the top prevalence of disease. Yet up to 30 percent of people are gluten intolerant and this is increasing due to our new wheat friend. This is driving the leaky gut process and causing increasing chaos in our immune systems and thyroid while fueling the epidemic of obesity and autoimmune disease.
Unfortunately, the calories that go in just does not equal calories out for most people, especially women, so the doctor says just eat less and exercise more and it will all work. Well, there is a big Dutch waterwheel spinning called your metabolism, and if this is not at full speed the equation does not work. So many women do everything right, yet nothing happens. They blame themselves and give up. Yet if they let us help them crack the code by identifying their food sensitivities, we can spin that wheel and everything works.
Can you really fix your lack of energy, hormone issues, joint pain, trouble losing weight and your thyroid problem by changing what you eat? Can food be medicine? Your kitchen your pharmacy?
Yes, Hippocrates got it right 2,000 years ago, but we’re just now listening.