The Snowball Effect
“And Then It All Went Downhill”
It can be difficult to find the initial cause of bodily pain and dysfunction. It's tempting, for all of us, to blame a tweaked low back on the twisted position, we managed to get ourselves into, taking groceries out of the car, at the same time a loaded tote bag dropped from our shoulder. In truth, and despite the immediacy of the pain in that moment, the initial insult to the body probably started much earlier — a long, stressful day at the computer, finishing up some work before vacation (remember those?) followed by the hurried haul of luggage (why did I bring our snow boots if we're headed south?) capped off by a long trip in the car. Weeks later, a shoulder started acting up — must have been the snow boots! In reality, that shoulder pain could have been signaling that your hips were tight and off-kilter, from sitting too much and stretching too little. Your spine — under stress, and as a consequence — caused the muscles of the back to pull this way and that, shortening a range of motion in your shoulder. Ding! The pain of an impinged nerve in the rotator cuff. Weeks after that, as this musculoskeletal dysfunction progressed, you reached for a bag of groceries and a white-hot pain shot across your lumbar region.
This is all to say, it wasn’t the snow boots so much as it was “the snowball effect.”
What happens to the body's musculoskeletal system can be easier to track, tied as it is to visible gestures we make or stretches we skip. What happens in the gut, with its ever-changing population of microbes and varying degrees of intestinal fortitude can be harder to track, but it's a process that's just as elaborate, and just as tied to cause-and-effect. What starts in the gut can snowball to various systems in the body. What you might think of as “something I ate” may begun much earlier.
Fortunately for all of us, the formerly invisible world of the gut — that busy factory in our body's core — has recently become more visible, and tracking associated disease has become more evidence-based through testing and research. As a consequence of mapping the microbiome, we're now able to correlate certain diseases to high and low levels of microbiota.
The mere presence of a potentially disease-producing organism (i.e. a pathogen) is not necessarily problematic. Remember, there are over a trillion organisms living in our intestines. They are supposed to be there. Issues arise when there are too few or too many of a specific organism.
Good health depends on microbial balance. Disease begins with imbalance — something called ‘dysbiosis.’ It can begin in small ways that grow larger and larger, when that initial problem is not corrected, and we allow the snowball to roll downhill.
There are three primary patterns of dysbiosis or microbial imbalance.
Insufficiency dysbiosis occurs when there are low levels of beneficial bacteria, with an increased risk for infection, decreased SgIA, and increased inflammation.
Inflammatory dysbiosis occurs when there are moderate-to-high levels of certain pathogens, often proteobacteria and producers of Lipopolysaccharides (LPS) that are pro-inflammatory.
Digestive dysfunction often develops due to low stomach acid, insufficient bile acids, poor digestion (low digestive enzymes), and reduced absorption of nutrients.
What causes these microbial imbalances in the first place?
Usually, it is the result of one or a combination of the following:
Pathogens — bacteria, viruses, parasites, worms
Medications — antibiotics, steroids, proton-pump inhibitors
Poor diet — processed foods, sugar, low vegetable intake
Digestive and immune dysfunctions — low stomach acid, low digestive enzymes, low secretory IgA
Toxins — environmental toxins, heavy metals, lipopolysaccharides (LPS),
Stress — the brain talks to the gut and the gut talks to the brain, through the two-lane highway of the vagus nerve
Aging — levels of hydrochloric acid naturally decline as we age; less HCL leads to all kinds of microbial shifting and changing
Dysbiosis, the overgrowth of bacteria that begins in the gut can progress to fatigue, dizziness, difficulty concentrating, hair loss, skin changes or rashes, constipation or diarrhea, numbness or tingling in the hands or feet — to name some of the most common symptoms. Dysbiosis can snowball further, creating a more debilitating state of disease.
Yesterday, in the clinic, I talked with women who had concerns including acne, recurrent vaginal yeast infections, reflux, fatigue, memory issues, and osteoporosis. All of these concerns share some level of imbalance in the microbiota.
Here are a few other diseases, well-known to women, that are associated with organisms out of balance:
Guillan-Barre Disease (Campylobacter)
Multiple Sclerosis (Chlamydia Pneumoniae)
Rheumatoid Arthritis (Citrobacter, Klebsiella, Proteus, Porteus mirabellis)
Asthma and Ankylosing Spondylitis (Klebsiella)
Grave’s Disease and Hashimoto’s Thyroiditis (Yersinia)
Irritable Bowel Disease (Fusobacterium)
Autoimmunity, in general (E. Coli, Proteus)
Additionally: my awareness of the bacteria Helicobacter pylori (H. pylori) and its handiwork has increased in the past few years. Fifty percent of the population has H. pylori and if you start Googling around, you will find it’s associated with increased incidences of stomach ulcers and gastric cancer. H. pylori causes significant hypochlorhydria, or low stomach acid, and subsequent maldigestion. Of particular relevance to many women I take care of: H. pylori is a significant cause of acne.
Leaky gut, also known as intestinal permeability, is a syndrome that develops from dysbiosis and is related to other chronic diseases and disorders. While our guts are designed to be permeable, the junctions, or tiny openings in the epithelial wall that regulate traffic, are wondrously-made and perfectly-sized. Various insults to our gut lining create junctions that are too large, allowing for “leakage” of partially digested food, toxins, and bacteria into our bloodstream. The beleaguered body reacts, and inflammation is triggered. The reaction is the body defending itself against any invader, after all — even locally grown, organic whole food, if it arrives at the wrong place at the right time. But is it always the fault of the food? Our instincts to blame something we ate, and leave it at that, can lead us to assume that all will be well if we just stop eating that type of food. Unfortunately, that solution can be short-lived or ineffective, altogether. Without finding the foundational cause, and healing the permeability, the course of disease can progress through the body, leading to other systemic issues or a state of general autoimmunity.
More on the crucial topic of autoimmunity in the coming weeks. For now, here are some helpful ways to avoid dysbiosis, or a microbiome out of balance.
Three Things To Try:
Eat vegetables at every meal
Manage stress in healthy ways
Use prescription medications judiciously and take side effects seriously
Three Things To Avoid:
Processed food
Long-term and/or repeated antibiotic and steroid use
Mismanaged stress