Showing posts with label Disease. Show all posts
Showing posts with label Disease. Show all posts

Friday, April 25, 2014

Why and How to Say No to an Unnecessary Root Canal Procedure

English: Root canal therapy of tooth #8 (front...
English: Root canal therapy of tooth #8 (front tooth) (Photo credit: Wikipedia)
 


PLEASE NOTE:
 This is the first of a two part series. Part two with comprehensive and specific options on what to do if you already have a root canal will be posted soon. These two articles are our effort to help save lives not teeth.

By Dr. Lina Garcia
One of the fundamental understandings that supports holistic, biological dentistry is that the dental procedures and materials used in them can affect your whole body, not just your teeth.
In the case of a root canal procedure, it can lead to a number of chronic health problems and even degenerative diseases. Unfortunately, it is very rare for someone in need of dental care to be aware of this.
Although you may be surprised to read this view of root canals, any time the procedure is done there is a real possibility it can endanger your overall health because of the infection and toxicity that can develop in your tooth after the root canal is performed.
The connection between a root canal treated tooth and disease in another area of your body is one the majority of health-care practitioners and their patients are simply unaware of.
The lack of awareness of this connection is puzzling when you consider that in conventional dentistry medicine there is an appreciation of research that has identified a connection between periodontal disease and other health problems, such as heart disease, stroke, respiratory diseases, diabetes, osteoporosis, and difficulties during pregnancy.
Periodontal disease is the general label used to describe chronic infection and/or inflammation of the gums and the supporting structures of the teeth. The American Academy of Periodontology actively seeks to educate the public about research that supports what perceptive dentists inevitably recognize: "Infections in the mouth can play havoc elsewhere in the body."

Periodontal Disease: A Risk Factor for a Root Canal

Periodontal disease has been identified as a potential risk factor for many systemic diseases. However, it is not well appreciated that microbes surrounding a periodontally involved tooth can invade it from the apex and damage or kill it.
When this happens, a conventional dentist will recommend a root canal procedure. Tragically, most conventional dental and medical establishments inexplicably disregard the connection between oral microbes associated with root canals and systemic disease.
So, every year, millions of Americans undergo at least one root canal procedure with no awareness of the risk involved to their overall health. The root canal procedure is typically done instead of extracting the diseased, dying, or sometimes already dead tooth.
Root canals have been, and continue to be, a conventional, or "standard of care," procedure done by a dentist or an endodontist. (An endodontist is a dentist who specializes in doing a root canal procedure, which is also called endodontic therapy.)
The root canal procedure is endorsed by the dental establishment as the preferred alternative to extraction. It is a big part of the business of dentistry. Give people what they want — and who wants to lose a tooth? So conventional dentistry offers a procedure that allows patients to keep a problem tooth while conveying confidence there are no risks involved.
But, unfortunately, there are risks.And what all too many dental practitioners don't realize is that a root canal treated tooth can be a direct cause of numerous degenerative diseases.

Many Diseases Can Be Related to Root-Canal-Treated Teeth

If you have at least one root canal treated tooth, acting upon the understanding that it can be damaging to your health may help you realize freedom from one of the diseases or ailments listed in the table below.
ArthritisAppendicitisEndocarditis and myocarditis (heart inflammation)Kidney, liver, and gallbladder problems
MeningitisAnemiaHardening of the arteriesNervous system breakdowns
PneumoniaHeart lesionsEye infectionsCancer
Many people suffer from diseases or ailments that modern medicine says are ofunknown cause. Well, the reality is that root canals are a seriously overlooked cause of many diseases.
More and more holistic-minded dentists, physicians and other practitioners are beginning to realize that many previously "incurable" diseases and ailments, which have no conventionally recognized cause, can sometimes be radically improved or completely resolved by extracting a root-canal tooth (or teeth) and properly cleaning out the tooth socket(s).

A Root Canal Will Leave Dead Tissue in Your Body

On the surface, having a root canal procedure instead of extracting a tooth is very appealing. A tooth is obviously an important part of your body that you want to keep if at all possible. But it's more important for you to see your health in a holistic way, so you can avoid losing much more than your tooth It's silly for us to think of ourselves as a collection of body parts that function independently of each other. 

Seeing your health in a holistic way leads to understanding that each and every, part of your body can have an influence on the whole. In cases of intense pain, it may be thought of as a "mercy killing," but having a root canal can definitely be an effective way to eliminate the pain — kill the tooth and you kill the pain.
The pain is gone because the nerves are gone. However, a much more accurate, no-nonsense way of describing the end result of a root canal is this: It doesn't "save" the life of the tooth, but it does keep enough of the tooth's structure intact so that the crowned chewing surface will be functional, and you keep the aesthetic value of the tooth.
So there you are — you are now left with a functional but dead tooth in your mouth that looks good when you smile. But think about this for a moment. Doesn't it seem unhealthy, and even strange, to leave a dead tooth in your mouth? If any another organ in your body, like your appendix, were dead, it would have to be removed or else very aggressive strains of microbes that nature uses to decompose dead tissue would set in and threaten your life! And something similar happens with a dead tooth, whether it is killed from infection, trauma or the root-canal procedure.
After a root canal is done, the dead tooth, not sometimes, but always becomes an environment conducive to harboring chronic infection and toxicity. Because there is no reliable way, practically speaking, to completely sterilize a root canal treated tooth, (while it is still in a patient's mouth), it will be a source of infection for the whole body until it is extracted and the tooth socket is cleaned.

How to Avoid the Root Canal Procedure That You Might Not Even Need

One of my biggest challenges as a Biological Dentist is when a patient cries with regret for agreeing to have a root canal procedure done to a tooth or teeth – a procedure they neither needed nor understood from the perspective of whole body health. Like any part of the body, a tooth can be inflamed, painful, or simply sensitive. If you go to a dentist they will quite often advise you to have a root canal.
But not so fast! Let's learn and make a wise decision. The table below lists several reasons a tooth can be sensitive or painful but please understand that it there is not enough space in this article to more fully elaborate. The best way to evaluate your specific pain would be with a qualified dental professional.
Clenching or grindingStressPoor hygieneReferred pain from your heart
Referred muscle pain from temporalis or masseter musclesLack of sleepTrigeminal neuralgiaSinus headaches
Sugars or processed foods, even fruitsIll-fitting restorationsNeuropathic painTumors or aneurisms
Hormone changes including perimenopause, menstrual cycles, and changes in testosterone levelsFracturesReferral headaches from migraines or cluster headaches that change the blood vessels and nerves of the headSalivary dysfunction
Every single tooth is a little organ, and the same blood and lymphatic fluid that flows to and through your heart and all the other organs and systems in your body also flows to and through your teeth. Additionally, there is a complex system of nerves that connect your teeth to your brain, and every tooth is connected to one of the channels of life-force energy most commonly known as the acupuncture meridians. So, when you see the whole picture, you understand that your teeth are affected by what is going on throughout your body, and, of course, your entire body is affected by what is going on in your teeth.
Unfortunately, we usually do not learn about the oral/systemic health connection and the hidden risks of conventional dental practices until after we have developed at least one chronic health problem conventional practitioners do not know how to resolve. I understand it can be hard to believe that established dental practices that have been around for many decades can be obstacles to your good health because it was a challenge for me as well. All biological dental professionals were once traditionally trained. The move away from that training to encompass a wider view is never easy, but vital to our integrity.

Be Your Own Advocate and Become Educated

Changing things for the better begins with questioning the status quo. It ultimately requires that you make better-informed choices so you do not wind up supporting the dysfunctional aspects of the conventional dental and medical establishments. Every time you accept and pay for a treatment, you are in essence saying, "I support this." So please, before paying for a root canal procedure, or for that matter, any other procedure, make sure the problem is not somewhere else and that the pain in your tooth will not subside if you properly address that issue.
The surest path to good health is to become educated (at least in a general way) about the different approaches to dentistry and medicine that are available to you before you actually have to make a choice for you or your children. With this in mind, I encourage you to seek out and create your own network of practitioners — family physician, dentist, and nutritionist, for starters — who have a holistic understanding of health and appreciate the value of working together as a team to meet the health-care needs of you and your children. While finding and creating your own network of holistic practitioners will take some time, it will be time well spent.
My years of practice have taught me that the best way to prevent disease is to build your health. We all have a self-healing potential, which I refer to as "the Health." I'm devoted to helping people learn how dental practices can either improve or damagetheir health. I want to help you make well-informed choices that support your health in body, mind and spirit. You certainly do have choices to make, especially avoiding unnecessary root canal procedures.
The holistic physician Dr. Thomas Rau, in his comprehensive book, Biological Medicine, says: "The disruptive fields which occur most frequently in the body, causing remote illnesses in other organs, are the teeth. So long as these disruptive factors are not eliminated, the physician will remain unsuccessful in many cases of chronic disease." Ultimately, the tragic consequence of not acknowledging the connection between our teeth, dental treatments, and our overall health is no attention is given to the real cause of — and curative treatment for — many chronic health problems.

Powerful Strategies to Consider Before a Root Canal

When you have pain in your leg, arm, stomach, eyes, or any body part, hopefully you are not advised to kill the nerves of the area to shut off the pain. While this is obvious for these body parts, this advice is not obvious, and certainly not routine in your mouth. Most conventional practitioners have accepted the idea of killing a tooth even though it causes a poisonous environment that harbors pathologic bugs and disease. If a tooth is sensitive or hurting, the following are some of my recommendations before agreeing and paying for a root canal procedure:
Ozone therapyProper oral hygieneStress management
NutritionOil pullingLocal support for the tooth such as adjusting an ill-fitting restoration, a splint or mouth guard, decay and more
Digest enzymesProper sleepTraditional osteopathic treatment and support
All of the above can buy time for your immune system to recover allowing your tooth to heal. In trying to support and encourage my patients' own healing capabilities, and based on my studies, I will tell you that, without a doubt, what you are eating and drinking every day has a huge influence on the health of your teeth and gums. Even more, it is essential for us to appreciate that good nutrition contributes to the structure and function of every cell in our bodies.
I want to do all I can to make sure my patients and readers of this article understand the importance of developing the right nutrition habits in order to prevent tooth decay, gum disease and other dental problems. Nutrition can also support you while your tooth is healing from a metabolic, physical, or emotional injury. In that respect, I firmly agree with Dr. Mercola's nutrition plan. If you haven't had a chance to review it, please do as it is completely free and over 100 pages. It is divided into beginner, intermediate, and advanced sections so you can easily customize it for yourself
There is absolutely no question that making a commitment to self-care practices to help to prevent tooth decay in the first place is an example of wisdom in action. Except for a tooth injured by some type of physical trauma, a tooth that has had a root canal procedure, also had some degree of decay.

Prevention Is the BEST Option for Avoiding Root Canals

To prevent the need for root canal treatments, you must eliminate tooth decay through proper oral hygiene and good nutrition. Proper oral hygiene and regular dental cleanings are preventative measures that help to remove the sticky plaque and calcified deposits that form on the surface of teeth and helps to minimize the impact of many individuals' nutritionally poor and sugar rich diets. I have learned, and so I teach, that faithfully practicing good nutritional habits is, without a doubt, the most important preventative measure, because tooth decay is a consequence of systemic metabolic disturbance.
As Dr. Weston Price wrote in his book, Nutrition and Physical Degeneration, "...when teeth are decaying, other things are going wrong in the body"! To achieve optimal oral and total body health, your teeth and the rest of your body needs you to choose high-quality foods that are in harmony with your metabolism. It is also absolutely essential to eliminate all sources of refined and processed sugar, white flour products, soft drinks, and all other "junk" foods and beverages. The wisdom is actually very simple: give your body what it needs and avoid hurting yourself with what you are eating and drinking!
A wise but simple oral hygiene practice that can be very supportive in helping you to have healthy teeth and gums, is the practice of "oil pulling." This wonderful practice not only has preventive value, but also therapeutic value for teeth and gums. Choosing to keep a dead tooth in your mouth can put you at increased risk of a variety of health problems. So, if a dentist recommends a root canal procedure to "save" your tooth from being pulled, remember to ask yourself, "How will I be affected if I have a dead, chronically infected tooth in my mouth?" Or "Do I really need this root canal?" Perhaps the tooth can heal without the unnecessary root canal procedure.
When I graduated from dental school, I took an oath that to this day encourages me. The oath said in part: "I will strive to advance my profession by seeking new knowledge and by re-examining the ideas and practices of the past." I hope that oath guides you, as well as me, on this journey toward making choices that will support your health. I hope it will encourage you, your family and the community to help forge a new dental and medical "Paradigm."

Resources to Help You Find a Biological Dentist

If you are seriously considering any of the dental procedures discussed above it is best to have them performed by a biologic dentist. The following organizations can help you to find a mercury-free, biological dentist that would best serve your needs:

About the Author:

Dr. Lina Garcia is a Doctor of Medical Dentistry as well as a Doctor of Dental Surgery. She has been dedicated to the research and teaching of alternative solutions for conventional dentistry. Dr. Garcia has published several articles and is soon releasing her first book, "Take Care of Your Teeth and Build Your Health." She has trained around the world and is excited to be able to offer holistic services at her practice. She sees patients from all over the United States and worldwide, in her South Barrington, IL office
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Thursday, April 17, 2014

Psychoneuroimmunology—How Inflammation Affects Your Mental Health

English: Cover of the book Take Control of You...
(Photo credit: Wikipedia)




By Dr. Kelly Brogan
Psychoneuroimmunology. This is what I aim to practice. Medical terms of this length command our respect for the interconnectedness of different subspecialties, for the futile segmentation and compartmentalization of the body into different organ systems.
As discussed in this previous article I wrote for Dr. Mercola, deconstructing the serotonin model of depression, psychiatry is in a crisis. It can no longer stand on its own, throwing more and more medications at its perceived target. 
It seems, therefore, fitting that psychiatry would follow the investigative path of other lifestyle-triggered chronic diseases such as cancer, autoimmunity, and heart disease. There already exists a bidirectional relationship between all of the major chronic diseases and psychiatric diagnoses (patients who struggle with chronic diseases are more likely to be depressed and vice versa). 
The role of inflammation, across these disease states, is better elucidated each day. Let's deconstruct what is known as it applies to mental health.

Inflammation and Depression

In this model, depression is a non-specific fever that tells us little about what is actually causing the body to react and protect itself in this way. The body is "hot" and we need to understand why. Depressive symptoms are the manifestation of many downstream effects on hormones and neurotransmitters, but if we swim up to the source, we will find a river of inflammatory markers coursing by.
The source itself may be singularly or multiply-focused as stress, dietary, and toxic exposures, and infection, as we will discuss here. As explored in the medical literature,1 inflammation appears to be a highly relevant determinant of depressive symptoms such as flat mood, slowed thinking, avoidance, alterations in perception, and metabolic changes. We understand this relationship based on:
Biomarkers  
Psychiatrists have longed to be legitimized in their role as science-based physicians. Despite this, there are no diagnostic tests that are validated for the assessment of psychiatric pathology. In the practice of functional medicine, however, the diagnosis becomes secondary to the individual's personalized interplay of factors and the "biomarkers" that can light the way toward healing. 

Cytokines in the blood, or inflammatory messengers, such as CRP, IL-1, IL-6, and TNF-alpha have taken the stage as predictive2 and linearly3 correlative with depression. 
Researchers have validated4 that, in melancholic depression, bipolar disorder, and postpartum depression, white blood cells called monocytes express pro-inflammatory genes leading to secretion of cytokines, while simultaneously leading to decreased cortisol sensitivity, the body's stress hormone and inflammatory buffer – a feedforward cycle.
Once triggered in the body, these inflammatory agents transfer information to the nervous system, typically through stimulation of major nerves such as the vagus, which connects5 the gut and brain. Specialized cells called microglia in the brain represent the brain's immune hubs and are activated in inflammatory states.
In activated microglia, an enzyme called IDO (indoleamine 2 3-dioxygenase) has been shown6 to direct tryptophan away from the production of serotonin and melatonin and towards the production of an NMDA agonist called quinolinic acidthat may be responsible for symptoms of anxiety and agitation. 

These are just some of the changes that may conspire to let your brain in on what your body may know is wrong.
Animal Models
While an animal model of depression may seem like an absurd idea, currently, lipopolysaccharide (LPS), an endotoxin produced by gram-negative bacteria, is used to induce these clinical models in rodents.
Mice that lack IL1-B7 (a cytokine that mediates inflammatory response), however, are protected against these LPS-mediated "depressive symptoms" (i.e., as demonstrated by loss of interest in sugar water), supporting the critical role of inflammatory messengers in the depressogenic cascade.
Pharmacology
One of the most predictable side effects of interferon therapy for Hepatitis C is depression. In fact, 45 percent of patients develop depression8 with interferon treatment, which appears to be related to elevated levels of inflammatory cytokines IL-6 and TNF.
A number of trials have examined the role of anti-inflammatory agents in the treatment of depression. In one recent trial,9 a subset of patients resistant to antidepressant treatment and identified by serum markers of inflammation, most notably C-reactive protein >3mg/L, were responsive to treatment with the TNF-alpha antagonist (anti-inflammatory) infliximab (Remicade).
The pain-killer celecoxib (Celebrex) has been found in randomized, placebo-controlled trials10 to be superior to placebo in antidepressant augmentation. In the setting of psoriasis treatment with etanercept (Enbrel), mood was improved11independent of psoriatic relief.
There has even been suggestion that the mechanism of action of antidepressants is through an anti-inflammatory effect, particularly on IL6. However, these observational studies have been largely inconclusive.12

The Gut-Brain Dance

What is driving this inflammation? How does it get kicked off? And how does it induce depression? With the limited clinical applications and revelations that came with the completion of the Human Genome Project in 2002, we have begun to focus on where we have outsourced our physiologic functions. 

The microbiome has become an important consideration, and particularly, the gut, which houses at least 10 times as many human cells as there are in our bodies, and 150 times as many genes as are in our genome. These microbes control many vital operations and are responsible for synthesis of neuroactive and nutritional compounds, for immune modulation, and for inflammatory signaling.
Our greatest interface with the environment is the 70+ percent of your immune system housed in your gut wall. Disturbances in gut microbiota, autoimmunity, head injury, childbirth, and infection can all trigger systemic inflammation. This immune activity takes the form of a TH1 dominant cellular response in which macrophages produce ILI, IL6, and TNFalpha, all of which have been shown to be elevated in the setting of depression.
The communication between our guts and brains appears to rely, in part, on the vagus nerve, and is bidirectional in nature as reported in this 12-year prospective study13 that looked at relationships between gut problems like irritable bowel disease, anxiety, and depression.  
The stage is set for the microbiome when we descend the vaginal canal and are breastfed. Unfortunately, the rate of cesarean sections doubled from 1990-2008, comprising one-third of US births. Maternal inflammatory states and diseases such as type 1 diabetes can increase risk of surgical birth, as can interventions such as ultrasound, 14 monitoring, and the epidural.15 Without vaginal transfer of mom's flora, the baby misses out on the most important inoculation.
A study16 of 24 Canadian babies at four months demonstrated that elective section resulted in the most diminished bacterial diversity. Surgically born babies had significantly less Bacteroides and Escherichia-Shigella species. In this cohort, formula-fed babies had overrepresentation of Clostridium difficilePeptostreptococcaceae, and Verrucomicrobiaceae. Excitingly, research is being done on "vaginal swabs" for inoculation in the setting of C-section.17

The Importance of Breast Milk

In our nationwide departure from physiologic birth and breastfeeding, less than one-quarter of women can be expected to be nursing by 12 months postpartumBreast milk18 contains unique nutrients for beneficial bacteria called oligosaccharides, but importantly, it is the vital follow up to the mother's vaginal flora, designed to support the baby's immune system during its infancy marked by an "anti-inflammatory" phenotype. During these first few months, the baby relies on the mother's breast milk to help inform its immune system of what is dangerous.
Over the course of lactation beginning with colostrum, the makeup of these bacteria and growth factors changes.19 A recent study20 confirms that mom's gut bacteria are vertically transferred through breast milk and that this "entero-mammary" connection is what helps to develop the baby's immune system. This is the beginning of natural immunity, which is so much more complex than vaccinologists would have you believe.
One of the many problems with formula is the glaring omission of these microbes leaving the baby susceptible to colonization by inappropriate strains, suboptimal diversity, and stimulation of the immune system by many of the toxic compounds in this synthetic food. In fact, infants fed breast milk had an anti-inflammatory cytokine milieu throughout infancy.21 Here22 is a stunning analysis of formula shortcomings.
Interestingly, this rat study23 demonstrated that the types of bacteria in the guts of these rat pups determined their response to stress on a physiologic level, and that it was more difficult to correct later in their rat-infancy. The gut bacteria influenced behavior and brain growth in these animals. I speak about some of the impediments to adequate milk supply here,24 but formula feeding25in the hospital and "supplementation" is a major offender.

Gluten Promotes Depression

Often processed with genetically modified oils in high glycemic foods, gluten is a brain and body poison. Its havoc begins in the gut, where it promotes intestinal permeability by upregulating a compound called zonulin. Local gut inflammation (often lectin-induced) precedes more systemic inflammatory responses accompanied by antibodies to the different components of gluten (gliadin and glutenin), complexes with enzymes called transglutaminase, and to tissue in the brain, gut, and thyroid through a process called molecular mimicry.
The neurologic effects of gluten intolerance include depression, seizures, headaches, multiple sclerosis/demyelination, anxiety, ADHD, ataxia, neuropathy as discussed here and here. Independent of the brain effects already discussed, gliadin peptides may travel through the blood stream and can stimulate opiate receptors in the brain, resulting in their being termed gliadorphins, accounting for temporary withdrawal symptoms! Get the full scoop in my anti-gluten missive.

The Impact of Unnatural Foods: GMOs

In the past year, there has been an explosion of terrifying information on the impact of herbicides like Monsanto's Roundup (glyphosate) on our gut microbiome. As it turns out, this chemical is very active in slaughtering beneficial bugs in your intestines via its impact on the "shikimate pathway" previously assumed not to exist in humans.
By imbalancing this flora, pesticides/herbicides also disrupt the production of essential amino acids like tryptophan, a serotonin precursor, and promote production of p-cresol, a compound that interferes with metabolism of other "xenobiotics" or environmental chemicals, making the individual more vulnerable to their toxic effects. Even vitamin D3 activation in the liver may be negatively impacted by glyphosate's effect on liver enzymes, potentially explaining epidemic levels of deficiency.
We also have evidence26 that insecticidal toxins such as “Bt” are transferred into the blood of pregnant women and their fetuses, and that glyphosate herbicide transfers to breast milk. Delve27 into this fascinating analysis of what we are learning about these chemicals in our food supply. Genetic modification of foods, in addition to guaranteeing exposure to pest and herbicides, confer risks of gene transference to human gut bacteria, even after a singular exposure.

The Hazards of NSAIDs

Most people think of ibuprofen as an innocuous, over–the-counter comfort for aches and pains. Some are so lulled into a sense of safety and efficacy, that they keep these pills in their purses and nightstands for even daily use. In addition to other known risks, its effects on the small and large intestine may be best summarized by this statement:28
"The initial biochemical local sub-cellular damage is due to the entrance of the usually acidic NSAID into the cell via damage of the brush border cell membrane and disruption of the mitochondrial process of oxidative phosphorylation, with consequent ATP deficiency"
For anyone who recognizes the role of brush border integrity and energy production in health, this is quite a damning assertion. We need the gut lining to keep the gut contents away from the blood stream. Resulting increases in permeability allow for luminal factors (intestinal contents) to access the immune system and to set off autoimmune and inflammatory processes. More recent evidence29 suggests that unbalanced gut bacteria set the stage for NSAID-induced permeability through neutrophil stimulation. These changes occur within three to six months. There are no ways to mitigate these negative effects, which argues for getting to the root of why one is experiencing pain and resolving it through lifestyle change rather than suppressing it with medications that will whack-a-mole their way to new, chronic, and potentially more debilitating symptoms.

The Role of Stress

The monoamine hypothesis of depression has very little to say about brain/hormone interplay. The majority of studies30suggest that depression is associated with high cortisol states, and potentially from responses of this stress-system that were ingrained at birth or before. In the context of inflammation, however, cortisol, prolactin, and sex hormones are often dysregulated; in this model, depression is thought to represent a hypercortisolemic state which may result from elevated levels of inflammatory cytokines. 
Peripheral glucocorticoid resistance may exacerbate this elevation in cortisol (by interfering with feedback mechanisms) and immune response, simultaneously, which would also drive changes in sex hormones progesterone, insulin, and androgens31ultimately affecting mood states. Sleep is often compromised in states of stress, and sleep difficulties can also beget stress. The inflammatory effects of insufficient sleep were quantified in a study32 that deprived participants of sleep (just under six hours) for one week resulting in expression of genes associated with oxidative stress and inflammation.

How to Resolve It—You Feel What You Eat

Restoring optimal gut flora requires a variety of interventions, but beginning with a grain- and dairy-free diet, eliminating sugar, and genetically modified foods is a good place to start. Remember the role of LPS in depression? How depressive patients are more likely to have intestinal permeability allowing for toxic intestinal agents to circulate in their bodies? A traditional/ancestral diet may be an important modulator, according to Selhub et al. who state:33
"Traditional dietary practices have completely divergent effects of blood LPS levels; significant reductions (38%) have been noted after a one-month adherence to a prudent (traditional) diet, while the Western diet provokes LPS elevations."
For some, a FODMAPs diet may be indicated, and for others, a GAPs or Specific Carbohydrate Diet. This dietary approach will also confer the insulin stabilizing benefits of a high-fat, slower burning metabolic shift which protects cortisol, thyroid, and sex hormones. Increasing natural fats may also serve to protect the 60 percent lipid content of the central nervous system, precursors to hormones, and cell membrane composition while stabilizing blood sugar. I discuss three changes to make here.34
Herbs and spices may also play a palliative role in depression through their anti-inflammatory effects. Curcumin, a polyphenol in the Indian spice turmeric with elaborate anti-inflammatory mechanisms was recently found to be as effective as Prozac in small a randomized study I discuss here.35 Fermented foods, a part of traditional cultural diets, would also play a beneficial role, in this paradigm of microbiome-oriented, diet-supported mental health in ways stated here:36
"'This could manifest, behaviorally, via magnified antioxidant and anti-inflammatory activity, reduction of intestinal permeability and the detrimental effects of LPS, improved glycemic control, positive influence on nutritional status (and therefore neurotransmission and neuropeptide production), direct production of GABA, and other bioactive chemicals, as well as a direct role in gut-to-brain communication via a beneficial shift in the intestinal microbiota itself.' In this way, we use bacteria to modify our own bacteria and subsequently dampen inflammatory signals."
The Environmental Working Group (EWG) offers an excellent guide to pesticide-free shopping,37 and a guide38 to avoiding genetically modified foods.

Psychobiotics

In a brilliant review entitled "Psychobiotics: A Novel Class of Psychotropic," Dinan et al tour us through the role of probiotics (therapeutic live organisms ingested as a supplement or as part of a fermented food) in mental health. Acknowledging the data for inflammatory cytokines influencing mood states, and the role of gut bacteria in triggering these cytokines, they review the available literature supporting antidepressant effects of probiotics. There is speculation that anti-inflammatory signaling through IL-10 may underpin probiotic efficacy.
For example, "germ-free" mice exposed to stress experienced normalization of their cortisol response after inoculation withBifidus infantis. In a related experiment testing the stress of maternal separation, adult rodent behavior was normalized with this inoculation despite persistent cortisol changes. Lactobacilli, on the other hand, improved both parameters. In human adults with irritable bowel syndrome, depression and anxiety symptoms improved with administration of Bifidus, and in the setting of chronic fatigue, subjects experienced improvement in anxiety with Lactobacillus casei, relative to placebo. 
In a recent double-blind, placebo-controlled randomized study, subjects receiving B. longum and L. helveticus for 30 days experienced improvement on the Hospital Anxiety and Depression Scale, with decrease in urinary free cortisol. A probiotic-containing yogurt was also found to improve mood within 20 days in elderly volunteers. Intriguingly, a three-arm study39 looked at women consuming a fermented milk beverage three times a day vs milk vs nothing, found that those in the probiotic group had MRI-based changes related to midbrain emotional processing.

The Benefits of Meditation

Activating the relaxation nervous system – the one that allows us to "rest and digest" – is an effective means of easing symptoms and restoring an anti-inflammatory state. You can start with something as simple as listening to a guided meditation for several minutes a day and working up to 20 minutes twice a day for a therapeutic effect.
The interconnectedness of your gut, brain, immune, and hormonal systems is impossible to unwind. Until we begin to appreciate this complex relationship, we will not be able to prevent or intervene effectively in depression, slated to become the second-leading cause of disability in this country, within the decade. For true healing, and meaningful prevention, take steps every day toward sending your body the message that it is not being attacked, it is not in danger, and it is well nourished, well supported, and calm.
As a society, we can begin to think about protecting the microbiome by demedicalizing birth and infant nutrition, and as individuls, by avoiding antibiotics, NSAIDs, grains, genetically modified and non-organic food. Promising interventions for depression from a gut-brain perspective include probiotics, fermented foods as part of a high natural fat diet, and relaxation response for optimal digestion, anti-inflammatory and insulin sensitizing effects. No antidepressant medication required!
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