The Link Between Probiotics and Gluten Sensitivity

A very exciting new discovery has been made regarding the population of probiotics (also known as the microbiome) in your intestine and how it affects your risk of gluten sensitivity and leaky gut.

Just as an aside, I’ve had a few people ask me if “leaky gut” is a real phenomena. Also known as “increased intestinal permeability”, leaky gut is not only real but a quick internet search will show that such respected journals as the Journal of Hepatology, Gastroenterology, the British Medical Journal, the Journal of Allergy and Clinical Immunology, Digestive and Liver Disease and the Journal of Pediatrics, to name a few, have multiple scientific studies focusing on the importance and effects of a leaky gut on health. There are literally hundreds of articles that focus on this issue. Okay, sorry for the digression.

What are probiotics? A major constituent of the intestinal immune system consisting of 100s of trillions of organisms. You have more (at least you should have) of these organisms in your gut than you have cells in your body!

It’s estimated that 70 - 80% of your immune system is housed in your gut. This is why we spend as much time as we do ensuring that our patients’ digestive systems are working optimally. More and more research is supporting the premise that without a healthy digestive tract, good health is all but impossible.

Not only do these good bacteria help defend you against infection but the new research that was just released shows that they have an ability to modify gene expression.

What does this mean? The researcher was evaluating why certain people “turn on” celiac disease and gluten sensitivity at different ages. If it’s genetic, as we know it to be, then why doesn’t that first teething biscuit or gold fish cracker begin the symptoms of gluten sensitivity? It does in some of course but for many the symptoms begin in later decades of life.

Dr Alessio Fasano believes that it’s not enough to have the gene and have the presence of gluten, but there must be a third factor, an initiator, that creates an insult to the gut enough for gluten to then be able to cause its inflammation and subsequent damage.

It’s like the spark that begins the forest fire. You can have a windy day and dry tinder but you need the spark to begin the decimation.

Dr Fasano believes that the “spark” is an unhealthy balance of good and bad probiotics in the gut. The good ones are protectors, but the bad ones are initiators. The make-up of probiotic populations actually have the ability to turn on and off genes at will.

This is terribly exciting and at the very least should have you interested in “who” is being housed in your intestines! There is a simple lab test that provides the data and treatment is similarly easy but very beneficial.

I hope this helps.

p.s. New Discovery - Appendix Provides an Important Function!

Did you think it was unlikely that you possessed a body part that had no function? I know I did. Well after a very long wait the reason why we have an appendix has been discovered.

It turns out that the appendix houses probiotics. Don’t worry if your appendix was removed. You can still restore health to your intestines.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

Gluten Sensitivity & Vitamin D, an Update on Supplementation

As I’ve said before, if you don’t like change then the field of clinical nutrition will not be a happy place for you. Fortunately I love the evolution that my field goes through and I am happy to share the changes with you.

So here’s the latest update on vitamin D supplementation.

A deficiency of vitamin D is a serious condition that affects not only those with gluten sensitivity but as well the general population. Bone density and increased cancer risk are just two of the dangers posed by a deficiency of this important nutrient.

Due to the damage suffered by the small intestine in those sensitive to gluten, absorption of fat soluble vitamins such as D is inhibited.

The “normal” that we should strive for in the blood has consistently risen as the importance of vitamin D has been revealed. Currently it is thought that a level of 60 ng/mL is optimal. Just several months ago I believe we were citing that a value of 40 was adequate with 50 being the target when there was a prior history of cancer.

The treatment options have similarly been refined with the publishing of an article in a French medical journal specializing in internal medicine. While it was previously thought that severely deficient levels of vitamin D would respond beneficially to high doses of vitamin D2 (50,000 IU) taken once per week for about 3 months, that protocol was dismissed with this research. The scientists revealed that D2 is much less effective than D3 due to its shorter half-life and lowered affinity for the vitamin D receptor, making vitamin D3 the recommended form for supplementation.

Here at the clinic we use a liquid form of D3 that’s more bio-available for enhanced absorption. Typically a dose of 5,000 IU in a deficient patient will improve their profile over the course of several months.

Needless to say adherence to a gluten-free (and likely dairy-free) diet is also needed to ensure absorption occurs.

I heartily recommend a blood test to discover your serum vitamin D levels. It’s simple but extremely important.

Please let me know if I can answer any questions in this area.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

Depression & Gluten, A reader's success story

I received this uplifting email from a reader today. I thought it might brighten your day and encourage you to share the data with anyone you know suffering from nervous system problems such as depression, anxiety, autism and the like.

The devastation such symptoms cause to not only the patient but their family is difficult to measure. Yet the dramatic results when the correct solution is implemented are a joy to behold!

Enjoy this success story:

Hi there,

I have been gluten-free for two weeks.

Within the first few days, I no longer suffered from depression, panic attacks, anxiety and obsessive compulsive disorder.

In the past my thoughts raced constantly and I found it impossible to withstand noise of any kind - even a radio.

Now my mind is clear, I can tolerate noise more easily, my spots are decreasing. (I cut out both sugar and milk from my diet last year, but the spots still stayed).
I had no abdominal pains or issues - only mental health issues.

To go from deeply unhappy to very well within a matter of days is truly remarkable.

My friend's son has autism and she has him on a gluten-free diet. Within two weeks, his headbanging stopped completely and his emotional outbursts decreased.

You probably hear anecdotal evidence on a regular basis, but I wanted to share with you, just how remarkable 'the freedom of being gluten-free' truly is.


I am excited about your blog - because it articulates the problem with gluten so well, which makes it easier for me to understand and to describe to others.
I would love to find ways of encouraging and promoting the awareness of the link between gluten and depression - if you have any ideas, please let me know.

In deepest appreciation for the work you do, with your words of confidence, passion and hope in your articles.
Thank you for your common sense!


Best wishes,
M.R.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of "The Gluten Effect"

Dairy and How it Can Damage the Intestine

A reader wrote the following:
I would like to learn more about dairy causing a leaky intestine.
Is it all dairy? Just cow’s milk? Goat’s milk? What about fermented dairy, yogurt and cheeses? Does pasteurization matter? Age of introduction? What about cream and butter?

If it hasn't apparently caused a problem for an adult, does it continue to be safe or is it a ticking time bomb?

The mechanism behind dairy causing the damage it does lies in several areas:

1. It stops the formation of glucosamine in the gut lining, thereby creating a leaky gut. (Glucosamine is known to help repair the mucosal-lining defensive barrier in our small intestine.)
2. It impairs immune system development in the gut and the maturation of important immune cells known as T helper cells – this can lead to autoimmune disease, asthma, allergies.
3. The milk from other mammals is too high in protein and phosphorus and the protein damages the gut lining.
4. Dairy products are highly chemically laden, the highest per gram of all food, and are thereby toxic to the gut lining.
5. Dairy creates a mucous “slime” in the lining of the gut that prevents the absorption of some nutrients as well as causing gut inflammation.

As a former dairy-lover, I understand the hopeful questions about yogurt, cheese, pasteurization, goat, sheep, etc. Unfortunately if it’s made from the milk of another mammal it’s not beneficial for us. Humans are able to digest their mother’s milk for the first few years of life only. After that they should no longer have it or anyone else’s milk.


I do have one piece of good news – Butter!

Butter is mostly fat and has very few milk solids. Therefore it is fine to consume for most people and the negative effects of the dairy protein are all but absent.

I would caution you to purchase organic butter because hormones are made from fat and we really want to avoid as many exogenous estrogens as possible.

Enjoy some butter!

Until next time, I wish you good health.

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

A Healthy Gluten-free Diet – What are the "Must Buy" Organic Foods

There is a “dirty dozen” currently amongst are fruits and vegetables. One receives this moniker by being one of the top twelve fruits or vegetables with the highest pesticide load.

We’ve been speaking lately about what a healthy diet entails and the importance of eating organic as much as possible. But what if you can only mostly eat organic? Is there a “Must” category?

Yes. When it comes to the “dirty dozen”, they are so bad that it would be better to forego eating them altogether if you can’t get the organic variety. Here they are:

1. Peach (worst)
2. Apple
3. Sweet Bell Pepper
4. Celery
5. Nectarine
6. Strawberries
7. Cherries
8. Kale
9. Lettuce
10. Grapes – imported
11. Carrot
12. Pear

Some of these are true staples of the American diet. Sorry to be the bearer of bad news, but better you know the truth than eat the “innocent” apple in ignorance.

If you enjoy fruit like peaches and strawberries, I might suggest the frozen organic variety when they’re not in season fresh. The frozen variety are great for smoothies and available pretty much year round.

Until next time, I wish you good health.

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

Gluten Induced Leaky Gut Linked to Autoimmune Diseases

We have spoken about increased intestinal permeability also known as a “leaky gut” before. We have also discussed autoimmune disease and its link to gluten. But considering that all autoimmune diseases when taken as a whole comprise the third leading cause of death, I would like to take this opportunity to delve into this further.

Celiac is an autoimmune disease. It’s the only one thus far that can be definitively “turned off” with an environmental change – namely eliminating gluten from the diet.

The root cause beneath gluten’s autoimmune trigger begins with a predisposed individual who eats gluten with the resulting damage being a leaky gut. The leaky gut then allows partially digested gliadin access to the blood stream where the immune system reacts and “self” is damaged, hence the correct label of autoimmune disease.

New research out of the University of Maryland states that the increased intestinal permeability doesn’t only result in celiac disease, but that type 1 diabetes, multiple sclerosis, rheumatoid arthritis and inflammatory bowel disease all have leaky guts as a factor in common.

This is very exciting and certainly corroborates the clinical findings we see here at our clinic. We observe other autoimmune diseases improving once a patient gets on a gluten-free diet and starts to heal up their intestine.

Is gluten the underlying cause of all these autoimmune diseases and upon its removal healing occurs and the immune system stops being activated? Or is the leaky gut the underlying common factor and the causative agent of that loss of integrity is gluten for some but something else for others?

I don’t have an answer for you but researchers are working diligently on this issue. Speaking of research, while I love to stay up to date on the latest results, I must confess that an impatient streak would make me a terrible researcher. A study I just read about zonulin, the protein responsible for increased permeability in not only the intestine but other organs as well, revealed that it took 5 years between hypothesizing the presence of zonulin and its confirmed discovery! If you're interested these studies can be found in "The Journal Of Immunology" 2006, 176 and "Nature Clinical Practice Gastroenterology and Hepatology in 2005 Vol 2 No 9. Let’s all give a moment of thanks to these wonderfully patient men and women who dedicate their lives to the endeavor of scientific research.

Back to being a clinician, what this data does support is something we strive to do with our patients and that is to repair the integrity of the small intestine via whatever means possible.
Typically this involves:
1. removing allergens/sensitive foods
2. diagnosing and eradicating pathogenic organisms
3. recolonizing the good bacteria in the gut
4. healing the lining through the use of nutrients.

So whether it’s gluten, dairy, a pathogenic organism and/or an imbalance of good flora, the key to reversing an autoimmune tendency seems to lie in fully restoring function to that 23 feet of pipe we call a small intestine.

I’ll keep you posted as this story continues to unfold, but what you can do right now is investigate the four points I’ve delineated above and eat “real” food. Trust me, your small intestine doesn’t like chemicals and overprocessed junk food.

Please let me know if I can be of any assistance.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

Decreasing Gluten Sensitivity for Future Generations

Scientific American, August 2009 had a nice article by Alessio Fasano, MD called “Surprises from Celiac”. In it he discussed the “Trio” of causes that create gluten sensitivity:
1. the trigger: gluten
2. genetic predisposition: nothing we can do about that one.
3. leaky small intestine

In # 1 and 3 we have some hope. It is suggested that in those infants with a suspicious genetic predisposition that restricting all gluten for the first year of life may empower the immune system sufficiently to lessen its responsiveness to gluten and tolerate it better. The research is currently occurring but preliminary findings suggest that such a delay in initiating gluten exposure may reduce fourfold that incidence of celiac.

If I was about to have a child I would definitely consider avoiding all gluten in the diet and after a good year plus had expired do a small challenge of gluten followed by an antibody test to see how the child’s immune system responded.

In the third point: trying to keep the small intestine intact and less “leaky” is something we work very hard on with our patients. It involves many steps and usually removing gluten and dairy are on the top of the list. What follows is the isolation and eradication of any unfriendly organisms, recolonization with beneficial probiotics and healing with amino acid L-glutamine and other nutrients as needed.

There is some evidence that dairy products are responsible for damaging the small intestine and creating a leaky gut. Dairy is also responsible, it is thought, for weakening the immune system. We know that Rotavirus is a culprit as an initiator of small intestine damage. Could a stronger immune system lessen the number of these infections?

All good food for thought. I believe the isolation of the underlying cause(s) of leaky gut is going to be a very important factor in restoring and maintaining good health.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”

Celiac and Gluten Sensitivity – What IS a healthy diet?

Once you realize gluten is not your friend and you eliminate it from your diet you are likely to feel much improved. That improvement may “flatten” after a time and you’re left feeling not quite as good as you’d hoped.

What to do?

I’ve posted before on the secondary effects of gluten and gone into the need to diagnose the presence of pathogenic organisms, adrenal fatigue, malabsorption, etc. But today I’d simply like to talk about a healthy diet.

All too often once we remove gluten, finding substitutes for all of our most favorite gluten containing foods becomes the highest priority. So you buy the gluten-free pizza crust, brownie mix, crackers, etc. In moderation that’s fine, but we still haven’t answered the question as to what a healthy diet truly is.

Obviously for you it’s not going to contain whole wheat, rye or barley. But what must it contain?

Vegetables and fruits are critical to maintaining good health and something we typical Americans tend to minimize in our diets. Every meal should contain a good amount of these, preferably fresh and organic whenever possible. Organic produce does provide a much higher amount of nutrition than its pesticide-laden counterpart. If you buy seasonal produce from a local grower it will be more affordable than trying to purchase strawberries in December!

The best fruits and vegetables are the ones that are very brightly colored as they provide the highest amounts of anti-oxidants that are protective against heart disease and cancer. Such things as blueberries, raspberries, pomegranate, blackberries, and citrus are very healthy. Vegetables such as peppers, broccoli, cauliflower, artichoke, spinach, kale, brussel sprouts, onions and garlic are very beneficial.

Oils are also important for their anti-inflammatory, hormone-producing qualities, not to mention being a good source of fat. Olive oil, coconut oil, avocado oil and some organic butter or ghee are all recommended. Coconut oil is nice for high heat cooking as it isn’t altered by the temperature. Olive oil is better when used on a medium heat. Fresh, raw nuts are another good source of fat. Good fat must be consumed in adequate amounts to prevent sugar or simple carbohydrate cravings and to stabilize blood sugar.

Protein is an interesting issue. We consume 6 – 8x more protein than any other country in the world. While protein is critical for growth and repair we could likely decrease our intake somewhat while increasing the quality of what we do eat.

With the chemicals and hormones being fed to our animals (3 million pounds of antibiotics/hormones given to livestock), it’s becoming increasingly difficult to find a “clean” source of animal protein.

Fish that are wild or farm raised on good quality feed are available. Eggs from organic farms that enhance the chicken’s feed with fish oil creates an egg that is higher in omega-3 fatty acids.

Of course there’s always the vegetarian option of whole grains (gluten-free of course!), legumes, beans, raw nuts, etc. I must admit to being quite leery of soy. I know it’s a “go-to” protein source but I find many of our patients to react poorly to it. I don’t know if it’s the genetic modification of the bean or what exactly, but I would caution moderation if you do seem to tolerate it. Another note, Dr Gonzalez, from New York who specializes in cancer treatment and gets outstanding results through use of diet, enzyme therapy and more, cautions his patients to “cross the street” if they see a soybean!

Dairy products, based on my most recent research, may very well not be a good idea for any of us. The enzymes that we have available to digest milk (and that’s human milk) stop getting produced after about the age of 3. It is thought that the proteins in cow’s milk are actually damaging to our gut lining, while creating a mucous buildup that prevents the absorption of some vital nutrients.

This theory segues very nicely with some recent research that makes the supposition that in order for gluten to initially create damage in the small intestine, there has to be an initial insult to the gut. Could this initial insult come from dairy? More on that in a future blog.

The toxic burden on our bodies from living in the US is huge as compared to other countries. Our FDA has approved 3,200 food additives to be used in our food while the European union only allows 6 different food additives.

My recommendation is to consume moderate amounts of protein from as clean a source as possible, meaning organic, grass-fed, hormone and antibiotic-free, etc.

I know that it’s extra work but remember than you can control what you put into your mouth. The other sources of toxins coming our way from air pollution and chemical exposures from industry are more difficult, if not impossible, to avoid. So if you control toxic exposure as much as possible in your food it will help a great deal.

I realize that I am promoting cooking and mostly eating from home. And I also realize that this isn’t the American way. But may I point out that the “American way” is not really working? Witness the statistic of dropping form 11th in the world for life expectancy down to our current ranking of 42nd.

To summarize, clean and pure sources of all food products is what you should be striving for as much as possible. This would entail also eating food that is in its natural state. E.g. a piece of organic fruit vs a fruit roll-up!

Increasing one’s consumption of fruits and vegetables is something we commonly see as needed in our patients. Balancing carbohydrates with good protein and fat in a meal is another good recommendation. If all you ate for a snack was a banana, you’re likely to find yourself “craving” in a couple of hours. Had you balanced that out by eating only half the banana with some raw nuts you likely would have felt much better.

Don’t forget to stay hydrated. Other than some green or white tea, your beverage of choice should be good clean water in the quantity of eight to ten or more 8 oz glasses per day, depending on your weight. (Hint: take you weight, divide it in half and you’ll have the number of ounces of water you should consume each day.)

While we’re all thrilled that Betty Crocker has come out with a line of gluten-free bakery mixes and that other companies have perfected that perfect brownie or cake, don’t fool yourself into thinking they’re good for you. Enjoy them in moderation on special occasions, but don’t make them a daily habit.

I think I could write another book on this topic alone, but until then I hope this helps.

To your good health,

Dr Vikki Petersen
Founder of HealthNOW Medical Center
Co-author of The Gluten Effect