Alzheimer’s and the Microbiome Part 2-Leaky Gut

We now know just how extensive the body’s microbiome is and how keeping it healthy is of the utmost importance. An unhealthy gut microbiome (dysbiosis) leads to leaky gut, chronic inflammation and stress, which all cause a plethora of health issues, from digestive disturbances to autoimmune and chronic diseases, including Alzheimer’s. Healing the gut’s microbiome might just be the biggest and most important hole to patch in Dr. Dale Bredesen’s roof of 36 Alzheimer’s causes.

“What does [leaky gut] have to do with Alzheimer’s disease? Everything,” Bredesen writes in “The End of Alzheimer’s.” “One of the most important contributors to Alzheimer’s disease is inflammation, and one of the most common ways to create systemic inflammation is a leaky gut.”

Let’s first go a little deeper on what actually happens in leaky gut. This condition is exactly as the name describes. The cells that make up the lining of the gut, or more specifically the colon, ideally form a tight junction that only allow through needed nutrients, such as amino acids, vitamins and the simplest sugar molecules (glucose and fructose). In instances of leaky gut, however, these tight junctions weaken, allowing much larger, unwanted fragments to enter the bloodstream. This sets off an inflammatory response as the body tries to fight these “foreign invaders.” For a slightly more visual description, these foreign invaders are, quite literally, poop fragments seeping into the bloodstream. Imagine filling a glass of water when all of a sudden the contents of the toilet leak into the pipe leading to the faucet. It’s no wonder the body flips out and goes on the attack!

“Since inflammation is a key cause of Alzheimer’s — especially type 1 — it is crucial to keep these large protein fragments from leaking out of the gut and into the bloodstream,” Bredesen writes. “Another reason to keep things sealed tight: Gut porosity allows other invaders such as bacteria and yeast, and fragments thereof, to enter your bloodstream. Again your immune system responds, sometimes in a way that causes collateral damage to your own tissues because, to the immune cells, they resemble the invaders. The result is autoimmune conditions in which you have persistent low-level inflammation and, in the worst case scenario, autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, or lupus erythematosus.”

Unfortunately the causes of dysbiosis and leaky gut are many and pretty much impossible to fully avoid. But we can stem the tide if armed with the right information — and not follow the mainstream point of view. First we must understand the causes and why they are toxic to the microbiome. Here are some of the biggest offenders:

Antibiotics

I decided to begin with the most obvious and possibly well-known microbiome disruptor. Antibiotics are just as their name implies. They kill bacteria. When dangerous bacteria take hold, such as streptococcus (strep throat) or staphylococcus (staph infection), antibiotics are necessary and potentially lifesaving. I don’t want to minimize the importance of using antibiotics when they are warranted. But this literally world-changing treatment doesn’t just target the bad bacteria. It also kills most of the good that make up a healthy microbiome, and the stronger the antibiotic, the more bacteria it kills.

Unfortunately, our society today has become one of antibiotic overuse, so our bodies and the bacteria within are growing increasingly resistant to them, forcing doctors to prescribe even more powerful doses to be effective against the bad bugs. While we absolutely should take an antibiotic when need truly arises, we also should be very wary about taking them too often. Doctors frequently will prescribe based solely on symptoms described, whether the need is there or not. And how many patients just blindly follow their doctor’s advice? I’ve had this happen to me twice in the last few years. The tests came back negative for infection, but the prescription was still written based on the symptoms I described. The first resulted in my needlessly taking a round of antibiotics. The second, I filled the prescription “just in case” but healed just fine without ever taking them.

When we are not countering the antibiotics with probiotics to help replenish good bacteria (more on this in the future), dysbiosis, leaky gut and all that go with it occur.

Unfortunately, taking prescribed antibiotics isn’t the only concern. They’ve become a major player in industrial farming with livestock receiving blanket treatments. A lot of the dairy and meat at the grocery is loaded with antibiotics. Agricultural use and irresponsible human use (flushing down the toilet to dispose) means antibiotics also can be readily found in our soil and water supply, leading to possible constant exposure if people don’t take steps to protect themselves.

Glyphosate

Glyphosate, how deadly are you to humanity and yet how completely ubiquitous? Let me count the ways. For those of you who’ve never heard of this poison, I’ve no doubt you’ve heard of its brand name: Roundup. That’s right, the herbicide that is used in massive amounts all over the world and is so powerful it kills every plant it touches except those that have been genetically modified to the point of resistance.

What’s interesting is Roundup isn’t even patented as a weed killer. It’s patented as an antimicrobial, killing bacteria, fungi and parasites — in other words, all the microbes that make up our microbiome. And here’s the great news (sarcasm): What always happens when something is used to kill plants or bugs, whether they be herbicides, pesticides or antibiotics? The things intended to be killed become resistant, so more and more glyphosate is needed to get the job done.

Glyphosate, therefore has become the most common chemical on the planet over the course of 15 years with approximately 5 billion pounds now being sprayed worldwide each year, according to the docuseries “The Gut Solution.” It’s everywhere — in the soil, in the water we drink, in the very air we breathe. Farmers are spraying it in extreme amounts, both through land application and through crop dusting. I’ve driven past fields in both instances, and every time I quickly turn off the fan in my car and hold my breath as long as I can until I’ve passed the cloud. But even then, I can still smell it, taste it in my mouth, and it’s awful. People who want to move out to the country to escape the pollution and get some fresh air, sorry about your luck.

And glyphosate isn’t just an issue out in the country. It’s used in large amounts on public property and parks, ditches and residential neighborhoods — because heaven forbid someone have a dandelion in his or her yard. Even people who eat a very clean, organic diet have been found to have a surprising amount of glyphosate in their systems, according to “The Gut Solution.”

“Broadcasting [glyphosate] into our environment on this kind of scale, 5 billion pounds a year, you start to realize how, not just human health, but biology itself is collapsing on planet Earth,” Zach Bush, MD, said on “The Gut Solution.”

Putting the welfare of the entire planet aside for now, just imagine what it does to our microbiome: Decimates it.

An entire generation of children have been born into this glyphosate world. Bush said he was speaking at an event and asked the audience how many when they were kids had, or new someone in their class who had, an allergy or intolerance to something. He said a few people raised their hands. He then asked how many of them now have children or know kids who have an allergy or intolerance. Every hand went up. This is no coincidence. Childhood cancer, autism, autoimmune conditions and other illnesses and chronic conditions are skyrocketing. Nearly 50 percent of children today have a chronic condition by the time they are 18. In the 1960s that number was 4 percent, Bush said. And adults aren’t faring much better.

While glyphosate is the biggest offender, it’s important to remember all herbicides, pesticides and antimicrobials damage the microbiome. All these antibacterial house-cleaning products were created and made popular for their ability to kill bacteria and viruses — to keep the family from getting sick. Turns out they are only making us sicker. Go figure.

Artificial sweeteners

Artificial sweeteners include saccharin (Sweet ‘N Low), acesulfame (Sunnett, Sweet One), aspartame (Nurtasweet, Equal), neotame and sucralose (Splenda). I’d always heard artificial sweeteners are bad for us. I’d figured they are bad because they are not natural — just chemicals created in a lab. I’ve heard the reports claiming they can cause cancer (I’m convinced they caused my dad’s bladder cancer since he drank nothing but diet soda and Crystal Light all day every day), autoimmune issues and even increased blood sugar. But wait, isn’t that why these sweeteners were created, to serve as a sugar substitute to prevent diabetes and obesity? Boy did they get that one wrong. I never knew, however, the reason artificial sweeteners caused these things — they damage the microbiome and cause leaky gut.

“We’ve made assumptions over the years that have simply turned out to be wrong,” Bredesen said in Dr. David Perlmutter’s docuseries “Alzheimer’s: The Science of Prevention.” “The approach of many has been to close your eyes and stick your head in the sand and say, ‘this can’t be, because we always did it this way and it’s got to be fine. … It’s just as good to have soda if we put something in it that’s not sugar, then everything is going to be OK.’ Well that turns out to be wrong. … Guess what, obesity is on the rise, Type 2 diabetes is on the rise. Alzheimer’s is on the rise.”

Refined sugar/carbs

Refined sugar and carbs are harmful to the microbiome primarily because they starve the good microbes of the food they need to survive — fiber — while feeding the bad microbes. Diet really is everything to the bugs that live within us. The No. 1 key to a healthy microbiome is a diet very low in refined carbs and sugar and high in prebiotic fiber, such as cruciferous vegetables (broccoli, cabbage, kale and Brussels sprouts) onions, garlic, chicory root, dandelion root and greens and flax seeds, to name a few, along with plenty of anti-inflammatory healthy fats, such as the omega 3s found in tree nuts, seeds and cold water oily SMASH fish (salmon, mackerel, anchovies, sardines and herring).

And don’t forget the near guarantee of diabetes as refined sugar/carbs and the stress from a leaky gut all spike blood sugar and cause insulin resistance. Take dysbiosis and insulin resistance/diabetes and add to them the huge inflammatory response these things also cause, and you get the three biggest drivers of Alzheimer’s disease. The moral? Cut refined sugar/carbs. Just do it. Simple, but not easy.

Gluten and dairy

Perhaps you looked at this header and said, “I can skip this section because I don’t have a gluten intolerance.” For those people, I first would like to point out that symptoms of gluten intolerance and allergy vary greatly, and many people would never guess the symptoms they experience are at all associated with this sticky protein found in wheat, barley and rye. Gluten has a far greater reach than gastrointestinal upset, including autoimmune disorders; mental conditions such as fatigue, brain fog, depression, anxiety, autism, epilepsy and more; osteoporosis; canker sores; migraines, and the list goes on and on. It all boils down to one thing: leaky gut. But here’s the clincher: it doesn’t only cause leaky gut in those who are intolerant.

“Studies from Harvard show that wheat creates leaky gut in everyone as a protein called gliadin, found in wheat and gluten, increases another protein, zonulin. Zonulin weakens the tight junctions of the gut lining and thereby contributes to leaky gut,” the Mindd (Metabolic, Immunologic, Neurologic, Digestive, Developmental) Foundation says.

I feel the need to repeat that for emphasis: Wheat and gluten cause leaky gut in everyone, not just those with celiac or who have an intolerance. Gluten is toxic to every human body. Gluten’s toxic effect on the microbiome and therefore the entire body has a dramatic effect on brain health, as is evidenced by the list of intolerance symptoms listed above. Gluten can play a key role in Alzheimer’s.

“This is a huge new breakthrough to understand why it is that people that have gluten problems have dementia,” Jeffrey Bland, PhD, said in “Alzheimer’s: The Science of Prevention.” Some people can have a gluten intolerance or allergy “whose major effect [symptom] is on the brain immune function, and that connects to dementia. So now it’s a whole new revolutionary breakthrough and understanding of the microbiome’s connection to neuronal function.”

Just like refined carbs and sugar, I strongly believe everyone just needs to bite the bullet and give up gluten. And in this day and age, with all the gluten-free alternatives now readily available at all supermarkets, it’s really quite easy.

Dairy, unlike gluten, doesn’t necessarily damage the gut in everyone. It is, however, an allergy or intolerance in most people, according to “The Gut Solution.” A small percentage of people are actually able to safely digest dairy into adulthood but most develop an intolerance that damages the gut.

I’ve heard such differing advice on dairy that I personally can’t say whether people should fully give it up or not. Bredesen says people should give it up completely. Perlmutter says people can eat cheese and butter to their hearts’ content, but all other dairy should be limited to only the splash of cream or milk they put in their morning coffee or tea.

I personally followed Perlmutter’s advice. As far as dairy goes. I think everyone should literally follow their gut. If you have no gut issues, no digestive issues, and you feel great having dairy in your diet, then enjoy. But if you’re experiencing any digestive upset or any of the above mentioned symptoms or conditions that point to leaky gut, dairy could very well be the culprit — or one of them.

People also should remember that all food intolerances damage of the gut. Some of the other biggest offenders include eggs, soy and tree nuts. Those with gut issues should make sure they are tested to learn all allergies and intolerances. (Rule of thumb: an intolerance is strictly gut/digestive issues and an allergy is anything above the gut, i.e., congestion, itchy eyes, breathing issues, tongue swelling, etc.) And remember, some intolerances will disappear once the gut is healed and can be slowly reintroduced.

Medications

I really have no idea just how many medications, both prescription and not, are harmful to the microbiome. Antibiotics, obviously, but if I had to wager a guess, I would say they pretty much all do to at least some extent. But for this post, I am going to focus on the over-the-counter ones many people take daily without giving it a second thought: pain relievers, both NSAIDS and not, and proton pump inhibitors (antacids).

NSAIDS (non-steroidal anti-inflammatory drugs), such as acetylsalicylic acid (Aspirin) and ibuprofen (Advil) have been shown to cause dysbiosis and leaky gut within two weeks of taking it even though the person taking it was still asymptomatic, according to “The Gut Solution,” and non-NSAIDS, such as acetaminophen (Tylenol), also wreak havoc. Both types also can damage the liver and kidneys when taken on a regular basis.

Proton pump inhibitors block the production of stomach acid. Unfortunately, stomach acid is vitally needed to maintain a healthy pH. For food to be properly digested and leave the stomach, pH must be at a 1 or 2, which requires lots of acid, according to “The Gut Solution.” If the pH is too high, the food sits and begins to rot, which makes it bubble, causing heartburn/acid reflux. People in turn take a proton pump inhibitor, which reduces stomach acid even more. It begins a chain of events that leads to small intestine bacterial overgrowth (SIBO) and throws the microbiome into turmoil as this now rotten, toxin-riddled food passes through the digestive tract. The pancreas also becomes stressed as it has to produce two to three times more digestive enzymes to help break down what the stomach couldn’t.

Stress and poor sleep

Dysbiosis causes stress and stress depletes the microbiome. Plain and simple. Talk about the ultimate vicious cycle. Stress has been shown to not just be harmful to our good bacteria, but also may target a select few of these important bacteria, Leo Galland, MD, said in “Alzheimer’s: The Science of Prevention.” One of its biggest impacts, however, is slowing the motility – movement — of the gut.

“Motility is one of the factors that keeps the microbiome well organized,” Galland said.

Sleep, considered one of the three pillars of good health along with diet and exercise, has the same bidirectional effects on the gut as stress. A healthy sleep pattern depends on a healthy microbiome and vice versa, Galland said.

“It’s the interaction between the microbiome, the immune system and the adrenal glands that creates this architecture to sleep,” Galland continued. “Now if you’re not sleeping, lack of sleep begins to impact immune function, and it throws the whole architecture of sleep off. That begins to create a stress response in your body, which then starts to alter the composition of the microbiome.”

Healthy sleep plays such a huge role in overall health and Alzheimer’s prevention, I haven’t even scratched the surface here. I will go much more in depth in the future.

You may have noticed the common thread of chronic stress and inflammation running through this shockingly long post. Bottom line, these two things are the root of pretty much all modern disease, and the gut is the body’s power center — mission control — that determines overall health. If we all could just open our eyes to these two powerful facts and live our lives accordingly, the human race would take a drastic turn for the better.

“We absolutely need to prioritize diet and other lifestyle choices to cultivate a robust and healthy microbiome, and that will lead to optimizing brain function as well as a brain that is resistant to disease,” Perlmutter said in “Alzheimer’s: The Science on Prevention.” “This is how we resist inflammation, and this is how we reduce our risk for diseases like Alzheimer’s.”

But how? How does a healthy microbiome optimize brain function? How do all the toxins running amok in the body due to leaky gut harm the brain when it’s supposed to be protected by the blood-brain barrier? Next time.