People with eating disorders such as anorexia simply do not experience hunger and satiety in the same way people who have a healthy relationship with food do. New research suggests that the composition of gut bacteria, or the gut microbiome, may play a role in the behavioral aspects of anorexia and eating disorders. For instance, previous research shows a connection between mood disorders such as depression and poor gut microbiome diversity. Less than half of people with eating disorders fully recover, showing that conventional treatments are failing untold numbers of people, the vast majority of them women.
The study showed that patients with anorexia had lower diversity of gut bacteria than healthy individuals. They also found that the less diverse the gut microbiome was the more depression and anxiety patients suffered. The researchers also found that as a patient with anorexia began eating again their gut bacteria diversity was partially restored, which in itself aided in recovery.
Alterations in the gut microbiome can affect how a person’s body functions, how they think, feel, and behave, and how they interact with others.
The gut microbiome is critical not only to regulating mood and behavior, it also plays a vital role in regulating metabolic function, appetite control, and weight.
A better understanding of the role of the gut microbiome in anorexia can help researchers forge new directions in treatment around determining target weight goals, how fast the anorexic patient should gain weight, and what type of diet the anorexic patient should follow to best support the brain’s role in eating disorder behaviors.
The researchers are now investigating whether targeted probiotics could ease the renourishment and refeeding phase of anorexia recovery — many patients struggle with gastric and abdominal distress when reintroducing foods. Customized probiotic therapy could also support the mental and emotional aspects of recovery from an eating disorder.
Gut bacteria targeted in eating disorders
Past research has also shown a link between the gut microbiome and eating disorders, which affect an estimated 5 to 10 percent of the population. A 2015 study from France showed gut bacteria plays a role in eating disorders.
The study looked at mice who had an inflammatory reaction to a protein made by gut bacteria. In essence, the mice responded to these bacteria as if it were an allergy or sensitivity. This immune response caused eating disorders in the mice.
The gut bacteria that triggered this reaction is very similar in structure to a hormone called alpha-Melanocyte-stimulating hormone (a-MSH). a-MSH is a satiety hormone that tells you when to feel full. When the immune system attacks the gut bacteria similar to a-MSH, it also attacks the a-MSH due to their structural similarity. This immune reaction can then dysregulate signals around feeding, energy usage, and anxiety.
When the immune system mistakenly attacks the body
This study is evidence of a “cross-reactive” immune reaction, in which the immune system confuses something in the body with something infectious and attacks both. This is a very common mechanism in autoimmune reactions, such as with Hashimoto’s hypothyroidism, type 1 diabetes, or multiple sclerosis.
The research suggests that some eating disorders may have an immune reaction driving the psychological disorder.
Tips on addressing eating disorders nutritionally
Although eating disorders are highly complicated and require intensive, sometimes multi-faceted therapeutic approaches, it’s still important to be mindful of nutritional strategies to support the brain and the gut microbiome:
Eliminate processed carbs and sugars as they trigger addictive tendencies metabolically.
Keep blood sugar stable to curbing cravings, food obsession, and relentless hunger. You may need to eat small, frequent meals that include protein initially.
Base your diet on plenty of vegetables and a wide, ever changing diversity of vegetables. This will increase the diversity of your gut microbiome, which promotes psychological health and stability.
Supporting your brain chemicals, or neurotransmitters. Neurotransmitters affect your mood, thoughts about yourself, behavior, energy levels, and other aspects of how you feel and function. For instance, you may need serotonin or dopamine support. Serotonin is the neurotransmitter that allows us to feel joy and stave off depression. Dopamine, on the other hand, is necessary to feel self-worth, motivation, and to not experience constant cravings. Both serotonin and dopamine have been shown to play a role in eating disorders. If you have been starving yourself, binging and purging, undereating, or affecting your diet in other ways due to an eating disorder, there is a strong possibility you may be deficient in either one or both of these important neurotransmitters.
Ask my office for more advice on how to support a healthier approach to balanced approach to recovering from eating disorders.
Sufficient vitamin D levels requires more than a healthy diet and taking supplements—good vitamin D levels need the right cofactors too. A shocking three-quarters of the US population has too little vitamin D, even in sunny locales. Vitamin D is necessary to dampen inflammation and tame autoimmune diseases. Some people with autoimmunity may even need extra vitamin D due to a genetic variation that affects the ability of their cells to absorb adequate vitamin D.
In addition to supplementing with fat-soluble vitamin D (cholecalciferol), make sure you are getting the right cofactors, or “helper molecules” that assist in the biochemical transformations required by vitamin D.
These include fat-soluble vitamin A, magnesium, and K2, which make vitamin D more bioavailable and help prevent D overload.
Vitamin A and vitamin D work together to make sure your genetic code functions appropriately. There are two main types of vitamin A:
Beta-carotene, found in brightly colored fruits and vegetables, apricots, mango, and leafy greens.
Retinol, found in organ meats and dairy products.
You can take vitamin A in supplement form as both beta-carotene and retinol, however retinol is the more active form. Although it’s also possible to take too much retinol. Your body can’t get rid of it easily, which can be harmful.
Magnesium. You can obtain sufficient magnesium through food, but high doses of vitamin D3 deplete magnesium. If you are already low in magnesium and supplement with vitamin D, supplementing with magnesium may avoid headaches, cramping, nausea, numbness and more that may accompany high doses of D3.
The Vitamin D Council recommends 500–700mg of magnesium per day. Supplement sources include magnesium glycinate, magnesium citrate, and magnesium malate. Each has unique effects, so consult with my office to learn which is right for your needs.
Magnesium-rich foods include dark leafy greens, potato, beans, lentils, avocado, bananas, figs, strawberries, blackberries, nuts, seeds, brown rice, and dark chocolate.
Vitamin K2. Vitamin D toxicity can cause soft tissue to accumulate calcium and calcify like bone. In contrast, sufficient vitamin D i may even protect against calcium deposits in arteries.
Vitamin K2 is an important cofactor for vitamin D to help the body deposit calcium in appropriate locations such as the bones and teeth, and to prevent calcium from depositing where it doesn’t belong, such as the soft tissues, arterial walls, joints and organs.
Healthy gut bacteria are necessary to convert vitamin K1 to the more active form K2. However, we can supply our K1 needs through eating cabbage, kale, spinach, chard, green leafy vegetables, broccoli, cauliflower, Brussels’ sprouts, and sauerkraut. These foods will also promote healthy gut bacteria.
The National Academy of Sciences recommends 90mcg of K2 for women and 120mcg for men.
However, Osteoporosis International recommends 180 mcg a day of K2 as MK-7.
If you take blood thinning medicines such as Warfarin or Coumadin, vitamin K supplements can affect how well your blood clots, so please talk to your doctor.
If you would like help understanding about the the necessity of vitamin D cofactors, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Checking your vitamin D level periodically can help you improve your health if you suffer from chronic illness.
In functional medicine we measure vitamin D levels with a serum 25-hydroxy vitamin D test. Optimal levels are between 50 and 80 ng/mL.
If you suffer from leaky gut or autoimmunity, you may be more prone to a genetic vitamin D deficiency, so make sure to pay attention to this vital vitamin.
The notion that genes dictate our destiny has been solidly debunked in favor of epigenetics, the study of external or internal mechanisms that switch genes on and off. Exciting new research shows epigenetic memory can span multiple generations.
Descendants of people who survived the Holocaust show abnormal stress hormone profiles, in particular low cortisol production. Because of altered stress response, children of Holocaust survivors can be at increased risk for PTSD, depression, and anxiety.
Children of women exposed to intimate partner violence during pregnancy have higher predisposition to mental illness, behavioral problems, and psychological abnormalities due to transgenerational epigenetic programming of genes acting in the hypothalamic-pituitary-adrenal axis (HPA axis), a complex communication pathway between glands involved in our stress response.
Classic genetic theory states that genetic change occurs over a time scale of hundreds to millions of years.
Epigenetics explains how our lifestyle, diet, environment, and experiences affect the expression of our genes over multiple generations, but it does not account for actual changes to our genetic code.
If you would like help understanding the Effects of trauma and harm passed on for generations, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
How do genetics and epigenetics relate?
Via epigenetics our genes can be influenced by factors such as:
Where you live
Who you interact with
Social support (or lack of it)
Method of birth (cesarean vs. vaginal)
We inherit one variant of each gene from each parent. Epigenetics can turn off one of these two gene variants (this is called “imprinting”).
This can result in a negative health outcome if the other, still-active variant is defective or increases our susceptibility to toxins or infections.
The cumulative impacts of our lives on our genes
Related to epigenetics is the exposome, the cumulative measure of all the exposures of an individual in a lifetime — starting at conception — and how they relate to our health. Some consider the exposome the environmental equivalent of the human genome.
The exposome is divided into three overlapping categories:
The environment inside our bodies that affects our cells:
Hormones and other cell messengers
Oxidative stress (excess highly reactive and damaging molecules)
Lipid peroxidation (damage to cell membranes and other molecules containing fats)
The external environment to which we expose our bodies:
Pathogens and toxins
The general external environment, including broader sociocultural and ecological factors:
Urban or rural residence
Using epigenetics to positively impact the future
Epigenetic processes are natural and essential to many bodily functions. But if they go wrong they can negatively impacts not only our health but the health of our children. Researchers feel the ability for these changes to be passed down has significant implications regarding evolutionary biology and disease causation.
There are factors we have no control over such as certain environmental toxins, method of birth, and exposure to some level of stress. The good news is we can affect change in many areas that can powerfully affect our epigenetics:
Good sleep habits
Who we interact with
Addressing food intolerances
Functional medicine offers many avenues to support healthy epigenetic expression. If you seek ways to help your body express its genes in the best ways possible, contact my office for help.
In functional medicine one of the most common causes we see for many health disorders is imbalanced blood sugar. The good news is it is also one of the easiest things to remedy. A powerful tool in this process is a botanical compound called berberine.
An epidemic of blood sugar imbalances
According to the CDC, nearly 84 million American adults — more than one out of three — have prediabetes, or metabolic syndrome, a serious health condition in which blood sugar levels are too high but not high enough to be diagnosed as type 2 diabetes.
Ninety percent of people with prediabetes don’t even know they have it. Prediabetes puts you at increased risk of type 2 diabetes, heart disease, stroke, obesity, autoimmunity, infertility, dementia, and other disorders.
In fact, high blood sugar is so clearly linked to Alzheimer’s that researchers refer to the disease as “Type 3 diabetes.”
Berberine for high blood sugar and diabetes
A natural plant compound, berberine is found within the stems, bark, roots, and rhizomes (root-like subterranean stems) of numerous plants such as barberry, goldenseal, Oregon grape, tree turmeric, and Chinese goldthread.
Berberine is generally well tolerated and has been used in Chinese and Ayurvedic medicine for thousands of years to treat digestive issues and infections. The extract has a deep yellow color and is also commonly used as a dye.
Recently, berberine has become known for its ability to reduce high blood glucose. By working at a cellular level, it helps move glucose (sugar) from your blood into your cells where it’s most needed.
Berberine also promotes healthy blood sugar levels that are already in normal range.
Berberine works by activating AMPK (adenosine monophosphate-activated protein kinase), an enzyme that that regulates how the body produces and uses energy.
AMPK senses and responds to changes in energy metabolism on both the cellular and whole-body level. It regulates biological activities that normalize lipid, glucose, and energy imbalances.
Metabolic syndrome happens when AMPK-regulated pathways are turned off. This triggers fat storage and burning abnormalities, high blood sugar, diabetes, and energy imbalances.
Depleted energy activates AMPK while excess energy inhibits it. In other words, high blood sugar inhibits AMPK while exercise and calorie restriction activates it.
Berberine’s effect is similar to what you’d see in someone who increased exercise while restricting calorie intake because it activates AMPK, making it a useful tool in the management of type 2 diabetes.
Berberine as effective as metformin
Other known AMPK activators include resveratrol and the diabetes drug metformin. Berberine is so effective at balancing blood sugar that both animal and human studies compare it to metformin in its effectiveness.
Berberine has also been shown to be as effective in treating other conditions that respond positively to metformin, including polycystic ovary syndrome (PCOS), the reduction of weight gain triggered by antipsychotics, and potentially cancer.
While berberine is most commonly considered for metabolic syndrome, inflammation, and cancer, its potentially helpful for a long list of other disorders, including high cholesterol, obesity, small intestine bacterial overgrowth (SIBO), leaky gut, lung inflammation, Alzheimer’s disease, and heart disease due to these actions.
Stimulates the release of nitric oxide, a signaling molecule that relaxes arteries, increases blood flow, and protects against atherosclerosis.
Stimulates bile secretion and bilirubin discharge.
Reduces dysfunction of the intestinal mucosal barrier.
How much berberine should I take?
For diabetes and blood sugar support, the recommended dose is 500 mg two or three times a day. It’s important to spread your dose out throughout the day because berberine has a short half-life in the body and taking it all at once might rob you of the full benefits. Make sure to take berberine prior to or with a meal.
Studies show that gut bacteria play an important role in transforming berberine into its usable form. Therefore, supporting microbiome diversity and abundance is a smart way to increase its effectiveness. Make sure to eat varied and plentiful produce (go easy on the sugary fruits) and consider supplementing short chain fatty acid supplementation (SCFA) to help your gut bacteria thrive.
How long should I take berberine?
Continual use of berberine can impact cytochrome P450 (CYP) enzymes in the liver which may affect drug-to-drug interactions. Therefore, it’s recommended to use it in a pulsed 8-week cycle with two to four weeks off, then starting again if symptoms have not resolved.
Research has shown that combining berberine with cinnamon may increase its bioavailability. What’s more, cinnamon has also been shown to support insulin sensitivity.
While berberine is highly recommended for high blood sugar issues, it does come with some cautions:
Berberine is considered UNSAFE for pregnant women and nursing mothers. It may cross the placenta during pregnancy, and some newborns exposed to berberine developed a type of brain damage. It also can be transferred to babies through breast milk.
Berberine can interact with a number of medications, increasing the risk of adverse reactions.
Taking berberine when you are on medications that reduce blood sugar can push your blood glucose levels too low.
Berberine can lower blood pressure, so it should be used with caution by anyone who already has low blood pressure.
If you are concerned about your blood sugar status and want to discuss non-medical methods for helping regulate your blood sugar, contact my office.
Have you ever wanted to know everything there is to know about your thyroid? This 7-part video series will cover thyroid lab testing, nutrition and infections that affect the thyroid, toxins, thyroid hormone conversion, lifestyle, and adrenal interplay.