According to the National Institutes of Health, nearly 50 million American adults have chronic pain or severe pain. The conventional medical model teaches us to reach first for medication to relieve pain, with ibuprofen and other NSAIDs (nonsteroidal anti-inflammatory drugs) at the top of the list. However, with research mounting to show NSAIDs have a notable list of dangers, it makes sense instead to look for the root causes of pain.
Many people turn to NSAIDs for relief from pain and inflammation. Common NSAIDs are ibuprofen (Motrin, Advil) and naproxen (Aleve). Celecoxib (Celebrex), diclofenac (Cataflam, Voltaren) are prescription NSAIDs. Aspirin is an NSAID, but it does not pose the same risks for stroke and heart attack.
Ibuprofen is metabolized by the liver, and can cause lesions, liver failure, or jaundice over time. The FDA has even warned against NSAIDs because they increase the risk of heart attack and stroke.
NSAIDs promote leaky gut
Another reason to avoid NSAIDs is their tendency to promote leaky gut.
In leaky gut, the lining of the small intestine becomes damaged and overly porous, allowing undigested food, bacteria, yeast, and other pathogens into the bloodstream. This triggers inflammation and pain throughout the body — the same thing people use NSAIDs to relieve.
So, if the typical go-to medications for pain aren’t an option any more, where do we turn? Functional medicine offers solutions.
Address inflammation to root out pain
When pain is treated with NSAIDs, it typically comes back when the medication runs out. However, in functional medicine the goal is to identify and address the cause of the inflammation and pain instead of simply putting a temporary Band-Aid on it.
It’s understandable to want relief so you can feel and function better. The good news is many people find their chronic pain diminishes substantially or disappears completely when they adopt functional medicine strategies.
Following are a few ways functional medicine can relieve pain and inflammation:
Anti-inflammatory diet. Remove foods that trigger inflammation, such as gluten, dairy, grains, legumes, eggs, sugar, and nightshades. This is typically done as an elimination and reintroduction protocol where you follow the diet strictly for a period of time and then customize it depending on your food sensitivities.
Avoid nightshades. Vegetables in the nightshade family can cause pain and inflammation in the joints. These include eggplant, potatoes (but not sweet potatoes or yams), peppers, tomatoes, tomatillos, hot pepper products and pepper-based spices. Simply removing nightshades from the diet has brought relief from joint pain for many, especially those with rheumatoid arthritis.
Turmeric and resveratrol. Each is a powerful anti-inflammatory alone, but research shows that taking them together is much more effective, making them potent tools for quenching the inflammation and damage associated chronic inflammatory disorders.
Improve your posture. Chronic pain can develop due to spinal misalignment. Rarely do patients with chronic pain have even pressure on both feet or eyes that move in synchrony. Many patients experience significant or total relief of chronic pain by addressing these imbalances.
Nutrients that fight inflammation and pain. These include vitamin D, vitamins A, E, and K, and plenty of omega 3 fatty acids.
White willow bark is an herb traditionally used for pain relief.
Moderate to high intensity exercise can help reduce inflammation. It also improves insulin sensitivity, a bonus for diabetes prevention. Just make sure to choose exercises that do not exacerbate joint pain; there are lots of options.
Balance your blood sugar. Many people have blood sugar dysregulation issues that contribute to systemic inflammation and pain. In addition, imbalanced blood sugar is one of the risk factors for Alzheimer’s and Parkinson’s.
Support production of SCFA. Short chain fatty acids (SCFA) produced by your “good” gut bacteria are helpful in dampening inflammation. Eat abundant and varied fresh vegetables daily, eat probiotic-rich fermented foods, and take SCFA-supporting supplements such as butyrate, Saccharomyces boulardii, Lactobacillus sporogenes, and DDS-1 Lactobacilli acidophilus.
Support glutathione. The most important antioxidant in your body, glutathione aids in detoxification, helps maximize immune system function, and shields cells from damage caused by oxidation and inflammation.
A healthy body makes enough glutathione, but faced with chronic stressors such as toxins, poor diet, sleep deprivation, smoking, and excess sugar, glutathione become depleted.
Glutathione supplements are not effective taken orally. Instead, boost glutathione levels through a liposomal cream, suppository, nebulizer, or IV drip.
One must also support glutathione recycling to balance the immune system, protect body tissue from damage caused by inflammation, and help repair damage.
To enhance glutathione recycling, remove stressors depleting glutathione levels such as lack of sleep, smoking, food intolerances, diets high in sugars and processed foods, and excess alcohol intake.
The following nutritional and botanical compounds have been shown to support glutathione recycling:
- Alpha-lipoic acid
- Milk thistle
- Gotu kola
These are just a few ways to use functional medicine to address the root causes of inflammation and pain so that you can stop taking NSAIDs. Ask my office for more advice.
Do you know those irritable people that always seem angry or depressed, sensitive to emotion, live in constant chaos, or seem perpetually stuck in unfavorable situations? Sometimes, this is just a byproduct of poor brain function. Of course, naturally optimistic people can suffer from poor brain function too—symptoms may consist of memory loss, brain fog, fatigue, anxiety, and depression.
All of these feelings—and others—can trigger symptoms in the gut. This gut-brain connection operates as a bi-directional system; therefore, a person’s gut inflammation or distress can be the cause or byproduct of stress, anxiety, or depression.
This is particularly true in circumstances when a person experiences gastrointestinal (GI) upset without a physical cause. For such functional GI disorders, it is a challenge to heal the gut without first looking at the connection between the gut and brain and considering the effects of stress and emotion.
One of the most significant things to understand is the intimate link between the gut and the brain. We have several receptors that fire into the brain, such as for sensation, sound, temperature, balance, etc. These signals stimulate the brain to relay information into the brainstem of the central nervous system (CNS), which is the area of the brain that keeps the heart beating, lungs functioning, and gut moving.
The wall of the digestive system is innervated by the CNS and the enteric nervous system (ENS)—it has millions of neurons that control blood flow and secretions to help you digest food. Inflammatory issues, such as in intestinal permeability (leaky gut) or an imbalance in the gut microbiome (dysbiosis) can impact the messages from the gut to the brain.
The vagus nerve, a cranial nerve that is a part of the ENS, is a key pathway to the activation of the digestive system. Degeneration of vagal function, or less activation of the vagus nerve, compromises the digestive function by decreasing blood flow to the gut (which leads to leaky gut, neuroinflammation, and a cycle of other inflammatory responses).
The multitude of neurons in the ENS not only influence our GI function but also how we “feel”—this is why the ENS is called our second brain. Though the second brain is not capable of in-depth thought, it does “talk” to the brain.
Stress, for example, is closely tied to the gut. The body responds to external and internal stressors with the “fight or flight” system. During a stressful situation, a redirection of energy takes place; your digestion is put on hold, your heart and respiratory rate escalate, and your palms may get sweaty. This protective mechanism is intimately related to cortisol levels, which are ruled by the hypothalamic-pituitary-adrenal (HPA) axis.
Typically, diffusion of the stressful situation resets your body back to normal. But if you are always stressed, anxious, or stuck ruminating on negative thoughts, your body gets caught in a fight or flight response.
The byproduct of this chronic response is chronic inflammation—the root of many diseases. Inflammation leads to serious health consequences, such as high blood pressure, intestinal permeability, autoimmune disorders, and neurodegeneration.
The trillions of gut microbes—collectively known as the microbiome—also play a role in the regulation of our immune response. Communication between the gut microbiome and nervous system may influence disorders like anxiety and depression, autism, and dementia.
GUT-BRAIN OR BRAIN-GUT IMPAIRMENT
How do you recognize if you need to improve your gut-to-brain or brain-to-gut axis?
If your brain is impaired (brain fog, memory loss), if you suffer from intestinal motility issues (constipation, nausea), and if you have not had a positive response to conventional digestive protocols, you may have a brain-to-gut impairment.
Furthermore, if you have digestive issues, these can impact your brain chemistry and impair your gut-to-brain communication.
It is not uncommon to be in a vicious cycle of both a gut-to-brain and brain-to-gut impairment; most people need to support both simultaneously.
A characteristic symptom of this cycle is a decrease in the motility of the gut and consequently constipation, straining during bowel movements, and incomplete elimination. Poor elimination means that waste sits in the intestines, promoting an environment for yeast and bacterial overgrowths and the development of small intestinal bacterial overgrowth (SIBO).
Poor vagal function also encourages gallbladder stones and attacks and reduces the effectiveness of digestive secretions; therefore, digesting food becomes difficult.
Many patients with chronic gut dysfunction never improve because they do not move past treating it at the gut level—this will create the vicious cycle. Poor gut health will impact your brain function thus causing depression, anxiety, poor cognition, and other brain-based symptoms.
GUT-BRAIN HEALING STRATEGIES
While there’s still much to discover about the mystery of the digestive system and all that it affects, we are sure of several things that can help improve the connection between your gut and brain.
Support for Your Gut-Brain Axis
- Follow the autoimmune paleo (AIP) diet.
- Avoid processed foods.
- Avoid gluten and other immune sensitive foods.
- Remove food sensitivities.
- Eliminate sweets.
- Eat a lot of vegetables.
- Have healthy fats.
- Consume different types of fiber.
- Eat probiotics and prebiotics.
- Remove pathogenic and reduce opportunistic bacteria and microorganisms.
- Supplemental support may include digestive enzymes, L-Glutamine, N-acetyl glucosamine, and antifungals (such as oregano oil).
Support for Your Brain-Gut Axis
- Every neuron needs oxygen, glucose, and stimulation.
- Oxygen – A reduction in blood flow to the brain, such as from a sedentary lifestyle, smoking, anemia, low blood pressure, and hypothyroidism, reduces the amount of oxygen the brain receives.
- Glucose – Glucose fuels the brain. If you become hypoglycemic (low blood glucose) from going too long without eating, you may feel dizzy or lightheaded. On the other hand, in insulin resistance (high blood glucose), glucose can’t get into the cells of your body or brain leaving you feeling sleepy or slow.
- Stimulation – Stimulation such as physical activity and mental challenges “exercise” your neurons and are essential to keep them active and healthy. Exercise also increases brain-derived neurotrophic factor and supports mitochondrial function.
- Support the brain with nutrition.
- Reduce inflammation with resveratrol, turmeric, and fish oils.
- Optimize with vitamins and supplements.
- Provide neurotransmitter support.
OPTIMIZE YOUR BRAIN WITH GUT REPAIR AND DETOXIFICATION
Healthy brain function is not just about boosting your score on a brain game, remembering where you put your keys, or preventing dementia.
A Healthy brain equals a better quality of life. When you have optimal brain function, you are happier, and you are naturally drawn to nourish your body and mind. Ask my office for more information about a detoxification and gut-repair program using the AIP diet. You can schedule to become a new patient or a free consultation.
You could be developing an autoimmune disease, one of the most common diseases today, and are not aware of it. This is because autoimmune diseases sometimes start off as “silent” autoimmunity. This means your immune system is attacking tissue in your body but the damage isn’t bad enough to cause symptoms yet.
Autoimmune disease is more common than cancer and heart disease combined, and that’s just the diagnosed cases. Many, if not most, cases of autoimmunity are happening without a diagnosis.
This is because medicine does not screen for autoimmunity until symptoms are advanced and severe enough for a diagnosis and treatment with steroids, chemotherapy drugs, or surgery.
Autoimmunity: The disease for the modern era
Autoimmunity can affect any tissue in the body or brain. It occurs when the immune system attacks and damages tissue as if it were a foreign invader.
Common autoimmune diseases include Hashimoto’s hypothyroidism, Graves’ disease, multiple sclerosis, lupus, rheumatoid arthritis, type 1 diabetes, celiac disease, and psoriasis. More than 80 different autoimmune diseases have been identified so far.
Autoimmune disease affects 1 in 5 people, the majority of them women. It is believed women are more commonly affected because of their hormonal complexity. Although autoimmune disease is very common, the statistics do not tell the whole story.
Autoimmunity can happen long before diagnosis
Autoimmunity can begin long before damage is bad enough for a disease to be diagnosed. Many people can go years, decades, or even an entire lifetime with symptoms but never have damage bad enough to be labeled disease.
As an example, autoimmunity against the pancreas can cause blood sugar issues long before the development of type 1 diabetes. Additionally, about 10 percent of people with type 2 diabetes, which is caused by diet and lifestyle, also have pancreatic autoimmunity. This is called type 1.5 diabetes.
One of the most common autoimmune diseases is Hashimoto’s hypothyroidism. Patients may need to gradually increase their thyroid hormone because although they were diagnosed with low thyroid, the autoimmunity was overlooked and left unmanaged.
Or a patient may have an autoimmune reaction that has not been recognized as a disease. For instance, autoimmunity to nerve cells may produce symptoms similar to multiple sclerosis (MS), which is an autoimmune reaction to nerve sheathes. However, because the autoimmunity is not attacking nerve sheathes specifically, the patient cannot be diagnosed despite MS-like symptoms.
Autoimmunity can attack anything in the body
People can also have symptoms that suggest many types of autoimmunity. Although symptoms vary depending on which tissue is being attacked, many autoimmune sufferers experience chronic fatigue, chronic pain, declining brain function, gastrointestinal issues, hair loss, weight gain or weight loss, brain fog, and more.
Fortunately, functional medicine offers lab testing that can screen for autoimmunity against a number of different tissues. We also use strategies such as an anti-inflammatory diet, blood sugar stabilizing, gut healing, addressing toxins, and habits that minimize stress and inflammation.
Ask my office if autoimmunity may be causing your strange and chronic symptoms.
Forget low-fat diets, especially in teens at risk for mental illness — healthy fats are vital for good brain health. They’re so important that fish oil has been shown to prevent schizophrenia in young people who show early signs of the disease, such as minor delusions or paranoid thoughts.
Schizophrenia is usually diagnosed in the late teens or early 20s when the brain is nearing the end of its development. However, a recent study showed that teens at risk for schizophrenia who took fish oil were less likely to develop the disease compared to those who didn’t.
Research has also shown that people with schizophrenia have lower blood levels of fatty acids the brain needs, suggesting their brains are deficient in these essential fats. Giving fish oils to adults diagnosed with schizophrenia has not produced good results — it appears the key is to give fish oil to youth before it’s too late, thus changing the trajectory of the disease.
Fish oils and other healthy fats, such as oils from olives, nuts, seeds, and avocados, have been shown to dampen inflammation in the brain, protect neurons, and enhance neuronal function and communication. Fish oils are high in the omega 3 fatty acids EPA, which dampen inflammation, and DHA, which supports brain health and function.
The brain is made up of primarily fat, especially the cell membranes, which are vital for communication within the brain, so the fats you eat determine how well your brain performs. It’s best to go for healthy fats and avoid trans fats, or hydrogenated oils, as they have been shown to sabotage brain health and function.
Fish oil group fares better than placebo group
The study followed 81 young people between the ages of 13 and 25 who showed early signs of schizophrenia. About half were given fish oil supplements to take daily while the other half were given a placebo.
A year later, the group given fish oil were less likely to develop psychosis.
A follow-up seven years later of 71 of the participants showed that only 10 percent of the group given fish oil went on to develop schizophrenia, compared to 40 percent of the group given the placebo.
Researchers say the results are striking but the trial needs to be done again with a larger group of people.
Gluten: Another factor in schizophrenia
Shoring up brain health with fish oils and other essential fatty acids isn’t the only tool in the prevention toolbox. A gluten- and dairy-free diet may also help.
Gluten, the protein found in wheat, has been found to play a role in many cases of schizophrenia.
Quite a bit of research has found a higher rate of a sensitivity to gluten among schizophrenics than in the general population. Casein, the protein in dairy, has also been linked with schizophrenia.
In fact, some research has shown symptoms in early-onset schizophrenia improved on a gluten- and dairy-free diet. Adding gluten back to the diets of patients who improved significantly worsened symptoms.
One interesting study from the 1960s even shows that hospital admissions for schizophrenia declined across Europe and the United States after the rationing of wheat during World War II.
Schizophrenia is a complicated disease with no easy answers. However, preventive measures before it’s too late may produce significant results in some people.