Ms. King (name and some details have been changed for privacy) has a lot going on. Her doctor referred her to me to help her address insulin resistance, high blood sugar levels, dyslipidemia and weight gain. During our intake assessment, Ms. King told me she suspects leaky gut is causing her problems. As we continued to talk, Pandora’s box pretty much started to explode.
I’m probably sounding like a broken record, and that’s because I feel it can’t be stated often enough… health begins in the gut. Our gut microbiome houses 70% of our immune systems. Ms. King’s case is another example of how this works.
You see, Ms. King revealed to me during our intake assessment that she has a hiatal hernia, which causes reflux, and that she’s been on acid blocking medications for years. A hiatal hernia creates an anatomical problem in the digestive tract that often results in reflux. Reflux is the most common symptom of a hiatal hernia, and primary treatment involves lifestyle modifications, such as diet, weight loss, and sleeping with a couple of pillows to elevate the head at night for example. Suppressing stomach acid with medications called proton pump inhibitors (PPIs) is a cornerstone of therapy, and unfortunately it’s a lot easier to take a medication than it is to change your diet, lose weight, and modify your sleeping position.
This is a huge problem. Why is this the case? We need stomach acid for a lot of reasons. It helps us break down foods, it causes the release of enzymes to further aid in digestion, it’s necessary for the digestion and absorption of very important nutrients like vitamin B12 and iron, and it helps protect us from invasion by pathogens often found in foods. When we don’t have enough stomach acid, all of this can shut down, and we can wind up with nutrient deficiency, gut infections and serious imbalances in the gut microbiome. This can lead to inflammation and yep, leaky gut. So Ms. King was spot on to suspect leaky gut, which we confirmed via functional testing, and she was unaware of this connection. This leads me to another point so I’ll digress for a moment. We are intuitive creatures. If you suspect something is wrong, feel it in your gut (pun sort of intended), we need to listen to that feeling. We know our own bodies better than anyone else. Tune in and listen. When you have what seems like random, unexplained symptoms, or stubborn conditions that won’t resolve, your body is talking to you, asking for help. My job is to help interpret what your body is saying. I speak its language.
Now let’s connect the dots between Ms. King’s gut and her primary goals to address insulin resistance, blood sugar and blood lipids, and weight.
Disturbances of the microbiome have been linked to cardiometabolic conditions, and our intestinal microbes play a role in the development of cardiometabolic diseases. Cardiometabolic conditions include those that increase your risk for having diabetes, heart disease or stroke. Insulin resistance, obesity, and dyslipidemia are some examples of conditions that increase your cardiometabolic risk.
The human microbiome plays a role in sugar (glucose) and fat (lipid) metabolism. Studies have shown that there are differences in the microbiome of people that are obese, and that have type 2 diabetes, and certain gut microbes may regulate glucose and lipid metabolism by changing intestinal permeability (cause leaky gut), which can drive inflammation. Most people that are obese will develop inflammation in the fat tissue around their middles, and having fat around your middle (visceral adiposity) puts you at greater risk for cardiometabolic conditions. Fat tissue is metabolically active, meaning it releases hormones, and chemical messengers that signal things to happen. In the case of obesity, these things are inflammatory leading to conditions like insulin resistance, and imbalances in the intestinal microbiota have been shown to be associated with these kinds of inflammatory changes. Gut bacteria can also produce lipopolysaccharides (LPS), which are toxic, inflammatory molecules that have the ability to trigger strong immune responses in the body. When we have leaky gut, LPS make their way into the bloodstream and can cause all sorts health problems, and contribute to obesity, insulin resistance, type 2 diabetes, and even autoimmune disease.
Isn’t biochemistry fun!?!?
So here we have a disrupted microbiome, contributing to Ms. King’s primary concerns. What did we do? We addressed her gut health by weaning her from acid suppressing medications (with support from her physician), and put her on a diet and lifestyle plan to address her hiatal hernia and cardiometabolic issues. We also added supplements and supportive foods to help remove gut pathogens, replaced digestive factors, balanced and restored her gut microbiome, and repaired her damaged and leaky gut. Ultimately we were able to improve her insulin, blood sugar, and blood lipid levels, and help her lose weight.
Need help connecting your dots? Interested in becoming your own success story? Contact me today to get started on your journey to better health and wellness.
"Your nutritional needs are as unique as your fingerprint, and they are dictated by your individual biochemistry. As a functional and clinical nutritionist, I can help you interpret your body's nutrient needs and customize a plan to reach your health and wellness goals. This is personalized nutrition."
-Jennifer Caryn Brand, MPH, MS, CNS, Clinical Nutritionist
Wishing you a delicious Friday and weekend!
Functional and Clinical Nutritionist