Bolstering Immunity by Optimizing GI Health
About 10 years ago, I contracted a GI infection, accompanied by chronic diarrhea that took over a year to fully resolve. In the first few months, I lost 14 pounds, putting me at 108# at my lowest (I'm 5'9"). This infection came after years of struggling with perioral dermatitis and asthma, which I came to realize were all related to microbiome imbalance (think of how the mouth, lungs and GI tract are all connected). What finally helped me resolve these issues was a DNA-based stool test that I collected at home. After approximately 18 months of treatment, coupled with diet and lifestyle changes, I was able to resolve salmonella as well as several chronic infections, and gain enough weight to be in a healthy BMI range for the first time in my life (WAIT! Before I lose you, balancing the GI tract helps normalize weight, so most patients see weight loss. :-)
Because so much of our body's immune response originates in the gut, optimizing its function is one of the most impactful things you can do to enhance immunity. At Leaves of Life, we know many of you may prefer a DIY approach, so that's what this blog post is all about.
It's rare that a new patient doesn't need to address their GI tract as one of the first and most important foundational pieces of their care, so even if you opt not to test, I feel confident that addressing the most common imbalances we see on stool testing reports would significantly boost your immune response.
Why DNA Stool Testing?
Parasites, bacteria and other invading microbes don't LIVE in the stool - most burrow into the gut lining, snagging nutrients from food passing by, and expelling their metabolic waste in exchange (akkk!--their poop!). However, they still shed cells, and DNA stool testing picks up the presence of non-human cells and identifies their microbial origin. This type of testing is much more sensitive than conventional stool testing.
Some microbes can cause or contribute to disease, but at the very least, "unfriendly" microbes:
Contribute to chronic, ongoing toxicity
Deplete nutrient levels
Weaken immunity by crowding out "friendly," beneficial flora
Cause chronic, systemic inflammation
Create or worsen leaky gut, which can lead to food and environmental sensitivities
Can be an underlying cause of insomnia and mood disorders (anxiety, depression, irritability)
Make it difficult to attain or maintain an ideal weight
Can trigger acute or chronic skin conditions
And more!
As you can see, eradication of unwanted microbes can be pretty critical to overall health. Below, we'll discuss what to use and how to dose it, but first things first...
Leaky Gut Lining
The gut lining is just one cell thick, and is protected by a mucosal barrier. We've learned over years of practice that healing the gut lining and associated mucosal barrier needs to come first. This keeps die-off-generated debris and toxins from crossing over into the bloodstream during the eradication phase.
More than 90% of our stool tests come back with indications of a leaky gut lining, and most patients feel noticeably better with just this first step. We typically have patients begin GI lining support 2 or more weeks before an eradication regimen begins.
There are three stool test markers we use to evaluate the integrity of the GI lining:
Secretory IgA (immune response at the mucosal barrier)
Levels of normal flora (the protective sentries along the GI lining)
Calprotectin (indicating levels of inflammation)
Here are some of our favorite products and dosing:
GI Revive by Designs for Health (contains a small amount of prune powder): comes in powder and capsules
If having less than 2 BMs per day, take 1 tbsp/7 caps at bedtime, mixed to taste with water or nut milk
If BMs are 2-3/day and formed, you may be best served using Intestinal Restore
Intestinal Restore by DesBio (can be used with any type of bowel pattern - contains bonus colostrum, though for some, additional mucosal barrier support may be indicated, as with Glutashield below).
1 scoop at bedtime, mixed to taste with water or nut milk
Glutashield by Orthomolecular (the chocolate is delicious - we often recommend for kids and adults with sensitive palates - some need additional mucosal barrier support such as aloe juice 1/4 cup or slippery elm powder - 1tsp)
1 scoop at bedtime (with optional aloe or slippery elm), mixed to taste with water or nut milk
Typically, we keep patients on GI lining support until their protocol is complete, and for some patients, it's necessary for them to take it for a longer period of time before beginning eradication. Heartburn and/or oral or digestive ulcers, if present, should be resolved before moving ahead with eradication.
Digestive Weakness
The most common cause of weak digestion is Helicobacter Pylori infection (H Pylori for short). If present, this microbe requires a 2-4 month treatment regimen, which I'll cover in more detail in a separate blog post (coming soon). H Pylori lowers stomach acid, which leads to the following problems:
Malabsorption since acid triggers enzyme production by the pancreas and bile flow from the gallbladder, both of which enable good absorption from the diet.
Proteins don't break down into amino acids needed for tissue repair (think leaky gut and achy joints) and neurotransmitter production (why mood disorders can stem from GI dysfunction).
Minerals and fat-soluble vitamins are poorly absorbed (we can often identify weak digestion by looking at a patient's micronutrient status).
Microbes that are present in much of the food we eat are able to survive digestion and set up camp in the intestines, impacting overall immunity (Hydrochloric acid sterilizes anything that passed through the GI tract as part of a healthy body's defense system).
Depending on the person, as the immune system becomes dysregulated, it may begin attacking body tissues (auto-immunity) or flounder in its ability to fight off infections such as cold and flu.
Here are some of our favorite digestive aids with dosing:
OrthoDigestZyme by Orthomolecular (blend of enzymes and hydrochloric acid for broad spectrum support) or Proactazyme by Nature's Sunshine (blend of pancreatic enzymes that work in various pH ranges, but containing no stomach acid for those who may be intolerant at treatment onset).
1-3 per meal, at the beginning of the meal, dose is based on level of digestive weakness and size and complexity/richness of meal - I recommend increasing starting at 1-2 per day and slowly increase per tolerance, continuing until you notice improved digestion
Metagest by Metagenics (contains betaine HCl and pepsin that stimulate bile flow and pancreatic enzyme output
Start with 1 per meal, mid-meal and slowly increase to 2-3 per meal, as tolerated. If stomach acid deficiency has been longstanding, the stomach may no longer be producing a sufficient mucosal barrier as protection, and this takes time to build back, so starting slow allows for this to take place. Most often, heartburn when beginning simply means more mucosal barrier support is needed before starting or increasing.
Because stomach acid triggers the next steps in digestion (bile flow and pancreatic enzyme output), hydrochloric acid (betaine HCl) is the workhorse of digestion. If I can only choose one product for digestion, I choose HCl (Metagest) because it will stimulate the patient's own digestive functions. I think of stomach acid as the bouncer at the door of a party. It won't do much good to eradicate infections already present if you don't ensure there is a sentry at the door to prevent new infections from settling in.
Pathogenic and Opportunistic Bacteria
There are nuances when addressing microbial overgrowth, dependent on what all is present and in what amount, but in general, after 2-3 weeks of intestinal lining support, we typically shift into broad-spectrum antimicrobials (alongside probiotics--see below).
Our favorite antimicrobials:
Candibactin BR by Metagenics (berberine based blend of dry herbs with broad-spectrum action)
GI Microb-X by Designs for Health (berberine-based blend with broad-spectrum action)
Candibactin AR by Metagenics (a blend of aromatic oil-based herbs that can penetrate biofilms)
Oil of Oregano by Designs for Health
Intestin-Ol by Orthomolecular (similar to Candibactin AR)
I typically choose one of these products and one of the parasite remedies below, and dose 1-2 per meal, though some patients may need to start low and build up to the full dose. As microbes die, they release toxins and bacterial debris into the intestines, so die-off symptoms may occur, though they're most likely to occur at the beginning when bacterial numbers are highest. As patients make headway and the numbers drop, they can typically tolerate the full dose.
Parasites
Whether or not parasites are present on the report, I typically like to treat for them. The stool test only looks for the specific parasites that are listed, and there isn't any way to test for every known parasite. If they’re present and not addressed, it can be very difficult to eradicate the other dysbiotic microbes, and it doesn't hurt to treat if they're not there.
Our favorite anti-parasitics:
Wormwood Complex by MediHerb, Paracid Forte by Orthomolecular, MicroDefense by Pure Encapsulations or Artemisia Combination by Nature's Sunshine
Take 1- 2 tablets per meal and take for 1-3 bottles, depending on what parasite is present.
Probiotics
Whether or not testing shows low levels of normal flora, they are impacted by anti-microbial treatments and should be supplemented during eradication of "unfriendly" microbes. Probiotics stand as protective sentries along the gut lining, bolstering the mucosal barrier and helping with nutrient absorption from the diet. They also produce vitamin K and some of the B vitamins. No wonder they're often referred to as "friendly!"
Because they also support respiratory health, we're currently favoring these probiotics:
Ultra Flora Immune Booster by Metagenics, Ultra Flora BiomePro and Ultra Flora Balance by Metagfenics
1-2 per day on empty stomach
I prefer dosing at bedtime when peristalsis slows and GI lining support can be paired with the probiotic as comprehensive support.
Diet
Refined carbohydrates and high-glycemic foods are the favored nutritional source for many harmful microbes, so continuing to consume them will prevent successful eradication. Fiber is the preferred food for the friendly flora (think vegetables, low-glycemic fruit and whole grains). You can see why most Americans are in need of a GI detox plan.
Rehabbing the Gut in a Nutshell:
Heal and seal the GI lining (GI Revive, Intestinal Restore or Glutashield - if using either of the latter 2, consider additional mucosal barrier support if indicated: slippery elm, aloe juice or Intestinal Soothe & Build capsules if powders won't work for you)
Digestive Support (Metagest and/or OrthoDigestZyme)
Broad-spectrum antimicrobials (Candibactin AR/BR, Intestin-Ol, Oregano oil, Wormwood Complex or MicroDefense)
Probiotics (Ultra Flora Immune Booster , UltraFlora BiomePro or Ultra Flora Balance)
Avoid sugar and refined carbs and include plenty of fresh veggies and low-sugar fruits.
I hope you find this article helpful. I'm available for consultations, with or without GI stool testing, if DIYing isn't your thing or you need additional help. Alternatively, you can schedule with Caitlin Pfeil or Francie Silverman to begin your health journey.
Remember: The Road to Health is Paved with Good Intestines!