Biomarkers for navigating autoimmune health challenges - DAO, LPS and Zonulin

3 Bio-markers are Potential Game Changers for Autoimmune Sufferers

This year has already flown by, I can’t believe we are in the third month already! I have many things in the works to share with you and have been eager for reliable internet service to share these fascinating diagnostic testing options with you.  Especially for those on that auto-immunity journey and those on that health journey roller coaster which seems to have wheels spinning in circles…

I’ll cut to the chase – DAO, LPS and Zonulin – Have you heard of them?  Do you know their significance?  Let me give a brief, and I mean brief, overview of what they are and why they are significant.

What are they?

DAO – Diamine Oxidase is primarily secreted in the digestive tract and helps set the stage for a healthy environment in the digestive tract.   Do you have any guesses as to one of the things which happens when someone has low DAO?  If you guessed an adverse environment with an unhealthy microbiome you guessed correct!

LPS – Lipopolysaccharide is also primarily located in the gut.  It is an endotoxin which comes about as your body is fighting bacteria. When we find this in the blood that tells us it is no longer confined in the digestive tract, rather has made its way into our system!

Zonulin – (this is one you may have heard about!) Dr. Alessio Fasano, from Italy, is responsible for discovering the role of this fascinating protein.  Simply put – Zonulin is responsible for opening the tight junctions thereby allowing ‘stuff’ to pass between the cells lining the digestive tract. (If you want to dig deeper and connect some dots on your health journey take a minute and do a quick search at Pubmed: “Fasano Zonulin” and see what turns up 🙂

zonulin illustration

What is the significance?

First, if you haven’t read about the microbiome you may want to check out this post. When our digestive tract has an unhealthy environment that sets the stage for unhealthy flora to take up residence.  In addition what is typically healthy flora can get out of balance and become overpopulated, thereby rendering this once helpful bacteria unhelpful.  Furthermore, this loops back to causing an imbalance so we are left with having an imbalance due to bad environment and a bad environment due to an imbalance – quite the ‘catch 22’ situation!

Next have you heard of antibodies?  Are you familiar with how they come about?  Again, a brief snapshot.  Antibodies are part of the second line of defense in our immune system.  SIgA is the first line involved in the elimination of ‘invaders’.  When these invaders make their way through the lining of the digestive tract(such as when Zonulin opens the door) antibodies come into the scene.  Can you see where this is headed and how this is tied to autoimmunity?

So, we have antibodies getting made and foreign invaders attaching to things where they shouldn’t and our body decides to do what it can to eliminate the offender despite the collateral damage!  It is rather fascinating how we are made!

In addition to all of this histamines and allergies come on the scene…  I said I was going to keep this brief so will leave it at that… Things start to go downhill and the circling domino effect magnifies… Autoimmunity takes hold…

zonulin related disease illustration

What can we do about abnormal findings?

Ah, the million dollar question!!!  I wish I had the answer you are looking for, the fact is there isn’t a one size fits all solution.  This is why those of us with autoimmune conditions often find ourselves spinning in circles trying this protocol and that protocol.  For instance, overall those with MS find Wahls protocol effective, others may find Autoimmune Paleo effective or perhaps SCD(Specific Carbohydrate Diet).  Some may need to tweak and eliminate FodMAPs, Histamines or Nightshades…

We find relief in one area and think we are on the road to healing then have another ‘episode’. What you do for your T1 Diabetic condition may be different than what needs to happen for my T1D son.  This is where these three tests can be very valuable! We know ‘leaky gut’ is associated with autoimmune diseases, so the challenge is to find the breach and fix it.  Is it due to low DAO?  Perhaps its an abundance of Zonulin?  What about a combination of the two?  This is where partnering with a functional practitioner is invaluable. We can help you identify patterns and nuances specific to your situation.   We have to look at all the clues given us, these three markers are just three of the many clues to your ‘health mystery’.

I would love to be able to tell you to take this probiotic, that combination of supplements and you go on your happy way to healing. But, one thing I am 10,000% certain of is we are individuals and a restoration of health must be customized!   Are there similarities and common components to the solutions?  Absolutely!!!

So, can I help you?  Most likely, but it would take looking at your health journey with a fine tooth comb! In the meantime I can recommend a few things which will encourage your body to seek homeostasis:

  • Lifestyle changes which support synchrony with circadian rhythms
  • Plenty of water
  • Real foods
  • Elimination of stress
  • Quality rest
  • Exercise
  • Laughter

The simplest way to come up with a customized plan will take one of two things:

Find a functional practitioner who is passionate about YOUR health challenges. (For instance my  primary interest is in autoimmune challenges, another practitioner may focus on cardiovascular or hormone challenges)  Many do not ‘specialize’ and that is ok, they can still help you formulate a plan!

or

Enroll in functional medicine training and put the pieces of your health back together.

Feel free to contact me with any questions or comments 🙂 And of course you can also take advantage of my free 15 min consult! Best wishes on your journey!

A few references:

Polyamine Oxidase and Diamine Oxidase Activities in Human Milk during the First Month of Lactation.
Bjelakovic L, Kocic G, Bjelakovic B, Najman S, Stojanović D, Jonovic M, Pop-Trajkovic Z.
Iran J Pediatr. 2012 Jun;22(2):218-22.
PMID: 23056889 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446060/

 

Zonulin, a regulator of epithelial and endothelial barrier functions, and its involvement in chronic inflammatory diseases.
Sturgeon C, Fasano A.
Tissue Barriers. 2016 Oct 21;4(4):e1251384. doi: 10.1080/21688370.2016.1251384. Review.
PMID: 28123927

http://www.tandfonline.com/doi/abs/10.1080/21688370.2016.1251384?journalCode=ktib20

 

Abnormal intestinal permeability and microbiota in patients with autoimmune hepatitis.
Lin R, Zhou L, Zhang J, Wang B.
Int J Clin Exp Pathol. 2015 May 1;8(5):5153-60.
PMID: 26191211 Free PMC Article

https://www.ncbi.nlm.nih.gov/pubmed/26191211

 

Chronic Kidney Disease Induced Intestinal Mucosal Barrier Damage Associated with Intestinal Oxidative Stress Injury.
Yu C, Wang Z, Tan S, Wang Q, Zhou C, Kang X, Zhao S, Liu S, Fu H, Yu Z, Peng A.
Gastroenterol Res Pract. 2016;2016:6720575. doi: 10.1155/2016/6720575.
PMID: 27493661 Free PMC Article

https://dx.doi.org/10.1155/2016/6720575

 

Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption.
Enko D, Meinitzer A, Mangge H, Kriegshäuser G, Halwachs-Baumann G, Reininghaus EZ, Bengesser SA, Schnedl WJ.
Can J Gastroenterol Hepatol. 2016;2016:4893501. doi: 10.1155/2016/4893501.
PMID: 28042564 Free PMC Article

https://www.hindawi.com/journals/cjgh/2016/4893501/

 

Lipopolysaccharide-Induced Middle Ear Inflammation Disrupts the cochlear Intra-Strial Fluid–Blood Barrier through Down-Regulation of Tight Junction Proteins
Jinhui Zhang, Songlin Chen, Zhiqiang Hou, Jing Cai, Mingmin Dong, Xiaorui Shi
PLoS One. 2015; 10(3): e0122572. Published online 2015 Mar 27. doi: 10.1371/journal.pone.0122572
PMCID: PMC4376743

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376743/?report=reader

 

Analysis of the human monocyte-derived macrophage transcriptome and response to lipopolysaccharide provides new insights into genetic aetiology of inflammatory bowel disease.
Baillie JK, Arner E, Daub C, De Hoon M, Itoh M, Kawaji H, Lassmann T, Carninci P, Forrest AR, Hayashizaki Y; FANTOM Consortium., Faulkner GJ, Wells CA, Rehli M, Pavli P, Summers KM, Hume DA.
PLoS Genet. 2017 Mar 6;13(3):e1006641. doi: 10.1371/journal.pgen.1006641. [Epub ahead of print]
PMID: 28263993 Free Article

http://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1006641

 

Systemic lipopolysaccharide induces cochlear inflammation and exacerbates the synergistic ototoxicity of kanamycin and furosemide.
Hirose K, Li SZ, Ohlemiller KK, Ransohoff RM. J Assoc Res Otolaryngol. 2014; 15:555–70. doi: 10.1007/s10162-014-0458-8 PMID: 24845404

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141430/?report=classic

 

Lipopolysaccharide alters the blood-brain barrier transport of amyloid beta protein: a mechanism for inflammation in the progression of Alzheimer’s disease.
Jaeger LB, Dohgu S, Sultana R, Lynch JL, Owen JB, Erickson MA, et al.  Brain Behav Immun. 2009; 23:507–17. doi: 10.1016/j.bbi.2009.01.017 PMID: 19486646

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2783557/

 

Restoration of impaired intestinal barrier function by the hydrolysed casein diet contributes to the prevention of type 1 diabetes in the diabetes-prone BioBreeding rat.
Visser JT, Lammers K, Hoogendijk A, Boer MW, Brugman S, Beijer-Liefers S, Zandvoort A, Harmsen H, Welling G, Stellaard F, Bos NA, Fasano A, Rozing J.
Diabetologia. 2010 Dec;53(12):2621-8. doi: 10.1007/s00125-010-1903-9.
PMID: 20853098 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/20853098/

Spectacular Kohlrabi & Beef Vegetable Medley Quiche

The weather has turned brisk which calls for warm delicious snacks.  We had some kohlrabi that I needed to do something with so a quick search on pinterest and thus the inspiration for our afternoon snack!

Spectacular Kohlrabi & Beef Vegetable Quiche

Spectacular Kohlrabi & Beef Vegetable Medley Quiche

  • Servings: 4-6
  • Time: approx 1 1/2 hour
  • Difficulty: easy
  • Print

Spectacular combination for those brisk winter days.


Ingredients

  • 2 Small Kohlrabi – grated
  • 1 cup grated Carrot
  • 1 small Leek
  • 1 cup Baby Spinach leaves(before chopping)
  • 13 Eggs
  • 1/2 lb ground Beef (I used grass-fed)
  • 1 1/2 tsp Salt (I most often use “Real Salt”)
  • optional garnish: Avocado slices

Directions

  1. Pre-heat oven to 375
  2. Rinse and grate Kohlrabi, add 1 tsp of salt – mix well and sit aside while preparing the rest of the ingredients.
  3. Brown the Ground Beef on medium low with 1/2 tsp Salt while preparing the rest. Remember to check for being fully cooked while preparing the other ingredients.
  4. Crack eggs and mix well in large mixing bowl
  5. Peel and grate Carrots – add to eggs.
  6. Rinse and chop Leek – add to egg mixture.
  7. Chop the Baby Spinach and add to the egg mixture.
  8. Finish cooking the ground meat, if it is not done yet and then set aside in a small bowl to cool off a little before adding to the eggs.
  9. With a cheese cloth or by another method – squeeze out as much water from the Kohlrabi as you can before adding it to the mixture. Then add to egg mixture
  10. Add the Beef to the egg mixture.
  11. Mix all of the ingredients together well. Be sure to stir from the bottom as the eggs will sink to the bottom of the mixture.
  12. Spoon mixture into 3 individual large ramekins.(again making sure to get at least one spoonful from the bottom of the bowl. Place remainder into a quiche or small pie pan. Place ramekins on a baking sheet, optional for pie plate, and place in oven for about 45 minutes.
  13. 13.TIPS: Keep some ground beef cooked in your freezer in 1/2 to 1 lb packages, when you are in the need for a quick meal you can pull them out and make a casserole or simple quiche. When preparing leeks make one slice long ways and that will allow you to rinse any dirt that may get down in the lower layers, this also makes it easier to chop them by laying them on the flat side.

Ch-ch-chili, celeriac style

Cold weather necessitates making some hearty, warming chili!!! We have been loving the celeraic so much I thought I would attempt a different twist – well according to the kiddos it turned out to be SENSATIONAL!!! (I have to agree with them 🙂

Hearty, satisfying heart warming chili!

Ch-ch-chili, Celeraic Style

  • Servings: 3-4
  • Time: 1 1/2 - 2 hrs
  • Difficulty: easy
  • Print

Hearty, satisfying heart warming chili!


Ingredients

  • 1 lb ground meat(I used grass-fed beef)
  • 1 medium Celeriac (chopped/cubed)
  • 3 stalks of Celery
  • 1 large can of Chilis
  • 1/2 c. chopped Onion
  • 1 tsp. Paprika
  • 3 cloves Garlic, mashed and diced
  • 1 tsp. Salt
  • 1 tsp. Chili Powder
  • 1 tsp. Cayenne Powder
  • 1 TB Butter or olive oil
  • 4 C. Water
  • 1 C. Beef Broth

Directions

  1. Peel and chop Celeriac – saute in butter(or oil) in large pot while preparing the rest of veggies.
  2. Rinse and chop Celery, dice up onion – add to the Celeriac, saute for about 3-4 more minutes
  3. Peel and mash, dice Garlic. Empty veggie contents into a bowl and set aside while preparing the meat. Add Garlic, spices and salt with Meat to the pot and cook until the meat is done.
  4. Add veggies back to the pot with the meat. Stir well then add water and broth – cook for approx 90 minutes. Then ENJOY!
  5. TIPS: This can be made with a variety of ground meat.

Delicious, Mayo-Free Tuna Salad!

One of my favorite quick dishes is egg salad, tuna or chicken salad.  The problem which I have encountered is I am not a fan of mayonnaise.  When we changed our diet it became one of my quests to find an alternative. Well – here is one of our favorite replacements.  This works for chicken or tuna, I happened to make tuna today:

Easy, Delicious Mayonnaise Free Tuna Salad!

Delicious Mayo-Free Tuna Salad

  • Servings: 3-4
  • Time: 15-20 min
  • Difficulty: easy
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Delicious Mayonnaise Free Tuna Salad


Ingredients

  • 1 Boiled Egg
  • 1 Can Tuna
  • 3-4 Small Stalks of Celery
  • 1/2 large Cucumber – diced
  • 1/4 c diced Onion
  • 1/2 Avocado
  • pinch of Salt (optional)
  • 1 TB Olive Oil

Directions

  1. Either start your egg first to boil it while you prepare the rest – or go ahead and move on to the next step. Put egg in pan of water and turn on high heat – keep covered, when water is boiling remove from heat and let sit for about 10 minutes.
  2. Rinse and chop Celery and Cucumber – add to mixing bowl.
  3. Chop, dice small amount of onion – add to mixing bowl.
  4. Add Tuna to mixing bowl.
  5. Mash up boiled egg in a small separate bowl, IF making fresh boiled egg let cool just a tad. Then add Avocado and Olive Oil and mix together well. Can add salt at this step.
  6. Once the avocado and egg are blended up add to the rest of the ingredients and mix well. This is wonderful when served on a bed of lettuce with a few apple slices! We love to sprinkle our favorite herbs on top.
  7. TIPS: Keep a couple of boiled eggs on hand to use to make a quick snack with left over chicken, turkey or for a day when you just don’t want to cook!

Super easy grain-free banana pancakes

There is nothing like a warm breakfast that is filled with scrumptious flavors!!!

super easy banana pancakes post

Super Easy Flourless Banana Pancakes

  • Servings: 1-2
  • Time: 15-20 min
  • Difficulty: easy
  • Print

Super yummy grain-free, flourless banana pancakes


Ingredients

  • 1 Egg
  • 2 Bananas
  • pinch of Salt (optional)
  • Butter or Oil to grease pan

Directions

  1. Peel and mash Bananas
  2. add Egg & stir well
  3. Grease hot griddle or skillet and Pour small amount onto hot griddle (medium heat, not too hot) or into a hot skillet
  4. Cook approximately 3-4 minutes on each side (varies depending on skillet temperature)
  5. Serve warm!
  6. TIPS: You don’t want the heat too high or they get done on the outside too fast.  They seem to cook better on medium to medium-low heat.  I sprinkle just a touch of salt on pancakes after finished cooking.  Also- they can be difficult to flip, highly recommend a very thin metal spatula for flipping.  And when you grease your skillet or griddle use a cold oil, such as butter straight out of the refrigerator or cold coconut oil from refrigerator.

Celeriac Surprise Soup

We really enjoyed the Celeriac Creamy (or Not) soup that I made last week and decided to try our hand at another celeriac combination! So, I looked in our refrigerator to see what I could throw together and thus I present:

 Tasty combination of cerleriac, leeks, asparagus and mushrooms

Celeriac Surprise Soup

  • Servings: 4-6
  • Time: 2hr 30mins
  • Difficulty: easy
  • Print

Tasty combination of celeriac, leeks, asparagus and mushrooms.


Ingredients

  • 1 Celeriac Root
  • 10-12 stalks of Asparagus
  • 1 small Leek
  • 5 ounces Shiitake Mushrooms
  • 1 tsp salt (I use Himalayan or Real Salt)
  • 1 TB Coconut Oil or Grass-fed Butter
  • 1 TB of Olive Oil
  • 6 cups Water
  • Optional: 1-2 cups homemade beef or chicken broth (I used some beef broth, a little over a cup)
  • Optional garnishes: Spoonful of Chilled Coconut Milk, Roasted Pumpkin Seeds, Parsley or other Herbs

Directions

  1. Rinse, peel and chop Celeriac
  2. Melt oils, on medium heat, in large stock pot and add Celeriac
  3. While Celeriac is sauteing rinse and chop Leek, Asparagus and mushrooms.  Occasionally stirring Celeriac.
  4. Add Leeks, Asparagus and Mushrooms.  Saute and stir about 3-4 minutes.
  5. Add water and bring to a boil. Then cover and turn down to a low boil/simmer for about 2 hours
  6. After almost two hours add optional broth and simmer another 10 minutes
  7. Garnish with spoonful of coconut milk, parsley, pumpkin seeds or other favorite garnishes!
  8. TIPS – I will often add a cup or two of beef or chicken broth during the remaining 10 min – especially the broth that is saved from a roast.

Super easy - Steam pears for about 10-15 min top with Ceylon Cinnamon!

‘Pearfectly’ Steamed Cinnamon Pears

Yet one more delicious item from my Azure Standard order… We have two cases and my darling husband came up with this recipe!

Super easy - Steam pears for about 10-15 min top with Ceylon Cinnamon!

'Pearfectly' Steamed Cinnamon Pears

  • Servings: 2
  • Time: 10-15 min
  • Difficulty: easy
  • Print

'Pearfect' blend of cinnamon with delectable pears.


Ingredients

  • 4 small pears
  • freshly ground Ceylon cinnamon

Directions

  1. Rinse and peel pears(can leave peel on if preferred)
  2. Steam pears for about 10 minutes
  3. Sprinkle with Cinnamon
  4. Enjoy!

Easy Peasy Skillet Salmon w/ Lemon & Butter Sauce

Today was a very busy day!  Which is one of the reasons I love this dish so much.  It is super easy, no prep needed and provides us a way to get in those much needed omega-3s!

easy-Super easy salmon w/ lemon & butter sauce theFunctionalPerspective.com

Easy Peasy Skillet Salmon w/Lemon & Butter Sauce

  • Servings: 4
  • Time: approx 20 min
  • Difficulty: easy
  • Print

Savory Salmon with just the right amount of zesty lemon.


Ingredients

  • 4 Salmon portions – fresh or thawed if previously frozen
  • 2 TB +1 tsp Cold Grass-fed butter
  • 1/2 Lemon
  • Salt & Pepper – to taste
  • Dill(Optional garnish)

Directions

  1. Pre-heat skillet on medium heat
  2. Once skillet is hot spread 1 TB of butter around bottom of skillet to lightly coat skillet, it may take less than the 1 TB depending on size of pan.
  3. Place Salmon in skillet with skin side down (or if no skin the darker side where the skin was)
  4. Cook for about 5 minutes then add in about 1 tsp of butter before flipping. If using salt sprinkle salt on top of salmon just prior to flipping this first time. As you flip spread some of the newly melted butter so it will be under the flipped salmon.
  5. IF your salmon has skin, you can remove the skin at this point with a fork or two, peeling it off with edge of fork.
  6. Squeeze a bit of Lemon over the salmon while it is cooking. Let it cook for 3-5 minutes and check for any pink in the middle. If there is pink you can continue to cook or flip one more time.
  7. Once the salmon flakes and finished cooking remove from skillet and place on plates.
  8. In same skillet melt the remaining butter, once butter is melted squeeze most of the 1/2 lemon. As you squeeze allow the juice to drizzle around the pan. It should sizzle. Let it sizzle for about 30 seconds then drizzle the lemon butter on the salmon.
  9. Garnish with pepper and/or dill as desired.
  10. TIPS: I only use stainless or cast iron pans. To keep foods from sticking I will heat up my pans before adding any oil. When I do add oil I make sure the oil is cold. Cold butter or cold coconut oil seems to work best at keeping things from sticking.

Leek & Spinach Egg Bake

This week has been filled with a variety of foods.  Leeks were one more of the exciting foods which arrived in my recent AzureStandard order.  And, once again, my search for a recipe began.  I came across this one at The Tasting Table which fit the bill for something unique to make.  As usual I made a few changes and the results were delicious!

Leek & Spinach Egg Bake - Fabulous combination of fall flavors!

Leek & Spinach Egg Bake

  • Servings: 3
  • Time: approx 1 hour
  • Difficulty: easy
  • Print

A tasty combination of fall flavors.


Ingredients

  • 3 Leeks
  • 5-6 cups Baby Spinach
  • 2 Cloves Garlic
  • 1 small Kale leaf
  • ¼ cup Coconut Milk
  • 3 Eggs
  • 1/2 tsp salt (I use Himilayan or Real Salt)
  • 1 TB Coconut Oil or Grass-fed Butter
  • 2 TB of Olive Oil
  • Parsley (Optional garnish)

Directions

  1. Pre-heat oven to 375
  2. Rinse and slice Leeks
  3. Melt Butter & Oil in stock pot, add in Leeks.
  4. Lightly saute while chopping up Spinach, Garlic, Kale and Salt
  5. Add Spinach & Garlic, continue to saute about 3-4 min
  6. Add Coconut Milk and stir for 1 minute.
  7. Spoon mixture into individual large ramekins. Place filled ramekins on a baking sheet. Make a small indentation in the center for egg. Be careful to not break the yolk when cracking the egg.
  8. Place in oven and bake for approximately 15 minutes – until the egg whites are done and egg yolk still soft.
  9. Garnish with parsley, or other favorite herbs and enjoy!
  10. TIPS – I purchase big containers of fresh baby spinach and put the container directly in the freezer. The spinach freezes without sticking together and is very easy to crumble when I am ready to use it.
  11. I will often add a cup or two of beef or chicken broth during the remaining 10