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/

Cardiovasular Disease & Diabetes: What is the connection?

The primary health concerns of the late 19th and early 20th centuries were infections diseases.  A shift in adverse health came about after the fortification and enrichment of foods.  Chronic diseases, such as heart disease, cancer and stroke became the prevailing ailments.  These diseases continue to rise, some at alarming rates.  Let’s take a quick look between two prevalent diseases today: Heart Disease and Diabetes. I am going to especially look at the incidents in Nacogdoches County in the State of Texas.  [PDF of this post here]

Some quick stats:

nacogdoches-statistics-cvd-and-diabetes

Is this a sign of malfunction in the bodies of the population?

Maintaining a healthy status requires a homeostasis of the bodily systems. Having healthy levels of glucose in our blood is vital for proper balance. When we eat, signals are sent in our body to aid in the metabolizing of the food we just ate.  Insulin is secreted as a result of some of those signals.  It is the “key” which allows glucose to enter the cells.  Without proper signaling of insulin, glucose cannot enter the cells.  This results in glucose going to other parts of the body.  For our body to function properly it is important to keep glucose levels stable.

When our glucose levels are outside a healthy range it attaches to proteins resulting in diabetes-1724617_1920Advanced Glycation End Products (AGEs).  Excessive AGEs leads to plaque forming in the blood vessels.  One consequence is an impairment of the endothelium which lines the blood vessels.  It is hindered in releasing nitric oxide into the blood stream.  With this compromised cardiovascular system, the body has a difficult time repairing daily wear and tear.  Thus an increase in inflammation.  Heart disease often ensues.

In fact…. Studies have shown an increased incidence of heart disease in the presence of diabetes! 

With a high prevalence of heart disease and diabetes there is a need to understand the role of a proper functioning body. In regards to diabetes and cardiovascular disease the role of glucose balance is of marked importance.  Maintaining proper levels eliminates an exacerbating risk factor for both diabetes and cardiovascular disease.  A body which is in homeostasis is free of disease contrasted with a body where malfunction is present, disease emanates.

What can you do today to ensure a proper functioning body?

Begin practicing the 5 Pillars to Healthy Function!!!

Eat Quality Foods

Get Adequate Sleep

Be Active

Promote Healthy Digestion

Embrace Peace & a Spiritual Connection (Eliminate Stress)

push-ups-888024_1280

Related Research:

A.G.E. Foundation. What are AGEs http://agefoundation.com/age/

CDC Interactive Atlas of Heart Disease and Stroke TablesGeographic Area 2010-2012.

Davis, C., and E. Saltos. (May 1999) “Dietary Recommendations and How They Have Changed Over Time,” America’s Eating Habits: Changes and Consequences, Agriculture Information Bulletin No. 750, USDA, ERS. Chapter 2.

Texas Department of State Health Services. (2012). 2012 Texas Heart Disease and Stroke

Fact Sheets, (2013). Diabetes Prevalence Among Adults BRFSS data Tables

Yamagishi, S-i., Nakamura, N., and Matsui, T. (2016) Glycation and cardiovascular disease in diabetes: A perspective on the concept of metabolic memory. J Diabetes, doi: 10.1111/1753-0407.12475.

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.

Expert Talk: David Perlmutter, MD Brain Inflammation, Autoimmune Disease and Nutrition

I just listened to the first ‘bonus’ video from the Autoimmune Revolution and I was STUNNED! ABSOLUTELY FABULOUS!!!  I am looking forward to the rest of the videos – I have a feeling it is going to end up being a great resource for me on this journey…  If you missed my previous post here is another link below to sign up for the free content!

After registering you will get an email confirmation with a link to the bonus content – The video I just watched was:

Expert Talk: David Perlmutter, MD Brain Inflammation, Autoimmune Disease and Nutrition

(Here is Dr. Perlmutters website http://www.drperlmutter.com/

https://www.thunderclap.it/projects/50763-the-autoimmune-revolution/embed

So, which came first?

Which came first – autoimmune disease or malfunction in the body?questions-1922476_1920

(Update 4/11/2017: Check out this post for a hint)

Beta cell regeneration – Hope for T1 Diabetics

I was at a wedding this evening and as our creator would have it my path crossed with another functional medicine minded individual with a Type 1 Diabetic family member!  One of the tidbits I picked up from this blessed encounter was the role the spleen plays in beta cell regeneration.. So you all can probably guess one of the first things that I did upon returning home was head to the research portals to see what I could dig up.. Well this was the first one I came across (while I was munching on leftover chili)

Here is the abstract:

Approaches Towards Endogenous Pancreatic Regeneration

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1783561/
Banerjee M, Kanitkar M, Bhonde RR. Approaches Towards Endogenous Pancreatic Regeneration. The Review of Diabetic Studies. 2005;2(3):165-176. doi:10.1900/RDS.2005.2.165.

The phenomenon of pancreatic regeneration in mammals has been well documented. It has been shown that pancreatic tissue is able to regenerate in several species of mammal after surgical insult. This tissue is also known to have the potential to maintain or increase its β-cell mass in response to metabolic demands during pregnancy and obesity. Since deficiency in β-cell mass is the hallmark of most forms of diabetes, it is worthwhile understanding pancreatic regeneration in the context of this disease. With this view in mind, this article aims to discuss the potential use in clinical strategies of knowledge that we obtained from studies carried out in animal models of diabetes. Approaches to achieve this goal involve the use of biomolecules, adult stem cells and gene therapy. Various molecules, such as glucagon-like peptide-1, β-cellulin, nicotinamide, gastrin, epidermal growth factor-1 and thyroid hormone, play major roles in the initiation of endogenous islet regeneration in diabetes. The most accepted hypothesis is that these molecules stimulate islet precursor cells to undergo neogenesis or to induce replication of existing β-cells, emphasizing the importance of pancreas-resident stem/progenitor cells in islet regeneration. Moreover, the potential of adult stem cell population from bone marrow, umbilical cord blood, liver, spleen, or amniotic membrane, is also discussed with regard to their potential to induce pancreatic regeneration.

Did you catch that?  Look at several factors which play a role in the regeneration…

“Various molecules, such as glucagon-like peptide-1, β-cellulin, nicotinamide, gastrin, epidermal growth factor-1 and thyroid hormone, play major roles in the initiation of endogenous islet regeneration in diabetes.”

Looks like I have the next few days cut out looking more in-depth as to what gets those things out of balance, what is needed to return those molecules to a homeostasis, what tests available to determine the status of those molecules in our system… my list will grow!

Anyway – just had to share as it’s another confirmation of hope for T1’s – when our perspective is changed from symptom management to system restoration our health takes on a whole new meaning!  Hope you all are excited about our upcoming new year – I know I am!  That’s it for now…

 

Ask Dr. Bernstein Tele-Seminar (relating to Type 1 & 2 Diabetics)

Dr. Bernstein is a Type 1 Diabetic who went against the main-stream way of thinking when it came to managing his diabetes. He is and type 1 diabetic endocrinologist with some great information!  Although those who are well versed in functional approaches may have some disagreements with some of his suggestions, overall he is still a wonderful resource especially for Type 1’s!!  I especially love his philosophy that all diabetics are entitled to the same blood sugar levels as non diabetics!

Ask Dr. Bernstein Webcast and Teleconference on, Wednesday, December 28th, you can listen to view the presentation for a limited time by going to this link :

dr.richard.k.bernstein

Watch December Seminar Here

The next webcast is January 25th at 8:00 pm EDT, 7:00 pm CDT, 5:00 pm PDT, and for our overseas guests, 12:00 am UTC (Wednesday).

Put all of the tele-seminar dates for 2017 in your calendar:   January 25th,  February 22nd, March 29th, April 26th, May 31st, June 28th, July 26th, August 30th,  September 27th, October 25th, November 29th, and December 27th, 2017.

If you have a friend who you feel would benefit from listening to the next tele-seminar, they can register here.

Betrayal: Autoimmune Disease, what they aren’t telling you…

This is a great series that delves into looking at health conditions through a functional lens, looking at it from a functional perspective 😉

This is an 7 part series which you can sign up here to get the entire series:

https://betrayalseries.com/episode-1-1nyawjkj2?inf_contact_key=7d0cbc282bdddf41ebe8765a8e30e2913dfccc53967e4ef6635564f98c6380b9

Common sense

I recently updated the “nuts & bolts” page where I touch on how our bodies provide ‘medicine’ to heal.  There is a LOT more to put on that page but I wanted to start sharing since there is a wealth of information that I hope to put there…

Anyway, I was reviewing a webinar regarding the cardiovascular system and one more of those ‘stop in my track’ moments occurred.  Most of us have probably heard about the “bad cholesterol” and “plaque” build up.  For those who haven’t – LDL cholesterol is termed the bad guy. Too much of it and it will start sticking to the lining of your blood vessels causing plaque.  High blood sugar and high amount of abdominal fat stimulate the body to release plasminogen activator inhibitor 1 (PAI-1) which promotes blood clotting and build up of plaque.

The “ah ha” moment was because I understand the wonderful function of LDL in our bodies – it is necessary for repair and damage.  For example, do you know what high blood sugar does to the body?  It is like glass or sand which makes abrasions along the cell wall. So when we see high LDL it is a sign that something is in need of repair.  In this example of high blood sugar, in essence our amazing body is protecting itself from ourselves!  The body gets a signal to go repair and protect the wall by forming the plaque.  Of course in the long run this is detrimental, but at least it provides us with the opportunity to make changes. ***

So often the focus is on lowering that LDL number rather than looking as to WHY is that number elevated?   Our bodies make most of the LDL that is measured in blood tests, it is making it for a reason! What is the reason it is making it??? Lowering the LDL doesn’t address the underlying malfunction in our body. Such as maybe its high blood sugar causing damage… Do you know how many diabetics are on statin drugs?  It’s alarming!

Do you now what statin drugs do?  Statins are prescription pills which are very effective at lowering levels of LDL.  Guess what the most common side effect is?  Muscle pain.   Is this surprising??  It shouldn’t be, after all when we take away a necessary repair mechanism from our body what is going to happen? Stuff is gonna start showing the wear and tear.  Not just in our blood vessels, but our entire body!  It is no wonder there is an increase in heart attacks despite the effectiveness of statins lowering LDL.

Common sense tells us things could go very, very wrong!  Fortunately, there are more and more who have decided to take a look at health from a different perspective, one that looks at how the body is supposed to function.  Getting clues from how the body reacts to an adverse environment, letting our body be the guide. Pinpointing the reason behind why the body took evasive action. This kind of digging gets me super excited about health!  Totally lights a fire for me to pursue healthy choices and be in harmony with what my body is telling me!  Am I the only one who feels this way?

Well, gonna get back to the webinar, maybe I’ll get me some veggies to snack on 🙂

{***I added some clarification to my original post as it may not have been clear I was referring to high blood sugar as just an example of damage to our bodies}