Two thousand years ago, Hippocrates suggested that many diseases may begin in the gut. He didn't have the benefit of the advanced microbial and cellular testing we have now but made the assertion based on observation of patterns.
There is likely a lot of truth to this statement. Naturopathic Doctors have been focusing on gut health for many years, and the concept is gaining more recognition as recent research supports connections between the gut microbiome, gut health, and various health conditions, from allergies to PTSD to cardiovascular health issues.
Many aspects of modern life may not promote optimal gut health, so it is worth paying extra attention to support or improve conditions linked to gut imbalances. This article will discuss gut health, its connection to other conditions, and how to test and support gut function.
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What is Optimal Gut Health?
Optimal gut health may look like having a healthy appetite, smooth digestion without discomfort such as bloating, and having 1-2 regular bowel movements daily. It also may look like metabolic health, the ability to maintain a healthy weight, lack of food sensitivities, lack of chronic health conditions, and generally experiencing a calm and positive mood and clear thinking.
On an ecological level, optimal gut health will be characterized by a healthy, diverse microbiome with low levels of unhelpful species, high levels of beneficial species, and a high diversity of gut microbes. There will be a healthy and intact mucosal barrier that can function well, protect from pathogens, and absorb nutrients.
In addition, as a high percentage of several neurotransmitters are made in the gut, a healthy gut may support healthy neurotransmitter levels. 95% of serotonin and up to 50% of dopamine is made in the gut. These are not primarily made by our cells but by certain microbes in the gut microbiome.
What Causes Poor Gut Health?
Many things people may not have thought to associate with gut health can negatively impact it. For example, stress, lack of exercise, and poor sleep impact the gut mainly through the impact on the microbiome. Intense exercise can redirect the blood flow away from the gut, potentially affecting the cells lining the gut, leading to increased permeability.
Eating foods one is allergic to or sensitive to may lead to low levels of ongoing GI inflammation, possibly affecting gut permeability and a cascade of systemic inflammatory processes as a result.
A diet high in sugar or unhealthy fats may shift the microbiome towards microbes that thrive in a high-sugar environment. However, these are generally not the ones that are beneficial to have at higher levels, so they are more likely to promote imbalance.
Other factors that affect the gut are the genetic effect on the microbiome and the use of antibiotics, which can have a rapid and lasting impact on gut health and the gut microbiome.
Imbalanced Gut Health Symptoms
Because gut health also influences systemic inflammation and neurotransmitter levels, a wide variety of symptoms can occur when the balance is disrupted. Some of the GI-focused symptoms may include:
- Bad breath
- Abdominal cramps
- Diarrhea
- Constipation
- Acid reflux
- Food intolerances
- Gas/bloating
- Nausea, upset stomach
Some more systemic symptoms could also include:
- Fatigue
- Generalized inflammation
- Achy body
- Skin problems, such as acne, rashes, psoriasis, rosacea
- ADHD or trouble concentrating
- Mood issues, anxiety, or depression
With prolonged gut dysbiosis, effects can become more deeply entrenched metabolically. Poor nutrient absorption may lead to micronutrient malnutrition despite an apparently adequate diet. An unhealthy gut microbiome can also negatively impact blood sugar regulation, potentially increasing insulin resistance. That, in combination with altering hunger signaling, may lead to weight gain or obesity.
Medical Conditions Associated with Poor Gut Health
Many medical conditions may arise from a long-standing gut imbalance because it may contribute to chronic low-level inflammation, a factor in many chronic illnesses.
Gut Conditions
Gut-specific illnesses associated with gut dysbiosis include Crohn's disease, ulcerative colitis (UC), colorectal cancer, gastritis, and gastric ulcers.
Metabolic Conditions
Metabolic conditions associated with poor gut health include obesity, high cholesterol, and type 1 and type 2 diabetes.
Allergy and Immune Conditions
Seasonal and food allergies can both be impacted by poor gut health and dysbiosis because gut health is linked to immune health. Autoimmune conditions can also be worsened by poor gut health. The gut plays a significant role in the onset of autoimmune conditions, specifically Multiple Sclerosis (MS), rheumatoid arthritis, Celiac Disease, and ankylosis spondylitis.
Cardiovascular Conditions
Cardiovascular disease risk may be influenced by gut health. In particular, coronary artery disease is strongly connected to the health of our gut flora.
Brain Conditions
Brain-focused conditions can often have a strong link to gut health. Conditions including ADHD, anxiety, depression, and even PTSD may be influenced by gut health and might respond positively to improvements in gut health as inflammation and neurotransmitters are supported.
Functional Medicine Labs to Test for Root Cause of Gut Health Issues
Functional Medicine labs can provide insight into many aspects of gut health. Labs can help us answer the following questions: How is the microbial balance? Is gut permeability increased? How well are nutrients being absorbed? These tests can also analyze factors that affect gut health, such as stress, toxins, and allergens.
Gut Health Testing
A GI-MAP test can give a thorough look into the microbiome's health. This test analyzes the DNA of the microbiota to provide detailed information about the microbe diversity and balance while also giving information on gut permeability.
A microbiome panel may be useful for additional insight into the microbiome's health. This test, in particular, gives some nutrition, lifestyle, and supplement guidelines to help practitioners guide treatments based on the test results.
A stool test for H. Pylori may be beneficial since H. Pylori is a common cause of Upper GI discomfort and pain.
SIBO breath testing may also be indicated if symptoms such as bloating or belching are present. But, it can also be helpful for individuals with IBD, pancreatitis, hypothyroidism, rosacea, restless leg syndrome (RLS), diabetes, Parkinson's disease, or coronary artery disease since all of these conditions have been linked to SIBO.
Nutrient Testing
Regarding nutritional status, a complete blood count (CBC) can show if there is anemia from GI bleeding or poor absorption (or low iron/b12/folate intake).
A cellular micronutrient assay (CMA) can assess micronutrient deficiencies resulting from longstanding gut health issues or poor diet.
Hormone & Neurotransmitter Testing
Stress impacts the gut, and the gut also affects the HPA axis. Testing the cortisol response throughout the day can give insight into how well the stress hormone systems are functioning.
Neurotransmitter tests can also provide insight into psychological or neurological conditions. Since neurotransmitters are mostly manufactured in the gut, this can be used to help determine overall gut health status.
Toxin Testing
Many toxins impact the gut. In certain situations, testing and tracking their presence in the body may make a lot of sense throughout the healing process. Some labs that can give information on toxin levels are urinary mycotoxins, environmental toxins, and heavy metals.
Allergen Testing
Allergies can contribute to and result from poor gut health. Avoiding known allergens can allow the gut to support itself and recover from systemic illnesses. If environmental or food allergens are suspected, testing both may provide useful insights.
How To Support Gut Health
What does it mean to support gut health? It means encouraging a healthy microbial balance, increasing healthy gut flora, and managing unhealthy or pathogenic gut flora while increasing the microbe diversity. It also means addressing any gut inflammation that may affect the gut wall.
Due to the wide variety of systemic effects, optimizing gut health is often among the first steps in a functional medicine plan. Having this in balance can cause other problems to simply resolve with no further treatment. But in cases where further work is needed, having addressed gut health first removes some of the noise.
Functional Medicine practitioners focus on supporting gut health with a whole foods nutrition plan, gut health-supporting supplements, and lifestyle adjustments. The following are some of the most common functional medicine recommendations:
Nutrition
At least initially, a gut-supporting diet should exclude all known allergens, as well as gluten, which has been shown to affect gut permeability, even for those without celiac or gluten sensitivities.
Sugar should be significantly limited or avoided as it may lead to excess growth of unfavorable microbes.
Foods likely to contain Glyphosate (i.e., GMO wheat), which is an herbicide that can affect the gut lining, potentially leading to negative impacts on the gut microbiome, should be avoided.
A high-fiber diet provides the substrate to grow bacteria that create short-chain fatty acids (SCFAs), including acetate, propionate, and butyrate, which are the fuel sources for our gut lining cells. Butyrate is particularly supportive of a healthy inflammatory response.
Supplements & Herbs
Many supplements may play a role in supporting optimal gut health, depending on what imbalances are in place.
A broad gut health-supporting protocol could include L-glutamine, an amino acid that aids in the support of the gut lining, and natural anti-inflammatories such as omega-3 fatty acids and curcumin to support a healthy inflammatory response.
Probiotics and prebiotics help support microbial balance, and zinc helps to support an impaired gut lining.
Antimicrobial herbs may help manage any pathogens such as H. Pylori or SIBO that have been identified. Lotus seed resistant starch (RS) has been studied for its potential to support changes in the gut microbiome to reduce food allergies.
Complementary and Alternative Medicine
Any activity like yoga or meditation that helps regulate the stress response may benefit gut health. As acupuncture, massage treatments, and exercise can also help to manage stress, they may be a supportive part of maintaining GI health.
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Summary
Gut health is central to determining our overall health. It can be impacted by many factors common in modern life, like high stress, poor nutrition, and taking antibiotics for an infection. If one wishes to support overall health, paying attention to gut health, using functional medicine testing, and holistically supporting the gut to maintain optimal function is an instrumental first step.
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