The Leaky Gut and Allergy Catch-22

The Underlying Trigger for a Myriad of Health Concerns

 

The complete transcript of the Webinar The Leaky Gut and Allergy Catch-22, The Underlying Trigger for a Myriad of Health Concerns, from April 26, 2018, is available below.   

Welcome to US BioTek Laboratories webinar on The Leaky Gut and Allergy Catch-22, The Underlying Trigger for a Myriad of Health Concerns. The presentation will be recorded today and will last a total of about 45 minutes, with a brief question and answer session at the end to round out the hour. At any time, please type your questions for the Q&A session in the chat box located at the bottom right of your screen. If you do not see the chat box there, you may first need to select the chat feature in the upper right area of your screen.

Please note that due to large attendance, all attendees microphones will be muted upon entry. Please, do not unmute your microphone during the presentation. To let you know, in case you're wondering about the chat box, I just posted a chat, so if you did not see it, then you will need to select the chat box up at the top right, it's an icon. I posted information about checking your audio settings.

I'd like to tell you a bit about Dr. Meletis, our presenter. Dr. Chris Meletis is an educator, international author and lecturer. His personal mission is changing America's health, one person at a time. He believes that when people become educated about their body, that is the moment when change begins. He has authored 16 books and over 200 national scientific articles in such journals and magazines as Natural Health, Alternative and Complementary Therapies, Townsend Letter for Doctors and Patients, Life Extension and Natural Pharmacy.

Dr. Meletis served as Dean of Naturopathic Medicine and Chief Medical Officer for seven years at NCNM, now NUNM and was awarded the 2003, Physician of the Year by the American Association of Naturopathic Physicians. He has a deep passion for helping the underprivileged and spearheaded the creation of 16 free natural medicine healthcare clinics in the Portland metropolitan area of Oregon.

Dr. Chris Meletis, ND

Dr Meletis slide 1a

On behalf of all of us, Dr. Meletis, I extend to you a warm welcome and now the mic.
 
Thank you very much, wonderful introduction and a wonderful topic that we're going to be working with today. And thank you one and all for taking time out of your schedule and allowing us to visit with you about a topic that I think is near and dear to all of us, leaky gut, allergies. And we all know Hippocrates, 400 B.C. said, "All disease begins in the gut." And we're seeing more Alzheimer's, more autism. We're seeing, of course, SIBO, which we never even talked about a few years ago.
 
And there's a common denominator amongst a lot of these different conditions, and we're going to discuss these and others and look at the peer review literature relative to how there's a catch-22 between leaky gut and food allergies.
 
So as we proceed, I'm going to offer some opinions as an independent educator and they don't necessarily represent the opinions of US BioTek. So if we look at the lumen of the intestinal tract in the colon, we have bacteria over here, which have mitochondria. And then our single layer of enterocytes or colonocytes, well they have mitochondria and then the basement membranes and the connective tissue, well, they have mitochondria.
 
And so often, I find that people aren't addressing the mitochondrial side of GI health and nurturing those cells so that these little tight junctions become a little tighter and that we heal the GI tract. So, I routinely incorporate mitochondrial support at the same time that I'm doing things like glutamine and butyric acid, which we'll talk about in passing today as well. I just find it's vitally important to always treat the mitochondria.
 
On a side note, if this represented mitochondria in a bacteria and, of course, bacteria produce butyric acid, butyric acid's now been shown to cross the membranes of these enterocytes or colonocytes and actually help fuel the mitochondria of the GI tract. Go figure.
 
So when we look at leaky gut or increased intestinal permeability, a little bit more scientific term, but we'll use the term, leaky gut, we see seasonal allergies and the thing that all our patients, they've done either antibiotics, or drinking chlorinated, fluorinated water. They're eating non-organic, non-free range poultry and again, all these different hormones.
 
And at the same time we have our patients with auto-immune disease. There's a correlation, as we know. Migraine headaches, I have a patient that used to, with the click of one finger, do billion dollar trades on the stock market. Now, she's in my age category, she's relegated to migraines, aches, and pains and so forth and we've been unraveling that mystery and food sensitivity testing and gut health has been part of that.
 
Of course, anxiety, depression, if any of you have heard my presentations on anxiety and depression. But when our gut's unhappy, we will see more neuro inflammation and with more neuro inflammation, tryptophan will be catabolized to kind of urinate and quinolate opposed to tryptophan being metabolized down to 5-HTP and serotonin.
 
Even cardiac symptoms, which I've written about in the Townsend Letter related to leaky gut. And what's interesting, when we do bioidentical hormones we think of postmenopausal women or now that a lot of people are doing cross training and Spartan Races and doing a lot more extreme exercise, it actually has been shown to increase intestinal permeability issues as well, which we'll discuss.
 
So interesting, the ultimate patient question and a lot of information that I'm going to share with you today is just part and parcel of what we do. But in my clinical opinion, as I share with my patients, I will often be asked, "Well, what should I eat, Doc? I want to do this diet. I want to do that diet. I want to do whatever the diet and the labor of the month is." And I'm saying, "Well, the question is, 'Is that a good diet for you?'"
 
And for example, if I was to come to you as a patient and I can say, "Well, can I eat avocados?" And, of course, that would be a trick question because no I can't. I have an anaphylactic reaction to them. But the question is, "Is my biochemistry able to tolerate the fats? Is my gallbladder and my liver able to tolerate the fats? And is the rest of my diet balanced out enough with the carbs or proteins and my GI integrity to tolerate that?"
 
And so when we look at the GI lumen here, and we look at leaky gut, we have to realize that any time we eat something, just like when we breathe something. Right now here in Oregon, where I live in Beaverton, if you leave your car out overnight that's lime green colored, well, if I go outside and inhale that air, of course it's going to trigger an immunological response to my respiratory mucus membranes. But now if I swallow some saliva, it goes into my GI tract and now there's pollen from post nasal drip going into my GI tract along with whatever foods I've consumed.
 
And if you haven't listened to my presentation about cross-reactivity and where the environment and foods collide, that was my last presentation, available on the US BioTek website. So really the question is, what's getting through? And good medicine and do no harm, so really testing not guessing, of course.
 
So I've been using US BioTek since 1992. In fact, I actually used before I graduated. I graduated in '92. And I've been doing food sensitivity testing and measuring and re-measuring and making sure things are good. But when I graduated in '92, we didn't even have the term, epigenetics in our vernacular, or in our vocabulary. But now we know there's nutrigenomics, there's the epigenetic modulation of our generic potential. The concept of diet and lifestyle load the gun and we ultimately pull that trigger.
 
But we look at things like ulcerative colitis and Crohn's. And I have a little boy that's 8-years old of East Indian descent and he has terrible ulcerative colitis. And the parents said, "Well..." I asked, first off, "What are you eating?" And he's eating non-traditional East Indian diet. He's eating very westernized, including cow and dairy and all kinds of other things, which he wouldn't have consumed otherwise. So the question is, ancestrally, has he gone outside his daily weak of genes, but more importantly, his microbiome is totally thrown off because he had been doing lots of antibiotics. So he has leaky gut on top of things, and he actually had a very virulent form of E. coli, which is causing him to bleed profusely, create lots of mucus.
 
But what's interesting in his case or with intestinal permeability in general, we start becoming nutritionally deficient. And this little boy, the little East Indian boy sweetheart, very bright, very capable, but he was only weighing 42 pounds, seven years old. Not very heavy, huh? But he wasn't growing. He was very diminutive in size. I never asked him whether he had night vision prongs when he was driving, because obviously at seven he's not driving, but you start looking at vitamin A, epithelial tissue health, zinc, epithelial tissue health, iron. He was anemic. Of course, he had ulcer colitis so he's bleeding. But he was also malnourished because the GI tract just wasn't absorbing things.
 
So now, the foods we're eating are worsening our leaky gut, and our leaky gut worsening the nutrients out of our food and it's perpetuating cause in a Catch 22. And let alone, if a person has a methylene tetrahydrofolate mutation, there's coronary alter, the healing process and the gut you call cell membrane. So I often will do a test to see what's your nutritional status while also doing this food sensitivity test because it's like I have to provide enough nutrients to allow the healing to occur that will ultimately allow the food sensitivities to become minimized over the course of time.
 
So what's interesting when you look at this picture here, and we look at once again, a pathogenic antigen, and we can be a virus, a parasite or a food pathogen, and that's crunching over our membrane and it's entered us, our bloodstream. And I often give the example for my patients of the concept of a scanner at the store that's reading bar code. And many of us are now well experienced in checking out our own groceries, our own hardware at home Depot or whatnot, and having that little barcode, a little scanner. Well, our immune system scanning all day long, as I share with my patients. And if that bar code is reading, wow, and all of a sudden he goes, moo, and we're not a cow, it's going to, of course, perceived that as foreign.
 
And right before a presentation day, I was going back and forth with a mom of a five year old boy with autism. And she says, "Well, I can't do gluten and I can't do tea feeds. I have to pick, which one to stop giving my child," because he was unwilling to stop both even though I sent her lots of literature, I said, "But there's a cross-reactivity and dairy is often realized by the immune system as so similar that it has an epitope and it actually cross-react." So I reiterated, "We have stool testing and we have food sensitivity testing showing that he reacts to both and we need to eliminate both."
 
But once again, how are we keeping the outside world from our well-ordered inside world? And if, as you can see here in the 2017 article, comments upon how the secretory IgA and the triggers of cytokines become an issue. And I pointed this out to the mom today that his protein levels were high, his lymphocyte counts were high, which is not a typical for autistic children. And I'm saying, "He's having immunoglobulin issues, he's having gut issues, and we need to start avoiding those foods because otherwise, we're fueling his body incorrectly unto him and his chemistry."
 
I really like this picture because it shows, from an education perspective for our patients, the time step that we just had a single little layer separating us, the outside world from them. And so it's like, okay, we have foods that are foreign proteins, sometimes foreign animal proteins, and we're not an animal in itself and non-self. And depending on the circulation that's going on, the vagal nerve tone, which I commented about quite a bit on my social media feeds, we're talking about, are we efferently perceiving friend or foe? And remember 80% of that vagal nerve is efferent, it's sensory, leading to dizziness and vertigo and for confusion, migraines, GERD, heart palpitations, but all based on what's happening down in our GI tract.
 
So it's interesting to see that feed. And I'll comment in a moment about a patient, which I spoke to last night via text, which actually is a realtor, a very successful realtor, and yet her gut is killing her. And we'll chat about that. And it's interesting to see all of what goes into healing the gut and her family runs very high on the atopic triad of asthma, eczema, and hay fever. And it's interesting, I treated the daughter for terrible eczema, full body eczema, but lo and behold, now she's having gut issues as a mom and one sitting in the appleman tree and they don't fall for apart.
 
So every day, the human body synthesizes three grams of secretory IgA in the intestinal lumen. Our bodies are very efficient, as we all know, and I don't know about you, but going through the basic sciences to hear all the magnificent factoids about the body just gives me off still to this day, that every day, on a good day, we lose 86,400 brain cells per day. We have 60,000 miles of blood vessels of your optimal weight, and for every extra pound you gain 2,500 miles, more of blood vessels. Our blood pressure is largely dependent upon our capillaries because 27% of the resistance occurs from our capillaries.
 
It's all these cool factoids, but it's three grams with secretory IgA. Why would our body expend energy making 3,000 milligrams of secretory IgA? Because it's our scratch card. It's our protection from the outside world. But, of course, any of us that have done stool tests know, we can also see high secretory IgA levels, which often reflect either parasitic, bacterial, fungal, or eating the wrong foods. So once again, our bias triggers huge immunological response, which therefore throws in cytokines, which are pro-inflammatory often, not always, an anti-inflammatory certain time. And it's like, "Okay, well, we got to break this Catch-22 again." And so why eat a food, no matter how yummy it is ... And this is where I try to educate, empower my patients.
 
Way back in 1992, when I graduated, one of the ways I built my practice with food sensitivity testing through US BioTek, which actually at the time was known as National Biotech. Because people would get the data and they know, okay, in the buffet of life, this is my tool. If I choose to cheat, I cheat. I cheat with conscious effort. First day party comes on, great, I'm going to have fun. I know I might feel poorly, but now I know why I feel poorly for a couple of days afterwards.
 
So zonulin, in which again, all of us at disarray, doctor as teacher educator, the concept is we have a zonulin and then we top had tight junctions, but that doesn't mean anything to most of our patients. So when zonulin levels go up, the tight junctions become often larger. And so I give the example of rice in a colander. So all of a sudden I made these holes bigger. Some of that rice is going to come through. But if that was my bloodstream opposed to the drain, I don't want rise floating around in my body and triggering the immune response. So having that picture for my patients and they're, "Okay," so that's a filtration thing.
 
So this leaky gut is like a colander and I'll give examples of noodles. We're all afraid or one of their food allergens and kind of just chat with them about that concept. But now they can repeat that concept because they get the filtration of a colander.
 
So when we get upregulation of zonulin, we actually have all kinds of interesting tidbits and what's interesting is elevated serum zonulin with detected in 70% of autoimmune subjects. And this was actually in diabetes 2006. And so we get an upregulation of zonulin, which causes increased permeability and noted in type 1 diabetics. For those of you that have been healthcare providers long enough, you remember those early phase where they had twins that were parted at birth and they were given dairy or they weren't given dairy and those that were given dairy would end up with type 1 diabetes more often than those children not raised on dairy and they're identical twins.
 
Well and now we start learning about dairy crush racks with gluten. It's like okay well, we know gluten also has a big feed into that cross-reactivity. But if whether we're doing IgG or IgA food sensitivity testing or IgE, what I call the obvious ones, because I always telling my patients, "Think of E for emergent or emergency room." These are the kinds of hives and angioedema and asthma. Whereas I often give a very simple example, "See G for gradual," it's like a sneaker wave, whereas the E is like a tsunami that you know you're soaking wet, IgG sneaks up on you and is more gradual over 72 hours.
 
So when we get to leaky gut and the triggers, what's interesting is food sensitivity and allergies exposed us to environmental toxins, chronic psychological stress, a diet high in sugar and processed foods, alcohol abuse, because of course, there is alcohol, a great solvent absorbed right from our stomach proper into our systemic circulation, antibiotics, all lead to not only dysbiosis and altered microbiome, but they also can contribute to leaky gut. So I routinely talk to my patients about stress.
 
But what's interesting, and I baffle my patients, I have a lot of Intel and Nike executives as patients, and I'm saying, "Hey, you just retired." And one of them just actually retired. And she was concerned that $10 million wasn't enough to retire on. And I told her, "I think $10 million is enough to retire on." And I quoted the Dalai Lama quote about what most surprising about humanity and he says, "Well, it was mankind because they'll trade their health to gain wealth and then trade all their wealth to regain their health." She's, "I'm not stressed, I'm retired." So I took her to the Holmes-Rahe Stress Chart and she's, "Here's getting fired from your job. Right underneath that is retirement."
 
I then showed her another very contrary piece of data, which is also on the Holmes-Rahe Stress Chart, which is actually, "If you get a mortgage from a bank that's over $100,000 or you get foreclosed on, they're also neck and neck." So this whole stress thing, you got the new phone, you have more connectivity, that's a stressor. We think it's a great thing. These kids are living with so much more stress than we did. And there's just so many considerations.
 
I just gave a lecture two days ago and I talked about how 90% of grocery items, processed grocery items actually have in it paraben. So we're not having to just cosmetics and toothpaste and personal lubricants and all these things, we're talking about grocery items actually have parabens in them. And so majoring parabens, like doing an environmental pollutant panel. And they've even went so far as to say, "If you're not dusting your house routinely with a HEPA filtered vacuum cleaner, the aerosol life parabens continue to get inhaled, so we're consuming them. Some people are still putting them on their skin and it's conscious vicious Catch 22.
 
If you see here, this little interesting question mark, why do I have it here? Other factors that may predispose to the development of leaky gut include low-fiber diet. Well, that's a duck because we're not making a feud rate, because we don't have the ability to actually have that health of the microbiome, the high-fat diets. So and I'm just raising the question here from one colleague to other colleagues, could a ketogenic diet be a bad thing in some individuals? So assuming they're not sensitive to it, could it be a problem? I just raised it as a question because clearly it's a high-fat diet.
 
So I would say definitely and base it on symptoms, base it on retesting. So if you've already done their food sensitivity test, that's too great. Let's try the ketogenic guide. Let's do an organic acid pathway for you. So let's do an organic acid test because a lot of my keto patients will end up becoming insufficient on the fat metabolism side, the right hand side of that organic acid pathway. And if you don't have one of those sheets, I use them all the time in my office for education, we can actually send you one. But it breaks down that whole ... the physical acid pathway and under feudness as well.
 
And we all know that glutamine is a conditional amino acid, so we need it for GI health. And now let's say we're going extreme again, we're doing crossfit and I have bigger arms than I did when I was a younger person. But then I got a cold. So I was straining my glutamine levels here, I got a cold or an illness or hay fever, sinus infection, and my GI health is going to suffer because there's a relative conditional glutamine level. So I routinely use glutamine and mitochondrial support, but I also find that increased permeability arises from the pollution of glutamine. And so I use a lot of glutamine.
 
What's interesting is glutamine, a lot of it is actually from either human hair or poultry feathers. So making sure you have a bacterial ferment. So we're not increasing allergenic burden is important. So knowing where your gluten source from is important.
 
So I have a picture of enterocytes and we got mitochondrial components here. And so we have here the brush border, but if we're not fueling our mitochondria, what will happen? We have mitochondrial health and we need to support the mitochondria in order to fuel the cells and help with the tight junctions. So, of course, we need to have good circulation. So we think nitric oxide. But once again, if you're stressed out, you're going to have hypoxia relative to your GI tract.
 
But once again, I always support the mitochondria because I want that resilience, that tight junction to be phenomenal in these patients because if I don't support the cells or single layer of cells, or clearly there's going to be a problem.
 
And so when we get to the Catch 22 of leaky gut, we have interesting things like butyric acid, protein, short-chain fatty acids. And interesting, I routinely tell my patients, "You need to have a high butyric acid level because if you don't have a high butyric acid level, I need to go ahead and support the body in a foundational way." So I cannot go ahead and recommend anything to a patient that's food sensitivity related, but the fact is I often will recommend high fat dairy products because high fat dairy products are foundational. Absolutely, totally foundational.
 
And so I tried to go ahead and avoid my dairy products, but I'll tell them, "Hey, do some organic butter." And I find it intolerated well, because there's not a whole lot of protein in those fats. So if your adapted or if they can afford it, I just give them butyric acid capsules. But once again, we make the healthy microbiome healthier and all of a sudden we're making our own butyric acid and it's better to teach a person to fish than to give them a fish.
 
So interestingly, the beautiful picture, once again, you'd see the journal that it came from and we've got the secretory IgA, we got our pathogens and this is why I love doing gut health and a stool test is we need to figure out what's going on here in terms of the overall bacterial load, but also the burdens. So we got food burdens, we got yeast burdens, we've got gram negative enterobacter burdens, we've got grandpa's wrap and staff and whatnot, and they're all ultimately like the straw on the camel's back. We needed to go ahead and support the body in a way that minimizes. Well, food is a way to do that. If you avoid the foods, which are a conscious choice, we can do that while addressing the other aspects and decreasing excess secretory IgA.
 
I actually highlight it here, and many of you have a subscribed to the Townsend Letter. But I have a three part series on the endocannabinoid system, but if you look here, cannabinoid receptors also play a pivotal role in gut health. So we got all kinds of stressors and unfortunately all too usually poor little rodents here. Hey, let's restrain the mouse and see how stressed out we can get. Let's do this to the rat to see what the insane ... Well, you get the idea, the rodents are being punished. And you can see, look at the effects on secretory IgA, that immune component. Once again, I don't see here a whole lot of food related side of things, but food-related side of things would also come into play here.
 
So then what we do is we look at food sensitivity and allergies. There is I bidirectional interplay between food allergies and sensitivities. This is why I employ IgG and IgA testing for my patients. Impaired gut barrier function leading to leaky gut is involved and the development of food allergies and intolerances, increased intestinal permeability allows undigested foods to translocate and actually go into the bloodstream. If you tell your patients, "Do you want a chunk of that going into your bloodstream diggers," because they know. So it's very empowering for them to actually see that.
 
Conversely, food allergies and sensitivities play a role in the etiology of intestinal permeability. So kind of interesting, and this is way back in 1992. This is when my children were born and there's less autism, there's one in a 500 chance. What's the number now? One in 68 some say one in 42 for boys. Oh my goodness.
 
And then we have leaky gut and nutrient deficiencies. So this is actually ... I don't know the nature of pathogen physician, but they actually have found this for a point of graphic. Leaky gut, leaky cells and leaky brain. Leaky gut can lead to deficiency of nutrients such as zinc, Vitamin A, iron, calcium. But I would also throw in methylene tetrahydrofolate as a consideration here. But look at all the references documenting these become deficient.
So once again, explaining to our patients we need to augment and heal the leaky gut by super charging them. And, of course, quantifying when possible is always great as well.
 
So let's talk about my real estate agent. My real estate agent, it's way stressed out. She's extremely successful, extremely smart, but she's scratched out and her gut is killing her. This is the one with the young girl with the eczema, which is now healed, thanks to doing the IgG, IgA food sensitivity tests. So we've got stress, it's affecting the hypothalamus. Of course, we won't get AC case and cortisol pathways, but we'll also get the medulla adrenaline.
 
This lady, as often gone from home and it's like she said, "I come home, I have to take my kid to this activity, that activity. I have the normal tasks that are my contribution to the household. And then I'm out until 10 or 11 at night showing houses." And then she's clamping down her blood vessels causing ischemia.
 
And we just did an upper lower scope, I referred her out for that obviously, but the vasoconstriction is liberally causing her gut to kill her, figuratively and literally, as greatly increases the likelihood of food sensitivities to develop onwards and onwards. So once again, we need the mitochondria but we need the oxidation phosphorylation and without enough oxygen and vasoconstriction, we have lack of nutrients delivery. This way, we're going to have a lack of nutrient delivery across the membrane and we're going to have a myriad of problems.
 
So from a health conditions perspective, leaky gut, so strong as camel's back. We're inhaling allergens, once again, my cross reactivity lecture, we're eating allergens, we're burdened like we've never been burdened before. And I did almost all of us are on Facebook, but my grandmother and grandfather never went to the store buying organic or a, they actually had their own garden plot most of the time and foods were not as toxic as they are now with the genetically modified and the ways that we even, for example, chicken now bound to be loaded with arsenic, let alone our farmed fish, which is actually, of course, been found to have synthetic tire residues in them.
 
Then we get to seasonal allergies, a topic disease in the gut. Gnotobiotic mice, which are either considered germ-free or they only have a certain strain of bacteria within their GI tract, were more susceptible to peanuts sensitization characterized by increased peanut specific IgE and anaphylactic symptoms with peanut challenges. So what's interesting is when we do supplementation with probiotics, and once again references here, they found that help rhinitis and atopic disease.
 
On a side note, there was a discovery that was discovered in Iowa and an animal feed factory. And they found that those workers are working blue collar work, hardworking folks, were actually making nutrient enriched animal feed and they were not getting ill. In fact, they were remarkably healthy if that their insurance premiums were not hardly even notice while everybody else's insurance premiums were increasing, theirs weren't, because they were inhaling a byproduct from a yeast ferment called Epicor, E-P-I-C-O-R, that actually protected their mucus membranes from disease.
 
Al of us are familiar to some degree or another on oral allergy syndrome. And of course, we start thinking IgE here particularly, but patients allergic to grass pollen may react to peaches, oranges, celery, tomatoes, melons. This is why we like to do the environmental pollution panels or ... I mean, sorry, environmental allergen panels to see whether or not we have these contributing factors as well.
 
So am I inhaling certain things, and for me it's birch trees. Right now if I was to eat an apple, a carrot, a celery, or tree nuts, along with another big lifts. So once again, that's another presentation you can find on our website. It's like, "Wow, no wonder our patients are so suffering. No wonder their brains were so foggy. No wonder they're so much more anxious, so much more depressed this time of year," or whatever time of year it is for them. That becomes their magical calling of the clock strikes 12.
 
So here's the example. Imagine this is me. Okay, well a, I don't have hair. A, I'm not that skinny and I don't have glasses like that. But birch trees, not my friend, I would just be dying in the birch tree. But now if I had a little picnic in my backpack of some carrots, some apples, some celery, and some on genetically modified soy and nuts, I'd be hum vining and having reactions five different ways. And then I'm inhaling it, on top of whatever other burdens I have within my GI tract. A picture like this showing the exposures for our patients are just very empowering in my opinion.
 
And when it comes to autoimmune disease, autoimmune diseases associated with increased intestinal permeability include inflammatory bowel disease, celiac disease, and gluten sensitivity, very important. So many of my patients are, "Well, I tested and I don't have celiac disease." Well, then I will go to my Google search for them right in front in my office and I'll say, "I'm going to Google something, gluten psychosis," and if you haven't done that for one of your patients or yourself, you'll see actually peer review literature showing non-celiac dependent incarceration, mental health breaks, psychosis from non-affiliated gluten issues, autoimmune hepatitis, type 1 diabetes, multiple sclerosis, lupus.
 
And moreover, lipopolysaccharide, a cell wall component of gram-negative bacteria can penetrate the intestinal epithelium and translocate into the tissues, causing the progression of lupus. It's like, wow. So once again, as Hippocrates said, 400 BC, "Hey, it's all about your gut."
 
And depression and healthy individuals over production of zonulin is suspected to be triggered by the wheat proteins gliadin, thus leading to impairment in the tight junction barriers and increase in intestinal permeability. It permits from the larger molecules to translocate into the bloodstream, leading to IgG dependent food sensitivities and associated immune response. This can cause synthesis of proinflammatory cytokines, which results in depression.
 
Once again, the organic acid test I routinely do on my patients, actual measure somewhat indirect measures of neuroinflammation, kind of urinate, quinolinate and I might catabolize on my serotonin, which I now need more than ever to deal with my stress and my depression. And so, once again, that testing and that guessing, ensuring that our patients are on the right track.
 
From an autistic perspective, and of course, I think all of us work at some level with autistic spectrum in our practice, biopsy specimens derived from the duodenum of 12 ASD and nine control patients revealed that 75% of ASD samples analyzed were characterized by lower expressions of tight junction components indicating an impaired intestinal barrier.
 
ASD also is associated with intolerance of dietary proteins with gliadin and cow's milk. And once again, right before my presentation today, I was having a friendly-ish debate with a patient of mine and says, "Oh no, I just need to avoid gluten or gliadin or dairy." And I, once again, reeducate her that there's a cross-reactivity and that her son or a major positive goes through a food sensitivity test as well as guts antigens to be positive for both. And the poor little boy definitely needs some help.
 
But once again, looking at their references, this is journal pediatrics 2017, a molecular autism 2016. So there's some older ones, newer ones, definitely saying, "Indeed, we are what we eat."
 
And then we get to the enteric short-chain fatty acids and the microbial messengers of metabolism, the mitochondria and the mind. And there's quite a bit of evidence now showing that the doctors expect from individual actually definitely has more gut and dietary factors, and is that systemic circulation and pro-inflammatory side of things.
 
So whether you're a child or an adult, if you got an inflammatory process, notable, you're hot, you're sweaty, you're inflamed, you're achy or subtle, just a neuroinflammatory process, we're going to start seeing all of these issues, including more obesity, more cardiovascular disease. And you see all these children now that are overweight and we'll call it young to tweens and teens and onwards. And is it all from the gut?
 
And of course, we're familiar with the concept of adiposity index. If our firmicutes and bacteroidetes bacteria are out of balance, this is going to be contributory to some of this dysfunction and, of course, what we want to do is heal the gut and eliminate a lot of these issues.
 
And when it comes to autism and Alzheimer's, I had raised the question of the 3A's. We got autism and are young, we got attention deficit and the young and the old, and we got Alzheimer's. All these A conditions despite chance, but they all have a gut brain neuroinflammatory component. And even metabolic syndrome has actually been shown to now be associated with increased permeability of the gut.
 
Once again, 2017, 2016 peer review literature pointing to this and instead of 363 people with higher zonulin levels correlate with higher waist circumference. So that doesn't make up, or, "Hey, I'm not going to do the zonulin test," but you can make a pretty good guess if they got a little wider midriff, they might have this problem. They might have some diastolic blood pressure problems, glucose concentration problems, all the classical issues along with the hyperlipidemia of metabolic syndrome. So treating the gut can help it.
 
They've also found that leaky gut, it's also associated with bacterial translocation and implicated in Alzheimer's disease. And on a random piece of tidbit news, Macular Degeneration now has been determined to be a comorbid factor with Alzheimer's, just exit abnormal amyloid, plaque creation and formation and stimulation and the back of the eye of a patient, which has Alzheimer's or Macular Degeneration. So once again, our bodies are talking to us in a tremendous way and if we treat the gut and we eat the right foods, we're going to be doing generally better.
So when we get to postmenopausal, and we often make target. Should I do hormone replacement therapy or not?
 
Well, estrogen protects the intestinal mucus layer against oxidative damage or reduces intestinal permeability. Nephropathy is another condition associated with intestinal permeability. I have several patients with kidney disease. They're crashing and levels are extremely high. Their GFR are very low, and the production of IgA type antibodies against gliadin, soy, HAV, which is the salt extracted antigen of oat flour and ovalbumin, are all common because once again, we're filtering our blood. And we're filtering our blood, you look at the GFR, we want our GFR greater than 60. So 60 that's 60 milliliters per minute of filtration. But now we have antigens from our cross-reactivity, particularly if we're susceptible.
 
Then we get endotoxins and migraines. Of course, we're all familiar with trip to fans and they're fermented and aged foods and so forth. But given the association between intestinal permeability and migraines, it's not surprising that IgE-specific food allergen and IgG-mediated food intolerances have been found to aggravate migraine attack. So yeah, it might be thiamin rich food or wine, and aged cheese or even leftovers? Leftovers also trigger migraines because of the bacterial fermentation process, but now, it's like, "Hey, IgE IgG, intolerances and allergies are, of course, considerations when dealing with migraine, but once again, endotoxins go figure.
 
So it's critical to test and retest. I like to get a person on a food sensitivity program and work on healing their gut and lessening their burden, remove this frauds on the camel's back, and then retest and perhaps six months of food sensitivity to see how many of these foods have improved and how many of these foods have not improved.
As I pointed out, even the most theoretically advantageous foods. So avocado, California is tremendous gift to America, or beats. What beets nitric oxide are half-life of nitric oxide, three to five seconds. A lot of people are low nitric oxide, they're on a circulatory issues and brain issues. But once again, if you were to give that to me and I'm a patient, I'm definitely allergic to avocados, kiwi, and also beets are my IgE anaphylactic side of things.
 
So once again, question, "How's my gut? Why am I all of a sudden, as an adult, 2nd December of 2016 reactive?" Something changed. And we as functional medicine providers can help determine what that is.
 
So if we, once again look at the antigens, we look at the fuel and going down to our basement membranes, blood vessels, lymphatics, we're actually seeing that we can actually get all the way down for the 2013 fate to the lymphatics. Which also wonder, "Okay, well, I'm wondering what's going on with the whole lymphatic side of things and the dissemination of antigens and allergens that direction." And that might seem like an odd commentary.
But, for example, there is a special procurement out in the marketplace, which we'll drill a name, which actually doesn't cross through the GI tract into the circulatory system of the blood vessels. It actually goes through the lymphatics to actually transpose and go right into and across the blood brain barrier. So you'll see a [inaudible 00:40:56]A, Patton, Dick or Kerman.
 
So once again, we didn't even think of that lymphatics as a way that certain things get delivered to the body, which may not otherwise be good for you or as a vehicle for new deliveries of nutraceuticals and pharmaceuticals.
So just the classical tests. This test has changed very little in its appearance over the years. I think I used to be green and blue when I first started back in the late 80s, early 90s. But the foods and the technology has advanced a lot. In fact, the cutting edge technology allows even more accurate results. But back in the 90s, this is what allowed my patients to liberate themselves, take charge of their health, and of course we look at things also like the cross reactivities.
 
So if a person has a yeast issue in their gut, I'm going to tell them even if they don't react this way, avoids those yeast products. Now, if they're elevated and they have a candida or another yeast issue, and they got definitely to avoid that and if you call from my cross-reactivity presentation, there's even evidence showing that if you have candida want to avoid phycomycosis and others because it's actually a peer review literature, pointing that direction.
 
I always like to do an IgA, IgG, and ideally an IgE as well, which would just put a nice little third black line along here as well along with the white and the gray.
 
And so then when we look at additional foods and reactivities, we also have to look at how are these proteins, carbohydrates and fats in assimilate. So I'm ketogenic or I am Atkins or paleo and do I have all the nutrients for things to work. Routinely, my ketogenic patients will end up on an organic acid test over the course of time to run low on procutan, low and quarantine, low and biotin or lipoacids, which are critical toe factor and nutrients to allow to fuel in into the citric acid pathway, allowing for ATT, NADH, and procutan to do their job. But you have to first get down this pathway or those steps to occur.
 
And this is why I like to do an organic acid test when working on gut health, and in general food and digestion, because at ATP from the citric acid pathway. And once again, if any of these little green measurements, which are all analytes of the test, are low, then we can figure out what are we going to do to help. But then we get the ATP production within, let's say the enterocytes and we could have, procutan production and there's actually in a few of your illusions way back 2004 mitral Q.
 
That's actually now a product that we can buy as the health care providers and it allows us to actually target and cross over the mitochondrial membrane where normal procutan just crosses over the cellular membrane but not over into the mitochondrial membrane nearly as well.
 
So all of a sudden I'm doing lots of mitral Q, along with the butyric acid, along with the glutamine, along with the good probiotics and food allergen testing and then avoidance to ensure that I'm actually addressing the fueling of the genetic potential of those cells to function.
 
And we'll fly from my last presentation on cross-reactivity. When foods in the environment collide, the antibiotics, the chlorinated water, the poor quality of water in many parts of the country with hormones and opioids and other things in the drinking water and along all the pills that people take these days, many of us don't realize is that fluoride or where would you find fluoride, of course you could say water or toothpaste. Prozac has three fluoride molecules. Paxil has a fluoride molecule like wow. Once again, so many things are sneaking in that never existed before. So the testing and retesting is vitally important.
 
And once again, it comes down to the straws on the camel's back. If I was the camel and I'm allergic to birch trees, all of these things will be a distal straws on my camel's back and it was slowed down my gut healing because I've triggered the secretory IgA, I've triggered more inflammatory issues, I triggered more zonulin issues, I triggered more of all of these things and this was not a good thing.
 
 If you want a copy or a connection to the cross reactivity presentation, other presentations I've given for US BioTek as the independent educator, more than glad to do it. But more importantly, I would love to hear any questions, any comments, because together we're stronger. I know what I know. I love sharing information, but the fact is all of us in clinical practice are pioneers. We're doing, we're seeing, and we're observing patterns and together we're going to start changing healthcare and go from disease management into truly wellness management. 
 
Thank you, Dr. Meletis. I must tell you that I thoroughly enjoy each presentation that you give and the humor that you infuse into them. Thank you very much. Before we launch into the questions, I would like to make mention of the collection kits that are used for the US BioTek test panels that Dr. Meletis addressed. All of our antibody tests use blood specimens. So these are all of the food specific and inhalants specific allergy tests. US BioTek offers two types of blood specimen collection kits, serum and whole blood. The serum kit may be used for any of our blood-based immunology panels and it's the required specimen type for all IgE tests as well as as the celiac panel.
 
The whole blood collection kit is what we refer to as the DBS or dried blood spot kits with collection performed by finger stick. And this kit may be used for IgG and IgA test panels as well as candida. Dr Meletis also mentioned some of our chemistry panels. The urinary metabolic profile, which is the pathways chart is the companion to the urinary metabolic profile, assessing organic acids and the environmental pollutants profile. Both of those use the urine specimen collection kits. If you need any of these kits, please contact our client services department by phone or email and we would be happy to send you your preferred kits.
 

Which food specific antibody test?

So Dr. Meletis, the first question that I have for you is, which tests for the food specific antibody tests. With the illustration of the IgG and IgA sample report being shown, do you prefer to order IgG and IgA together or what is your standard choice for US BioTek food specific antibody tests?
 
So it all comes down to, of course, the patient budget, but I invariably may do more IgG, IgA combo because I want to know what's going on in the mucus membranes. I want to know how directly irritating are these foods and are they working on that pathway and I give the example for my patients. If we do a celiac panel to see whether or not a person has celiac disease, what do we do to ensure that that test is accurate? We do a baseline CIRM IGA.
 
And so what I like to do is I always like to look at how our mucus membranes, that interface doing with the outside world. And if they have gut issues, allergy, hay fever, mucus membrane, sinus issues, IgA always. Now, many of us have noticed that there's a lot of crossover between IgG and IgA and even looking at this graphic you can see, well they are pretty common, but every once in a while I will get an outlier of a couple of just pure white lines with no gray associated with them. And missing something, which otherwise are eating a lot of and that is an IgA related and wouldn't otherwise have shown up, is important.
 
And I'll give an example here of the cheddar cheese. If everybody can see the screen, the cheddar cheese, actually that IgA is even higher than the IgG. And if I had a choice between mozzarella cheese for this person or cheddar cheese and they're going to have pizza no matter what. I'm going to go for the mozzarella cheese.
Great, thank you. The next question is regarding a specific patient with laboratory findings. A patient with CLL and concurrent elevated IgG. Do you think that this could be related to the gut and food sensitivity or just as a marker of CLL?
 
So I'm assuming we're talking about chronic lymphocytic leukemia.
 
That's what I'm assuming as well.
 
Okay. So I would say that any ... So clearly the body's talking to us and as functional medicine providers, since there is already, this hypervigilant within the body, anything that's further perturbing this needs to be minimized because it's all about immunological control. And if we're triggering immunoglobulins in the humoral immunity, we need to try to quiet down thing. So I would approach as much like I would an auto immune patient. Let's quiet down things while addressing the underlying cause, what were the triggers? For these patients which I actually have treated CLL patients, I would actually go ahead and do the environmental pollutant panel.
 
Actually one of the gentlemen that have this condition, used to work in a truck, I don't know, warehouse manufacturing and repair and he was high in Ben jeans and [inaudible 00:50:40], which were poison in his bone marrow and had this some toxic mill. And so I would probably avoid the ... I do the foods, but I also do an environmental pluton panel on that patient. My experience in some sort of detox.
 

The cross reaction between gluten and dairy

That was a fantastic question and a wonderful answer. And we're especially fortunate that you have that clinical experience. Then next question, Dr. Meletis is about the cross-reactivity that you mentioned of gluten and dairy because they're not closely related by food families. What is the mechanism of that cross reaction?
 
It's actually an epitope. So because I'm old ... I don't like to say I'm old, but I'm old enough to have grown in houses which had still a little keys which allowed you to pass from room to room. But if you think of the key and lock mechanism, which has really fallen out of favor immunologically to a larger group because there's so many more mechanisms, but they're close enough in terms of receptor activity that they actually will cross react and actually trigger in neurological reactivity. It's actually on my cross-reactivity lecture. Actually, I have a couple slides dedicated to visuals and graphics on this epitope cross-reactivity.
 
So basically, it's close enough like I'll give it a silly example that just comes to my mind. I have a catcher's mitt and it's for softball, but it's good enough to catch our baseball. I have a baseball mitt, but it's capable to catch a softball, different games, same rules, but the cross reactivity is because of the epitopes.
 
Great explanation. Thank you so much. I am not receiving any more questions, which I suspect is because you've shared with us a very thorough educational presentation, Dr Meletis. Is there anything else that you would like to add?
 
I'm just in my clinical practice, I'm a test, don't guess I'm actually off to the naturopathic university, which I graduated under NCNM, but now it's in NUNM because we have so many other degree programs, much like that steer and other naturopathic college has grown over the years. And I'm going to be just lecturing on how this is one of the ways which now is going to empower patients. So this could be a 90-minute lecture, I give this weekend on how testing is a great way to support your practice, to get patients back. And I've found over the years, when my patients see it, they're going to believe it. I can tell them, I think this is a problem, that's a problem and I'll give one short little story.

The US BioTek food sensitivity test

When I was a young guy, 26 years old, just graduated, so I'd gone from high school to undergraduate at Reed college and on my bachelor's degree in biology and pre-med and then went to two years of conventional allopathic medicine and went into naturopathic medicine. I went boom, boom, boom. So at 26, I graduated and I have a 77 year old gentleman and he comes in. He has been years, his name was Harley. And I said, "Harley, I think you have a dairy issue and I think you have a wheat issue." He says, "Son, I grew up on a dairy farm and a wheat farm. I don't have either of those. That never bothered me." I said, "Will you humor me and just do the National BioTek," which is now US BioTek food sensitivity test."
 
He said, "I will, but you're going to be wrong." I said, "I'll find out. I'll eat my fruit and I'll have all this crow," and lo and behold, he actually ends up being both wheat and dairy sensitive and he was 77 years old and was downhill skiing and he wanted to start downhill skiing again. And down here in Portland we had a little deli called roses and he's actually, the room was just start spinning and lo and behold he started downhill skiing again. It's been years got better and begrudgingly he said, "Son, you're right, dairy and wheat were a big issue." Thanks for allowing me to speak.
 
Again, with the humor, thank you. Well, Dr. Meletis, since we have no more questions, I would like to offer a big thank you to you for sharing your knowledge and expertise with us. And also I am going to see if we can pop up to the last slide so that it displays our contact information. Dr. Meletis has generously shared his email with all of us for any questions about the information that he's presented today.
 
Thank you everyone again for joining us today. I hope you enjoy the rest of your day and this concludes our webinar.
 
Thank you. Thank you everyone.
 
Thank you too, Dr. Meletis.