Welcome to the third in our special series sharing insights and recent research from the MEDMAPS 2023 Spring Conference attended by Dr. Potter. MAPS stands for Medical Academy for Pediatric Special Needs and arose from the original Defeat Autism Now organization initially serving parents and providers caring for children with autism spectrum disorder). This Spring Conference focused not only on autism research but on Lyme and other infections including COVID’s effects on children. Come back in the coming weeks to read more about what I learned at the conference so that Sanctuary can provider cutting edge care to your precious little ones.
(Continued from the prior essay. Refer back to part 1 for insights into the GI tracts interaction with the immune system and the nervous system.)
While our GI tract obviously deserves applause for the work it does in bringing in the nutrients for our bodies’ functioning, it should also get credit for expelling a lot of toxins alongside the the left-overs of your food. A great deal of detoxification occurs between the liver and the bacteria of the gut. As a parallel part of the GI tract alongside the intestines, the liver filters the blood 24/7/365, both the blood coming from the intestine but the systemic blood as well. Various toxins, metabolic byproducts, and medications are altered to either active or inactive states by the liver cells.
If the liver does not break down the particular substance fully, it can be excreted into the bile where it has a chance to be excreted in stool soon afterwards. Many fat-soluble substances make their way out of our bodies through this method.
Substances that entered through our mouths in foods or even as medications, as well as these fat soluble, bile-excreted chemicals, can then be acted upon by bacteria in our colons. Various bacteria possess various enzymes which break down various substances. Without a particular bacteria to process a particular chemical, that chemical may then enter the body at higher, potentially toxic concentrations. With the wrong bacteria present, an otherwise excretory detox process can backfire and allow even re-entry of things excreted in bile by the liver. Balancing these bacteria can play a large role in our health.
The functioning of the liver and the balance of these colonic bacteria also plays a role in handling of reproductive hormones. Hormones are made elsewhere by endocrine organs and float through the bloodstream, leading to effects in distant body parts. An appropriate level of hormones must be maintained for good health and avoidance of adverse effects like breast cancer, endometriosis, or other more vague symptoms of imbalance. The liver processes these hormones and excretes breakdown products in the bile. If the wrong bacteria are present, these hormones can return into the blood stream leading to excess levels.
Helping our children’s GI tract to detox better requires a few simple things. On one hand, good energy sources are needed for efficient detox as it requires a good bit of energy. Treating malabsorption described further below through the use of digestive enzymes, anti-inflammatories, and phytonutrients improves the detox ability. On another hand, avoiding the addition of new toxins means the liver can focus on cleaning up old toxins. If the detox burden appears high, adding things like taurine, glutathione, vitamin C, N acetyl cysteine, phosphatidylcholine, and other nutraceuticals can boost the detox ability.
Finally, our mitochondrial energy production system depends on the GI tract for so many nutrients that books have been written about this topic alone. If the small intestine does not provide energy nutrients, vitamins and minerals, as well as building blocks through proper absorption, the mitochondria may struggle to provide needed energy for the nervous system or the muscles or any other system for that matter. Malabsorption can occur in many ways. There can be congenital deficiencies of some enzymes which, from birth, prevent someone from fully breaking down something like carbohydrates or fats or proteins. These can not only prevent absorption of calories, but also GI symptoms that further interfere with digestion and absorption.
Someone may develop malabsorption in different ways later in life. Foods like gluten may cause inflammation through either immune or chemical means, which then interferes with absorption of various nutrients. The first sign of celiac may be iron deficiency or low protein with weight loss. Without iron, insufficient oxygen gets to the cell’s mitochondria and enzymes cannot function as well to turn carbs, fats, and proteins into energy. Toxins like mold can damage the lining of the gut, directly to the cells or indirectly through effects on the microbiome. While one might think a leaky gut would allow more substances to enter the bloodstream, in reality, absorption requires energy and intact brush borders or else nutrients keep sliding down the intestines and out the back door. Fatigue sets in when insufficient vitamins are absorbed and weight loss occurs due to lacking calories.
The mitochondria also require good fats like phosphatidylcholine for their membranes. Healthy membranes are necessary for the mitochondria to extract energy from the oxidation of carbs and fats in the metabolic Krebs cycle. Without good ratios of different good fats, the little enzymes responsible for the Krebs cycle can’t do their jobs. If the intestines are unable to absorb fats, the good fats are lost, as well as fat soluble vitamins like Vitamin A and Vitamin E.
For our child patients with neurologic conditions, we assess their diets with history and testing as well as look for physical exam clues to deficiencies. We address confirmed nutrient shortcomings in the short term with supplements but work in the long run to depend on food sources of these vital nutrients. Sometimes we add things like CoQ10 or ribose. Sometimes we replace missing vitamins like riboflavin (B2). Regardless we work through the GI tract to be sure the mitochondria throughout our bodies have their necessary nutrients for proper functioning.
For children with neurodevelopmental or neuropsychiatric conditions, supplying the various systems as noted above are important but avoiding triggers and saboteurs of good brain health also work through GI system. A GI tract which allows in toxins to trigger brain inflammation can at least worsen autism and PANS/PANDAS. A GI tract which harbors inflammatory bacteria like clostridia or unwanted parasites can provide the inflammation which damages growing brain cells or trigger a young immune system to mistakenly attack these nerves. A GI tract which leaves one short of nutrients means that the inflammation and damage cannot be quickly repaired, leaving long lasting changes rather than recovering. If the liver’s detox pathways are not open through phase 1 and phase 2, leading into phase 3, a halfway done chemical process can actually make some toxins even worse than they began. A fully functional liver detox is needed.
In all these ways and more to be discovered in the future, the GI tract must be considered as we care for the young patients we see as well as the adults. Restoring both to healthier more abundant lives requires often starting with the GI tract but most need more. Skipping this step however means the later steps don’t have a foundation on which to stand. We work patients through the whole process.
Medical Disclaimer: These essays are for educational purposes only. We assume no responsibility for your choice to implement something from these essays. Even if you are a patient of our clinic, you should consult with us before adding therapies. If you are not one of our patients, talk with your health care provider before trying any of these therapies.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.
