Dr Dingle's Blog
Diet has a profound impact on gut microbiota composition and function including the role of food additives.
The study found that TiO2 could alter the release of bacterial metabolites in the gut and affect the distribution of the commensal bacteria. They also found reduced expression of the colonic mucin 2 gene, a key component of the intestinal mucus layer, and increased expression of the beta defensin gene, indicating that TiO2 significantly impacts gut homeostasis. These changes were associated with gut inflammation and an increase in the rick of colon cancer.
These findings collectively show that TiO2 is not inert, but rather impairs gut homeostasis which may in turn prime the host for disease development.
Glyphosate is an active ingredient of the most widely used herbicide Roundup. Human exposure to glyphosate among the participants has increased by 500 percent in the past two decades. In the years of 1993-1996, only 12 percent of participants had detectable levels of glyphosate in their urine. By 2013-2016, this number increased to 70 percent. The researchers also found a thirteen-times increase in glyphosate concentrations between the two collection periods.
Although glyphosate was designed to kill weeds, it also kills susceptible bacteria that have biochemical pathways similar to plants and weeds. Glyphosate impacts the intestinal microbiome through the residues from spraying, since glyphosate was shown to have negative effects on the composition of the intestinal flora of glyphosate from contaminated food. Even at incredibly low environmental concentrations (0.1 ppb) glyphosate had an impact on rat gut microbiome composition. In particular, it lowered the diversity of many of the beneficial microorganisms in experimental rats which enabled the proliferation of opportunistic E. Coli strains. These gut microbiome disturbances showed a substantial overlap with those associated with liver dysfunction in other studies. Several studies have also proposed that it may be a cause of autism through its impact on the gut microbiota.
Medical statistics are often used to justify the overuse of pharmaceuticals because they use different types and they are hard to understand then there is even a simpler number which is used in medicine, the Number Needed to Treat (NNT). This is how many people you need to treat to stop one negative outcome occurring. The negative outcome might be heart attack, stroke, cancer or even recurring ear infection. The NNT offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person. In this case the higher the number the worse it is and the lower the number the more effective the medication. So an NNT of 1 is fantastic and an NNT of 100 is absolutely useless.
If a new drug reduced the death from heart attacks by say 50% (absolute statistics) then the number needed to treat is around 2 (NNT =2). So you only need to treat two people to have a benefit and save one life. This is great. If the new drug cuts the heart attack rate by only 25%, that is 1 in 4 then the NNT is 4. If the drug is only one percent effective which means of the 100 people given the drug it will only potentially (remember we are not even considering the side effects here) save one life, like the statin drugs, then the NNT is 100.
Fortunately the NNT is well established in medicine but not widely promoted. One website however TheNNT.com puts all this information in one place. Even for the most skeptical GP’s and specialists and it is available free to everyone. Just as important it is a group of physicians, medical doctors, that have collected the information. They only use the highest quality, evidence-based studies (frequently, but not always Cochrane Reviews), and they accept no outside funding or advertisements so they are independent of pharmaceutical companies.
In addition, for every therapy they review, they provide a color-coded summary for you to use (borrowed from the traditional stoplight). Unlike most sites this group also report harm that may be caused by the drug or the procedure and then they rate them into a stoplight colour coded. They have developed a framework and rating system to evaluate therapies based on their patient-important benefits and harms. The therapies rated green are the best you can get – there is clear evidence of benefits which clearly outweigh any associated harms. For example: Steroids for Asthma Attack: if you give steroids to 8 patients with asthma attack in the emergency department, you prevent one from having to be admitted to the hospital. There are definitely side effects to steroids – high blood sugar, hyperactivity – but are considered minor in comparison. The NNT for this treatment is 8. Remember the lower the number the better. Therapies rated yellow require more study because they don't think the data is conclusive or substantial enough to be able to give a clear rating yet. So they are not recommended but if you do use them go with caution. Red suggests that while there may be some benefits, they are far outweighed by the harms. One extreme example: if a medicine were to save 2% of people's lives, but cause strokes in 10% of people, it's hard to say that this medicine clearly is overall helpful. Black is the "worst" or "lowest" rating. Therapies rated black have very clear associated harms to patients without any recognizable benefit. What is frightening is that most of the major medications and procedure used for cardio vascular disease fit into the black.
While there are many drugs and procedures listed I will start with some of the common procedure for cardio vascular disease as this is the biggest killer and there is just not enough space here to cover all the listings on TheNNT.com web site. For statin drugs for acute coronary syndrome the NNT is 0% in other words no person who took the drug were helped (life saved; heart attack, stroke, or heart failure prevented) however, an unknown number were harmed (medication side effects/adverse reactions). This was put on the black list. Statins Given for 5 Years for Heart Disease Prevention (With Known Heart Disease) NNT was 83. In fact they reported 96% saw no benefit however 1% were harmed by developing diabetes and 10% were harmed by muscle damage, just two of the side effects. This is also put on the black list as the harm outweighs any insignificant benefit of the drugs. Statin Drugs Given for 5 Years for Heart Disease Prevention (Without Known Heart Disease) also put on the black list and has a NNT of 104 for non-fatal heart attack but they reported 0% life saved and 1 in 100 were harmed, they develop diabetes and 1 in 10 had severe muscle damage. In contrast, they reported the Mediterranean Diet for Secondary Prevention After Heart Attack got the green light and a NNT of 30 for mortality and no negative side effects and as low as 1 in 18 were helped. Not to mention the other benefits in other conditions such as cancer and diabetes.
Beta Blockers for Acute Heart Attack (Myocardial Infarction) are also commonly prescribed by specialists are put on the black list and listed with no benefit, but 1 in 91 were harmed by cardiogenic shock. Hormone Replacement Therapy for Cardiovascular Prevention of a First Heart Attack or Stroke, black list and no benefit found but 1 in 250 were harmed (heart attack due to HRT oops, exactly what they were supposed to prevent), 1 in 200 were harmed (stroke due to HRT) and 1 in 100 were harmed (blood clot in the leg/lung). To support this a recent study which investigated 27 trials found only one trial showing a 0.7% benefit and 26 trials that suggest no aggregate mortality benefit to beta-blockers. All the more recent, and larger, trial that utilized double-blind techniques (COMMIT, 2004) found no benefit.
Even putting a stent (a little piece of artificial artery) in an artery got on the black list. In the case of Coronary Stenting for Non-Acute Coronary Disease Compared to Medical Therapy none were helped, that is no life saved, no heart attack prevented, and no symptoms reduced, however, 1 in 50 were harmed including complications such as bleeding, stroke, kidney damage. Coronary Artery Bypass Graft Surgery (Heart Bypass) for Preventing Death over Ten Years was marginally better. The NNT was 25 to prevent death however, 1 in 83 died, 1 in 100 had stroke, 1 in 43 had kidney failure, 1 in 28 in the operation, 1 in 14 required extended life support and get this, 1 in 3-5 had cognitive decline. Not such a good outcome if you look at the whole picture and any wonder it was put on the black list
Aspirin Given Immediately for a Major Heart Attack (STEMI). Got the green light. So if you have a heart attack taking an aspirin straight away has some benefit. The NNT was 42 for mortality as 1 in 42 were helped (life saved) but 1 in 167 were harmed (non-dangerous bleeding). However, with Aspirin to Prevent a First Heart Attack or Stroke the NNT was 1667 for cardiac benefit, that is 1 in 1667 were helped (cardiovascular problem prevented), 1 in 2000 were helped (prevented non-fatal heart attack) and 1 in 3000 were helped (prevented non-fatal stroke). But no deaths prevented and 1 in 3333 had a major bleeding event.
The NNT for Blood Pressure Medicines for Five Years to Prevent Death, Heart Attacks, and Strokes were 125, 1 in 67 prevented stroke, and 1 in 100 prevented heart attack. However, 1 in 10 had side effects and stopped taking the drug. Treatment of Mild Hypertension for the Primary Prevention of Cardiovascular Events was given the yellow light and the there was no NNT as no benefit was found. However, 1 in 12 experienced medication side effects.
On a positive note oral anticoagulants (warfarin) for primary stroke prevention (no prior stroke) got the green light and the NNT was 25 for prevented stroke and 1 in 42 were helped (preventing death from any cause). However, 1 in 25 were harmed (having bleeding), 1 in 384 were harmed (intracranial hemorrhage).
It seems we spend billions of dollars, even trillions of dollars on drugs and procedures that don’t work and and are likely to be doing more harm than anything just because of trust and a lack of knowledge on statistics. While I am likely to criticized for presenting this information and you might question your doctor or specialist, remember I am just the messenger presenting factual numbers. See for yourself www.TheNNT.com.
Many studies have reported abnormal gut microbiota in individuals with Autism Spectrum Disorders (ASD), suggesting a link between gut microbiome and autism-like behaviors.
The human gut and brain interact in complex ways, and abnormal conditions in the gut may predispose individuals to neurodevelopmental disorders. Individuals with Autism Spectrum Disorders (ASD), Parkinson’s disease, and Alzheimer’s disease, have been known to experience chronic gastrointestinal (GI) symptoms as a common co-occurring medical condition, suggesting the presence of a gut-brain axis. In a study of 192 twin pairs they found that both genetic and environmental factors contribute to the etiology of ASD.
The gut microbiome represents an important environmental factor that may exert an influence on symptoms, and a growing number of research groups have observed that children with ASD have distinctive gut microbiomes compared to children without ASD symptoms. More importantly, multiple mouse studies have reported that gut microbes and their metabolites can impact behavior through the gut-brain axis, including for ASD.
Considering the link between the gut and brain, modulating the gut microbiome by probiotics, prebiotics, and/or fecal microbiota transplant (FMT) could be a viable therapeutic option. In FMT, a large diversity and number of commensal microbes from a healthy donor are used to transform a dysbiotic gut microbiome into a healthy microbiome.
Modifying the gut microbiome is a potential route to improve gastrointestinal (GI) and behavioral symptoms in children with ASD, and fecal microbiota transplant could transform the dysbiotic gut microbiome toward a healthy one by delivering a large number of commensal microbes from a healthy donor.
In this study they report a follow-up with 18 participants two years after FMT treatment was completed. Notably, most improvements in GI symptoms were maintained, and autism-related symptoms improved even more after the end of treatment around 50% improvement. Also important changes in gut microbiota at the end of treatment remained at follow-up, including significant increases in bacterial diversity and relative abundances of Bifidobacteria and Prevotella. These observations demonstrate the long-term safety and efficacy of MTT as a potential therapy to treat children with ASD who have GI problems, and warrant a double-blind, placebo-controlled trial in the future.
Long-term benefit of Microbiota Transfer Therapy on autism symptoms and gut microbiota
Candida has a high degree of resistance to many available drugs. In the case of candida it is not just candia on its own but the potential associations it has with other opportunistic species and how they work together to protect each other with a resilient biofilm. The most important feature of biofilm growth is the high resistance to antimicrobial agents. To deal with this the best options are to use multiple strategies.
The best approach is to eat more of the functional foods, herbs and spices on a daily basis which help rebalance the gut microbiome and eliminate the opportunistic specises like Candida. Aloe vera in both its crude and extract form has been shown to have positive antimicrobial effects especially against Candida species. Aloe has also been shown to be effective against some pathogenic specis including Salmonella gallinarum. One study investigated the effect of Aloe when consumed orally in patient suffering from an inflammatory bowels disease given at the rate of two ounces three times daily for a week was able to rebalance the regulating gastrointestinal motility and decrease stool transit leading to curing diarrhea.
Coconut oil and its constituent fatty acids have potent antifungal activity and have been shown to both inhibit the growth of and kill C. albicans in vitro (Kabara et al 1972). In mice, coconut oil effectively reduced colonization of candida across a range of doses (12 to 30%).
Herbs are rich in phytochemical constituents like polyphenols that possess antioxidant, antimicrobial and immunomodulatory properties. A number of natural products have been shown to be effective in controlling fungi growth including curcumin from turmeric. Trumeric, ginger and Xanthorrhizol, isolated from Curcuma xanthorrhiza a cousin of turmeric in the ginger family have been shown to be effective against multiple Candida species and other opportunistic fungi and as a treatment for the treatment of candidiasis. Garlic’s antibacterial activity has been first stated by Louis Pasteur; and there are also reports of its antifungal and antiviral activities.
Other herbs including Berberine has also been shown to have significant antimicrobial activity against bacteria, viruses, protozoa, fungi, and yeasts (Tan et al 2011). As well as extracts from Trigonella foenum-graecum (fenugreek) seeds, Cinnamomum verum (Celyon cinnamon) bark, Carica papaya (papaya) leaves and seeds and sweet basil leaf herbal oils seem to be highly effective anti-Candida choices.
Disturbances of the bacterial community in the GI tract promote C. albicans colonization suggesting that the normal bacterial microbiota of the GI tract have an inhibitory effect against fungal colonisation and invasion. Lactobacillus spp. appear inhibit the growth and virulence of C. albicans by the production of hydrogen peroxide and organic acids, but not fully eradicate them. They may also exert some effect on the Candida through the immune system. Similar results have also been shown for supplementation with some fungal probiotics, such as Saccharomyces boulardii which compete with Candida species for gut space.
After initial breakdown by chewing, food is churned by the smooth muscles of the stomach and is broken down by hyrdochlooric acid and stomach juices (enzymes). The pH of the stomach is highly acidic, around 1.5 (1.0-2.5) due to the hydrochloric acid which helps to kill harmful microorganisms, denature protein for digestion, and help create favorable conditions for the enzymes in the stomach juices such as pepsinogen (Adbi. 1976, Martinsen et al 2005). Not to mention sending messages along the GI tract that everything is working well in the stomach. If the pH is too high, say 3 or 4 (more alkaline) then the system does not work and you end up with digestive and health complications.
The small intestine is more alkaline as the acid contents from the stomach are neutralised so that digestion and adsorption of carbohydrates, proteins and fats can occur. As the mixed juices (chime) from the stomach moves into the small intestine, the pancreas secretes sodium bi carbonate and the gallbladder releases bile which is produced in the liver, to make it slightly alkali to a pH of 7 to 8. Bile salts play an important role in the balance of the gut microbiota and like the pH in the stomach are important in controlling disease microorganisms entry into our system.
Further breakdown of protein and fat takes place, and absorption of nutrients through the use of enzymes which break down complex molecules into simpler ones. However, all enzymes need certain conditions, including pH to work. At pH's that are not optimum, the enzyme becomes less efficient until it cannot work at all. In the small intestine, the enzymes that "work" there need an alkaline pH in order to have optimum working conditions. Inadequate acid neutralization in the small intestine likely interferes with nutrient absorption by diminishing further digestive enzyme activity (Borowitz et al 2015).
The more alkaline pH also favours the non-acid loving bifidobactria which produce short chain fatty acids (SCFA) such as acetic, propionic, and butyric acid, and hydrogen ions (Vernia et al 1988) which lower the pH of the food as it moves through to make it more acid, again for the more acid loving bacteria including lactobacilis species further down the large intestine. The large intestine absorbs water and salts, and stores the leftover material ready for excretion out of the anus is a little more acidic and favours the acidopholus species. The pH of the large intestine might go as low as 3.
The pH of the gut, right from the mouth to the anus is incredible important in determining the type of gut microbiota, gut health and your own health. In the stomach if it is not acid enough (no not too much acid) it sets of a chain of events that favours the wrong type of microbiota including helicobacteror and candida species known for causing stomach ulcers and other gut health problems as well as an overgrowth of lactobacillus which should not be there and lead to Stomach Bacterial Overgrowth (SBO). So optimal functioning of the gut relies on the optimal pH for that part of the GI tract. Even in the mouth if it is too acidic it favours lactobacteria, acid loving bacteria, which in the large intestine are really beneficial, but in the mouth contribute to tooth decay and periodontal disease. Similarly, if the pH in the small intestine is out of balance it contributes to an overgrowth of lactobacillus and a condition called Small Intestinal Bacterial Overgrowth (SIBO). It all comes down to the pH and getting it right from the start.
The question of whether sunscreen prevents skin cancer is an ambiguous one. Many epidemiological studies show an increased risk of skin cancer to the sunscreen user. Similarly, a review of studies on skin cancer and sunscreens by Science News, vol 153 1998, found that people who used sunscreen are more likely to develop basal cell cancer than people who did not. Science News also examined ten studies of melanoma, five of them concluded that people who used sunscreen were more likely than non users to develop melanoma. Three of the studies found no association between melanoma and sunscreen use, and two studies found that people who used sunscreen were the most protected. Science News, vol 153 1998, found that epidemiological data was not conclusive. This may be because people involved in the studies were not wearing effective sunscreen, or were staying in the sun longer because they thought they were protected or some other factors that were not considered in the studies. This highlights the difficulty in studying and interpreting studies of humans and the study of epidemiology.
More recently, results of a randomized controlled trial of adults using sunscreen daily found increased risk of basal cell carcinoma. Other results have shown a case-control study from southern Sweden of 571 patients diagnosed with malignant melanoma showed significantly raised odds ratio for developing malignant melanoma after regular sunscreen use.
Different factors must be taken in to account to elucidate the preventive effects or actual lack of preventative effects from sunscreen. This can include sunscreen misuse and actual application methods that provide a false impression of safety in the sun. Sunscreen needs to be reapplied every 2 hours as total skin absorption of most sunscreens is around 2 hours. It may also be that sun-sensitive persons typically are more likely to use sunscreens and are at a higher risk of melanoma, thus reports of increased risk for melanoma among sunscreen users may reflect an increased risk among sun-sensitive persons rather than an increased risk solely due to sunscreen use. Sunscreen use may also be leading to increased risk of melanoma by individuals assuming that the use of sunscreen allows them to be exposed to sun light for extended periods of time without any ill effects. The point is we just do not know.
Early sunscreens primarily protected against UVB radiation but not UVA radiation. 90% of melanomas are caused by UVA radiation. Since older sunscreens only blocked UVB radiation they would not have blocked the full range of wavelengths causing melanomas, so their protection against melanoma would have been minimal. Therefore prior to the addition of UVA absorbing compounds to sunscreen in 1989, by allowing increased exposures by preventing UVB burning, sunscreen users could actually increase UVA exposures and melanoma prevalence. This suggests that any studies prior to 1989 that found sunscreen to increase the likelihood of melanomas do not accurately portray the effects of sunscreens used today and further highlights the serious limitations of epidemiological studies..
The possibility still remains that these products may be contributing to skin cancers and this is supported by the fact that a potential mechanism for the development of skin cancers with some of the toxic chemicals used in sunscreens can occur and cannot be ignored.
My personal preference is to use less toxic chemicals on my skin and get more sun.
Treatments for obesity have been shown to reduce pain secondary to weight loss. Intestinal microbiota has been shown to influence obesity and pain sensitivity.
Physiological pain plays a life-essential protective role, while acute or chronic pathological pain indicates a medical problem that needs treatment and imposes a medical challenge. Neurotransmitters, immune cells, and hormones have been demonstrated to contribute in pathogenesis of chronic pain.
Pain threshold is influenced by several factors, including obesity, which alters adipose tissue metabolic and endocrine functions leading to alterations in systemic physiology including an increased release of fatty acids, hormones, and proinflammatory molecules that contribute to obesity associated complications. Studies have demonstrated that obese humans and rats are more sensitive to pain stimuli than normal weighted ones.
Previous studies have demonstrated a relationship between intestinal microbiota and diseases including pain disorders with probiotics having a positive effect.
In this study the mice taking probiotics had a significantly lower sensitivity to mechanical stimulation compared to their corresponding control. The results of this study suggest a protective effect of probiotics on nociception circuits, which propose a direct result of the weight reduction or an indirect result of anti-inflammatory properties of the probiotics.
Potential Nociceptive Regulatory Effect of Probiotic Lactobacillus rhamnosus PB01 (DSM 14870) on Mechanical Sensitivity in Diet-Induced Obesity Model