Anti-malarial medications and autoimmunity.

Malaria is a parasitic infection carried by mosquitoes in many tropical areas of the globe. Anti-malarial drugs are not only effective against malaria but they can also balance the immune system and reduce strong pro-inflammatory molecules involved in many autoimmune disorders.

Quinine was the first anti-malarial medication, isolated from cinchona bark. Since then many quinine related medications were synthesized. Quinine is also used in treatment of lupus, arthritis and the restless leg syndrome. Tonic water contains very small amounts of quinine.

Hydroxychloroquine is a quinine related compound originally used as an anti-malarial. It is also sold under the name Plaquenin, Axemal (in India), Dolquine and Quensyl.

Hydroxychloroquine is often given to people with autoimmune disorders such as lupus erythematosus and rheumatoid arthritis. Rheumatoid arthritis is the most common autoimmune disorder coexisting with thyroid autoimmunity, about 3-4% of people with GD and HT also have rheumatoid arthritis and hydroxychloroquine is often prescribed.

Sometimes, doctors prescribe Hydroxychloroquine (Plaquenil) for Hashimoto’s thyroiditis with positive results. It seems to be a slow acting medication. Trials are being undertaken to determine the exact effect of Hydroxychloroquine treatment in Hashimoto’s Thyroiditis.

This medication is not used to treat thyroid autoimmunity as such and there are no current studies that I could find in regards to Hydroxychloroquine and thyroid autoimmunity.

Halofuginone is a very promising agent for treatment for many autoimmune disorders. It is a plant alkaloid. Scientists are looking at its effects on autoimmunity and studies look very positive. It is currently used to treat malaria and scleroderma, an autoimmune disease of the connective tissue. It was isolated from a root of a plant called Dichroa febrifuga, ‘Chinese quinine’, (a blue evergreen hydrangea which grows in Tibet and Nepal) and had been used to treat malaria for thousands of years in China. This compound protects plant from stress and is more powerful than quinine. Halofuginone is also used in veterinary medicine to treat coccidiosis (protozoa parasites).

Researchers have discovered that halofuginone blocks the development of harmful immune cells called Th17 which are believed to be strongly involved in generation of autoimmunity. Halofuginone only affects these harmful immune cells and its action is to restrict amino acids proline incorporation into proteins (8). Proline deprivation blocks TH17 cells generation. TH17 immune cells are implicated in many autoimmune diseases such as inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, and psoriasis. Preliminary animal studies look very positive for Graves’ disease.

An animal study (3) has shown that Halofuginone decreased the incidence of autoimmune thyroid disease in mice in which Graves’ disease was induced.

As anti-malarial drugs have been prescribed to patients with autoimmunity, let’s look at the possible actions of these drugs on the immune system, although the way they work is not completely known.

Anti-malarial medications such as quinine are believed to be effective against Mycoplasma microorganism infections which have been implicated as possible causative agents of autoimmunity (including thyroid autoimmunity).

Patients with Graves’ disease were shown to have increased levels of Plasmacytoid Dendritic Cells (pDCs) in perithyroidal lymph nodes. These cells are the eyes of the immune system and they produce strong pro-inflammatory cytokines, such as IFNα and IFNβ. They are believed to be important in production of auto-antibodies. These cytokines can influence the central thymic tolerance to Thyroid Stimulating Hormone Receptor which may lead to Graves’ disease.

Hydroxychloroquine can reduce TLR (Toll like Receptor) signalling on pDCs. It impairs production of strong pro-inflammatory molecules such as INFα. It is therefore an immunosuppressant and that is why it is used in the treatment of some autoimmune disorders.

Anti-malarial medications which are alkaloids may alter pH within vesicles in immune cells called macrophages or other antigen-presenting cells which may influence the immune response to auto-antigens (6).

References:

1. Road back foundation. Mycoplasmas and Autoimmune Diseases. URL: http://www.roadback.org/blog/mycoplasmas-autoimmune-diseases/#_edn2
2. https://www.ehealthme.com/ds/plaquenil/graves-disease/
3. Hou X, Zhou J, Yang R, Liu S, Bi M, Liu T, Fan C, Guan H, Teng W, Shan Z, Li Y. Effect of Halofuginone on the Pathogenesis of Autoimmune Thyroid Disease in Different Mice Models. Endocr Metab Immune Disord Drug Targets. 2017;17(2):141-148
4. Jorge Cárdenas Roldán, Jenny Amaya-Amaya, Juan Castellanos-de la Hoz, Juliana Giraldo-Villamil, Gladys Montoya-Ortiz, Paola Cruz-Tapias, Adriana Rojas-Villarraga, Rubén D. Mantilla and Juan-Manuel Anaya. Autoimmune Thyroid Disease in Rheumatoid Arthritis: A Global Perspective. Arthritis. 2012; 2012: 864907.
5. Ben-Zvi I, Kivity S, Langevitz P, Shoenfeld Y. Hydroxychloroquine: from malaria to autoimmunity. Clin Rev Allergy Immunol. 2012 Apr;42(2):145-53
6. Fox R. Anti-malarial drugs: possible mechanisms of action in autoimmune disease and prospects for drug development. Lupus. 1996 Jun; 5 Suppl 1:S4-10.
7. Karim Sacre, Lindsey A. Criswell, and Joseph M. Hydroxychloroquine is associated with impaired interferon-alpha and tumor necrosis factor-alpha production by plasmacytoid dendritic cells in systemic lupus erythematosus. Arthritis Res Ther. 2012; 14(3): R155
8. Sundrud MS, Koralov SB, Feuerer M, Calado DP, Kozhaya AE, Rhule-Smith A, Lefebvre RE, Unutmaz D, Mazitschek R, Waldner H, Whitman M, Keller T, Rao A. Halofuginone inhibits TH17 cell differentiation by activating the amino acid starvation response. Science. 2009 Jun 5; 324(5932):1334-8.

New formulations of thyroxine available in Australia

A new brand of thyroxine is now available in Australia. The Therapeutic Goods Administration has approved a new generic and new strength brand of thyroxine under product names of Eltroxin, Aspen thyroxine and Thyroxine Aspen in 2014, sponsored by Aspen Pharma Pty Ltd. This brand of throxine has been widely used in Europe and other countries. Previously we only had two brands of thyroxine in Australia, Oroxine and Eutroxsig.

Eltroxin tablets come in a plastic bottle in new strengths of thyroxine sodium – 25, 50, 75, 88, 100, 112, 125, 137, 150 or 200mcg tablets. They also do not need refrigeration (not above 25 degrees C) which may be useful when traveling for example or for finer adjustment of hormones. Eltroxin might be an easier option for some people who are taking two doses of Eutroxsig at different days of a week (like myself). When changing from on brand of thyroxine to another, it is important to note that dosing may not be interchangeable due to different fillers present in tablets as they may change the bio-availability of thyroxine in individuals. It is important to monitor hormonal levels when changing from Eutroxsig/Oroxine to Eltroxin, which may be slightly less bio-available when compared to Oroxine (you might need to take a slightly higher dose). I have not tried Eltroxin but would be very interested in any comments from people who take it or switched from one brand to another.

New liquid thyroxine (not available in Australia just yet)

SERB company in France has developed a liquid formulation of thyroxine, levothyroxine in drops. One drop contains 5 mcg of thyroxine. This formulation might be beneficial for young children and older people who have problems swallowing tablets.

FDA in USA has also approved a liquid formulation-Tirosint-SOL (levothyroxine sodium oral solution; IBSA). It is supplied in unit gel capsule containing following strengths (mcg/mL): 13, 25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200 (colour labelled). It contains only levothyroxine, gelatin, glycerin, and water.  It has been developed by Italian Swiss Company IBSA and it has been available in Italy since 2012.

References:

1. 1. URL: https://www.tga.gov.au/auspar/auspar-thyroxine-sodium-1
   2. URL: https://serb.eu/products/l-thyroxine-150mg/
   3. Salvatore Benvenga, Giovanni Capodicasa and Sarah Perelli. Thyroxine in an oral liquid or softgel formulation ensures more normal serum levels of Free T4 in patients with central hypothyroidism. Front Endocrinol (Lausanne). 2017; 8: 321.
   4. URL: https://www.empr.com/news/tirosint-sol-hypothyroidism-thyroid-thyroxine/article/638154/
   5.  URL: https://www.rxlist.com/tirosint-sol-drug.htm
   6. URL: https://www.tirosint.com/why-tirosint/what-makes-tirosint-different/

Hypothyroidism and a low resistance to colds and flu- natural remedies

This blog will only discuss scientific research on natural remedies which may help to fight off a respiratory infection during the flu season. The flu and the common cold are caused by different viruses with flu being generally more severe than a cold and harder to overcome.

My experience with sub-optimal thyroid hormonal replacement made me aware that my risk of getting common colds and flu increases when I was hypothyroid. In fact, I used to have a constant cold during winter which lasted for months when I was hypothyroid. The flu was also more severe and hard to overcome. Number one resistance from colds and flu in thyroid patients is to have optimal levels of thyroid hormones (TSH, T4 and T3) in my opinion. This is important as sub-optimal hormonal replacement affects all body systems negatively, including the immune and digestive systems.

Nutritional deficiencies are common with hypothyroidism which affect cause a lowered resistance to viruses. Common deficiency with thyroid autoimmunity are iron, B vitamins and vitamin C, D and vitamin A with hypothyroidism. It is also important to have adequate vitamin D levels. Vitamin D is a steroid hormone that balances the immune system obtained from the sun, therefore a reasonable sun exposure is beneficial. I personally supplement with vitamin D during winter months to have optimal levels. It is common do have low levels of vitamin D with thyroid autoimmunity.

The winter season is approaching in the southern hemisphere and so too here in Australia. However I feel that the warmer months are the time to boost the immune system. Vitamin D from the sun, fresh seasonal fruits and vegetables, swimming in the ocean, outdoor walks, relaxing summer holiday, all these enjoyable things leave healthy deposits in our body so that we are stronger during the colder months and are more able to fight off colds and flu virus faster. We need strong adrenals to overcome winter illnesses. Certainly when we are stressed, our immune system is not strong enough to be effective in fighting viruses. When we are hypothyroid we are severely weakened, we have lowered immunity and other hormonal imbalances. Therefore resistance to flu viruses involves a whole body approach.

Viruses are tiny (much smaller than bacteria) and they only replicate inside of a host cell. They can attach and then invade a human cell. Viruses are like tiny protein robots which carry genetic material that instructs the host cell to make more viruses, destroying the host cell in the process. Respiratory viruses like the Influenza virus are spread by coughing and sneezing. They can be breathed in but viruses can survive on surfaces for up to 24 hours so touching a contaminated surface and then touching your nose, mouth or face can cause an infection. Really, our immune system is our best defense against a viral infection.

Viruses can be ‘killed’ by heat (75-100 degrees C) and by some cleaners, detergents, soaps or hand gels. Hand gels and sanitizes are mainly antibacterial but also work for viruses given sufficient time of contact so it is good idea to rub the gel until hands feel dry.

Viruses are not really killed as they are not alive to start with but their protein and genetic material becomes damaged so they become are unable to invade a host cell. Antibiotics work only on bacteria and do not work on viruses and there are limited antiviral medications. Antibiotics are given for secondary bacterial infections as  mucous membranes damaged by viruses are easily invaded by opportunistic bacteria.

Here I would like talk about some of the current research into natural remedies for overcoming colds/flu much easier.

It is beneficial to have lots of colorful vegetables in a diet, mainly because they can alkalize body cells which then become are more resistant to invasion by viruses. Anthocyanins (a type of flavonoid) is a group of compounds with amazing antioxidant effects. A scientific study (3) has discovered that certain gut bacteria called Clostridium orbiscindens, degrades flavonoids to produce a metabolite called desaminotyrosine which boosts the immune system and prevents influenza-related lung damage in the mice.

Colostrum may also be an effective supplement for flu prevention. Italian researches have stated in their study (20) on Colostrum: “Colostrum, both in healthy subjects and high-risk cardiovascular patients, is at least 3 times more effective than vaccination to prevent flu and is very cost-effective.”

We all know benefits of garlic for combating colds. A study (21) of one hundred forty-six volunteers investigated allicin containing garlic supplement for flue prevention. It has  concluded that: “An allicin-containing supplement can prevent attack by the common cold virus.”

Raw apple cider vinegar is believed to be great for the immune system as it improves the balance of gut bacteria. It also stimulates absorption of nutrients from food.

A prominent physician in 1925 has made an observation that Bicarbonate of Soda had some protective effects on fighting influenza while working for U. S. Public Health Service during 1918- 1919 flu epidemic. Some people believe that small amount of baking soda in water can help to resolve colds, taken on onset by alkalizing the body. I have not tried this myself and have not found any current research in support of this remedy but for those interested, there are a number of interesting websites which discuss it, I include some (15, 16 and 17).

A great alkalizing fruits are lemons, even though they taste acidic, they change in the body to alkalizing substances.

People with autoimmunity need more antioxidants in their diet. One amazing vegetable with incredible amount of anthocyanins is red cabbage. It is a worthwhile vegetable to include in your diet in winter. Fruits such as blueberries also contain lots of anthocyanins and if you can have these in winter months, it might be beneficial. Fermented foods and probiotics might also help.

Adrenal support might be important especially if you are stressed or overworked. Good sleep is important for the immune system. Adrenal glands need lots of vitamin C and B to function well. Adequate levels of zinc and magnesium are also important. Zinc tablets and lozenges are beneficial for sore throats. Epsom salt baths or rubbing with magnesium gels may be beneficial to increase magnesium levels as it gets absorbed through skin. Very warm Epsom salt feet soak is wonderful when you have a chill. It is beneficial to keep your feet warm. Last winter I found that if I had a teaspoon of vitamin C powder 3 times a day in some water, it helped with my cold and muscular aches.

Everybody has their own cold remedies passed through generations. The goal is to get over a virus as soon as possible without getting a secondary infection which would require antibiotics. Having an appropriate rest is important.

A study has found that some essential oils attenuate influenza virus infections. These oils are: wild orange peel, clove, cinnamon, eucalyptus, thyme and rosemary. A scientific study (5) has shown that several oil blends such as On Guard™ have antiviral activities.

Few drops of these oils may be added to some vodka in a small spray bottle and used to spray in the house. The oils may be used in diffuses or vaporizers.

Good old chicken soup or bone broths provide many glutathione building nutrients. Glutathione molecule is important for the immune system to function well. Most of us know the benefits of garlic, black elderberry, cinnamon, ginger, raw honey in fighting of colds. A hot toast with butter, honey and sprinkled with cinnamon is soothing as well as garlic and butter toast. My friends swears by a smoothie containing lemon juice, ginger, garlic and parsley. Some people like the benefits of Echinacea extract. It was found to stop the virus binding to cells in an in vitro study (6). However some people with ragweed or pollen allergy might be allergic to Echinacea as their molecules are similar. Ragweed or pollen allergy are quite common in people with thyroid autoimmunity. Lots of warm drinks with lemon, ginger and honey helps to soothe a sore throat. Green, black and liquorice teas have some antiviral activity. Polyphenols in black tea called theaflavins have antiviral activities (7). Coffee components (such as caffeic acid and natural flavonoids) have also been shown to have anti influenza virus activities. Resveratrol in grapes is also known for antiviral properties. Guava leaf tea was shown to have a stronger anti-virus activity than green tea in a study, probably due to the presence of flavonoids (8). Olive leaf extract has also shown to have anti influenza effects (11). Gurgling a sore throat with olive leaf tea may bring some relief. Hibiscus tea may help as it is rich in vitamin C.

A study (1) on mice has shown that extract from leaves of wild black currants (500 micrograms) given to mice through nose stopped the replication of the human influenza A virus in lungs by 85% when compared to other mice. The extract was also effective in cell cultures infected with influenza virus. The scientist believe that this extract may also be beneficial to humans. The leaves are rich in phenolic compounds in particular flavonoids and tannins which are believed to be responsible for the antiviral effects.

Cistus incanus tea may also be beneficial for influenza. A scientific study (2) has shown that Cistus inacus extract has anti influenza virus activity in cell cultures study blocking the virus entry into the cells.

Herbs known for its antiviral properties include rosemary, thyme, sage, fennel seeds and oregano. Marshmallow root and black elderberry extract (Sambucol) can soothe inflamed membranes. Inhalers with tea tree oil, rosemary, eucalyptus, lemon, thyme, oregano or lavender may be beneficial. The oils can be used in steam breathing, vaporizers, baths, compresses and for rubs in massage carrier oils.

Andrographis paniculata (King of bitters) study (18) has shown Kan Jang tablets containing this herb had a preventive effect against common colds during the winter period.  Astragalus root is also known for the anti-viral and immune boosting properties.

Let’s not forget about iodine, a potent killer of viruses. Iodine is used to make a thyroid hormones in the thyroid gland. Some people with hypothyroidism may be iodine deficient. Iodine should be used carefully by people with Grave’s disease as it may aggravate the symptoms in some cases.

Aerosol sprays with iodine can kill viruses, iodine gargling preparation from your local chemist may also be effective. Scientists, Burnet and Stone had experimented with iodine and influenza viruses on mice in Melbourne laboratories in 1945 and had found out that putting iodine on mice snouts prevented the mice from being infected with live influenza virus from 10 min exposure in high concentration virus mists.

I always make sure that I have my own herbal remedies for winter (recipe below) for winter coughs and colds. This tea is helpful for coughs, irritated throat and it makes sleeping easier.

Soothing tea for colds and coughs:

4tbl spoons dry marshmallow root

2tbl spoons thyme dried

2tbl spoons dried fennel seeds

2tbl spoons dried sage.

Please note: this blog is for educational purposes only, please speak to your doctor first before using natural remedies mentioned here.

References:

1. Emanuel Haasbach, Carmen Hartmayer, Alice Hettler, Alicja Sarnecka, Ulrich Wulle, Christina Ehrhardt, Stephan Ludwig and Oliver Planz. Antiviral activity of Ladania067, an extract from wild black currant leaves against influenza A virus in vitro and in vivo. Front Microbiol. 2014; 5: 171.
2. Ehrhardt C., Hrincius E. R., Korte V., Mazur I., Droebner K., Poetter A., et al. (2007). A polyphenol rich plant extract, CYSTUS052, exerts anti influenza virus activity in cell culture without toxic side effects or the tendency to induce viral resistance. Antiviral Res. 76 38–47.
3. Ashley L. Steed, George P. Christophi, Gerard E. Kaiko, Lulu Sun, Victoria M. Goodwin, Umang Jain, Ekaterina Esaulova, Maxim N. Artyomov, David J. Morales, Michael J. Holtzman, Adrianus C. M. Boon, Deborah J. Lenschow, Thaddeus S. Stappenbeck. The microbial metabolite desaminotyrosine protects from influenza through type I interferon. Science, 2017; 357 (6350).
4. Wolkerstorfer A., Kurz H., Bachhofner N., Szolar O. H. Glycyrrhizin inhibits influenza A virus uptake into the cell. Antiviral Res. 2009. 83 171–178.
5. Shuhua Wu, Krupa B Patel, Leland J Booth, Jordan P Metcalf, Hsueh-Kung Lin and Wenxin Wu. Protective essential oil attenuates influenza virus infection: An in vitro study in MDCK cells. BMC Complement Altern Med. 2010; 10: 69. URL: https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-6882-10-69
6. Pleschka S, Stein M, Schoop R, Hudson JB. Anti-viral properties and mode of action of standardized Echinacea purpurea extract against highly pathogenic avian influenza virus (H5N1, H7N7) and swine-origin H1N1 (S-OIV). Virol J. 2009 Nov 13; 6:197.
7. Nakayama M, Suzuki K, Toda M, Okubo S, Hara Y, Shimamura T. Inhibition of the infectivity of influenza virus by tea polyphenols. Antiviral Res. 1993 Aug; 21(4):289-99.
8. Sriwilaijaroen N, Fukumoto S, Kumagai K, Hiramatsu H, Odagiri T, Tashiro M, Suzuki Y. Antiviral effects of Psidium guajava Linn. (guava) tea on the growth of clinical isolated H1N1 viruses: its role in viral hemagglutination and neuraminidase inhibition. Antiviral Res. 2012 May; 94(2):139-46.
9. Zakay-Rones Z, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med. 1995 Winter; 1(4):361-9.
10. Hulisz D. Efficacy of zinc against common cold viruses: an overview. J Am PharmAssoc, 2004 Sep-Oct;44(5):594-603.
11. Renis HE. In vitro antiviral activity of calcium elenolate. Antimicrob Agents Chemother (Bethesda). 1969; 9:167-72.
12. David Derry, MD, PhD. Iodine: the Forgotten Weapon against Influenza Viruses. Thyroid Science 4(9):R1-5, 2009. URL: http://www.thyroidscience.com/reviews/derry/Derry.flu.iodine.9.19.09.pdf
13. Burnet, F.M., Holden, H.F., and Stone. J.D. Action of iodine vapour on influenza virus in droplet suspension. Austral. J. Sci.1945; 7:125-126.
14. https://www.cdc.gov/immigrantrefugeehealth/pdf/seasonal-flu/contamination_cleaning_english_508.pdf
15. https://articles.mercola.com/sites/articles/archive/2012/08/27/baking-soda-natural-remedy.aspx
16. Dr Sircus. Sodium Bicarbonate (Baking Soda) for Cold And Flu. URL: http://drsircus.com/sodium-bicarbonate-baking-soda/for-cold-and-flu/
17. http://www.healing-from-home-remedies.com/old-baking-soda-home-remedy-for-colds-and-flu.html
18. Cáceres DD, Hancke JL, Burgos RA, Wikman GK. Prevention of common colds with Andrographis paniculata dried extract. A Pilot double blind trial. Phytomedicine. 1997 Jun;4(2):101-4
19. URL: https://www.drweil.com/vitamins-supplements-herbs/herbs/astragalus/
20. Cesarone MR, Belcaro G, Di Renzo A, Dugall M, Cacchio M, Ruffini I, Pellegrini L, Del Boccio G, Fano F, Ledda A, Bottari A, Ricci A, Stuard S, Vinciguerra G. Prevention of influenza episodes with colostrum compared with vaccination in healthy and high-risk cardiovascular subjects: the epidemiologic study in San Valentino. Clin Appl Thromb Hemost. 2007 Apr; 13(2):130-6.
21. Josling P. Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Adv Ther. 2001 Jul-Aug; 18(4):189-93.

Gut and autoimmunity connection

The health of digestive system is very important for people with autoimmunity problems. Our immune system is closely connected with our gut. The intestines can be compared to the roots of plants that absorb nutrients for them to grow. If the soil is poor and roots weak, the plant will be struggling to survive. Unhealthy gut has been connected to autoimmunity.

There are few factors which can benefit the health of our digestive system. These are: healthy diet, lots of vegetables (including some cruciferous ones like broccoli, cabbage, horseradish, wasabi), herbs, fiber, fermented food, limiting processed food, avoiding foods one is sensitive too (like gluten) and avoiding stress. Frequent use of antibiotics and some other medications (like steroids, NSAIDs- aspirin, ibuprofen and others ) can also affect the balance of bacteria in our gut and promote imbalances with a loss of beneficial bacteria. Antibiotics and some other medications can damage the lining of our intestines. Frequent infections may also have a negative effect. Hormonal balance is also very important for gut health. Imbalance of thyroid hormones for example may lower the stomach acid, digestive enzymes and bile and change the time food travels through the digestive system, ultimately causing an imbalance in gut bacteria, nutrient deficiencies and health issues.

The gut flora consists of over 500 species of bacteria (Firmicutes/Bacteroidetes most common), fungi and viruses. Beneficial bacteria help to digest food, absorb and make vitamins (B and K2), help to metabolize hormones and other chemicals (such as short-chain fatty acids used for energy by our body) that keep our body healthy and our immune system balanced. They help to remove toxic heavy metals (6, 7). Lactobacillus strains were found to be able to absorb and remove cadmium from culture mediums in a study (8). Cadmium toxicity has been implicated in thyroid autoimmunity.

We live in a symbiotic relationship with our gut microflora as it interacts with the cells of the intestines. The live microorganisms in our gut interact with our nervous system and our immune system as well, they can induce a production of certain immune-regulatory molecules which are also absorbed by our intestines. Balanced gut flora can help the immune system not to over-react. Most of our immune system is associated with our gut. Serotonin, happy molecule is produced predominantly by our gut. Beneficial microorganisms in our gut protect our body from bad, pathogenic organisms. If there is imbalance of gut flora and ‘bad’ inhabitants predominate over ‘beneficial’ inhabitants, the nervous system and the immune system of an individual will be affected. Some bacteria can influence our mood for the better, there is a saying healthy gut, happy person. It was found in animal study (2) that Lactobacillus rhamnosus (beneficial bacteria) in our gut can reduce anxiety by producing molecules which directly interact with our brain. Interestingly, Lactobacillus species can be depleted by overgrowth of Candida yeast. Even though having some Candida in the gut is normal, overgrowth can be a problem. Many people with autoimmunity may have imbalances in their gut microbiota (dysbiosis). An example of that is the lack of Lactobacillus or Bifidobacterium species in the gut. As mentioned before, lack of Lactobacillus can make a person more anxious. Different bacteria can have a specific effect on our body, for example Styreptococcus thermophiles may improve lactose intolerance.

Low stomach acid may play a havoc with the balance of bacteria in the digestive and immune system. Low stomach acid may be seen with thyroid hormonal imbalance and stress. Low stomach acid may allow harmful bacteria like H. pylori to survive (this bacteria may cause stomach ulcers). Low stomach acid is connected to a poor absorption of minerals and vitamins. This then causes loss of essential nutrients. Eating processed packaged food and food with preservatives (after all, preservatives do not allow bacteria to reproduce) will affect our gut flora. Diet high in sugar, high carbohydrate diet, predominantly wheat flour based products, fatty food, low in vegetables, fiber and low in fermented food and essential fatty acids can lead to an unhealthy gut. One more reason for imbalanced gut flora is stress. Stress activates the sympathetic nervous system in place of parasympathetic nervous system which is responsible for proper digestion of food. We cannot also forget about vitamin D which is absolutely vital for people with autoimmunity as it activates pathways to make antibacterial molecules which are designed to kill harmful bacteria in our gut and generally in the body. Vitamin D balances the immune system. Frequent use of some medications like the anti-inflammatory NSAIDs, steroids and antibiotics negatively alters the gut microbiota. High consumption of alcohol also alters the balance of bacteria in the gut.

Complete stool analysis test can determine the health of the digestive system, digestion and gut health. This test is generally requested by the integrative medical doctors so that the specific problems can be rectified. If you have bacterial gut imbalance (or parasites), you might be given specific probiotics or herbal remedies by your holistic doctor (such as those containing oregano, thyme, licorice, slippery elm, marshmallow root, olive leaf, garlic and other herbs) to correct the problem. If you have digestive problems, HCl-betaine (for a low stomach acid) or enzymes may be prescribed.

Gas, burping, bloating, heartburn, constipation, diarrhea, indigestion would be the obvious signs that there is something wrong with your digestion. However other signs can be allergies, itching and anxiety. Therefore, signs of gut microbiota imbalance can be difficult to recognize. Obviously if you suffer from thyroid problems, have imbalanced of deficient hormones, the digestive system will not work well. It is common problem with hypothyroidism. I had poor digestion and stomach ulcers as a direct consequence of being on sub-optimal thyroid hormonal treatment. Personally, I saw a great improvement in my gut health by adding NDT to my levothyroxine hormonal replacement, making sure my hormonal balance was the best I could achieve. My integrative medical doctor put me on a quality probiotic for a month.

Fermented food can help to balance gut bacteria (such as sauerkraut, other fermented vegetables). Eating organic, non- processed and non-preserved food can help. Soluble fiber was found to benefit intestines (found in oats, beans, lentils, peas, flax seeds, other seeds and some fruits and some vegetables). Supporting your adrenals, good sleep, rest and relaxation can help with stress and limiting frequent infections requiring antibiotics. Some people find colostrum beneficial for balancing their gut flora. Apple cider vinegar also helps to re-balance the gut. Hormonal balance is also very important. The health of the gut can be achieved back through a healthy diet, fermented foods, probiotics, herbal remedies, improving digestion with specific supplements (glutamine), avoiding food one is sensitive to, balancing hormones and limiting stress. Glutamine is great for a leaky gut but some people should avoid it, especially if they get more nervous after taking glutamine and in specific conditions) so consult your doctor regarding glutamine. I personally took glutamine supplement for a month (1 tsp) per day to improve my gut. The positive steps you will take in the direction of your gut health, can greatly benefit your overall health and help with autoimmunity problems.

This post in for educational purposes only. Consult your doctor/ health practitioner if you experience any digestive and gut issues and regarding any supplements and remedies.

References:

1. Eamonn M. M. Quigley, MD, FRCP, FACP, FACG, FRCPI. Gut Bacteria in Health and Disease. Gastroenterol Hepatol (N Y). 2013 Sep; 9(9): 560–569.
2. Javier A. Bravo, Paul Forsythe, Marianne V. Chew, Emily Escaravage, Hélène M. Savignac, Timothy G. Dinan, John Bienenstock and John F. Cryana. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci U S A. 2011 Sep 20; 108(38): 16050–16055.
3. Candida and Gut Dysbiosis. URL:http://www.ei-resource.org/illness-information/environmental-illnesses/candida-and-gut-dysbiosis/
4. Geraldine O. Canny and Beth A. McCormick. Bacteria in the Intestine, Helpful Residents or Enemies from Within? Infect Immun. 2008 Aug; 76(8): 3360–3373.
5. Françoise Rul, Leila Ben-Yahia, Fatima Chegdani, Laura Wrzosek, Stéphane Thomas, Marie-Louise Noordine, Christophe Gitton, Claire Cherbuy, Philippe Langella, and Muriel Thomas. Impact of the Metabolic Activity of Streptococcus thermophilus on the Colon Epithelium of Gnotobiotic Rats. J Biol Chem. 2011 Mar 25; 286(12): 10288–10296.
6. S Salminen, et al. Probiotic bacteria as potential detoxification tools: assessing their heavy metal binding isotherms. Can J Microbiol. 2006 Sep; 52(9):877-85.
7. JN Bhakta, et al. Characterization of lactic acid bacteria-based probiotics as potential heavy metal sorbents. J Appl Microbiol. 2012 Jun; 112(6):1193-206.
8. Anna V. Kirillova, Anna A. Danilushkina, Denis S. Irisov, Nataliya L. Bruslik, Rawil F. Fakhrullin, Yuri A. Zakharov, Vladimir S. Bukhmin, and Dina R. Yarullina. Assessment of Resistance and Bioremediation Ability of Lactobacillus Strains to Lead and Cadmium. International Journal of Microbiology. 2017. URL: https://www.hindawi.com/journals/ijmicro/2017/9869145/

Naltrexone – a promising medication for autoimmune disorders

Naltrexone is a medicine used in high doses to treat people with substance addiction problems. Naltrexone binds to opiate receptors.

When a person receives low doses of Naltrexone, it works only for a short time but manages to send signals to the body to increase the production of endorphins which assist in balancing of the immune system. Naltrexone is believed to have little side effects on the body in low doses taken at bedtime and it may help with metabolic processes. There are some positive reports from people with thyroid autoimmunity on internet forums. Many report a reduction in thyroid antibodies.

There has been some small pilot studies on use of Naltrexone for other autoimmune disorders (doses around 1.5 to 4.5mg/daily), such as Crohn’s disease, MS and fibromyalgia with positive outcomes. There are also reports of positive benefits in other autoimmune disorders and illnesses by pioneering physicians, such as Dr. Bihari.  However there are no scientific studies on Naltrexone and Graves’ disease or Hashimoto’s thyroiditis at the moment. Even though it has not been approved for treatment of Graves’ disease, some doctors prescribe it.

Naltrexone can increase the levels of endorphins in the brain. The levels of endorphins are lowered in Graves’ disease, also due to chemical imbalances in the brain and lowered levels of GABA, a calming chemical.  

So, why endorphins are so important? Endorphins are ‘feel good’ chemicals produced by the body like natural opiates, similar to morphine. They are a reward system for our body cells, which enhance our life experience. Endorphins are produced in the brain when we experience happiness, love and relaxation. They are reduced on exposure to chronic stress and pain, with levels varied among individuals. The levels of these ‘happy molecules’ may be reduced in people with autoimmunity. We can see that when describing what endorphins do in the body. They strengthen and balance the immune system, reduce blood pressure, heart rate, dilate blood vessels, slow down breathing, reduce stress, lower pain, slow down neuron firing, improve digestion, excretions of harmful toxins and give feelings of pleasure, love and reward.

To enhance levels of endorphins in the brain, smelling scents and oils, such as lavender, chamomile, rosemary, mint, vanilla and grapefruit may help. Rhodiola rosea herb may also help to increase endorphins. Nutritional yeast (or brewer’s yeast) is high in inositol, which may help to enhance endorphins. Flaxseed oil and fish oil enhance the release of endorphins. Cacao and chocolate stimulate the secretion of endorphins. Craving for chocolate and fatty foods might indicate low level of endorphins in a person. Other pleasurable activities, such as listening to slow rhythmic music, looking at beautiful pictures, smiling, loving, exercise, massage and laughter may all increase endorphins levels. Living peaceful life with positive attitude and expression of one’s feelings would enhance endorphins. Being in a secure, loving and stable relationship is also beneficial. Even acupuncture, reasonable sun exposure and spending time in nature increase endorphins levels. Meditation is also beneficial as alpha rhythms (electrical patterns or waves in brain), which increase during meditation, tend to stimulate the release of endorphins. Lack of vitamins C and B and other minerals reduces endorphins.

References:

1. Medical Hypotheses 72 (2009) 333–337 URL: http://www.opioids.com/naltrexone/lowdosenaltrexone.pdf
2. The Use of LDN for MS, Crohn’s, and Other Autoimmune Diseases by Elaine Moore. URL: http://www.elaine-moore.com/Articles/LowDoseNaltrexone/LDNUseforMSCrohnsandOtherAIDiseases/tabid/195/Default.aspx
3. Thyroid. Factor Fiction. URL: http://www.tiredthyroid.com/blog/2012/02/20/ldn-low-dose-naltrexone-for-graves-and-other-autoimmune-diseases/
4. The low dose Naltrexone Homepage. URL: http://www.lowdosenaltrexone.org/
5. LDN and Autoimmune Disease. URL: http://www.lowdosenaltrexone.org/ldn_and_ai.htm
6. LDN science. URL: https://www.ldnscience.org/ldn/how-does-ldn-work