The Miraculous Possibility of Hope
by Sarabeth Matilsky
If you're anything like me, you get really skeptical when someone presents a new miracle cure. This is the sort of necessary skepticism that prevents one from being snake oiled. Especially when you're trying to sort through medical advice, you need a fully-functioning baloney detector.
So now I'm going to tell you some interesting things. Not about miracle cures, in the sense that miracles are generally effortless, but I'm going to talk about people curing “incurable” illnesses, and potentially reversing the course of chronic diseases like arthritis and asthma. I'm here to report that often intractable mental illnesses, such as bi-polar disorder and schizophrenia and depression, all stand to be healed by the same dietary protocol that could heal your irritable bowel syndrome, allergies, ulcerative colitis, and celiac disease.
I'd hope that right about now, you're getting pretty worked up. “You're nuts!!” might be an appropriate response from the skeptical among you. Or maybe, “I refuse to read any more of this ridiculous nonsense!” Definitely, you should be thinking this, because you are a smart, thinking person, and especially if you have any of the health issues I just mentioned, you've probably been told by numerous doctors that there are no cures, only a lucky chance that you can manage the symptoms with drugs and lifestyle changes. Additionally, you can get a new diet book delivered to your doorstep everyday, without making even a dent in the available titles. Why should you believe what I'm about to tell you?
I appreciate that you're still reading.
Here are some less-controversial facts: Autism used to be a rare disorder (twenty years ago, it was one child in 10,000). Now, in some communities in Britain and the USA, one child in 88 is being diagnosed with the highly variable symptoms of this highly debilitating disease.
Is this skyrocketing incidence because of genetics? Nobody knows for sure. But one thing is true: genes just don't work that way. Is the increase in autism due to better diagnosis? Could be. But if this is the case, where are all the autistic adults who should have been diagnosed two decades ago?
The prevailing Western medical opinion is that Autism Cannot Be Cured. Same with ADHD/ADD, Oppositional Defiant Disorder, allergies, and a crazy plethora of behavioral and learning problems that has reached epidemic proportions. Western medicine has virtually nothing to offer these children and their families, apart from only-sometimes-useful drugs, and expensive and time-consuming (and often marginally effectual) therapies to help manage the symptoms.
Here's some more fuel for the controversy:
Some of the disorders I've mentioned thus far seem unrelated to any of the others. Yet, peculiarly, children almost never have only one of these conditions. A child with allergies might have a couple of asthmatic episodes and eczema, and also have learning problems. Approximately 50% of those with dyslexia also have dyspraxia (and vice versa), and there's a 30-50% overlap between ADHD and dyslexia. Children who suffer severe eczema in infancy often develop autistic features later in life.
Apart from being hyperactive, many autistic children have severe allergies, asthma, eczema, dyspraxia, and dyslexia. Many children with these disorders later develop substance abuse problems, schizophrenia, depression, bipolar disorder, and other psychological problems. When you start looking at the whole picture, diagnoses become an increasingly sketchy proposition. Is it “autism, with accompanying digestive disturbances”? or “Chronic diarrhea and constipation, with pronounced depression and skin rashes”? or “Obsessive Compulsive tendencies, coupled with severe food allergies, and a Really Bad Mood”?
What does this mean, apart from the obvious, which is that the Modern Child does not tend to fit neatly into diagnostic boxes? What unites these sick children, with their often radically divergent symptoms, personalities, and family backgrounds? What can we say about these conditions, apart from the fact that although they sometimes improve as a person gets older, often they just get worse?
“Not much,” you're probably thinking, “except that you like laundry lists! You're not a medical professional, so how can you begin to discuss diagnostic criteria for mental health disorders?? Also, you're randomly throwing those other autoimmune illnesses into the mix, and all in all, I'm not impressed with your research background.”
Okay. I admit. I am exceptionally unqualified to diagnose anyone's disease. Which is why I, too, was floored to discover the one factor that unites patients, in a clinical setting, who present with the aforementioned conditions: the state of their digestive systems.
Back in 1904, researchers examined the poop of children who had symptoms of Celiac disease (only back then, they called it “stools”). These children were found to be excreting abnormally large numbers of fermentative and putrefactive bacteria. This may seem like a mundane point, possibly because doctors who spend their lives researching the contents of human feces are seldom granted a notorious existence. (Genetics is much more sexy.) But this suggested that the patients were not digesting dietary carbohydrates properly, and were thus providing food for microbial fermentation rather than absorbing the nutrients necessary for normal human growth and development.
Since then, preliminary evidence has shown that certain diets can have a profound effect upon the development, progression, and treatment of disease, not only in the case of those with celiac. Cystic fibrosis patients, as well as those suffering from Crohn's, ulcerative colitis, refractory constipation, many skin ailments like psoriasis, and irritable bowel syndrome, have responded exceptionally well to dietary treatment. The common denominator in these diets has been the exclusion of double- and other multi-chain sugars.
More recently, a link has been shown between diarrhea and the inability to digest starch and double-chain sugars. Synthetic elemental diets (essentially, chemical formulas for humans, assembled in labs) have shown great promise in the treatment of gastrointestinal illnesses. “The malabsorption problem seen in cystic fibrosis of the pancreas, as well as diarrhea which occurs after cancer chemotherapy, have been overcome by the use of the synthetic elemental diet,” writes Elaine Gottschall in “Breaking the Vicious Cycle.” Use of a synthetic formula can cause remission from Crohn's disease; the resuming of normal growth in children who have not done so in years; and the reversal of many other intestinal disorders.
Synthetic formulas are very expensive, taste absolutely horrible, and often, patients must be fed through a stomach tube. When given an option, most people would strongly prefer a do-it-yourself alternative.
In the early twentieth century, Dr. Sidney V. Haas came up with a tasty, inexpensive, and natural diet with the same important distinction that allows elemental formulas to provide digestible nutrition: only a certain type of carbohydrate predominates. In both the synthetic and natural diets, double-chain sugars, such as sucrose, and many-chained sugars, such as starch, are excluded. In the elemental formula, glucose (requiring little to no digestion) is the legal carbohydrate. In the Specific Carbohydrate Diet, one eliminates nearly all carbohydrates, except for those single sugars found in non-starchy vegetables, fruit, honey, and long-fermented dairy.
Gottschall notes: “During the early 1900's, numerous physicians brought further insight to our understanding of the effect of food on intestinal problems. Dr. Christia Herter, a physician and professor at Columbia University, noted that in every case where children were wasting away with diarrhea and debilitation, proteins were well tolerated, fats were handled moderately, well but carbohydrates (sugars and starches) were badly tolerated. He stated that ingestion of some carbohydrates almost invariably caused a relapse or a return of diarrhea after a period of improvement.
“About that time, Dr. Samuel Gee, another world-renowned childrens' specialist, saw clearly several important facts that continue to be missed by modern researchers. Dr. Gee said that if the patient with intestinal disease could be cured at all, it would have to be by means of diet. He added that milk was the least suitable food during intestinal problems and that highly starchy food (rice, corn potatoes, grains) were unfit. Dr. Gee stated, 'We must never forget that what the patient takes beyond his power to digest does harm.'
“Any food, and particularly carbohydrate, given to a person with intestinal problems should, therefore, be a food that requires little or no digestion so that the digestive process itself will not stand in the way of the absorption of the carbohydrates. Contrary to what some may think, undigested (and, therefore, unabsorbed) carbohydrates are not passing harmlessly through the small intestine and colon and out in the feces but, somehow and somewhere in the digestive tract, are causing problems.
“In 1951, after many years of clinical experience, Drs. Sidney V. and Merrill P. Haas published a book entitled 'Management of Celiac Disease.' Directed to the medical community, the book documented the doctor's experiences in treating and _curing_ [my emphasis] hundreds of cases of celiac disease as well as cases of cystic fibrosis of the pancreas. Their approach was dietary and they used a well-balanced, normal diet that was highly specific as to the types of sugars and starches allowed. When patients followed this Specific Carbohydrate Diet for a minimum of one year, they were then able to return to a normal diet with complete and permanent disappearance of symptoms.”
At this point, you may be grudgingly interested. If you know anyone on a gluten-free diet, you may be thinking, “If the Specific Carbohydrate Diet is so effective at curing celiac, why does everyone say that there is no cure?” You may be suspicious that I've made up the whole story, so I hope you are about to go check my facts. You also might also be thinking: “Okay, so maybe diet can help with Crohn's and ulcerative colitis, but these are gastrointestinal disorders! Drs. Haas' research didn't involve autism or mental health issues at all.” True. This correlation came later.
Tom Cowan, M.D., writes: “Back a number of years ago there was a startling paper published in The Lancet, the biggest English language medical journal in the world. The article was by a researcher named Andrew Wakefield, who claimed he had discovered the cause of autism.
“What Wakefield did was to take a number of children with autism, do small intestine biopsies on them and from those he discovered that they had abnormally wide holes in their small intestinal lining [just like the holes found in patients with celiac, ulcerative colitis, etc.]. He postulated that these holes in their intestines were allowing proteins to leak from the inside of the bowel into the bloodstream, and that these foreign proteins were acting like neuro-toxins and interfering with the neurological functioning of these children. He further went on to say that these intestinal defects were caused by the MMR vaccine.
“This last part is what became big news... Interestingly, the media and the medical establishment attacked Wakefield, not for the theory of autism (which as far as I know has never really been disputed) but for claiming it was caused by the MMR vaccine. The shame of this is that Wakefield had in fact uncovered one of the most important mechanisms which lead people to get and stay sick, but he got the cause wrong.
“Not that I'm a big fan of the MMR vaccine but, as claimed by the medical establishment, there are many autistic children who have never had this vaccine. In other words, while the vaccine is not healthy for a child's immune system or even their gut flora, Wakefield was off base in claiming it was the sole cause of what he called autistic entero-colitis. It is the entero-colitis that is the big news here.”
Here are four more pertinent pieces of information (paraphrased by me), which aid in understanding the big picture:
1. Each of us has millions of intestinal villi, which are tiny finger-like hairs projecting into the small intestine. These villi dramatically increase the surface area of the intestinal lining, making it a more effective semi-permeable barrier (meaning that unwanted things stay out of the bloodstream while nutrients can flow right through).
2. In order to do their job, the villi require a protective layer of mucus which in turn nourishes “good” microbial flora--some estimate a total of 5-7 pounds of millions of different bacteria, viruses, yeast, and other microbes--which reside in the human gut. These healthy bacteria are essential for a healthy human existence. They make vitamins, they digest food, they make antibiotic substances to keep down pathogens, and they function as our immune system.
3. These intestinal villi are the sole site in the body where production of an enzyme called disaccharidase occurs. Just as lipases digest lipids (fats) and proteases digest proteins, these disaccharidases digest disaccharides. When the microbial flora balance is tipped in favor of pathogenic microbes, the protective layer of mucus in the small intestine gets eroded. The villi become blunted, they lose the ability to make this important enzyme, and we lose the ability to digest disaccharides. When we keep eating foods with disaccharides and can't digest them, they become perfect food for the pathogens that always reside in our gut, particularly species of candida. We then continue to produce an overgrowth of candida, other yeasts, clostridia and other potent pathogens - and these often make unhealthy proteins instead of the B vitamins made by our healthy gut flora.
4. Due to all this irritating activity in the small intestine, it becomes more permeable and “leaky,” as noted above, which allows foreign proteins to enter directly into the bloodstream.
A quick fix sure would be nice. Since the 1920s, researchers have been hoping to isolate certain strains of microbes that might be blamed for this mess and then eradicated from our bodies. No one has, to my knowledge, succeeded in this quest. In part, this must be due our bodies' small-scale and yet extremely complex ecosystems. There's room for small populations of even highly pathogenic microbes in a normal, fully-functioning digestive tract that enjoys the symbiotic benefits of a full complement of hundreds of types of flora. But in a compromised gut, microbes like Candida or clostridia or countless others can wreak terrible havoc.
Antibiotics have often been tried, but they have the undesirable effect of killing _all_ gut microbes, pathogenic or not--and during the several weeks or months it may take for healthy gut flora to regenerate after a course of antibiotics, there is plenty of time for--and few natural controls to prevent--opportunistic, pathogenic flora to proliferate in the gastrointestinal system.
Gottschall writes, “A sensible and harmless form of warfare on the aberrant population of intestinal microbes is to manipulate their energy (food) supply through diet. Most intestinal microbes require carbohydrates for energy, and the Specific Carbohydrate Diet severely limits the availability of carbohydrates. By depriving intestinal microbes of their energy source, their numbers gradually decrease along with the products they produce.”
Gottschall spent her life researching and promoting the Specific Carbohydrate Diet as a healing protocol for disease, after it saved her daughter's life at age eight by curing her (“incurable”) ulcerative colitis--after all the available drugs had failed.
About fifteen years ago, a doctor named Natasha Campbell-McBride had a three-year-old son who was diagnosed as profoundly autistic. Since Campbell-McBride happened to be a neurologist and nutritionist, she was unwilling to accept the opinion that autism is an “incurable” disease. She used the Specific Carbohydrate Diet and--with slight tweaks to the protocol--used diet to completely cure her son.
Since then, she has run a successful clinical practice in the UK, extensively studied the link between physical/mental health and intestinal flora, and coined the phrase “Gut and Psychology Syndrome” to describe the symptoms from which her “schizophrenic,” “ADHD/ADD,” “dyslexic,” “dyspraxic,” “bi-polar,” “depressed,” and/or “obsessive” patients suffer. She calls autism a “digestive disorder,” and prefers to remember that while we often treat mental health issues as biological malfunctioning, there is virtually no acknowledgment that each of these seemingly disparate diagnoses share an underlying pathology: a more or less exceptionally leaky gut.
Campbell-McBride explains it like this: “In GAPS, there's greatly increased toxic flow from the gut [due to that permeable intestinal lining]. The toxicity causes a traffic jam. There are blocked detoxification pathways, and toxins bypass filtration and go into the bloodstream. These toxins can include wastes from pathogenic microbes, heavy metals, phenols, petro-chemicals, glue adhesives, agricultural chemicals, personal care and cleaning product ingredients, plasticizers, by-products of the body's own metabolism, etc.” Many neurotransmitters are also recycled by the liver; the body fills up with partially broken down serotonin, and dopamine, etc., which are still partly active but don't work properly, as in the case of many “neurological” ailments.
Here, Campbell-McBride says, is where autoimmunity always joins in, caused by mal-absorption of proteins and toxins through the damaged gut wall. As the immune system recognizes invaders, that sometimes attach to and mimic the body's own proteins, the immune system produces antibodies which then attack the body's own tissues.
For instance: in type 1 diabetes--”insulin dependent diabetes”--pancreatic cells are attacked. (Campbell-McBride has clinical experience with children whose guts have healed to the point where they no longer need insulin injections--essentially, healing type 1 diabetes.) In celiac disease, cells lining the small intestine are attacked. In multiple sclorosis, autism and other neurological problem, the nervous system is the victem. (Myelin coats the nerves like the sheathing on electrical wires. Certain toxins have an affinity for the fatty structures in the myelin, and when the immune system doesn't recognize these new structures it can actually produce antibodies to myelin.)
More than one tissue is always attacked, because there is always more than one toxin leaking through the gut (not just casein or gluten, as some popular autism diets assert). These illnesses are the symptoms of a body attempting to deal with these toxins simultaneously, as best it can.
This, says Campbell-McBride, is the underlying cause of issues like eczema, multiple sclerosis, diabetes, arthritis of any kind, fybromialgia, “You're not tired because you've got 'chronic fatigue'--you're tired because you're toxic.” Your body can't focus on producing energy, and fatigue comes first.
In the case of autism and other neurobehavioral problems, circulating toxins reach the blood brain barrier and find it permeable. Usually, the Barrier is very selective about what can get through; it is comprised of cells that are very similar to the enterocytes that line the intestinal wall. These cells also have glue like junctions, with proteins holding them together. But in compromised individuals, toxins that dissolve the glue in the gut wall can also dissolve the glue in the blood brain barrier
So: microbial toxins open the junctions, toxins and microbes and antibodies get through, and impaired brain function leads to impaired learning, behaviors, social skills, and perception. (Epileptic seizures are powerful electric signals passing through the brain, which is partly the body's way of destroying a lot of toxins in one go--people can often be incredibly lucid directly after a seizure.)
Diagnoses of children with brain toxicity can range from autism, to ADHD/ADD, Dyslexia, dyspraxia, and a large group of “learning and behavioral and social problems” that don't fit into any good diagnostic box. In the latter cases, “doctors analyze a patient, and say, 'Come back in six months, and well see how it goes,'” Campbell-McBride notes. “These kids have a bit of autism, a bit of OCD, a bit emotional instability, a few food allergies, and have some trouble concentrating--but nothing fits exactly. So doctors don't give a diagnosis, and parents don't seek solutions, and meanwhile valuable time is lost that could be used in healing the gut.”
Okay, so yeah--we've got bacteria living in our guts. But what makes them get out of whack?
According to Campbell-McBride, the list of factors that negatively influence gut flora “is long, and getting longer and longer. Starting with antibiotics. Then there's steroids, the pill, other pharmaceutical drugs, stress, poor diet, infections, disease, bottle feeding, old age, pollution, radiation, alcohol, toxic chemicals, even dental work...”
Antibiotics kill everything--all types of bacteria, beneficial and not. In an ideal scenario, a good balance of microbes take two weeks to two months to recover after such treatment. But in reality, this time period allows opportunistic, pathogenic microbes to put down roots, since they're normally controlled by the beneficial ones. This can happen not only in the gut, but also on any or every mucous membrane, and anywhere on the skin. Antibiotics (including acne medications given to teenagers) change the composition of the body's flora.
Diet, particularly processed carbohydrates and junk food, are extremely detrimental and provide lots of food for pathogens growing in the gut. The older we become, the less robust our gut flora becomes. And then there's this chicken and egg cycle, once a person is sick – chronic disease weakens gut flora, which then makes chronic disease worse, which then further weakens gut flora.
A newborn baby's gut is sterile. As it passes through the birth canal, it swallows its first dose of flora. Then it spends the next few weeks picking up further doses of microbes from breastmilk, others' skin, the air, etc. In this way, gut flora passes through the generations.
And at this point, we have generations of women and men who, since antibiotics have been invented, have themselves been developing increasingly abnormal gut flora. Maybe Grandma was born during the second world war, with decent flora, since antibiotics were rare, all food was organic, and there just weren't that many processed foods. In Mom's generation, though, antibiotics were given for every sneeze and cough. And breastfeeding went out of vogue, and mothers were encouraged to bottle feed. Now these daughters are coming of age, having inherited abnormal gut flora form their moms. And we can't forget widespread use of the pill, which severely affects gut flora. And now these daughters are having children themselves, and these are the kids that can be compromised severely from birth.
These are the kids who are dyslexic and have eczema and asthma and autism and ADHD. With every generation, the damage to gut flora gets worse. As Campbell-McBride notes, “The epidemic of neurological disease in children is not abating--it is currently getting worse. There is nothing worse than having a disabled child.”
Fathers are not exempt from the gut flora equation, because the father is sharing his gut flora with his wife on a regular basis. In the rare cases in Campbell-McBride's clinical practice when a mother of an autistic child doesn't have any signs of gut dysbiosis, the father is riddled with it. All this means is that the baby does not develop normal gut flora, and the immune system is compromised. The baby might, for example, get frequent ear infections, and chest infections, and may receive round after round of antibiotics. Children with learning disabilities, on average, go from one course of antibiotics to the next, which causes increasing damage to gut flora and the immune system.
And then there are vaccinations, which are designed for healthy children, with a healthy immune response. According to Campbell-McBride, we have a growing population of children who are not fit to be vaccinated. She believes that combined vaccines should never be given, and individual ones, in healthy children, should be given with a minimum of two months between shots. In the real world, it's extremely rare for a child to get two diseases (like mumps and measles) at the same time. In the rare documented cases when this has happened, the doubly diseased child generally ends up with severely impaired cognitive capabilities.
In addition to all these environmental factors, the foods we feed our weaning babies are generally made from processed carbohydrates and grains. GAPS children are generally moderately to extremely picky, gravitating toward sweet and starchy foods. These are full of substances that impair digestion, which further damages the gut wall. All this damage adds up, and soon, GAPS children begin to display food allergies, intolerances, and other allergies. Various toxins begin to be absorbed through the leaky gut, and depending on their particular affinities, they will attach to different tissues and cause myriad different problems.
Campbell-McBride is adamant: “We need to heal and seal the gut lining, and the junctions between the cells that are allowing toxins to leak through. Food allergies are _not_ for life. Illnesses are not cast in stone. Allergists will say, you're allergic to this, this, this, and this--and you're told that it is forever. But when you heal and seal your gut, you can start eating foods again that you could not eat before.”
You may not agree with the details of Haas', Gottschall's, Cowans, or Campbell-McBride's hypotheses. Even if you're still reading, you may doubt my authority, as a non-mental-health expert, to chart anyone else's course as they navigate the confusing waters of treating chronic illness in children and adults.
I urge you not to take my word for it. If you, or anyone you know, is suffering from gastrointestinal, neurobehavioral, hormonal, or autoimmune issues, I hope that you are reading everything you can get your hands on. The odds don't appear to be on our side. But maybe, if we take control of that which we _can_ control, we just might be able to help avoid or heal from “the diseases of affluence” in our own families, in our lifetimes.
Good Luck. May the Beneficial Microbes Be With You!
Please see this list of references/resources: http://www.lifeisapalindrome.com/articles/gaps-resource-list