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Quarta-feira, 27 / 11 / 19

The Latest Insights on Gut Permeability and Depression

 

By Kelly Brogan, M.D.

Green Med Info, Wake Up World.

Posted November 27, 2019 by Wes Annac. 

 

 
 
If you know what depression feels like – the brain clouding, the flat moods, the tiredness – you’re not alone. Over 300 million people around the world have depression, and yet there’s a lot that we still don’t quite understand.1
 
Thankfully, the medical field is developing some new insights that just might help us understand depression better. In a new 2019 study, researchers decided to examine the potential mechanisms of major depressive disorder in teenage girls and found some evidence that could help us better understand exactly how gut permeability (leaky gut) can lead to inflammation, which in turn, leads to depression.
 
New Insight into Leaky Gut and Depression
 
In this 2019 study, Baylor College of Medicine researchers are directly looking at gut permeability and major depressive disorder, a study that is the first of its kind.2
 
With a sample of forty-one 12-17 year-old teenage girls who were medically healthy, the study measured the severity of the girls’ depressive symptoms, the activity of the autonomic nervous system, intestinal permeability, or gut leakiness, and the number of inflammatory cytokines.
 
To measure whether the girls were depressed, an interviewer performed the Children’s Depression Rating Scale-Revised (CDRS-R) and a clinical interview. The CDRS-R is a rating scale that requires interviews of both child and parent to understand the severity of a child’s depression. Over the past few decades, the CDRS-R has become the most widely used rating scale for assessing severity and change in depression for clinical trials involving children and adolescents.3 In order to collect data on the autonomic nervous system activity, researchers measured pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) data, which are indicators for the activity levels of the sympathetic nervous system and parasympathetic nervous system respectively. They measured the leakiness of the gut using the lactulose-mannitol ratio (LMR), which involves having the teens first fast overnight and then ingesting a premeasured amount of lactulose and mannitol. The researchers then collected the urine for four hours after ingestion. By looking at the ratio of lactulose and mannitol that passed through the gut lining, researchers could calculate the permeability of the gut lining, or how “leaky” it was. To measure inflammation, the researchers took blood samples and measured inflammatory cytokines.
 
They found that in unmedicated teenage girls between the ages of 14-17, depression severity was associated with increased intestinal permeability, as measured by the lactulose to mannitol ratio. The leakier the gut, they found, the more severe the depression and depressive symptoms. They saw that the higher the concentration of the cytokine IL-1β, the more severe the depression. They also found that increased intestinal permeability may be the path between sympathetic nervous system activation and depression severity. Additionally, their evidence suggested that increased intestinal permeability may activate the innate immune system and push the development of depression.
 
The result of this study also helps clarify the mechanisms through which activating the sympathetic nervous system can increase gut permeability and activate the innate immune system–two things that are likely contributing to depression symptoms.
 
The Brain, The Gut, and the Immune System
 
If you’re wondering why intestinal permeability is related to depression, let’s back up and walk through the whole pipeline.
 
We start with the immune system. Throughout the last century, psychiatry has been exploring the role of the immune system in certain presentations of depression. Importantly, the gut houses over 70% of our immune system, which makes sense given that the lining of your gut is the barrier between your insides and the outside world. The gastrointestinal epithelium usually forms a single-cell-thick barrier that prevents the free movement of toxicants, microbes, and microbial antigens from entering into the rest of your body. This lining usually does a good job absorbing things we need (like food) and interfacing with foreign things that might wreak havoc–which is probably why most of our immune cells are located in the gut.4 The relationship between the gut and the brain is both complex and important. We’ve all felt the butterflies in our stomachs when we’re nervous or anxious, but it turns out that the relationship between the brain and the gut is actually bidirectional. Not only can our brains affect how our guts feel, but our gut can relay its state of calm or alarm to the nervous system and send those immune reactions up the vagus nerve to the brain.
 
To understand how the gut and depression are related, we should first better comprehend the triggers for inflammation, what inflammation is, and how it happens.
 
Stress Drives Inflammation
 
So what IS inflammation in the first place? Inflammation is the body’s defensive response to stresses, like injury or the ingestion of bodily-incompatible chemicals. Upon approaching a stressor, the immune system kicks into a higher gear to heal the body.
 
Stress is a catch-all term, a trigger that links hormones to inflammation. Essentially, when the body thinks something is wrong, the body releases hormones that tell the body to be on the lookout and get on defense, and inflammation occurs. These triggers can come in all forms, many of which are actually staples of modern American life, from sugar to stress to pesticides and pollution to anxiety to beyond. Whether psychological or physiological, stress drives the inflammation response by telling the brain to release cortisol, the steroid hormone that acts as nature’s built-in alarm system and makes it for our bodies to use blood sugar for energy so that we can flee from whatever is causing the stress.5
 
Once inflammation is started, not only does inflammation cause more inflammation, but recent studies have linked low-grade inflammation to depression. When inflammation reaches the brain, cells begin to take their limited supply of tryptophan to produce more anxiety-provoking chemicals like quinolinate.6 Medical literature has found that inflammation seems to be a consistent marker of depressive symptoms, like flat mood, slowed thinking, avoidance, alterations in perception, and metabolic changes.
 
How does inflammation get provoked in the gut?
 
So let’s understand how exactly a leaky gut can lead to inflammation – the body’s language of imbalance.
 
When the body is stressed, the junctions between cells in the stomach can be less effective than they should be.7 This allows bacteria and toxicants to enter the bloodstream that can continue to cause widespread inflammation and possibly trigger a far-reaching reaction from the immune system.8 Having leaky gut cause inflammation sets off a problematic chain of events because the gut has a direct link to the brain through the vagus nerve.9
 
The medical field has been slowly inching up on a fuller understanding of the link between intestinal permeability (“leaky gut”) and depression. Previous studies focusing on depression and have found the chemical hints of leaky gut. For example, one study showed that patients with a recent suicide attempt had higher concentrations of an anti-lipopolysaccharides (LPS) antibody, meaning that the immune system had either encountered more of or reacted defensively against LPS, which is a molecule that marks microbe-associated patterns in the body.10 In another study, compared to healthy controls, adults with depressive or anxiety disorders, who didn’t have any symptoms of gastrointestinal disorders, still had higher concentrations of fatty acid-binding protein-2, which is produced to signify impaired intestinal epithelium integrity.11 These studies, and the first study we discussed in this post, suggest that intestinal permeability may be impaired in depression.
 
 
So What Do We Do?
 
All of this sounds kind of complicated, but really, this approach to depression-seeing it as a symptom that results in unhealthy inflammatory balance-means that we might be able to do more about it. It means that depression isn’t happening because of genetics or not enough serotonin. Instead, you’re probably experiencing low-grade inflammation that’s happening because your gut is stressed and leaky. The goal is to send your system a signal of safety – from the gut, from the mind, or by lessening perceived stressors and burdens through detox.
 
Interested in step-by-step support to help you optimize your health?
 
Vital Life Project is a community for like-minded wellness seekers in search of a better way to live with vitality in a world that can make it challenging to move toward this goal.
 
This monthly membership provides guidance and accountability to help you make small changes in mindset and daily routine that can lead to radical shifts in health reclamation.
 
 
About the Author
 
Dr. Brogan is boarded in:
Psychiatry/Psychosomatic Medicine/Reproductive Psychiatry and Integrative Holistic Medicine, and practices Functional Medicine, a root-cause approach to illness as a manifestation of multiple-interrelated systems. After studying Cognitive Neuroscience at M.I.T., and receiving her M.D. from Cornell University, she completed her residency and fellowship at Bellevue/NYU. She is one of the nation’s only physicians with perinatal psychiatric training who takes a holistic evidence-based approach in the care of patients with a focus on environmental medicine and nutrition. She is also a mom of two, and an active supporter of women’s birth experience. She is the Medical Director for Fearless Parent, and an advisory board member for GreenMedInfo.com. Visit her website.
 
References
 
      **© [11/19/19] GreenMedInfo LLC. This work is reproduced and distributed with the permission of GreenMedInfo LLC. Want to learn more from GreenMedInfo? Sign up for the newsletter here
http://www.greenmedinfo.com/greenmed/newsletter
    .**
 
 
 



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publicado por achama às 20:33
Sexta-feira, 31 / 05 / 19

Adverse Effects of Antipsychotic Drugs in Children ~ Kelly Brogan

Adverse Effects of Antipsychotic Drugs in Children. 

By Kelly Brogan, M.D.

Guest writer for Wake Up World.

May 31st, 2019. 

 

 

Originally published at kellybroganmd.com and reproduced here with permission.
We’ve all wished for it at one time or another. It may have been with your son who can’t sit still in school, your niece who was throwing a temper-tantrum, or a child who won’t stop crying on that redeye flight. Wouldn’t it be nice to pull out a tranquilizer dart and poof…turn that little Tasmanian devil into a calm, quiet, sleeping beauty!?
The idea of that is not far from reality. Tranquilizer darts often contain antipsychotic drugs and there is a growing trend to prescribe these to our children. From 1993 to 2002, the number of office based visits that included an antipsychotic drug increased more than 500%.1
As a parent desperate for answers, reaching for a quick fix pill can be understandably tempting. But what is the cost of doing so?

Adult Side Effects of Antipsychotic Drugs

Our collective focus on the quick fix makes it easy to ignore the long-term considerations around such an intervention. We have vast amounts of data showing that antipsychotic drugs cause high blood sugar, excess fat accumulation around the waist, low levels of good cholesterol (HDL), high levels of triglycerides, and increased blood pressure 3 in adults. Having three out of these five risk factors means that you have something called the metabolic syndrome. Basically, this is a fancy term that means you are at an increased risk of developing diabetes, heart disease and stroke.4Longitudinal studies have shown that up to 52.4% of schizophrenic patients who start an antipsychotic drug will develop metabolic syndrome within the first three months of treatment.5Pretty scary stuff.
However, the vast majority of this data comes from studies done on adults, and we’re here to talk about using these drugs in our children. Surprisingly, even though they are being used more and more in our youth, we don’t have a lot of data to see what the long-term consequences will be. Do antipsychotic drugs predispose our children to the metabolic syndrome just like adults? Or are they somehow protected from these deleterious effects?

Recent Study Sheds Light

A recent study helps us to further understand these questions. Children between the ages of six and eighteen were randomized into three groups. Each group was given one of the following ‘second-generation’ antipsychotic drugs: olanzapine, risperidone or aripiprazole. All subjects had behavior problems and at least one psychiatric diagnosis, such as ADHD. None had ever taken antipsychotic drugs before.
At the conclusion of the twelve-week study, all three groups showed behavioral change. However, all three groups also showed significant negative side effects. Subjects showed an increased resistance to insulin, putting them at higher risk for early onset diabetes. They also showed an increase in body fat with specific increases deep within the abdomen around the organs. It may seem trivial to include this specific bit of information.

Fat is Fat…Right?

One of the fascinating developments in our understanding of chronic disease is that the anatomical distribution of fat matters. To sum up a still developing story, fat distributed in the abdomen around the organs (visceral fat) is much more dangerous than fat just below the skin (subcutaneous fat).6 Thus, two people with the same amount of body fat may have very different health risks based on where their fat is stored. In short, excess body fat is a risk factor for disease, but if that fat is distributed in the visceral region, it confers an additional independent risk for cardiovascular disease, diabetes, certain cancers, high blood pressure and abnormal cholesterol.6
More disturbingly, researchers hypothesized that their study “likely underestimates longer-term treatment effects” because these negative changes are often progressive over the first year of treatment. For those of you who don’t like math, what they’re saying is that they only looked at the score in the first quarter, not at the end of the game. The real long-term risks of obesity, diabetes, cardiovascular disease, are probably much greater than those detailed in this short three month study. Further, children are “physically and emotionally more vulnerable to the adverse effects (of antipsychotic drugs) because of their smaller size, developing physiology, and negative impact on peer perceptions.2 To answer our previous question, children are not more resilient to the adverse effects of antipsychotic drugs, they are more susceptible.
Although alarming, these results are not particularly shocking. They confirm that what is bad for adults is also bad for youth…actually worse.

Why are These Drugs Given to Children in the First Place?

In the pediatric population, the majority of antipsychotic drugs are actually not given to treat psychosis, as the name implies. Surprisingly, they are generally prescribed to treat behavioral disorders. For example, only 2.8% of the subjects in this study actually had symptoms consistent with psychosis (some further percentage of whom were likely already treated with a stimulant known to induce psychosis). The remaining 97.2% had behavioral symptoms deemed unacceptable by school, family, or both.
Use of antipsychotic drugs in this manner is largely not approved by the FDA due to “insufficient evidence of safety and efficacy.” 2 So why is there a growing trend to prescribe them when they are not approved by the FDA and studies are mounting showing severe negative side effects?

Do We Really Practice Evidence Based Medicine?

Robert Whitaker, a medical journalist and author, writes that the field of psychiatry is experiencing an institutionalized form of cognitive dissonance – a conflicted psychological state that occurs when new information challenges deeply held beliefs. In the context of this article, long held beliefs about the safety and efficacy of antipsychotic drugs are being challenged by new data showing their dangerous side effects and overall ineffectiveness. In general, people resolve this conflicted state “by sifting through information in ways that protect their self-esteem and their financial interests.” 7
Psychiatry, as an institution, is doing just that. Sifting through data to suit their needs. Research that shows psychiatric drugs in a negative light often gets swept under the rug as being biased, of poor quality or otherwise uninformed. There is little acceptance for anything that goes against that status quo. The goal is no longer to seek for better treatment protocols, but to protect the power, prestige and financial interests of the psychiatric institution. Unfortunately, in this state, evidence based medicine cannot be practiced.
As Upton Sinclair famously stated, “It is difficult to get a man to understand something, when his salary depends on his not understanding it.” 8
Article sources:
Recommended articles by Kelly Brogan, M.D.
About the author:
Kelly Brogan, M.D. is a holistic women’s health psychiatrist, author of the NY Times Bestselling book, A Mind of Your Own, the children’s book A Time For Rain, and co-editor of the landmark textbook, Integrative Therapies for Depression. She completed her psychiatric training and fellowship at NYU Medical Center after graduating from Cornell University Medical College, and has a B.S. from M.I.T. in Systems Neuroscience. She is board certified in psychiatry, psychosomatic medicine, and integrative holistic medicine, and is specialized in a root-cause resolution approach to psychiatric syndromes and symptoms. She is on the board of GreenMedInfo, Price-Pottenger Nutrition Foundation, Functional Medicine University, Pathways to Family Wellness, Mindd Foundation, SXSW Wellness, Chickasaw Nation Wellness, and the peer-reviewed, indexed journal Alternative Therapies in Health and Medicine. She is Medical Director for Fearless Parent and a founding member of Health Freedom Action. She is a certified KRI Kundalini Yoga teacher and a mother of two. For more articles, sign up for her newsletter at kellybroganmd.com.
© February 10th, 2019 GreenMedInfo LLC. This work is reproduced and distributed with the permission of GreenMedInfo LLC. Want to learn more from GreenMedInfo? Sign up for their newsletter here..
 
 



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Discernment is recommended.

 

All articles are of the respective authors and/or publishers responsibility. 

 

No religious or political belief is defended here. (Investigate yourself)

 

Individually you can be helped to find your Truth that is different of everyone. 

If you use discernment you are free to research with an open mind. 


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publicado por achama às 18:51
A Luz está a revelar a Verdade, e esta libertar-nos-á! -Só é real o AMOR Incondicional. -Quando o Amor superar o amor pelo poder, o mundo conhecerá a Paz; Jimi Hendrix. -Somos almas a ter uma experiência humana!

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