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Transcript of the Autoimmune Epidemic video

Below is a transcript of the video:

Hi, I’m Dr. Gerard Guillory and today we’re going to talk about the autoimmune epidemic. This is a discussion that I had with a large physician group and it was very well received and we decided we need to record this again and do it for you, the patients. For those of you that don’t realize that we are in the throes of an autoimmune epidemic and autoimmune disorders have gone up about 400% in the last 25 years. Now, can you imagine if we had a 400% increase in cancer or heart disease? Everybody would be running around looking for the cure, so it’s time to wake up and address this autoimmune epidemic. Just to give you a little background about myself, I wrote the first book in 1989 for patients with Irritable Bowel Syndrome and here are three editions of the second book that I wrote. The last one came out in 2001, so I have been studying gut health for the past three decades. I have a functional medicine practice in Aurora, Colorado and had been practicing for about 34 years.

You’re going to hear a lot in nowadays about leaky gut, the importance of the gut microbiome and so forth. And it’s true that as Hippocrates said, 2000 years ago, all disease begins in the gut. And so we’re going to talk about the autoimmune epidemic and its relationship to increased intestinal permeability or what is referred to as leaky gut. So in this presentation we’re going to discuss the prevalence and economic impact of autoimmune diseases, which is rather large and discuss a few specific autoimmune diseases and how they relate to increased intestinal permeability. We’re going to talk about Celiac disease, autoimmune or Hashimoto’s Thyroiditis, type one diabetes, et cetera. And we’re going to discuss how you can apply this information to really help yourself. And at the bottom line, that’s our main objective, is to give you some information to increase your awareness of the autoimmune epidemic so you can help yourself and you can help your friends and loved ones. So I’d like to take a minute to talk about what is functional medicine because a lot of people aren’t familiar with this term.

And with functional medicine we look for the root cause of the problem, use natural treatments whenever possible and try and avoid medications. Also, we try and look at how all the different organ systems interrelate with each other and when you contrast that to traditional medicine, which is the disease-drug model, here’s the disease, here’s the drug. It’s very different and I really think it’s the way that we should all be practicing medicine. So instead of calling this leaky gut, let’s call it Increased Intestinal Permeability because quite frankly, a lot of physicians, when you talk about leaky gut will roll their eyes and they think this is a quiet diagnosis when indeed it’s not a, it would be like saying you have tennis elbow and nobody believes it. And then we changed the name to lateral epicondylitis and all of a sudden it sounds legit, but if you go to PubMed and google increased intestinal permeability, you’ll find over 8,000 articles on this topic and the numbers keep going up. It’s a very hot topic of research now.

And if you Google increased intestinal permeability, aka, leaky gut and autoimmune disorders, you’ll find about 1,260 articles. So it is legit for anybody that thinks that it’s not. A study by the NIH in 2012 found that 23.5 million Americans have an autoimmune disorder and they only looked at 24 of the 80 autoimmune diseases that have been identified and they stayed. Autoimmune disorders are becoming increasingly prevalent for reasons unknown. Well, we’re going to talk about why I think they’re becoming more prevalent. How much money are we spending treating auto immune disorders? So let’s talk about that for a minute. We spend $100 billion per year treating autoimmune disorders versus $50 billion a year for treating cancer. Although only $591 million is spent by the NIH on autoimmune disease research compared to 6.1 billion spent on cancer. It really doesn’t make any sense. So let’s start our discussion about our immune disorders by discussing celiac disease, which is an autoimmune disorder and the most severe reaction to gluten. A lot of people still today think this whole gluten thing is a fad.

I’m here to tell you that it is not, just evidenced by the fact of how many people will avoid gluten and feel better. How many people have been diagnosed with celiac disease today compared to 25 years ago? A couple of things about celiac disease. One, a lot of people think of it as a digestive disorder when in fact 40% of people with celiac have no digestive symptoms and there are more neurological manifestations of reactions to gluten or celiac disease, then there are digestive symptoms. That begs the question, why is the incidence of celiac disease going up and in the past to diagnose celiac disease, you had to do a biopsy of the small intestine and find damage to the villi in the small intestine which serve as roots of your plant body to extract the nutrients. So that’s how you diagnose it. Then along the way, the gene for celiac disease was discovered. There are actually two genes and there has been a host of blood tests that you can do looking for various antibodies to diagnose celiac disease, so you really didn’t have to be so sick that biopsy was warranted and an endoscopy.

They were able, since the genes were discovered, to go back to stored blood in the 70s and look to see how many people had the gene in the 70s and it turns out about 25% of the population had the gene in the 70s and about 25% of the population has the gene today. So there hasn’t been a genetic shift to account for the increased incidents of celiac disease. So others will contend now that we have these blood tests, we’re diagnosing celiac disease more commonly because it’s easier to do. You don’t have to put somebody through an endoscopy and a biopsy. So they went back to the stored blood in the 70s now that the antibodies have been discovered to see what was the prevalence of celiac disease back then, and it turns out it was about one in 3000 compared to about one in 133 today. So the incidents of celiac disease has actually gone up. So to get Celiac disease, three things have to happen.

You have to have the gene, you have to be exposed to gluten, and you have to have increased intestinal permeability from something else that is allowing the gluten antigen to be presented to your immune system inside the small intestine. And just to note 80% of your immune cells are actually found in the small intestinal lining, making it the largest immune organ in the body. The other thing to point out is that there are a lot of extra-intestinal manifestations of celiac disease. Now that we’ve talked about celiac disease, let’s talk about another related condition called non-celiac gluten sensitivity. That affects maybe as much as a third of the population. In my experience, it’s probably higher than that. So these are people that don’t react well to gluten but they don’t have the antibodies that define the celiac patient. So here’s a slide from the journal toxicology that came out in 2013 and the yellow bar represents the increase of celiac disease going back from 1990 until 2010 and you can see how much it has increased.

And then the black line shows the use of glyphosate, which is roundup on our crops.rAnd what’s felt to happen here is that glyphosate or Roundup damages the lining of the small intestine. And recall what I said on the previous slide, to get celiac you have to have the gene, you have to be exposed to gluten and you have to have increased intestinal permeability from something else. And when one thing damages the lining of your small intestine, then you’re more likely to have reactions to foods. You’re more likely to get auto immune disorders. And what is going on is that chunks of the gluten protein as an example of getting into the bloodstream because the lining of the small intestine, which I like into a cheesecloth is disrupted under normal circumstances. The individual amino acids that make up a protein should come across that cheesecloth or lining of the small intestine and not chunks of the protein. And we’re going to talk a little bit more about that as we get further along.

But in this same article, there are slides looking at multiple sclerosis in the use of a glyphosate or roundup and thyroid disorders and thyroid cancer. And I think what we’re going to find is that it was the introduction of glyphosate or roundup that was the tobacco of the decade that really started us on this path toward increased autoimmune disorders. So the bottom line that there is try and eat organic as much as possible. This stuff is terrible for you. I’m often asked if there is a test for leaky gut, and the short answer is yes, there is a test you can measure Zonulin in levels. Now what is Zonulin? Zonulin is a protein molecule that modulates the permeability of the small intestine and patients with leaky gut have elevated levels of Zonulin. Now we don’t do this often and it’s only done in a cutting edge functional medicine labs. It’s not readily available. Now, the good news is there is a Zonulin inhibitor that’s under investigation, which will block the effects of Zonulin and they’re in clinical trials looking to use this for patients with celiac disease.

It’s called Larazotide. I’m expecting when that drug comes to market and now we have a pharmaceutical to treat leaky gut, it’s going to get a lot of increased awareness in the traditional medical circles. The same thing happened with small intestinal bacterial overgrowth or SIBO, which you might’ve heard of. It was described years ago. Nobody paid much attention until an expensive antibiotic came out to treat it. So that’s the good news. I think we need to increase awareness and I think this is going to help to do that. Let’s turn our attention to Hashimoto’s, or so-called Autoimmune Thyroiditis. I’d like to point out that about 12% of the population will develop the thyroid problem during their lifetime, another virtual epidemic. There’s not a day goes by in my office, I don’t see four or five patients that have Hashimoto’s. Hashimoto’s, as it turns out is probably related to another way that we react to gluten through a process called cross-reactivity.

Now what happens there is your body is making antibodies against a segment of the gluten protein, and those same antibodies can attack the native thyroid tissue because the sequence of amino acids is the same or similar. So you’re making antibodies against this, a portion of the gluten protein, those same antibodies are damaging your thyroid. So it’s very important in my view, to try and find patients that have Hashimoto’s early on because there’s about a five year, what I call burn-up phase, where the antithyroid antibodies, which you measure in the blood, and that’s the way you make a diagnosis of Hashimoto’s. So these anti-thyroid antibodies are elevated, but the thyroid hormone levels are still in the normal range and your thyroid gland is under attack, but it’s able to keep up. Now, if you find patients in that burn-up phase and you get them off gluten, you can see the antithyroid antibodies go down and a lot of times you can prevent the full blown development of a Hashimoto’s.

Another thing I like to point out is if you have one autoimmune disorder, you’re three times more likely to get a second one and you need to heal and seal your gut to keep from developing another autoimmune disorder. Another thing I would point out too is if you look at celiac patients and you get them off gluten 100% and you do a biopsy 18 months later in this study was done, you’re only going to find that eight percent of the biopsies are normal. So in other words, 92% still have abnormal biopsies, the villi are still damaged, and that’s probably because whatever caused the increased intestinal permeability to begin with, that then led to turning on of your celiac gene, whatever caused that was not addressed. I really can’t emphasize this enough. Basically, if you have a thyroid disorder, Hashimoto’s, autoimmune thyroiditis, you really should go gluten free. And here’s the study that proves that where they showed normalization of subclinical hypothyroidism, which is to say your thyroid’s not quite working at 100% but in these patients, they put them on a gluten free diet and they had a normalization of their antithyroid antibodies.

We see this all the time in our office. So here’s another study that relates ciliac disease to autoimmune thyroiditis. And that’s not to say that there’s always a connection, but in this study they found that patients who had celiac disease required more thyroid hormone replacement, and those patients who went on a gluten-free diet reduce their need for thyroid hormone. So here’s a study from Frontiers in Immunology looking at another autoimmune disorder, type one diabetes, showing the relationship between the development of type one diabetes, a leaky intestinal mucosal barrier, AKA leaky gut, and altered gut microbiota, which is your gut microbiome you’re probably hearing a lot about, and then altered immune responsiveness. If I haven’t convinced you by now that leaky gut is a real disorder, I would like to read you this quote from frontiers in Immunology. The permeability of the epithelial lining may be compromised, allowing the passage of toxins, antigens and bacteria in the lumen to enter the bloodstream, creating a leaky gut. In individuals with a genetic predisposition, a leaky gut may allow environmental factors into the body triggering the initiation and development of auto immune disease.

Celiac is the perfect example. You have the gene, you’re exposed to gluten, that’s the environmental factor and you have a leaky gut from something else. Bingo, you’ve got Celiac disease. Okay, so we’ve talked about Celiac disease, Hashimoto’s, and type one diabetes, but basically all of these different autoimmune disorders are on the rise. Look at the incidents or increase incidence of multiple sclerosis, inflammatory bowel disease, lupus, rheumatoid and various autoimmune liver diseases. Can increased intestinal permeability or leaky gut alter your mood? The answer is yes. There is a relationship between the so-called gut brain and your regular brain. One of the ways that is felt to happen is we talked about Zonulin increasing the permeability of the small intestine and you get an over-expression of Zonulin in patients with leaky gut. Well as it turns out Zonulin also regulates the permeability of the so-called blood-brain barrier, which is under normal circumstances, very selective in terms of what gets into your brain.

So if you’ve got leaky gut, increased Zonulin, then you have increased permeability of the blood-brain barrier and you’re getting more toxins and things into your brain and that’s one of the ways that it might affect your mood and lead to neurologic toxicity over time. Here’s another quote that I like from the journal, Expert Review of Gastroenterology and Hepatology: it has become apparent that intestinal barrier defects are key players in the pathogenesis of diseases affecting the gut and beyond. We have come to realize that a Western lifestyle has a significant impact on health, including the strength of the intestinal barrier. Turns out Hippocrates was right. All disease begins in the gut, if not all disease, certainly a large number. So you’re probably wondering by now what causes your gut to be leaky. In a broad sense, it’s three different things. One is diet and we talked about trying to eat non-GMO foods or foods that don’t have glyphosate. That’s one of the things in the diet that can cause your gut to be leaky. Gluten is chicken and egg thing. You can have leaky gut from one cause and then your celiac gene gets turned on.

And gluten in and of itself can cause increased intestinal permeability in susceptible people that don’t really have full blown celiac disease, as we mentioned, that’s the so-called non-celiac gluten sensitive patient. You also can have pathogenic microorganisms or what we call dysbiosis, which is an imbalance of good and bad bacteria in the gut. That can often come about from such things as taking a course of antibiotics, which can kill off the good guys allowing a pathogenic or opportunistic bacteria or yeast to take hold, or maybe you picked up a parasite on your trip to a third world country. The third thing is medications, and we see this a lot. Someone has leaky gut from one cause, now they’ve got systemic inflammation causing their joints to be achy. Now they’re taking medications like ibuprofen, which can damage the lining of the intestine and further exacerbate their leaky gut. So you may have heard of small intestinal bacterial overgrowth, which I alluded to earlier, described years ago, didn’t become really on everyone’s radar until an expensive antibiotic came out to treat it.

The other thing that sounds quaky is the notion of yeast overgrowth. Well, let’s call it small intestinal fungal overgrowth and it sounds more scientific. Yes, it’s a real disorder and this is a quote from the journal, a Current Gastroenterology Reports, which States that fungal overgrowth may occur in the small intestine and cause unexplained GI symptoms. Until recently, small intestinal fungal overgrowth was not well known; however, recent studies have revealed that this can cause symptoms such as belching, bloating, indigestion, nausea, diarrhea and gas, and it can be a contributing factor to your leaky gut. So I’d like to present a case study. This is a real patient and we could do lots of these case studies, but this one was pretty dramatic in that he had elevated liver enzymes. He goes to see a gastroenterologist who does an antibody panel and found that his anti-mitochondrial antibodies were slightly elevated and he was diagnosed with Primary Biliary Cholangitis. So why is that important? Well, Primary Biliary Cholangitis or PBC as it’s called, is a potentially fatal disorder.

So here, he thinks he’s got this potentially fatal disorder, not to mention the fact that his insurance ratings are going to be messed up for the rest of his life. So I told him on that first visit, I said, “I don’t think that’s what you have, I think you have nonalcoholic fatty liver disease”, which is another disorder that’s arising quite rapidly. And when you think about it, all of the blood supply from the small intestine goes to the liver next for further modification of our nutrients. So if you’ve got leaky gut, the liver is being deluged with all this sewage from the small intestine. So basically, we treat it as leaky gut, liver enzymes normalized and his anti-mitochondrial antibodies came back down to normal. Needless to say, this was a very happy patient at the end of the day. So in conclusion, I would just like to say that although increased intestinal permeability is becoming more studied and accepted, many healthcare practitioners dismiss the notion that leaky gut underlies many of the disorders that we treat, both autoimmune and non-autoimmune.

And if you can’t tell by now I’m very passionate about getting the word out about this epidemic and the association between autoimmune disorders and increased intestinal permeability, I would really encourage all of you to pass this along to anybody that you care about. Let’s help spread the word. We’re going to go on to talk a little bit about steps that you can take to try and seal and heal your gut. So the first thing that you should do is try cleaning up your diet and basically eat a nutrient dense whole food diet, which is free of processed foods, GMOS, alcohol, and foods that are known to be pro-inflammatory such as gluten, dairy, soy, and try supplementing with the good probiotic. Dr Alessio Fasano, who’s one of the leading researchers on celiac disease and gluten reactions suggest that everybody tried going gluten free at least for a period of time just to see how you feel. In my experience, most people feel better and then when they reintroduce it, not so great.

So we talked about diet and the first thing you want to do is avoid foods that are going to damage your small intestinal lining. The other thing you want to do is reinoculate with a good probiotic. Now here are some brands that I like, Visbiome, which used to be VSL number three, new chapter makes a good probiotic Klare Labs and Garden of Life. There’s a lot of different probiotic manufacturers out there, but I think it’s important to get a probiotic from a reputable company and I think it’s also good to rotate probiotics and there’s a lot of nuances between, let’s say, soil or spore based probiotics and probiotics that are derived from humans. And the last thing that I like to do to help patch up your gut is to use a bovine derived immunoglobulin complex and Enteragam is one name for that. So we’re going to talk more about that on the next slide. So I’d like to talk a little bit more about the serum derived bovine immunoglobulins because I think this is really one of the secrets in the sauce, if you will, to try and heal your leaky gut.

And the immunoglobulins are derive from cows. So immunoglobulins, just so you understand, are antibodies. So these are antibodies created by the immune system of the cow in response to any pathogenic or disease causing microorganisms that the cow’s immune system has encountered. And this is one of the ways that you can get rid of some of the bad guys that might be lurking in your gut and it’s very effective along with changing your diet, taking a good probiotic. We use the ortho molecular bovine derived immunoglobulins, and just so you know, if you find all this confusing, you can always reach out to our office. It’s The Care Group, P.C. Look at our website, we have a lot more information out there. So I put together some selected references that you might want to look at if you want to delve into this a little bit further. As I mentioned to our website is here at the bottom of this page, and we also have a link to a PDF, which is a guide to how you can begin this path of sealing and healing your gut.

And I’m here to tell you we do this, we’ve treated probably 3000 patients since 2013 for their leaky gut, and it’s a real game changer. Thank you so much for your attention and I hope you find this helpful and please feel free to pass it along to anybody that you care about. Let’s get the word out about this autoimmune epidemic.

December 3rd, 2019