What do you know about autoimmunity?

Autoimmune disease can be simply defined as when the immune system attacks healthy cells in the body by mistake, a dysfunction of the immune system. Autoimmune diseases have been found in virtually every organ system in the body.  There are differing schools of thought as to how many conditions there are, but well over one hundred would not be exaggerating, and it’s rising. Some estimate that up to one in ten suffer from an autoimmune condition in the United States and many of them are unaware of their condition. Women are most likely to be affected. In some cases modern pharmaceuticals and medical practices do a good job of masking these conditions, treating the symptoms or keeping them under control, in other cases people just live with them and while no major organ is involved, they remain chronic.

The most common of the one hundred or more autoimmune conditions are:

  • Graves’ disease. 
  • Hashimoto’s thyroiditis. 
  • Systemic lupus erythematosus (lupus). 
  • Type 1 diabetes. 
  • Multiple sclerosis (MS). 
  • Rheumatoid arthritis.

Other conditions include ones like Pernicious Anaemia – B12 deficiency – where the immune system destroys stomach cells that make intrinsic factor. Intrinsic factor helps the body absorb vitamin B12 in the intestine.  Eczema has recently been included in the growing list of autoimmune conditions.  In this case the immune system causes changes to lipid formation in the skin which affects the skin’s barrier. Vasculitis is one of the connective tissue disorders and another of the autoimmune conditions. It damages blood vessels, weakening them which can lead to aneurysms. Autoimmune hepatitis is a rare disease in which the body’s own immune system attacks the liver and causes it to become inflamed which leads to cirrhosis, increasing the risk of cancer and liver failure.

Interestingly, the predisposition to develop or suffer from an autoimmune condition runs in the family. It may be hereditary, but if one member of the family has one condition, it doesn’t mean another member of the family will develop that same autoimmune condition.

What triggers an autoimmune response? There are a number of triggers and they range from a simple infection, bacterial or viral, to a chemical in the environment, a permeable gut lining and stress. When the condition has been diagnosed, most doctors will look at suppressing the immune system or treating the symptoms but it is critical to identify the trigger(s). For example in the case of type 1 diabetes the immune system has destroyed the function of the pancreas, but that’s not necessarily the end of it. Other autoimmune conditions develop, such as type 1 diabetes and celiac, because of a shared gene that predisposes for these conditions. About 25% of people with one autoimmune condition are likely to develop another.

My advice to someone diagnosed with an autoimmune condition is to reduce exposure to potential triggers. This means they should adopt a strict nutritional program, known as the Autoimmune Protocol, avoid stress and look at improving sleep hygiene, take steps to improve digestion and micronutrient absorption i.e. take enzymes and apple cider in water before a meal and take supplements, avoid exposure to environmental toxins and finally take exercise.  Some of these steps are easier said than done so careful preparation is necessary. The autoimmune protocol needs to be followed rigidly for at least a month before considering which foods to re-introduce. Foods like wheat however should never be reintroduced, but thats another story.

Please contact me if you would like some meal ideas for the autoimmune protocol, ways to improve sleep or how to avoid some of the toxins we’re exposed to everyday.


Controlling Inflammation with food

Mirriam Webster dictionary define inflammation, and i quote “as a local response to cellular injury that is marked by capillary dilatation, leukocytic infiltration, redness, heat, pain, swelling.” This cellular injury can be caused by a number of things from oxygen deprivation, as a response to chemicals or drugs, as a result of a physical event as in an accident, from an infection or immune response like autoimmune thyroid condition, Hashimoto’s, to genetic issues, e.g. Downs syndrome or even to nutritional imbalances – e.g. very common these days, atherosclerosis.

How best to reduce the inflammation and associated pain without the use steroids and NSAIDs anti-inflammatory drugs like ibuprofen which can cause gastrointestinal damage and heart attack?     Proteolytic Enzymes will help.  This article in Nutrition Review explains, they increase the “appetite” of macrophages, a large white blood cell that consumes bacteria, viruses, fungi, and parasites and increases the potency of natural killer (NK) cells. They also degrade pathogens that might inhibit normal immune function. Amongst other things they increase blood flow and break down cellular debris, which makes them easier for the lymphatic system to remove and thus reduce swelling.

Proteolytic enzymes can be bought in a tablet form. Wobenzym is one that I have used. However these enzymes can be found in foods and my favourite source would be pineapple, pawpaw, ginger and kiwi fruit. I advocate a smoothie made from pineapple and ginger with a teaspoon of honey (also full of enzymes), if necessary, a couple of times a day.   I also recommend eating some raw fruit or vegetables with each meal to supply enzymes to help with digestion.

Try a smoothie, experiment with raw food until you find what you like and see how it helps with any inflammation.

The Gut Microbiome and chronic illness


I’ve been working with someone recently who has been suffering with a number of chronic health issues. He is not alone. There are increasing numbers of people in today’s society who suffer from an ever-increasing range of chronic health issues. Defined as a condition that lasts for more than 3 months, chronic illness includes obesity, diabetes, allergies, heart disease, kidney disease, alzheimer’s, cancer and arthritis. These conditions are linked to inflammation and efficacy of our immune system which is inexorably linked to our gut microbiome and its reduced species diversity.

The 2014-15 National Health Survey indicated that 50% of all Australians had a chronic health issue and this rose to 60% in the 65 year-old bracket. The survey found that chronic conditions accounted for around 9 in every 10 deaths in Australia in 2015. This survey was based on self-reporting and so the figures might be even higher as people fail to understand that they actually have a condition, as their symptoms are so minor. A friend recently told me he was fit and healthy, dismissing the psoriasis I noticed as ‘nothing’.  Psoriasis is an inflammatory autoimmune condition.

The considerable interest and number of recent research on the microbiome, show that in the modern world our diet and environmental exposure to microbes is severely limited. Whilst our diet might be a little more diverse than the average slum dwelling Indian, our exposure to microbes from the environment is not. However it is generally understood that in order to encourage a healthy, diverse microbiome we need to consume a healthy, balanced and diverse diet.  However the modern diet is not diverse and consequently the species diversity of our microbiome is lacking. The much studied Hadza tribes of Tanzania eat a rich variety of foods also have higher levels of microbial diversity and biodiversity.  Our modern diet is not healthy or balanced meaning the number of species is low and the many functions of a healthy microbiome, like breaking down foods into more useful nutrients, producing chemicals that act as neurotransmitters and regulating the immune system are not fulfilled as effectively as they might be.  Moreover the colonisation by harmful bacteria and viruses is facilitated instead of opposed.

So the loss of species diversity in the gut is associated with increased chronic health issues. Dysbiosis refers to an imbalance in the species of the microbiome, an increase in the more harmful with a reduction in the beneficial bacteria.  The balance and composition of microbes in the gut microbiota changes regularly. Probiotics and fibre rich foods encourage the beneficial bacteria. Processed foods and sugar rich foods encourage the less desirable microbes, as does exposure to environmental toxins. The composition of the gut microbiota changes with diet, age, stress levels and environment.

Manipulating the gut microbiota will be the future of managing chronic illness.

Histamines – can they be the cause of my symptoms? It’s complicated.

Histamine is a chemical involved in your immune system, proper digestion, and your central nervous system. As a neurotransmitter, it communicates important messages from your body to your brain. It is also a component of stomach acid, which is what helps you break down food in your stomach.

You might be most familiar with histamine as it relates to the immune system. If you’ve suffered from food allergies or even seasonal allergies you may have noticed that antihistamine medications like Zytrec, Allegra or Benedryl provide quick relief of your symptoms. This is because histamine’s role in the body is to cause an immediate inflammatory response.  Histamine causes your blood vessels to swell, or dilate, so that your white blood cells can quickly find and attack the infection or problem. The histamine buildup is what gives you a headache and leaves you feeling flushed, itchy and miserable. This is part of the body’s natural immune response, but if you don’t break down histamine properly, you could develop what we call histamine intolerance.

Because it travels throughout your bloodstream, histamine can affect your gut, lungs, skin, brain, and entire cardiovascular system, contributing to a wide range of problems often making it difficult to pinpoint and diagnose.

Common symptoms of histamine intolerance include:

  • Headaches/migraines
  • Difficulty falling asleep, easily arousal
  • Hypertension
  • Vertigo or dizziness
  • Arrhythmia, or accelerated heart rate
  • Difficulty regulating body temperature
  • Anxiety
  • Nausea, vomiting
  • Abdominal cramps
  • Flushing
  • Nasal congestion, sneezing, difficulty breathing
  • Abnormal menstrual cycle
  • Hives
  • Fatigue
  • Tissue swelling

What Causes High Histamine Levels?

  • Allergies (IgE reactions)
  • Bacterial overgrowth(SIBO)
  • Leaky gut
  • GI bleeding
  • Fermented alcohol like wine, champagne, and beer
  • Diamine Oxidase(DAO) deficiency
  • Histamine-rich foods

In addition to the histamine produced inside your body, there are also a variety of foods that naturally contain histamine, cause the release of histamine, or block the enzyme that breaks down histamine, diamine oxidase.

  • Histamine-Rich Foods:
  • Fermented alcoholic beverages, especially wine, champagne and beer
  • Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc
  • Vinegar-containing foods: pickles, mayonnaise, olives
  • Cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs
  • Soured foods: sour cream, sour milk, buttermilk, soured bread, etc
  • Dried fruit: apricots, prunes, dates, figs, raisins
  • Most citrus fruits
  • Aged cheese including goat cheese
  • Nuts: walnuts, cashews, and peanuts
  • Vegetables: avocados, eggplant, spinach, and tomatoes
  • Smoked fish and certain species of fish: mackerel, mahi-mahi, tuna, anchovies, sardines
  • Histamine-Releasing Foods:
  • Alcohol
  • Bananas
  • Chocolate
  • Cow’s Milk
  • Nuts
  • Papaya
  • Pineapple
  • Shellfish
  • Strawberries
  • Tomatoes
  • Wheat Germ
  • Many artificial preservatives and dyes
  • DAO-Blocking Foods:
  • Alcohol
  • Energy drinks
  • Black tea
  • Mate tea
  • Green tea

Don’t give up!  Here is a list of low histamine foods. Just remember though that freshness is vital if you have histamine intolerance!

Low-histamine foods:

  • freshly cooked meat, poultry (frozen or fresh)
  • fresh fish
  • eggs
  • gluten-free grains: rice, quinoa
  • pure peanut butter
  • fresh fruits: mango, pear, watermelon, apple, kiwi, cantaloupe, grapes
  • fresh vegetables (except tomatoes, spinach, avocado, and eggplant)
  • dairy substitutes: coconut milk, rice milk, hemp milk, almond milk
  • cooking oils: olive oil, coconut oil
  • leafy herbs
  • some herbal teas

Once formed, histamine is either stored or broken down by an enzyme. Histamine in the digestive tract is broken down primarily by diamine oxidase (DAO). The American Society for Clinical Nutrition found that DAO is the main enzyme responsible for breaking down ingested histamine.   Low DAO can be caused by –

  • Gluten intolerance
  • Leaky gut
  • SIBO
  • DAO-blocking foods: alcohol, energy drinks, and tea
  • Genetic mutations (common in people of Asian-descent)
  • Inflammation from Crohn’s, ulcerative colitis, and inflammatory bowel disease.
  • Medications:
  • Non-steroidal anti-inflammatory drugs (ibuprofen, aspirin)
  • Antidepressants (Cymbalta, Effexor, Prozac, Zoloft)
  • Immune modulators (Humira, Enbrel, Plaquenil)
  • Antiarrhythmics (propanolol, metaprolol, Cardizem, Norvasc)
  • Antihistamines (Allegra, Zyrtec, Benadryl)
  • Histamine (H2) blockers (Tagamet, Pepcid, Zantac)
  • Although histamine blockers, a class of acid-reducing drugs, seem like they would help prevent histamine intolerance, these medications can actually deplete DAO levels in your body.

Testing for Histamine Intolerance

  • Elimination/Reintroduction
  • Remove the above high histamine foods for 30 days and reintroduce them one at a time.
  • Blood Testing

I recommend a test like the one these labs offer to test for histamine levels and DAO levels. A high ratio of histamine/DAO signifies that you are ingesting too much histamine and that you don’t have enough DAO to break it down.

  • Trial of DAO supplements
  • If testing is unavailable to you, you could simply try a diet low in histamine and add DAO supplementation at each meal. If your symptoms resolve, you could have low DAO.

How to Treat Histamine Intolerance?

Remove the high histamine foods for 1-3 months and add in supplements of DAO. Most importantly, find the root cause for the histamine intolerance. If you’re on a medication that is causing the intolerance, work with your physician to see if it is possible to wean off of these medications. The main causes are likely to SIBO (Small Intestine Bacterial Overgrowth) and gluten intolerance, which cause a leaky gut. In this case, I suggest reading about how to heal the gut and over time you should be able to stop the DAO and go back to eating histamine-containing foods.

If you’re currently suffering from histamine intolerance, you may not have to avoid these foods forever. It can be a short-term solution until your histamine or DAO levels return to their optimal ranges. Depending on your situation – which is always unique, you may find that you tolerate some foods better than others.



Low Stomach acid – how would you know?

Our ability to digest our food is reduced as we age and one of the main reasons is that we produce less and less stomach acid. So many symptoms we attribute to a, so-called ‘normal’ ageing process, is actually because we have reduced levels of stomach acid. We are simply unable to breakdown proteins, carbohydrates and fats. We are unable to absorb vitamins and minerals as they become less available. This leads to a variety of conditions like heartburn, bloating, flatulence and diarrhoea, post adolescence acne and a few more but also some disorders which are more serious

Addison’s Disease
Celiac Disease
Chronic Autoimmune Disorders
Food Allergies
Gall Bladder Disease
Gastric Cancer
Graves Disease
Pernicious Anemia
Acne rosacea
Ulcerative Colitis
Hair Loss
Multiple Sclerosis
Rheumatoid Arthritis

How can you test for low stomach acid?

Well there is a test, not that reliable but if you did every morning for 3 mornings in as row and got consistent results it might indicate a result.

  • Mix ¼ teaspoon of baking soda in a small glass of water first thing in the morning before anything else.
  • Drink the solution
  • Time how long it takes you to burp. Time up to 5 minutes.

If you have enough stomach acid you’d likely burp in two or three minutes, after that or no burp would indicate low stomach acid.

A little apple cider vinegar in a little water before a meal can be useful, otherwise consider taking Betaine with HCl.

Check out this paper from Nutrition Review



What is the best diet?

This is the question we all ask of ourselves, our nutritionalists or dieticians at some stage or another.  “What is the best diet?” We will often discuss the pros and the cons of all the different diets we are presented with in order to be healthy and disease free, strong, slim and fit. Nutritionalists and dieticians will give you the benefit of their training and might suggest for example you should avoid the glucose spike from eating the simple carbohydrates like ice-cream and instead eat complex carbohydrates like brown rice. We have developed a food pyramid of foods suggesting a little of this and lots of that. We understand that our glucose response is critical.  The consequences of But, are missing something?   This interesting study suggests we have.  We need to be looking at the individuals microbiome before we give dietary advice.  We can have a different glucose response the the same foods. One person can have their blood glucose levels spiked by ice cream and not by brown rice whilst another person might have it the other way around.

Our response to glucose and insulin is critical to the maintenance of health and wellbeing. Low blood sugar levels (Hypoglycaemia) will show some or all of the following symptoms –

  • hunger and irritability
  • tremor or trembling
  • sweating and anxiety
  • heart palpitations
  • accelerated heart rate
  • tingling lips
  • dizziness and weakness

Whereas high blood sugar levels (Hyperglycaemia) will have these symptoms –

  • Increased thirst and headaches.
  • Trouble concentrating.
  • Blurred vision.
  • Frequent peeing.
  • Fatigue
  • Weight loss.

The aim is not to have spikes in our blood sugar levels, but to hold it steady. What this study has shown is that we all respond differently to different foods. What works for you, does not necessarily work for me, and if we think about that, we’ve seen it. We’ve probably wondered how some people seem to ‘get away’ with eating something while others don’t

Watch a TED talk by Prof. Eran Segal and form your own opinion. There were some interesting comments.

High Oestrogen?

Too much oestrogen can be a real problem for women, and it’s not uncommon. A multitude of issues can arise.  The following symptoms can occur with an excess of oestrogen: –

  • Breast tenderness,
  • Anxiety,
  • Weight gain,
  • Hair loss,
  • Bloating,
  • Headaches,
  • Memory issues,
  • Irregular menstruation,
  • Irritability,
  • Poor sleep.

To combat this oestrogen excess, we need to reduce its production. Aromatase is an enzyme responsible for a step in the biosynthesis of oestrogen. It can be inhibited by anti-inflammatory herbs like milk-thistle, rosemary and turmeric. Another consideration is women with abnormal hormone activity are often magnesium deplete (magnesium bisglycinate is best).
Foods such as cruciferous vegetables like broccoli and other foods oranges, grapes, celery and onions all play an important role in regulating the amount of oestrogen in the body because they also inhibit Aromatase. A favourite of mine is button mushrooms. They play an important role in achieving hormonal balance in women, and whats more in men too!

Of great concern is the ever increasing amount of plastic in our environment. Plastic contains chemicals that mimic oestrogen.  Continued exposure to plastic will disrupt our hormones, no matter how good our diet is.

Stomach pain

What causes stomach pain?

Stomach or abdominal pain may have its origins in the small intestine, large intestine, liver, gallbladder, spleen or the pancreas. There are many reasons for abdominal pain. It may even be a result of tissue damage around the abdomen. Commonly it is a result of gas or a blockage causing stretching. Often it’s due to inflammation and occasionally it may be when not enough blood is getting to one of the organs.

A diagnosis can be made following a series of checks. Where exactly is the pain? What are the characteristics of the pain? When does it occur? How long does it last? What pattern does it follow? Is it for a short time after a meal or does it last for days? What relieves the pain? Will food, pressure, or release of gas relieve the pain? What makes it worse? How long has it been going on for?   Are there any other symptoms like fever? There are many questions a practitioner may ask a patient before making a diagnosis.

Sometimes it may be necessary to have some laboratory tests. A Complete Blood Count (CBC) will look at white blood cells, which may indicate inflammation or infection, it’ll look at liver enzymes for gallstones and pancreatic enzymes for inflammation of the pancreas. Urine tests will check for blood in the urine while a stool test will, amongst other things, will check for while blood cells suggesting inflammation. There are many other tests from and ultra sounds to an endoscopy. Diagnosing the causes of abdominal pain can be a challenge.

The following list of conditions covers most of the common causes:

  • Trauma or injury
  • Appendicitis
  • Indigestion and gas
  • Gallstones
  • Pancreatitis
  • Gastroenteritis and food poisoning
  • IBS, Ulcerative colitis, Stomach ulcers
  • SIBO or Small intestine bacterial overgrowth
  • Gastritis and Gastro-oesophageal reflux disease (GORD)
  • Parasite infection
  • Food intolerances i.e Coeliac
  • Constipation

Getting the correct diagnosis is important. Masking the pain with pain killers and ‘off the shelf’ medications can do more harm than good in the long term.  Finding the root cause of the pain can be a long process. Go and see your doctor immediately, if it occurs too regularly or becomes too uncomfortable.