Tuesday, June 22, 2010

Microflora and Neurology

Oh, I actually don't like "weighing in" on food conversations. I also don't like controversy. I know this is all ripe for debating. Regarding GFCF (Gluten-Free Casein-Free) and autism causation....

I'm not suggesting a causation. I am suggesting a connection. I am suggesting that if diet affects neurology then addressing dietary/digestive imbalances can have an effect on the neurological/sensory/inflammatory issues associated with autism. An effect. Not cure.

I hope the above is clear enough that instead of arguing that I'm somehow camped out on DAN blogs, I'm thinking about something that is only just starting to be recognized in the biomedical community, and integrated into various specialties, looking at the relationship to various conditions/diseases/states of being.


I cannot eat dairy. I once found some amazing almond cheese. I ate LOADS of it. This resulted in bad diarrhea. Checked ingredients and discovered it had casein in it. Other foods with casein (the protein in milk) also affect me badly - cramps, pain, bad poops. Evil.

I have, despite cutting out dairy, major digestive problems. At the very least, abdominal pain and problems digesting and processing food makes it really really hard to focus on other things, because the pain is bad.

Another anecdote: When I was in the hospital and had to have surgery, I was put on fluids only. Y'know, the glucose bag. So. I had no food for days. I have outside verification that I was more clear-headed, communicative, coherent -- on narcotics, even -- than I usually am. I made some effort afterwards to avoid dairy, gluten and soy. It's hard, and I stopped. I still slip up on the dairy. Brain no workie. Stomach ouchie. Suffering. Yes, because of food. Not only because of food, but some because of food.

Now; if I had a healthy gut, I have no idea what I would be like. I do know that even if everything could be explained away by horrible stomach pain my entire life and the inability to connect to my peers because I was loaded up on dairy and other foods I couldn't digest, I would still be who I am if I healed my gut now. I developed in a certain way, and even if I change my neurology in the future I would still be who I am right now. Even if children get their guts in order through diet changes, I do not assume that all the problems go away. Understand that much.

And now, moving beyond anecdote...

Fact: Your brain is connected to your gut. You have nerves running to and from your organs and this is a part of your neurology.

Still really young, the study of gut microflora offers an interesting take on what diet might do for autism. But first take a step back from the label "autism". Take a step back even from notions of "disorder and syndrome" which are really interesting to pick apart (...there are no objective things in the DSM, no clear pictures, only sketches of checklists that provide a common and arguably useless language; ).

While this article deals with immunity and microflora (things like allergic response, which isn't far off topic from dietary issues), see what it has to say about how both innate and acquired immunity is related to other body systems:
Whatever influences, modifies, enhances or suppresses the immune response (at any stage or level) does not exist by itself, and is not going to have any effect unless it is harmonised, connected and influenced in two ways. One is by a number of other systems in the body, including first and foremost the central nervous system, which includes the mind. Second is the endocrine system, which creates and influences emotions.
So the nervous system, the nerves, indeed *neurology* is intertwined with immunity. This isn't, from what I'm reading, a one-way causality thing. Why should it be? Brain communicates with gut, gut communicates with brain. Signal and response. Gut affects nervous system??? Whoa.
Gut microflora is an acquired ecosystem, meaning, when we are born, we have no bacteria in our gut. Microflora consists of many many different bacteria. We actually contain these helpful bacteria in our gut, mouth, genitals, on our skin, really everywhere -- and the human body has more non-human DNA than human-DNA (isn't that fraakin' mindblowing?) :)
Total microbial cells found in association with humans may exceed the total number of cells making up the human body by a factor of ten-to-one.
So. What does this mean?

An Interpretation

The body's ability to deal with its environment, regulate the nervous system, emotions, sensory input, etc etc. is impacted by the balance of microflora in a person's gut (and other parts of the body). The more diverse the microflora, the better that ecosystem processes a variety of foods, and other potentially harmful and benign substances from the environment. If the ecosystem is less diverse, it may not be able to process some types of food.

The simplest and best known example is yogurt. (Active culture) Yogurt is basically dairy that has live cultures which have partially digested it. It contains the bacteria necessary to digest it (albeit, not necessarily in enough quantities for someone like me to handle it). A home remedy for yeast infections is yogurt. A big problem is also candida, the overgrowth of yeast in the system. We're supposed to have yeast, but if we have too much, the system is imbalanced. Anything we eat with sugar in it will promote the growth of yeast, for instance. Reducing sugar can 'starve' the yeast.

This doesn't just apply to yeast. If any kind of bacteria gets too prolific it can make it hard for some of the other useful bacteria to do its job. We have some kinds of bacteria that are ok in small quantities but not in larger quantities. Some bacteria we don't know much about. We don't know what they do. We can't even culture some of them.

So a lot is not even known about this field, and while there has been scarce study of any microflora link to autism, there is also microflora research and anecdotal mention in relation to obesity and diabetes, MS, Celiac...

It doesn't seem like it's nonsense to make a connection between neurology and acquired immunity (which is what microflora is).

Restricted diets because of sensory defensiveness could affect microflora balance. So could a lot of processed food which is primarily sugar, corn and soy. I've read anecdotes that when a child is removed from one of the "offending foods" like sugar, corn, dairy.. they will have what might be called an 'adverse reaction'. I think if I were a bacteria colony and had my main source of goodness taken away, I would scream bloody hell. Donna Williams writes of a backlash reaction (too fatigued to cite, go see Donna Williams' articles on food intolerances and addictions in autism and her own experiences). We are what we eat and we eat what we are.

That isn't asserting a causation. This is not autism=bacterial infection. Nor is it vaccine -> kills gut bacteria = autism.

What it is asserting, however, is that balancing out microflora can affect mood and cognition. Mood and cognition can affect gut. Stress can create intestinal problems. What we think can influence neurology. Intestinal problems affect neurology.

If I can potentially address sensory problems like sensitivities or disregulation by altering my diet (adding foods that promote healthy microflora or eliminating foods that cause pain or promote bacterial overgrowht), I'll try it :)

And that is very different that saying I think I'll cease being autistic if I stop eating dairy and high fructose corn syrup.

I actually must thank my husband for his understanding of neurology, psychology, nutrition, and prolific research into peer-reviewed sources. This cobbled together post doesn't do his thoughts justice.

(I reposted this from my contribution at Autism Women's Network in response to The Myth of GFCF Foods)

Monday, June 14, 2010

Keeping a Diary

I saw my doctor today and she really does think I have IBS. She told me to do a bunch of things, one of them is to keep a symptom diary.

Okay. So in my life I have considered and even tried keeping diaries of various sorts. I kept a diary for a little bit when I was quite young, maybe 8. I kept a private blog for a little while that I still check into now and then. I've considered a mood diary, a food diary, a menstural diary, an exercise diary, a yoga teaching diary... feck it all, I said.

The main reason I rejected the idea of a diary is that, especially when it comes to mood and food, I figure that my obsessive tendencies would drive me over the edge and into the nutty realm of meticulous record-keeping.

So a symptom diary for IBS, which includes what I eat, when I poop, and how I feel at any given moment, that is an all-encompassing project. And for a whole month! I have already added in obsessiveness -- I am writing down the approximate amount of fiber each meal contains. Since part of my doctor's instructions is to get 25g of fiber a day (and at least 3 in any given meal).

I think I'm at about 6-8 grams today, that's not much. Can you tell I'm already obsessing?

Wednesday, June 2, 2010

Gut Problems

I won't get into gory details, but I'm pretty sure I have Irritable Bowel Syndrome or some such difficulty. I have had problems all my life with my stomach. Frequent stomach aches, and gory other things I won't talk about, but to say, it all hurts, is inconvenient, and probably means I'm not absorbing nutrients like I should.

I definitely have a problem with dairy, and I am 90% successful at avoiding it. Recently I ate a whole Mac n' Cheese tv dinner, and I ended up going to the doctor because I thought I was having organ failure. I had my gall bladder removed in 2008, and depending on what sources I read, my diet should/shouldn't change to avoid fatty foods and I should take lecithin to replace bile salts. I don't bother with any of this. I don't know if I should completely eliminate other foods, though, and if anything I think I should focus on removing all processed foods from my diet. And probably butter (yes I avoid dairy, including stuff wtih casein or whey -- it's not just lactose -- and yes, I eat butter, because a nutritionist told me that was likely okay)

Having these issues impacts me socially:

I have many cravings, and many food aversions. So, I'm picky. Many people have dislikes, and so not everything I dislike is because of some neuro issue like sensory defensiveness, but it's hard to tell the difference sometimes.

Ordering at a restaurant is an exercise in running the server back and forth from the table to the kitchen to inquire about ingredients (some restaurants are amazing though, and accommodate "allergies" and have special menus, or can say exactly which items I could order).
Then, I often order something from a restaurant and then can't really eat it. I'll lose my appetite halfway through a meal, usually because the meal is too dry and I can't figure out how to remedy that (the only bbq sauce many restaurants have is steak sauce like A-1, when I need something sweet).

At home, I often go on spurts of wanting to eat the same thing over and over (most recently it was artichokes). I find it hard to cook for my husband and me, and provide the variety he probably wants, and make things he really likes while accommodating my own proclivities. I do not like most rice because of the texture. I love pasta, but I think (cooked) tomatoes bother my stomach. I started making olive oil & white wine pasta with some flax meal thrown in. I can sometimes not figure out what to make, and finding recipes is overwhelming.

Often I'll eat and during the meal or shortly after, I get a very bad stomach ache and have to run to the bathroom over and over. The patterns vary, but it can be a struggle to manage outings when I'm having episodes of this. Sitting through a movie, or going to a restaurant, or even worse, being out and about and suddenly needing a bathroom so bad that I'm worried about accidents.

This is embarassing. But I understand that it's not uncommon for people on the spectrum to have gut issues. See Donna Williams for one perspective on sensitivities and gut issues.

I went backpacking this long weekend and I'm really suffering - I think I ate too much protein and not enough of other stuff. My last day of hiking was really bad, I felt nauseous, hungry, but unable to eat. We went for dinner at Outback and I barely ate my food. I couldn't eat the steak I had ordered, only the shrimp, and bread, and a sparse bit of fries.. I took it home but it was embarassing and it annoyed my husband.

I really want to (and need to!) change what I eat, reduce stress, and figure out other ways to cope with this. I haven't addressed it completely in my first thirty years because in general, because I grew up feeling this way, it often doesn't occur to me that difficulty eating, nausea, severe abdominal pain and unrelenting irregularity just. isn't. normal. Or okay.

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