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Gastro Intestinal Health

Back Clinic Gastro Intestinal Health Functional Medicine Team. The gastrointestinal or (GI) tract does more than digest food. It contributes to various body systems and functions. Dr. Jimenez takes a look at procedures that have been created to help support the GI tract’s health and function, as well as promote microbial balance. Research shows that 1 in 4 people in the U.S. have stomach or intestinal problems that are so severe that it interferes with their daily activities and lifestyle.

Intestinal or digestion problems are referred to as Gastrointestinal (or GI) Disorders. The goal is to achieve digestive wellness. When an optimally working digestive system is on track, an individual is said to be in good health. The GI tract protects the body by detoxifying various toxins and participating in the immunological processes or when the body’s immune system interacts with antibodies and antigens. This combined with supporting the digestion and absorption of nutrients from an individual’s diet.


Understanding The Metabolic Connection & Chronic Diseases (Part 2)

Understanding The Metabolic Connection & Chronic Diseases (Part 2)


Introduction

Dr. Jimenez, D.C., presents how chronic metabolic connections like inflammation and insulin resistance are causing a chain reaction in the body in this 2-part series. Many factors often play a role in our health and wellness. In today’s presentation, we will continue on how these chronic metabolic diseases affect the vital organs and organ systems. It can lead to overlapping risk factors associated with pain-like symptoms in the muscles, joints, and vital organs. Part 1 examined how overlapping risk profiles like insulin resistance and inflammation affect the body and cause muscle and joints pain-like symptoms. We mention our patients to certified medical providers that provide available therapy treatments for individuals suffering from chronic conditions associated with metabolic connections. We encourage each patient when it is appropriate by referring them to associated medical providers based on their diagnosis or needs. We understand and accept that education is a marvelous way when asking our providers’ crucial questions at the patient’s request and acknowledgment. Dr. Alex Jimenez, D.C., uses this information as an educational service. Disclaimer

 

How The Liver Associated With Metabolic Diseases

So we can look to the liver to find earlier cues of cardiovascular risk. How can we do that? Well, let’s understand some liver biochemistry. So in a healthy liver cell hepatocyte, when you have increased insulin being secreted because there was a meal that required glucose to be absorbed, what you expect if the insulin receptor works is that the glucose would go in. Then the glucose would get oxidized and turned into energy. But here’s the problem. When the hepatocyte has insulin receptors that don’t work, you’ve got that insulin on the outside, and the glucose never made it in. But what also happens on the inside of the hepatocyte is it was assumed that the glucose was going to get in. So what it does is it turns off fatty acid oxidation, thinking, “Guys, we don’t need to burn our fatty acids. We’ve got some glucose coming in.”

 

So when the glucose is not there, and you’re not burning off fatty acids, very common for people to feel fatigued because nothing is burning for energy. But here is the secondary sequela; where are all those fatty acids going, right? Well, the liver may try to repackage them as triglycerides. Sometimes, they stay in the hepatocyte or get shifted out of the liver into the bloodstream as VLDL or very low-density lipoprotein. You might see it as a high triglyceride shift in a standard lipid panel. So, when all of us are talking about getting a triglyceride level to around 70 as your 8+ goal, when I start seeing triglycerides rising, we wait until they’re 150, even though that’s the cutoff for our labs. When we see it at 150, we know they are shunting triglycerides out of the liver.

 

So that will happen many times before we find impaired fasting glucose. So look at your triglycerides, fasting triglycerides, as an emerging or early biomarker of insulin dysfunction. So this is another diagram that says that if the triglycerides are being created because the fatty acids are being oxidized, they can stay in the liver. Then that makes steatosis or the fatty liver, or they can be pushed out, and they turn into lipoproteins. We’re going to talk about that in just a second. The body is like, “What are we going to do with these fatty acids?” We can’t try to shove them into places because nobody wants them. To that point, the liver is like, “I don’t want them, but I will keep some with me.” Or the liver would have these fatty acids transported and stuck to the blood vessel walls.

 

And then the blood vessels and arteries are like, “Well, I don’t want them; I’ll put them underneath my endothelium.” And so that’s how you get atherogenesis. The muscles are like, “I don’t want them, but I’ll take some.” That’s how you get the fatty streaks in your muscles. So when the liver is getting bogged down with steatosis, inflammation occurs in the body and produces this feed-forward cycle inside the hepatocyte, damaging the liver. You’re getting cellular death; you’re getting fibrosis, which is just an extension of what happens when we don’t address the core issues for fatty liver: inflammation and insulin resistance. So, we look for subtle rises in AST, ALT, and GGT; remember that it is a liver-based enzyme.

 

Hormone Enzymes & Inflammation

GGT enzymes in the liver are smoke detectors and tell us how much oxidative stress is going on. Will we look at HSCRP and APOB to see the output of this liver? Is it starting to dump excess fatty acids through VLDL, APOB, or triglycerides? And how it picks that is just genetics, honestly. So I look for liver markers to tell me what’s going on in the liver as a sign of what’s happening everywhere. Because that might be the genetic weak spot of the person, some people are genetically vulnerable just in terms of their lipid profiles. To that point, we can look for something called metabolic dyslipidemia. You know this as high triglycerides and low HDL. You can specifically look for a ratio; an optimal balance is three and lower. It starts going from three to five and then five to eight, like eight is almost pathognomonic of insulin resistance. You’re just reaching becoming more and more insulin resistant.

 

As the number increases for that trig over HDL ratio, that is a simple, easy way to screen for insulin resistance. Now some people look 3.0 on this but still have insulin resistance. So there are other tests you do. This is a way to find those who show insulin resistance through lipids. And remember, everybody is different. Women with PCOS could have amazing lipids but could express an increase or decrease of hormones associated with insulin, estrogen, and inflammation. So look for something other than one test or ratio to indicate whether they’ve got it. You’re looking to see what could be the place where we will find the clue.

 

So let’s use the word healthy. A healthy person has VLDL that looks to be a healthy normal size in their bodies, and they have normal LDL and HDL. But now look at what happens when you get insulin resistance. These VLDL ls start to pump up with triglycerides. That’s why they’re fattening up. It’s lipotoxicity. So if you start looking at the VLDL three numbers in a lipoprotein profile, you’ll see that that number is creeping up, and there are more of them, and their size is bigger. Now with LDL, what happens is that the cholesterol amount within the top and the bottom is the same. If I pop all these water balloons, it’s the same amount of LDL cholesterol. However, that amount of LDL cholesterol in insulin resistance is repackaged in small dense LDL.

 

How Does Functional Medicine Play Its Part?

Now we understand that there may be some of you who cannot or do not have access to this testing, or your patients cannot afford it, and that’s why we answered the questions and looked for other clues of insulin resistance and treat the root cause that is affecting the body. Look for signs of inflammation and other overlapping profiles of insulin resistance. The particle number is higher when they’re insulin resistance. So cholesterol is the same, whereas the particle number is more elevated, and small dense LDL is more atherogenic. Treat it because whether or not you have access to knowing the LDL particle, there should be something in your head that says, “Man, even though this person’s LDL cholesterol looks good, they have tons of inflammation and insulin resistance; I can’t be sure that they don’t have higher particle number.” You might assume that they do this just to be safe.

 

The other thing that happens in insulin resistance is that the HDL or the healthy cholesterol tends to become small. So that’s not very good because the efflux capacity of HDL is lessened when it’s smaller. So we like the larger HDL, if you will. Access to these tests would give you a solid indication of what’s going on with your patient from a cardiometabolic perspective.

 

When it comes to these tests, it is important to utilize them to determine the patient’s timeline when they have inflammation or insulin resistance in their bodies, affecting their quality of life. However, many people would often express that these tests are expensive and would go with the gold standard of testing for affordability and be able to decide if it is worth it to better their health and wellness.

 

Look For Cardiometabolic Risk Patterns

So when it comes to cardiometabolic risk factor patterns, we look at the insulin aspect and how it correlates with mitochondrial dysfunction associated with insulin resistance and inflammation. A research article mentions how two mitochondrial dysfunctions can affect the body. Okay, let’s talk about the first issue, which is the quantity issue. One could be endotoxins that we encounter in our environment, or two; it can be genetically passed along from generation to generation. So the two types could indicate that you don’t have enough mitochondria. So that’s a quantity issue. The other problem is it’s a quality issue. You got plenty of them; they don’t work well, so they don’t have high output or at least normal results. Now how does this play out in the body? So out in the periphery, your muscles, adipocytes, and liver, you have mitochondria in those cells, and it’s their job to energize that lock and jiggle. So if your mitochondria are in the right number, you’ve got plenty to energize the insulin cascade lock and jiggle.

 

Interesting, right? So here it is in summary, if you don’t have enough mitochondria, which is the problem in the periphery, you get insulin resistance because the lock and jiggle aren’t working well. But if you do not have the mitochondria working well in the pancreas, especially in the beta cell, you don’t secrete insulin. So you still get hyperglycemia; you don’t have high insulin state. When this happens, we know your brain should be hurting, but hopefully, it will come together slowly.

 

Another article mentions that it connects mitochondrial dysfunction with type two diabetes, and poor maternal nutrition can prime it. This one talks about how fatty liver is associated with lipotoxicity, right? That’s that increased fatty acid, and oxidative stress, which, remember, is the byproduct of inflammation. ATP depletion and mitochondrial dysfunction. When this happens, it can affect the liver, which then turns into the fatty liver, and can also be associated with gut dysfunction, which leads to chronic inflammation, elevated insulin resistance, mitochondrial dysfunction, and many more. These chronic metabolic diseases are connected, and there are ways to reduce these symptoms from affecting the body.

 

Conclusion

When having a conversation with their doctors, many patients know that the same drivers affect a whole host of other phenotypes, all commonly rooted in inflammation, insulin, and toxicity. So when many people realize these factors are the root cause, doctors will work with many associated medical providers to develop personalized functional treatment plans. So remember, you always have to use the timeline and the matrix to kind of help you know where do you start with this patient, and for some people, it might be you’re just going to tweak a little bit of lifestyle because all they’re working on is changing their body count. So it’s one of the blessings of functional medicine that we were able to turn off the inflammation in the gut, which helps reduce the toxic impact burdening the liver. It also allows the individual to find out what works or doesn’t work with their bodies and take these small steps to improve their health.

 

We hope you have fresh eyes about inflammation, insulin, and toxicity and how it is at the root of so many conditions that your patients are facing. And how through very simple and effective lifestyle and nutraceutical interventions, you can change that signaling and change the course of their symptoms today and the risks they have tomorrow.

 

Disclaimer

Understanding The Metabolic Connection & Chronic Diseases (Part 2)

The Metabolic Connections Between Chronic Diseases (Part 1)


Introduction

Dr. Alex Jimenez, D.C., presents how metabolic connections are causing a chain reaction to major chronic diseases in this 2-part series. Many factors often play a role in our health and wellness. It can lead to overlapping risk factors associated with pain-like symptoms in the muscles, joints, and vital organs. Part 2 will continue the presentation on metabolic connections with major chronic diseases. We mention our patients to certified medical providers that provide available therapy treatments for individuals suffering from chronic conditions associated with metabolic connections. We encourage each patient when it is appropriate by referring them to associated medical providers based on their diagnosis or needs. We understand and accept that education is a marvelous way when asking our providers’ crucial questions at the patient’s request and acknowledgment. Dr. Jimenez, D.C., makes use of this information as an educational service. Disclaimer

 

How Inflammation Affects The Body

Dr. Alex Jimenez, D.C., presents: So here you have a lean set of adipocytes on the left, and then as they start to plump up with more cellular weight, you can see those macrophages, the green boogies come around looking, saying, “Hey, what’s going on here? It doesn’t look right.” So they are investigating, and this causes local cell death; it’s just a part of the inflammatory cascade. So there is also another mechanism happening here. Those adipocytes are not just getting plumper by accident; it’s often related to a calorie surfette. So this nutrient overload damages the endoplasmic reticulum, leading to more inflammation. What these cells and the adipocytes are trying to do is protect themselves from glucose and lipo toxicity.

 

And the whole cell, the adipocyte cell, is creating these caps that are trying to say, “Please stop, we can’t take any more glucose, we can’t take any more lipids.” It’s a protection mechanism known as insulin resistance. It’s not just some random thing happening. It is the body’s way of trying to prevent glucose and lipotoxicity. Now that the inflammation alarm is occurring more than just in the adipocytes, it’s getting systemic. Other tissues and organs are starting to feel the same burden of the calorie surfette, causing inflammation and cell death. So glucose and lipotoxicity look like fatty liver when dealing with the liver. And you can also have it just like fatty liver progresses to cirrhosis with hepatocyte death. The same mechanism that’s happening in muscle cells. So our skeletal muscle cells specifically see cell death after inflammation and see fatty deposition.

 

The best way to think about it is, for example, the cows raised for food consumption and how they have marbled. So that’s the fatty deposition. And in humans, you can think about how people become sarcopenic as they become more and more insulin resistant. It’s the same phenomenon when body tissue tries to protect itself from glucolipotoxicity, causing a local inflammatory response. It becomes an endocrine response when it starts targeting other tissues in the periphery, whether the liver, muscle, bone, or brain; it’s just whatever is happening; they’re in the visceral adipocytes that can occur in other tissues. So that’s your paracrine effect. And then it can go viral, if you will.

 

Inflammation Associated With Insulin Resistance

Dr. Alex Jimenez, D.C., presents: You’re getting this local and systemic pro-inflammatory response coupled with insulin resistance, returning to this protection mechanism against glucose and lipotoxicity. Here you see how the blood vessels in our arteries get caught in the loop of fatty deposition and cell death. So you’ll see leaky blood vessels and fatty deposits, and you’ll see damage and pro-atherogenesis. Now, this is something we explained in AFMCP for the cardiometabolic module. And that is the physiology behind the insulin receptor. This is known as the lock and jiggle technique. So you have to have insulin lock into the insulin receptor up at the top., which is known as the lock.

 

And then there’s a phosphorylation cascade called the jiggle that then creates this cascade that ultimately causes the glucose-4 channels to open up the glucose-4 receptors to go into the cell so that it can be then the glucose, which is then utilized for energy production by the mitochondria. Of course, insulin resistance is where that receptor isn’t sticky or as responsive. And so not only do you fail to get glucose into the cell for energy production, but you are also rendering a hyper insulin state in the periphery. So you get hyperinsulinemia as well as hyperglycemia in this mechanism. So what can we do about that? Well, many nutrients have been shown to improve the lock and jiggle things that can improve the glucose-4 transporters coming up towards the periphery.

 

Anti-Inflammatory Supplements Reduce Inflammation

Dr. Alex Jimenez, D.C., presents: You see these listed here: vanadium, chromium, cinnamon alpha lipoic acid, biotin, and another relatively new player, berberine. Berberine is a botanical that can dampen all primary pro-inflammatory signals. So what precedes these comorbidities often and it’s insulin dysfunction. Well, what precedes insulin dysfunction many times? Inflammation or toxicity. So if berberine is helping the primary inflammation issue, it will address the downstream insulin resistance and all the comorbidities that can happen. So consider berberine as your option. So again, this shows you that if you can reduce inflammation up here at the top, you can minimize many cascade effects downstream. Berberine specifically seems to act in the microbiome layer. It modulates the gut microbiota. It may create some immune tolerance, therefore not rendering as much inflammation.

 

So consider berberine as one of the tools you can use to support insulin dysfunction and insulin resistance-related comorbidities. Berberine seems to increase insulin receptor expression, so the lock and jiggle work more effectively and improve the cascade with the glucose-4 transporters. That’s one mechanism by which you can start to find the root cause of many of the conditions we discussed when you see paracrine and endocrine glucose toxicity, lipotoxicity organ damage. Now another mechanism for you to consider is leveraging NF kappa B. So the goal is to keep NF kappa B grounded because as long as they don’t translocate, a host of inflammation signals do not get triggered.

 

So our goal is to keep NF kappa B grounded. How can we do that? Well, we can use NF kappa B inhibitors. So in this presentation of treatment options for any comorbidities related to insulin dysfunction, there are many ways to reduce these overlapping conditions affecting our bodies. So you can directly affect insulin resistance through anti-inflammatory supplements or indirectly help insulin resistance or insulin dysfunction by leveraging things against inflammation. Cause if you remember, insulin dysfunction is what then causes all those comorbidities. But what causes insulin dysfunction is generally inflammation or toxins. So our goal is to address pro-inflammatory things. Because if we can address pro-inflammatory things and nip the insulin dysfunction in the bud, we can prevent all the downstream organ damage or organ dysfunction.

 

Reducing Inflammation In The Body

Dr. Alex Jimenez, D.C., presents: Let’s move on to the next section that you can leverage or reduce the inflammation and insulin soup damage if you will, that the genes bathe in the body. This is the one you’ll often hear in our presentation, and that’s because, actually, in functional medicine, we help fix the gut. That’s usually where you need to go. And this is the pathophysiology for why we do that in cardiometabolic medicine. So if you have that poor or sad diet, that modern western diet with bad fats, it will directly damage your microbiome. That change in the microbiome can render increased intestinal permeability. And now lipopolysaccharides can translocate or leak into the bloodstream. To that point, the immune system says, “Oh no way, buddy. You’re not supposed to be in here.” You’ve got these endotoxins in there, and now there is a local and systemic inflammatory response that inflammation will drive the insulin dysfunction, which will cause the metabolic disorders that come after that.

 

Whatever the person’s genetically prone to, it gets clicked on epigenetically. So remember, if you can quell the inflammation in the microbiome, meaning create this tolerant and strong microbiome, you can reduce the inflammatory tone of the entire body. And when you reduce that, it’s been shown that it sets the insulin sensitivity. So the lower the inflammation, the higher the insulin sensitivity related to the microbiome. So surprise, it’s been shown that probiotics are associated with improved insulin sensitivity. So the right probiotics will create immune tolerance. Microbiome strength and modulation occur with probiotics. And so insulin sensitivity is preserved or regained based on where you are. So please consider that as another indirect mechanism or treatment option for leveraging cardiometabolic health for patients.

 

Probiotics

Dr. Alex Jimenez, D.C., presents: So when it comes to probiotics, we will use them in someone who might also concurrently have irritable bowel syndrome or food allergies. We might pick probiotics over NF kappa B inhibitors if they also have insulin resistance issues. But if they have many neurocognitive problems, we might start with the NF kappa B. So, that’s the way you can decide which ones to pick. Now, remember, when talking with patients, it is important to discuss how their eating habits are causing inflammation in their bodies. It is also important to note that it’s not just a quality conversation; it’s a quantity conversation and an immune conversation.

 

This reminds you that when you fix the gut by feeding it well and reducing its inflammatory tone, you get a host of other preventative benefits; you stop or at least reduce the strength of the dysfunction. And you can see that, ultimately can reduce the overlapping risk of obesity, diabetes, and metabolic syndrome. We are trying to drive home that metabolic endotoxemia, or just managing the microbiome, is a powerful tool to help your insulin-resistant or cardiometabolic patients. So much data tells us that we cannot just make the conversation about eating right and exercising.

 

It’s so much beyond that. So the more we can improve the gut microbiota, we can change inflammation signals through proper diet, exercise, stress management, sleep, all the other things we’ve been talking about, and fixing the gums and the teeth. The less the inflammation, the less the insulin dysfunction and, therefore, the less all those downstream disease effects. So what we want to make sure you know is to go to the gut and make sure that the gut microbiome is happy and tolerant. It’s one of the most potent ways to influence a healthy cardiometabolic phenotype. And aside, although it was a bigger thing a decade ago, non-caloric artificial sweeteners do as they might be non-caloric. And so people may be tricked into thinking it’s zero sugar.

 

But here’s the problem. These artificial sweeteners can interfere with healthy microbiome compositions and induce more type two phenotypes. So, even though you think you’re getting the benefit with no calories, you’re going to increase your risk for diabetes more through its effect on the gut microbiome. All right, We’ve made it through objective one. Hopefully, you’ve learned that insulin, inflammation, adipokines, and all the other things that happen in the endocrine response affect many organs. So let’s now start to look at emerging risk markers. Okay, we’ve talked a bit about TMAO. Again, that’s still a relevant concept here with gut and insulin resistance. So we want to make sure that you look at TMAO not as the end all be all but as another emerging biomarker that could give you a clue about microbiome health in general.

 

Looking For The Inflammatory Markers

Dr. Alex Jimenez, D.C., presents: We look at elevated TMAO to help the patient recognize that they have changed their eating habits. Most of the time, we help patients reduce unhealthy animal proteins and increase their plant-based nutrients. It’s generally how many doctors use it in standard medical practice. Alright, now another emerging biomarker, okay, and it sounds funny to call it emerging because it seems so obvious, and that is insulin. Our standard of care is centralized around glucose, fasting glucose, to our postprandial glucose A1C as a measure of glucose. We are glucose so centric and need insulin as an emerging biomarker if we try to be preventative and proactive.

 

And as you remember, we talked yesterday that fasting insulin in the bottom of the first quartile of your reference range for fasting insulin might be where you want to go. And for us in the US, that tends to be between five and seven as a unit. So notice that this is the pathophysiology of type two diabetes. So type two diabetes can happen from insulin resistance; it can also occur from mitochondrial problems. So pathophysiology of type two diabetes could be because your pancreas is not secreting enough insulin. So again, this is that little 20% that we talk about the majority of the people who are getting type two diabetes; it’s from insulin resistance, as we would suspect, from a hyper insulin problem. But there is this group of people who have damaged mitochondria, and they are not outputting insulin.

 

So their blood sugar rises, and they get type two diabetes. Okay, then the question is, if there is a problem with pancreatic beta cells, why is there a problem? Is the glucose going up because the muscles have insulin resistance, so they cannot capture and bring in glucose? So is it the liver that’s hepatic insulin resistant that cannot take in glucose for energy? Why is this glucose running around in the bloodstream? That’s what this is paraphrasing. So contributing role, you have to look at the adipocytes; you have to look for visceral adiposity. You must see if this person is just a big belly fat inflammatory-like catalyst. What can we do to reduce that? Is the inflammation coming from the microbiome?

 

Conclusion

Dr. Alex Jimenez, D.C., presents: Even the kidney can play a role in this, right? Like perhaps the kidney has increased glucose reabsorption. Why? Could it be because of an oxidative stress hit to the kidney, or could it be in the HPA axis, the hypothalamus pituitary adrenal axis where you’re getting this cortisol response and this sympathetic nervous system response that’s generating inflammation and driving the blood insulin and blood sugar disturbances? In Part 2, we will talk here about the liver. It’s a common player for many people, even if they don’t have fulminant fatty liver disease; it’s generally a subtle and common player for people with cardiometabolic dysfunction. So remember, we’ve got the visceral adiposity causing inflammation and insulin resistance with atherogenesis, and the liver is like this innocent bystander caught up in the drama. It’s happening before sometimes the atherogenesis starts.

 

Disclaimer

The Digestive Process: Functional Medicine Back Clinic

The Digestive Process: Functional Medicine Back Clinic

The body needs food for fuel, energy, growth, and repair. The digestive process breaks down food into a form the body can absorb and use for fuel. The broken-down food gets absorbed into the bloodstream from the small intestine, and the nutrients are carried to the cells throughout the body. Understanding how the organs work together to digest food can help with health goals and overall health.The Digestive Process: Chiropractic Functional Medicine Clinic

The Digestive Process

The organs of the digestive system are the following:

  • Mouth
  • Esophagus
  • Stomach
  • Pancreas
  • Liver
  • Gallbladder
  • Small intestine
  • Large intestine
  • Anus

The digestive process starts with the anticipation of eating, stimulating the glands in the mouth to produce saliva. The digestive system’s primary functions include:

  • Mixing food
  • Moving food through the digestive tract – peristalsis
  • The chemical breakdown of food into smaller absorbable components.

The digestive system converts food into its simplest forms, which include:

  • Glucose – sugars
  • Amino acids – protein
  • Fatty acids – fats

Proper digestion extracts nutrients from food and liquids to maintain health and function properly. Nutrients include:

  • Carbohydrates
  • Proteins
  • Fats
  • Vitamins
  • Minerals
  • Water

Mouth and Esophagus

  • The food is ground up by the teeth and moistened with saliva to swallow easily.
  • Saliva also has a special chemical enzyme that starts breaking down carbohydrates into sugars.
  • Muscular contractions of the esophagus massage the food into the stomach.

Stomach

  • The food passes through a small muscle ring into the stomach.
  • It gets mixed with gastric chemicals.
  • The stomach churns the food to break it down further.
  • The food is then squeezed into the first part of the small intestine, the duodenum.

Small Intestine

  • Once in the duodenum, the food mixes with more digestive enzymes from the pancreas and bile from the liver.
  • The food passes into the lower parts of the small intestine, called the jejunum and the ileum.
  • Nutrients are absorbed from the ileum, lined with millions of villi or thread-like fingers that facilitate the absorption.
  • Each villus is connected to a mesh of capillaries, which is how nutrients get absorbed into the bloodstream.

Pancreas

  • The pancreas is one of the largest glands.
  • It secretes digestive juices and a hormone called insulin.
  • Insulin helps regulate the amount of sugar in the blood.
  • Problems with insulin production can lead to conditions like diabetes.

Liver

The liver has several different roles that include:

  • Breaks down fats using bile stored in the gallbladder.
  • Processes proteins and carbohydrates.
  • Filters and processes impurities, medications, and toxins.
  • Generates glucose for short-term energy from compounds like lactate and amino acids.

Large Intestine

  • A large reservoir of microbes and healthy bacteria live in the large intestine and play an important role in healthy digestion.
  • Once the nutrients have been absorbed, the waste is passed into the large intestine or bowel.
  • Water is removed, and the waste gets stored in the rectum.
  • It is then passed out of the body through the anus.

Digestive System Health

Ways to keep the digestive system and the digestive process healthy include:

Drink More Water

  • Water helps the food flow more easily through the digestive system.
  • Low amounts of water/dehydration are common causes of constipation.

Add More Fiber

  • Fiber is beneficial to digestion and helps with regular bowel movements.
  • Incorporate both soluble and insoluble fiber.
  • Soluble fiber dissolves in water.
  • As soluble fiber dissolves, it creates a gel that can improve digestion.
  • Soluble fiber may reduce blood cholesterol and sugar.
  • It helps your body improve blood glucose control, which can aid in reducing your risk for diabetes.
  • Insoluble fiber does not dissolve in water.
  • Insoluble fiber attracts water into the stool, making it softer and easier to pass with less strain on the bowels.
  • Insoluble fiber can help promote bowel health and regularity and supports insulin sensitivity which can help reduce the risk of diabetes.

Balanced Nutrition

  • Eat fruit and vegetables daily.
  • Choose whole grains over processed grains.
  • Avoid processed foods in general.
  • Choose poultry and fish more than red meat and limit processed meats.
  • Cut down on sugar.

Eat Foods with Probiotics or Use Probiotic Supplements

  • Probiotics are healthy bacteria that help combat unhealthy bacteria in the gut.
  • They also generate healthy substances that nourish the gut.
  • Consume probiotics after taking antibiotics that often kill all the bacteria in the gut.

Eat Mindfully and Chew Food Slowly

  • Chewing food thoroughly helps to ensure the body has enough saliva for digestion.
  • Chewing food thoroughly also makes it easier for nutritional absorption.
  • Eating slowly gives the body time to digest thoroughly.
  • It also allows the body to send cues that it is full.

How The Digestive System Works


References

GREENGARD, H. “Digestive system.” Annual review of physiology vol. 9 (1947): 191-224. doi:10.1146/annurev.ph.09.030147.001203

Hoyle, T. “The digestive system: linking theory and practice.” British journal of nursing (Mark Allen Publishing) vol. 6,22 (1997): 1285-91. doi:10.12968/bjon.1997.6.22.1285

www.merckmanuals.com/home/digestive-disorders/biology-of-the-digestive-system/overview-of-the-digestive-system

www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

Martinsen, Tom C et al. “The Phylogeny and Biological Function of Gastric Juice-Microbiological Consequences of Removing Gastric Acid.” International journal of molecular sciences vol. 20,23 6031. 29 Nov. 2019, doi:10.3390/ijms20236031

Ramsay, Philip T, and Aaron Carr. “Gastric acid and digestive physiology.” The Surgical clinics of North America vol. 91,5 (2011): 977-82. doi:10.1016/j.suc.2011.06.010

Kombucha Fermented Tea Health Benefits: Back Clinic

Kombucha Fermented Tea Health Benefits: Back Clinic

Kombucha is a fermented tea that has been around for nearly 2,000 years. It became popular in Europe in the early 20th century. It has the same health benefits as tea, is rich in probiotics, contains antioxidants, and can destroy harmful bacteria. Kombucha sales are growing at stores because of its health and energy benefits.

Kombucha Fermented Tea Health Benefits

Kombucha

It is typically made with black or green tea, sugar, healthy bacteria, and yeast. It is flavored by adding spices or fruits into the tea while it ferments. It is fermented for about a week, when gases, 0.5 percent of alcohol, beneficial bacteria, and acetic acid are produced. The fermentation process makes the tea slightly effervescent. It contains B vitamins, antioxidants, and probiotics, but the nutritional content will vary depending on the brand and its preparation.

Benefits

The benefits include:

  • Improved digestion from the fact that fermentation makes probiotics.
  • Helps with diarrhea and irritable bowel syndrome/IBS.
  • Toxin removal
  • Increased energy
  • Improved immune system health
  • Weight loss
  • Helps with high blood pressure
  • Heart disease

Kombucha, made from green tea, includes the benefits of:

Probiotics

Beneficial bacteria are known as probiotics. These same probiotics are found in other fermented foods, like yogurt and sauerkraut. Probiotics help populate the gut with healthy bacteria that aid digestion, reduce inflammation, and produce essential vitamins B and K. The probiotics improve bowel movements and alleviate nausea, bloating, and indigestion.

Antioxidants

The antioxidants and polyphenols benefits include:

  • Increased metabolic rate
  • Reduced blood pressure
  • Lowered cholesterol
  • Improved cognitive function
  • Decreased risk of chronic diseases – cardiovascular disease, type 2 diabetes, and certain cancers.

Anti-Bacterial Properties

  • The fermentation process produces acetic acid that destroys harmful pathogens like invasive bacteria and yeasts, preventing infection.
  • The anti-bacterial effect also preserves the beneficial bacteria.

Liver Detoxification

  • It can help detoxify the liver, which:
  • Improves overall skin health
  • Improves liver function
  • Decreases abdominal bloating and pain
  • Improves digestion and bladder function

Pancreatic Support

  • It can improve pancreatic function, which can help protect the body from diseases and illnesses like:
  • Acid reflux
  • Abdominal spasms
  • Numbness
  • Pancreatic cancer

Joint Support

  • The tea contains compounds like glucosamines that have been shown to improve joint health and relieve joint pain.
  • Glucosamines increase hyaluronic acid, lubricating the joints, which helps protect and strengthen them.

Satisfy Soda Craving

  • The variety of flavors and natural carbonation can satisfy the craving for a soda or other unhealthy beverages.

Injury Medical Chiropractic and Functional Medicine Clinic includes elements of integrative medicine and takes a different approach to health and wellness. Specialists take a comprehensive view of an individual’s health, recognizing the need for a personalized treatment plan to help identify what is needed to get healthy. The team will create a customized plan that fits an individual’s schedule and needs.


Dietitian Explains Kombucha


References

Cortesia, Claudia et al. “Acetic Acid, the active component of vinegar, is an effective tuberculocidal disinfectant.” mBio vol. 5,2 e00013-14. 25 Feb. 2014, doi:10.1128/mBio.00013-14

Costa, Mirian Aparecida de Campos et al. “Effect of kombucha intake on the gut microbiota and obesity-related comorbidities: A systematic review.” Critical reviews in food science and nutrition, 1-16. 26 Oct. 2021, doi:10.1080/10408398.2021.1995321

Gaggìa, Francesca, et al. “Kombucha Beverage from Green, Black and Rooibos Teas: A Comparative Study Looking at Microbiology, Chemistry and Antioxidant Activity.” Nutrients vol. 11,1 1. 20 Dec. 2018, doi:10.3390/nu11010001

Kapp, Julie M, and Walton Sumner. “Kombucha: a systematic review of the empirical evidence of human health benefit.” Annals of epidemiology vol. 30 (2019): 66-70. doi:10.1016/j.annepidem.2018.11.001

Villarreal-Soto, Silvia Alejandra, et al. “Understanding Kombucha Tea Fermentation: A Review.” Journal of food science vol. 83,3 (2018): 580-588. doi:10.1111/1750-3841.14068

The Mechanics Of Toxic Metals In The Immune System

The Mechanics Of Toxic Metals In The Immune System

Introduction

The immune system‘s role is to be the “protectors” of the body by attacking invaders that enter the body, cleaning up old cells, and making room for new cells to flourish in the body. The body needs the immune system to function and be healthy from many environmental triggers the body is exposed to daily. When environmental triggers come in contact with the body, it can cause many disruptive factors over time and causes the immune system to mistakenly attack healthy, normal cells as they see it as a foreign invader, thus causing the body to develop autoimmune diseases. Some environmental triggers like toxic metals could be associated with autoimmune diseases that can affect the body, causing various symptoms to affect the body. Today’s article looks at the effects of toxic metals on the body, how it affects the immune system, and ways to manage the impact of toxic metals on the immune system. We refer patients to certified providers specializing in autoimmune treatments to help many individuals with autoimmune diseases associated with toxic metals. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

The Effects of Toxic Metals On the Body

 

Have you been experiencing abdominal pain in your gut? Do you have a bitter metallic taste in your mouth? What about experiencing inflammation affecting not only your joints but your gut as well? Many of these symptoms are signs correlating that you might suffer from toxic metals in your body. The body is constantly exposed to various environmental factors that affect many individuals over time. It can be the foods consumed, the environment a person is exposed to, and their physical activity. Studies reveal that heavy metal pollutants from environmental pollution can enter the human body through various pathways like the respiratory, cutaneous, and gastrointestinal paths and begin to accumulate in different organs. When the body suffers from autoimmune diseases associated with toxic metals, symptoms of inflammation will start to affect the joints in the body. To that point, toxic metals will begin to facilitate their interaction with the immune system, causing the development of autoimmune disease symptoms.

 

How Does It Affect The Immune System

So how do toxic metals affect the immune system, thus causing symptoms associated with autoimmunity? As stated earlier, the immune system is the body’s protector and, when exposed to environmental disruptors over time, leads to the development of autoimmune diseases. For toxic metals, many people are usually exposed to low levels of metals through consuming fish and shellfish (containing low levels of mercury). However, when individuals are exposed to high levels of heavy metals, studies reveal that certain metals can seriously affect the immune system by overstimulating the different muscle tissues and soluble mediators that cause chronic-inflammatory reactions associated with heavy metals. Some of the symptoms associated with toxic metals causing autoimmunity in the body include:

  • Numbness
  • Prickly sensation down hands or feet
  • Abdominal pain
  • Inflammation
  • Joint pain
  • Muscle weakness

 


Introduction The Immune System-Video

Have you been experiencing inflammation in your joints? How about feeling muscle weakness in your back, arms, legs, or neck? Or have you been feeling overall discomfort in your body? Many of these symptoms are signs of autoimmune diseases associated with toxic metals. The video above introduces the immune system and how it plays its role in the body. When the body gets exposed to environmental factors like heavy toxic metals, it can cause the development of autoimmune diseases associated with chronic issues like joint inflammation and muscle pain. Different heavy toxic metals can affect other body parts, as studies reveal that these different heavy toxic metals are systemic toxicants that induce adverse health effects on the body. When an individual has been exposed to high levels of heavy toxic metals, chronic issues like joint inflammation can progressively cause pain over time unless treated early on. Luckily, treatments are available to help manage the effects of toxic metals in the immune system associated with joint inflammation.


Managing The Effects Of Toxic Metals In The Immune System

 

Since the body is exposed to environmental factors constantly, if it is not treated right away, it can lead to autoimmunity associated with chronic symptoms like joint inflammation. Fortunately, there are ways to manage the effects of environmental factors, like lowering the impact of toxic metals on the body system. Studies reveal that incorporating essential minerals protects the DNA sequence from further oxidative damage in the body’s immune system. Other treatments like chiropractic care utilize spinal manipulation on spinal subluxation or spinal misalignment on the joints to reduce inflammation associated with toxic metal autoimmunity. Since there are many ways that autoimmunity can affect the body through environmental triggers, the symptoms associated with autoimmunity are treated through chiropractic care. Chiropractic care not only utilizes spinal manipulation but can help improve the immune system in the body by increasing lymphatic fluid circulation and loosening stiff muscles surrounding the joints. To that point, it allows the body to get rid of toxins and waste that is in the body. Incorporating treatments like chiropractic care can help restore the body to its functional state.

 

Conclusion

The immune system is the body’s protector from foreign invaders that enter the body. When there are environmental triggers that the body is being exposed to, it can put the body at risk of developing autoimmune disease associated with chronic symptoms like inflammation of the joints. Environmental triggers like heavy metals can be associated with joint inflammation and cause pain in the body. When this happens, the body experiences pain and dysfunction due to inflamed joints. Fortunately, chiropractic treatments utilize spinal manipulation on subluxation (spinal misalignment) to reduce joints’ inflammation and improve lymphatic system circulation. These treatments can help the body manage autoimmunity associated with heavy metals and their symptoms.

 

References

Ebrahimi, Maryam, et al. “Effects of Lead and Cadmium on the Immune System and Cancer Progression.” Journal of Environmental Health Science & Engineering, Springer International Publishing, 17 Feb. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7203386/.

Jan, Arif Tasleem, et al. “Heavy Metals and Human Health: Mechanistic Insight into Toxicity and Counter Defense System of Antioxidants.” International Journal of Molecular Sciences, MDPI, 10 Dec. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4691126/.

Lehmann, Irina, et al. “Metal Ions Affecting the Immune System.” Metal Ions in Life Sciences, U.S. National Library of Medicine, 2011, pubmed.ncbi.nlm.nih.gov/21473381/.

Tchounwou, Paul B, et al. “Heavy Metal Toxicity and the Environment.” Experientia Supplementum (2012), U.S. National Library of Medicine, 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC4144270/.

Disclaimer

The Gallbladder & The Parasympathetic Nervous System Function

The Gallbladder & The Parasympathetic Nervous System Function

Introduction

The digestive system in the body helps with the process of digesting food that the host consumes. The food being digested goes through a bio-transformation where it turns into nutrients and is stored in the intestinesliver, and gallbladder, where it turns into bile to be excreted out of the system to ensure a healthy functional gut system and body. But when disruptive factors like poor eating habits or gut issues start to affect the body and gallbladder, this causes many problems that can make an individual miserable. This affects their quality of life since they are dealing with painful issues in their bodies that overlap the primary source risk profiles. Today’s article looks at the gallbladder, how it functions with the body and parasympathetic nervous system, and how referred shoulder pain and gallbladder dysfunction are connected. We refer patients to certified providers specializing in gastroenterology and chiropractic treatments that help those with issues that affect their shoulders and gallbladder. We also guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is the solution to asking our providers insightful questions. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

What Is The Gallbladder?

The digestive system comprises the mouth, the internal organs from the GI tract, the liver, the gallbladder, and the anus, where food is consumed, digested, and excreted out of the body to keep it healthy. The gallbladder is a small organ that store and releases bile at the appropriate time into the intestines to be mixed with the digested foods to be excreted out of the body. This pear-shaped organ inflates and deflates like a balloon when it stores and releases bile while having a casual relationship with the nerves and hormones that help regulate the gallbladder functioning properly. Studies reveal that the ganglia become the target of causing the hormone cholecystokinin and the parasympathetic nerve to up or downregulate the neurotransmission to the gallbladder. This causes the gallbladder to be functional in the body.

 

What Are Its Functions In The Parasympathetic Nervous System?

So what are the functions that the gallbladder provides to the body? For starters, the parasympathetic nervous system allows the body to rest and digest the consumed food to be turned into nutrients. The parasympathetic nervous system also provides gallbladder stimulation as studies reveal that the gallbladder receives innervation from the parasympathetic nervous system connected to the vagus nerve that transmits information to the spine and the brain. Keeping and releasing bile from this pear-shaped organ helps regulate the gastrointestinal tract. This causal relationship between the gallbladder and the parasympathetic nerve is essential because the body needs to know when to store and release bile from the gallbladder, or it might trigger some issues that can do more harm to the body and even affect the gallbladder itself.


Do You Have Shoulder Pain?- Video

Have you been experiencing gut issues causing a sharp or dull ache in your back or sides? How about questionable shoulder pain that seems to come out of nowhere? Or are your experiencing inflammation in your digestive system? Many of these symptoms are signs of visceral-somatic pain affecting the gallbladder. Visceral-somatic pain is defined when there is damage to the organ, and it starts to affect the muscles in a different location in the body. The video above gives an excellent example of visceral-somatic pain in the gallbladder and the shoulder. Now many people wonder how shoulder pain is the mediator of the gallbladder? Well, inflammation in the liver and gallbladder causes the nerve roots to be hypersensitive and compressed. This leads to overlapping profiles, triggering pain in the shoulder muscles and associated with upper mid-back pain.


Referred Shoulder Pain & Gallbladder Dysfunction

 

Now say the individual is experiencing shoulder pain; however, when they rotate their shoulder, there is no pain? Where is the source of shoulder pain localized, and what is causing the issue? And why is it correlating to the gallbladder? This is known as referred pain, where the source of pain is poorly localized when it is located elsewhere. Studies reveal that gallbladder dysfunctions like cholecystitis might be associated with acute thoracolumbar shoulder pain. So what does this mean? It means that any referred pain that is the causation of shoulder pain gives the impression that something is wrong with the gallbladder. This would provide much-needed information when individuals are being examined by their physicians.

 

Conclusion

The body needs the digestive system to help process food the host consumes and excretes for a healthy functioning system. The gallbladder stores and releases bile to the digested food. This ensures that the nutrients and bile are transported and passed out of the body. When disruptive factors cause gut issues and affect the gallbladder, it can correlate to different problems impacting the body. An example would be gallbladder issues associated with shoulder pain. This is referred to as pain, which is from an affected organ and associated with the muscle in a different location. This can make the individual feel miserable and wonder what is going on with their shoulders when it might be something associated with their gallbladder. Available treatments can provide better knowledge to determine the problem and how to alleviate the issues.

 

References

Carter, Chris T. “Acute Thoracolumbar Pain Due to Cholecystitis: A Case Study.” Chiropractic & Manual Therapies, BioMed Central, 18 Dec. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4683782/.

Jones, Mark W, et al. “Anatomy, Abdomen and Pelvis, Gallbladder.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 8 Nov. 2021, www.ncbi.nlm.nih.gov/books/NBK459288/.

Mawe, Gary M., et al. “Nerves and Hormones Interact to Control Gallbladder Function.” Physiology, 1 Apr. 1998, journals.physiology.org/doi/full/10.1152/physiologyonline.1998.13.2.84.

Medical Professional, Cleveland Clinic. “Gallbladder: What Is It, Function, Location & Anatomy.” Cleveland Clinic, 28 July 2021, my.clevelandclinic.org/health/body/21690-gallbladder.

Disclaimer

A Look At Gut-Brain Dysbiosis & Chronic Inflammation

A Look At Gut-Brain Dysbiosis & Chronic Inflammation

Introduction

One of the unique features of the body is when the gut and nervous systems have this communication partnership where information is transported back and forth throughout the entire body. The data transmitted to the brain and the gut travels through the nerve roots spread throughout the muscles, tissues, and ligaments that control the motor-sensory functions of the body. When the nerve roots become damaged or when there are gut issues affecting the organs in the gut system or even neurological disorders can cause the body to become dysfunctional and result in other matters affecting the muscles in the legs, arms, back, and neck. Today’s article looks at the functionality of the gut-brain axis, how this connection helps the body, and how disorders like inflammation and gut dysbiosis cause problems to the body and the gut-brain axis. Refer patients to certified, skilled providers specializing in gut treatments for individuals that suffer from gut dysbiosis and chronic inflammation. We guide our patients by referring to our associated medical providers based on their examination when it’s appropriate. We find that education is critical for asking insightful questions to our providers. Dr. Alex Jimenez DC provides this information as an educational service only. Disclaimer

 

Can my insurance cover it? Yes, it may. If you are uncertain, here is the link to all the insurance providers we cover. If you have any questions or concerns, please call Dr. Jimenez at 915-850-0900.

The Functionality Of The Gut-Brain Axis

 

Have you been experiencing inflammation in your gut? How about feeling tired constantly throughout the entire day? Do any of your joints or muscles ache or feel stiff? Many of these are signs that the gut-brain axis is affected by common factors that the body has encountered. There is evidence that the bi-directional signaling between the gastrointestinal tract and the brain is connected with the vagus nerve. Research studies have mentioned that the vagus nerve is the modulator of the gut-brain axis and is considered the primary component in the parasympathetic nervous system that is vital for maintaining homeostasis in the body. The vagus nerve helps the body by overseeing every bodily function like heart rate, digestion responses, immune responses, and sending the brain information about the state of the inner organs. The vagus nerve is also involved in the etiology of several metabolic and mental dysfunctions/disorders that the body encounters that affect the muscles and internal organs. Additional research studies have shown that the vagus nerve has anti-inflammatory properties that are activated from the HPA axis and release the hormone cortisol in the body. The macrophages in the spleen make tumor necrosis factor (TNF) a potent inflammation-producing molecule when the vagus nerve is stimulating the TNF production in the spleen, causing it to decrease. At the same time, the survival portion increases in the body.

 

How Does The Gut-Brain Axis Help The Body?

With the bi-directional that the gut and brain have on the body, it is evident that environmental factors like oxidative stress, inflammation, and mood disorders cause changes in the glutamatergic pathways and neurotrophins in the body. Research studies have mentioned that the gut-brain axis helps influence the autonomic nervous system by activating the immune system. When the immune system is activated, the body can generally function like muscle endurance, provide microbiota-derived SCFAs to the blood-brain barrier, and regulate the body’s homeostasis. When the gut-brain axis starts to become dysfunctional, the immune system will begin to increase its production of cortisol which can cause muscle stiffness and spasms to affect the body. When there is inflammation in the gut system, it can cause the muscles in the body to become weak, and it can affect the spine causing low back pain issues to develop over time. Whenever the gut-brain axis is affected by environmental factors, the body will begin to start causing trouble with these symptoms and making the individual miserable.


The Microbiome Being Affected By Inflammation-Video

Are you experiencing muscle stiffness or weakness in your lower back, neck, or other body parts? Have you experienced mood swings or felt anxious constantly? Many of these symptoms you are experiencing are dysfunctional gut-brain axis affecting your body. The video above explained what happens when the gut microbiome is affected by inflammatory factors causing gut dysbiosis and neurological disorders. Research studies have mentioned that the composition between the gut and the brain as they communicate helps shape the body. When a person starts changing their dietary habits and lifestyle, their gut composition will not only be affected, but their nervous system begins to change too. Unwanted factors can cause many disturbances in the body and, if not treated right away, can develop into chronic issues that affect the joints, muscles, and tissues.


Inflammation And Gut-Brain Dysbiosis

 

When the gut-brain system is affected by unwanted factors, various symptoms will begin to rise in the body and start wreaking havoc on specific organs, tissues, muscles, and joints that need the gut-brain axis to keep the body functioning. Not only can inflammation cause these unwanted factors, but gut dysbiosis can also affect the T-cells in the immune system. Research studies have mentioned that when inflammatory markers start to translocate harmful bacteria across the gut-epithelial barrier to the blood-brain barrier, it can contribute to multiple sclerosis on the spine. Additional research studies have found that a stroke-induced gut dysfunction in the body allows the commensal bacteria to infect the peripheral tissue, causing infections like pneumonia and urinary tract infections. When individuals start to figure out what is causing their gut-brain axis to become dysfunctional, they can begin to heal their bodies.

 

Conclusion

The gut and nervous systems have a special bi-directional connection known as the gut-brain axis. The gut-brain axis helps the body function by metabolizing the immune system and regulating homeostasis with the vagus nerve. The vagus nerve is part of the parasympathetic nervous system that allows every bodily function like heart rate, digestion, and immune response while sending information about the state of the inner organs to the brain. The vagus nerve also makes sure that the inner organs are functioning correctly. When unwanted environmental factors like inflammation or gut dysbiosis start to affect the gut-brain axis, it can wreak havoc on the internal organs and cause the body to become dysfunctional. When people notice that their body becomes dysfunctional, they will find treatments available to relieve these issues in their bodies and continue on their health and wellness journey.

 

References

Appleton, Jeremy. “The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health.” Integrative Medicine (Encinitas, Calif.), InnoVision Health Media Inc., Aug. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6469458/.

Bonaz, Bruno, et al. “Vagus Nerve Stimulation at the Interface of Brain-Gut Interactions.” Cold Spring Harbor Perspectives in Medicine, Cold Spring Harbor Laboratory Press, 1 Aug. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6671930/.

Breit, Sigrid, et al. “Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders.” Frontiers in Psychiatry, Frontiers Media S.A., 13 Mar. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/.

Gwak, Min-Gyu, and Sun-Young Chang. “Gut-Brain Connection: Microbiome, Gut Barrier, and Environmental Sensors.” Immune Network, The Korean Association of Immunologists, 16 June 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8263213/.

Günther, Claudia, et al. “The Gut-Brain Axis in Inflammatory Bowel Disease-Current and Future Perspectives.” International Journal of Molecular Sciences, MDPI, 18 Aug. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8396333/.

Stopińska, Katarzyna, et al. “The Microbiota-Gut-Brain Axis as a Key to Neuropsychiatric Disorders: A Mini Review.” Journal of Clinical Medicine, MDPI, 10 Oct. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8539144/.

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