In Gut and Psychology Syndrome, British neurologist and nutritionist Natasha Campbell-McBride, MD reveals the connection between the gut flora — the microorganisms in the digestive tract — and the brain. Campbell-McBride illuminates the gut's vital role in supporting the full range of our mental and physical health. Her findings relate to both children and adults.
Medinform Publishing, 2004 ISBN 978-0954852009 266 pages

We live in a world of epidemics
85% of the body's immune system can be found in the gut
The vital functions of gut flora
Gut flora protect and nourish the digestive tract
Symptoms of gut dysbiosis
What kind of toxins are we talking about?
The importance of re-establishing gut flora

We live in a world of epidemics

Fifteen years ago, autistic spectrum disorders affected one in 10,000 children. Today in the West, on average one in 200 children are diagnosed on the autistic spectrum.

Millions of children are taking brain altering medications such as Ritalin to combat attention deficit hyperactivity disorder (ADHD/ADD) and depression while many millions more are being diagnosed with other learning problems with labels like dyslexia and dyspraxia.

How many families do you know personally who complain of being plagued by allergies, eczema, and asthma?

Other epidemics include schizophrenia and obsessive compulsive disorder (OCD), which was unheard of only a few decades ago and now affects 2 million people in the United Kingdom alone.

Many other neuropsychological and psychiatric problems in children and young adults are becoming more and more common.

Chronic degenerative diseases afflict over 120 million Americans with 50 million more suffering from one or more auto-immune diseases such as type 2 diabetes, hypothyroidism, adrenal fatigue, MS, chronic fatigue, irritable bowel syndrome, and a host of other syndromes.

Cancer is now close to being expected to develop in 1 out of every 2 people in their lifetime.

Antibiotic resistant infections are increasing at an alarming rate.

Approximately 90% of medication can only suppress symptoms of disease with no ability to fix or cure the diseases.

Possibly most worrying is that the Centers for Disease Control in Atlanta has stated that for the first time in history those born after the year 2000 are expected to die before their parents — a truly frightening prospect.

We have created different diagnostic boxes in which to fit these "diseases." But often we do not fit into any one of them neatly. The modern westerner in most cases fits into a rather lumpy picture of overlapping neurological and psychiatric conditions. This picture leads us to the fact that these conditions are related to each other by similar underlying causes.

85% of the body's immune system can be found in the gut

Not many people know that an adult on average carries 2 kg of bacteria in the gut. There are more cells in that microbial mass than there are cells in an entire human body. It is a highly organised micro-world, where certain species of bacteria have to predominate to keep us healthy physically and mentally. Their role in our health is so monumental that we simply cannot afford to ignore them.

A typical modern mother was probably not breast-fed when she was a baby, because she was born in the 60s or 70s when breast-feeding went out of fashion. Why is it important?

Because it is well known now that bottle-fed babies develop completely different gut flora compared to breast-fed babies. This compromised gut flora in a bottle-fed baby later on predisposes her to many health problems. Having acquired compromised gut flora from the start, a typical modern mum had quite a few courses of antibiotics in her childhood and youth for various infections. It is a well known fact that antibiotics have a serious damaging effect on gut flora, because they wipe out the beneficial strains of bacteria in the gut. At the age of 16, and sometimes even earlier, the modern mum was put on a contraceptive pill, which she took for quite a few years before starting a family.

Contraceptive pills have a devastating effect on the beneficial (good) bacteria in the gut.

One of the major functions of the good bacteria in the gut flora is controlling about 500 different species of pathogenic (bad) and opportunistic microbes known to science. When the beneficial bacteria get destroyed the opportunists get a special opportunity to grow into large colonies and occupy large areas of the digestive tract. A modern diet of processed and fast foods provide perfect nourishment for these pathogens and that is a typical diet a modern mum had as a child and a young adult.

As a result of all these factors a modern mum has seriously compromised gut flora by the time she is ready to have children. The most common health problems in mothers are digestive abnormalities, allergies, autoimmunity, PMS, chronic fatigue, headaches and skin problems.

Whatever microbial flora the mother has she passes to her new-born child. And indeed clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with neurological and psychiatric conditions.

The vital functions of gut flora

Gut flora is something we do not think much about. And yet the number of functions the gut flora fulfills is so vital for us that if some day our digestive tract got sterilised we probably would not survive.

The first and very important function is appropriate digestion and absorption of food. If a child does not acquire normal balanced gut flora, then the child will not digest and absorb foods properly, developing multiple nutritional deficiencies. And that is what we commonly see in children with learning disabilities, psychiatric problems, and allergies.

Many of these children are malnourished. Even in the cases where the child may grow well, testing reveals some typical nutritional deficiencies in many important minerals, vitamins, essential fats, many amino-acids and other nutrients. The most common deficiencies, recorded in these children, are in magnesium, zinc, selenium, copper, calcium, manganese, sulphur, phosphorus, iron, potassium, vanadium, boron, vitamins B1, B2, B3, B6, B12, C, A, D, folic acid, pantothenic acid, omega-3, 6, 9 fatty acids, taurine, alpha-ketoglutaric acid, glutathione and many other amino-acids.

This usual list of nutritional deficiencies, commonly seen in these children, includes some of the most important nutrients for normal development of the child's brain, immune system, and the body as a whole.

In addition to promoting normal digestion and absorption of food, healthy gut flora actively synthesise various nutrients: vitamin K, pantothenic acid, folic acid, thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6), ciancobalamine (vitamin B12), various amino-acids, and proteins. When tested, people with gut dysbiosis always present with deficiencies of these nutrients. Clinical experience shows that restoring the beneficial bacteria in their gut is the best way to deal with these deficiencies.

The majority of children with neurological and psychiatric conditions look pale and pasty. When tested, they show various stages of anaemia, which is not surprising. To have healthy blood we require many different nutrients: vitamins (B1, B2, B3, B6, B12, K, A, D, etc.), minerals (iron, calcium, magnesium, zinc, cobalt, selenium, boron, etc.), essential amino-acids, and fats. These children are not only unable to absorb these nutrients from food — their ability to produce many of them in the body is also damaged.

What's more, people with damaged gut flora often have particular groups of pathogenic bacteria growing in their gut, including iron-loving bacteria (Actinomyces spp., Mycobacterium spp., pathogenic strains of E.Coli, Corynebacterium spp. and many others). These bacteria consume whatever iron the the diet provides, leaving that person deficient in iron. Unfortunately, supplementing iron only makes these bacteria grow stronger and does not remedy anaemia. To treat anaemia, the person requires all the nutrients we have mentioned, many of which healthy gut flora supply.

Gut flora protect and nourish the digestive tract

In addition to taking a direct part in nourishing the body, beneficial bacteria in the gut act as the housekeepers for the digestive tract. They coat the entire surface of the gut, protecting it from invaders and toxins by providing a natural barrier and producing a lot of antibacterial, anti-viral and anti-fungal substances.

At the same time, they provide the gut lining with nourishment. It is estimated that 60-70% of the energy that the gut lining derives is from the activity of bacteria which live on its surface.

It is no surprise, then, that when the gut flora is abnormal the digestive tract itself cannot be healthy. Indeed, most children with learning disabilities, psychiatric disorders and allergies present with digestive problems. In many cases these problems are severe enough for the parents to talk about them first.

In some cases they may not be very severe, but when asked direct questions the parents describe that their child never had normal stool, that their child suffered from colic as a baby, and that tummy pains and flatulence are a common part of the picture. In those cases where these children have been examined by gastro-enterologists, inflammatory process in the gut was found along with faecal compaction and an over-spill syndrome.

The most recent research was performed at the Royal Free Hospital in London by Dr. Andrew Wakefield and his team. They found an inflammatory condition in the bowel of autistic children, which they have named Autistic Enterocolitis.

Schizophrenic patients were always known to have serious digestive problems. Dr. Curtis Dohan, MD has devoted many years to researching digestive abnormalities in schizophrenia. He found a lot of similarities between coeliac disease and the state of the digestive tract in schizophrenics.

In my clinical practice, I see that long before these patients develop psychotic symptoms they suffer from digestive problems and all other typical symptoms of gut dysbiosis and have done so pretty much from the start of their lives. Children and young adults with ADHD/ADD, OCD, depression and other neuropsychological problems are very often reported to suffer from digestive abnormalities though there have not been formal studies published yet.

Symptoms of gut dysbiosis

What other symptoms of gut dysbiosis do we know? Well-functioning gut flora is the right hand of our immune system. The beneficial bacteria in the gut ensure appropriate production of different immune cells, immunoglobulins, and other parts of the immune system. But most importantly, they keep the immune system in the right balance. What typically happens in a person with gut dysbiosis is that two major arms of their immune system, Th1 and Th2, get out of balance with underactive Th1 and overactive Th2. As a result, the immune system starts reacting to most environmental stimuli in an allergic or atopic kind of way.

A baby is born with an immature immune system. Establishment of a healthy balance of gut flora in the first few days of life plays a crucial role in the appropriate maturation of the immune system. If the baby does not acquire appropriate gut flora then the baby is left immune compromised. The result is lots of infections followed by lots of courses of antibiotics, which damage the child's gut flora and immune system even further.

The most common infections in the first two years of life in the children with neurological, psychological, and atopic disorders are ear infections, chest infections, sore throats, and impetigo.

At the same time, in the first two years of life the child receives a lot of vaccinations. A child with compromised immune system does not react to vaccinations in a predicted way. In most cases, vaccines deepen the damage to the immune system and provide a source of chronic persistent viral infections and autoimmune problems in these children.

A considerable amount of research has been published regarding the state of the immune system in children with learning disabilities and psychiatric problems. The research shows deep abnormalities in all major cell groups and immunoglobulins in these children. The most common autoantibodies found are to myelin basic protein (MBP) and neuron-axon filament protein (NSFP). These antibodies attack the child's brain and the rest of the nervous system.

So, the modern child did not get normal gut flora from the start and then got it damaged even further by repeated courses of antibiotics and vaccinations. As a result, these children commonly suffer from digestive problems, allergies, asthma, and eczema.

For children who then go on to develop neurological and psychiatric problems, something even more terrible happens. Without control of the beneficial bacteria, different opportunistic and pathogenic bacteria, viruses, and fungi have a good chance to occupy large territories in the digestive tract of the child and grow large colonies.

Two particular groups which are most commonly found on testing are yeasts (including Candida species) and Clostridia family. These pathogenic microbes start digesting food in their own way, producing large amounts of various toxic substances which get absorbed into the blood stream and are carried to the brain, where they cross the blood-brain barrier.

The number and mixture of toxins can be very individual, causing a variety of neurological and psychological symptoms. Due to the absence or greatly reduced numbers of beneficial bacteria in the gut flora, instead of being a source of nourishment the child's digestive system becomes a major source of toxicity in the body.

What kind of toxins are we talking about?

There are many toxins which have not been studied very well yet. But some toxins have received a considerable amount of research. Let us have a look at them.

Acetaldehyde and alcohol — what have these substances got to do with children? The most common pathogenic microbes shown to overgrow in the digestive systems of children with neuropsychological conditions and allergies are yeasts, particularly Candida species. Yeasts ferment dietary carbohydrates, producing alcohol and its by-product, acetaldehyde.

Let us see what a constant exposure to alcohol and acetaldehyde does to the body. The effects include:

• Liver damage with reduced ability to detoxify drugs, pollutants, and other toxins.
  
  
• Inability of the liver to dispose of old neurotransmitters, hormones, and other byproducts of normal metabolism. As a result, these substances accumulate in the body, causing behavioural abnormalities and many other problems.
  
  
• Degeneration of the pancreas with reduced ability to produce pancreatic enzymes, which impairs digestion.
  
  
• Reduced ability of the stomach wall to produce stomach acid.
  
  
• Damage to immune system.
  
  
• Brain damage with lack of self-control, impaired co-ordination, impaired speech, development, aggression, mental retardation, loss of memory and stupor.
  
  
• Peripheral nerve damage with altered senses and muscle weakness.
  
  
• Direct muscle tissue damage with altered ability to contract and relax plus muscle weakness.
  
  
• Nutritional deficiencies from damaging effect on digestion and absorption of most vitamins, minerals and amino acids. Deficiencies in vitamins B and A are particularly common.
  
  
• Alteration of metabolism of proteins, carbohydrates, and lipids in the body.
  

Alcohol has an ability to enhance the toxicity of most common drugs, pollutants, and other toxins. Acetaldehyde is considered to be the most toxic of alcohol by-products. It is the chemical which gives us the feeling of having a hangover. Anybody who has experienced a hangover can tell you how dreadful he or she felt.

Children who acquire abnormal gut flora with a lot of yeast from the start may never know any other feeling. Acetaldehyde has a large variety of toxic influences on the body. One of the most devastating influences of this chemical is its ability to alter the structure of proteins. Acetaldehyde-altered proteins are thought to be responsible for many autoimmune reactions. Children with neuropsychological problems are commonly found to have antibodies against their own tissues.

Other toxins include:

Clostridia neurotoxins. There are about 100 different Clostridia species known so far. They are present in the stools of people with autism, schizophrenia, psychosis, severe depression, muscle paralysis, muscle tonus abnormalities, and some other neurological and psychiatric conditions. Many Clostridia species are normal inhabitants of a human gut. For example, Clostridium tetani is routinely found in the gut of healthy humans and animals.

Everybody knows that tetanus is a deadly disease, due to an extremely powerful neurotoxin Clostridium tetani produces. Clostridium tetani, which lives in the gut, is normally controlled by the beneficial bacteria and does us no harm, because its toxin can not get through the healthy gut wall. Unfortunately, the children we are discussing do not have a healthy gut wall. In gut dysbiosis this powerful neurotoxin may well get absorbed through the damaged gut lining and then cross the blood-brain barrier affecting the child's mental development.

Many other species of Clostridia (perfringens, novyi, septicum, histolyticum, sordelli, aerofoetidum, tertium, sporogenes, etc.) produce toxins similar to tetanus toxin as well as many other toxins. Dr. William Shaw at Great Plains Laboratories describes in detail the number of autistic children who showed significant improvement in their development and biochemical tests while on anti-Clostridia medication. Unfortunately, as soon as the medication was stopped the children slipped back into autism, because these children do not have the healthy gut flora to control Clostridia and prevent their toxins from traveling through the gut lining into the bloodstream.

In many cases, Clostridia were not identified in the stools of these children because Clostridia are strict anaerobes and are very difficult to study. We need to come up with some better ways of testing for these potent pathogens.

Yeasts and Clostridia have been given a special opportunity in the era of antibiotics. Broad-spectrum antibiotics do not touch them while they do kill the beneficial bacteria in the gut, which are capable of controlling the yeasts and Clostridia. So, after every course of antibiotics, these two pathogenic groups get out of control and overgrow. The children that we are talking about usually are exposed to numerous courses of antibiotics pretty much from the beginning of their lives.

Gluteomorphins and casomorphins or opiates from gluten and casein. Opiates are drugs — such as opium, morphine, and heroin — which are commonly used by drug addicts. What have they got to do with children?

Gluten is a protein present in grains — mainly wheat, rye, oats, and barley. Casein is a milk protein, present in cow, goat, sheep, human, and all other milk and milk products. In the bodies of children and adults with autism and schizophrenia, these proteins do not get digested properly because their digestive systems are full of abnormal microbial flora. As a result of misdigestion, gluten and casein turn into substances with chemical structure similar to opiates such as morphine and heroin.

There has been quite a substantial amount of research conducted in this area by Dohan, Reichelt, Shattock, Cade and others, in which gluten and casein peptides, called gluteomorphin and casomorphin, were detected in the urine of schizophrenic patients and autistic children. Incidentally, these substances were also found in patients with depression and rheumatoid arthritis. These opiates from wheat and milk get through the blood-brain barrier and block certain areas of the brain, just like morphine or heroin would do, causing various neurological and psychological symptoms. Based on this research, the gluten- and casein-free diet (GFCF diet) has been developed, which helps a lot of children and adults with autism and schizophrenia.

Dermorphin and deltorphin. These are two frightening toxic substances with opiate structure that have been found in autistic children by biochemist Alan Friedman, PhD.

Dermorphin and deltorphin were first identified on the skin of a poison dart frog in South America. Native people used to dip their darts into the mucous on these frogs in order to paralyse their enemy, because deltorphin and dermorphin are extremely potent neurotoxins. Dr. Friedman believes that it is not the frog that produces these neurotoxins, but rather a fungus which grows on the skin of this frog. It is possible that this fungus grows in the gut of autistic children, supplying their bodies with dermorphin and deltorphin.

Organic acid testing now available in many laboratories around the world can identify various metabolites of microbial activity taking place in the gut which are absorbed and then excreted in the child's urine. Many of these metabolites are highly poisonous substances.

Low serum sulphate is a common finding in these children. It is an indirect indication of toxicity in the body because sulphates are essential for many detoxification processes and the normal metabolism of brain neurotransmitters. In many cases the child may be getting plenty of sulphates through the diet, but they all get consumed by the detox pathways struggling with the river of toxicity which is constantly coming from the child's gut.

At the same time, another large group of bacteria which commonly overgrow in the gut dysbiosis situation are sulphate-reducing bacteria, which make sulphur unavailable for the body to use. These bacteria metabolise sulphate coming from food into sulphites, many of which are toxic. Hydrogen sulphide, for example, is the gas with the rotten egg smell. Some parents of autistic, hyperactive, and other children tell me that their child's stool has this characteristic smell.

The importance of re-establishing gut flora

The mixture of toxicity in each child can be quite individual and different. But what they all have in common is gut dysbiosis. The toxicity, which is produced by the abnormal microbial mass in these children, establishes a link between the gut and the brain. These children can present with symptoms of autism, ADHD, ADD, OCD, dyslexia, dyspraxia, schizophrenia, depression, sleep disorders, allergies, asthma, and eczema in any possible combination.

These are the children who fall in the gap in our medical knowledge. Any child with a learning disability, neurological or psychological problems, or allergies should be thoroughly examined for gut dysbiosis. Re-establishing normal gut flora and treating the digestive system of the child has to be the number one treatment for these disorders, before considering any other treatments with drugs or otherwise.