Does Neurodegeneration Start in the Gut?
At Nature Cures clinic, we help our patients get to the root of their health issues, through a combination of Eastern and Western, ancient and contemporary medicine. For us, the digestive system has always been what has linked these multiple systems. In fact, we even painted our treatment room walls Yellow. This is because In Chinese medicine, digestion is controlled by the Earth element and its related organs, the Spleen and Stomach, and Yellow is the color associated with this. Over the past few years, our clinic has specialized in brain regeneration and neurodegenerative conditions such as Parkinson’s disease. And we continue to learn more about the connection between digestive health and brain health.
Did you know that humans have a nervous system in our Gut? It’s called the Enteric Nervous System (ENS). Scholarpedia defines it as a part of the autonomic nervous system, consisting of ganglia (groups of neurons) that lie within the walls of digestive organs such as the esophagus, stomach, intestines, pancreas, gall bladder and pancreato-biliary ducts. The ENS contains about 200-600 million neurons, which is about the same number of neurons as in the spinal cord, and more than in any other peripheral organ. It is capable of controlling the digestive organs on its own, making it the only part of the peripheral nervous system capable of functioning on its own locally.
The ENS is constantly in two-way communication with many other systems. These include the endocrine and immune systems of the gastrointestinal tract; the Central Nervous System; and the sympathetic and parasympathetic nervous systems, especially the Vagus nerve. The ENS is also communicating with the bacteria, fungi, and other microorganisms that make up the gut microbiome. There have been many research studies done on the connection between PD and the gut microbiome in recent years. So many in fact, that there has already been a published Systematic Review studying the utility and validity of the studies.
When these systems are out of balance, all sorts of issues can occur. Research shows that dysregulation of the brain-gut-microbiota axis in PD patients can lead to motor symptoms, as well as to gastrointestinal issues that often precede the motor symptoms. This supports the hypothesis that the pathological process starts in the gut and spreads from there to the brain. GI dysfunction is present in over 80% of PD patients. Gut microbiome issues like dysbiosis, small intestinal bacterial overgrowth, and increased intestinal permeability, may lead to excessive stimulation of the innate immune system, resulting in systemic inflammation. This may lead to changes in the ENS that could contribute to the initiation of alpha-synuclein misfolding.
PD is characterized by misfolded alpha-synuclein proteins in both the brain and the Enteric Nervous system. There is also a deficiency of the neurotransmitter Dopamine, in an area of the midbrain called the Substantia Nigra. It is less well-known that 50% of the Dopamine in the human body is found in our digestive systems. The conventional treatment for PD remains Carbidopa/Ldopa medication to address the Dopamine deficiency. While this medication can be useful in treating PD symptoms,Its efficacy can often wane after around 5 years.
And this medication does not treat the root imbalance, nor is it intended to. Conventional medicine Is not in the business of offering tools for patients to address their root imbalances. Instead, people with PD are often given disempowering diagnoses like “incurable” and “degenerative”. Or they are told that they have “a genetic disease”. However, research shows that only 10% of PD cases are familial. This speaks to the importance of lifestyle factors and environmental factors in PD etiology.
We believe that symptoms are often merely the tip of the iceberg, and that imbalance in the body can precede symptoms by years or even decades. Our goal in treatment is not merely to remove symptoms, but to get to the root of the issue, by bringing the body back into its natural state of balance. When we do this, symptoms will naturally improve. As our course of treatment helps the body bring itself back into balance, we will see improvement in the GI symptoms, as well as the symptoms most directly associated with PD like tremors, bradykinesia (slowness of movement), impaired speech, and gait and balance issues.
From a Chinese Medicine perspective, ten different PD patients with GI symptoms could have ten different patterns of root imbalance. For us to treat the root could entail focusing on the Stomach and Spleen, or on the Liver and Gallbladder, or possibly on other organ systems and their associated channels. When there is imbalance, we know that blood, nutrients and energy are not moving where they need to, and that this is affecting function in one or more organs, channels and/or body areas. This might be due to excess and stagnation, either in the affected place or elsewhere. Or there may be deficiency somewhere. This information will affect our choice of acupuncture points, herbal formulas, etc.
To figure out what is imbalanced, we use our Chinese medicine diagnostic tools, including listening, feeling the wrist pulse, looking at the tongue, and palpating for trigger points on the back. Similarly from a functional medicine perspective, root imbalances might be very different for different patients, even ones who present with the same symptoms. One functional medicine diagnostic tool that we often use is lab testing. This can include testing for hormone imbalances, heavy metal toxicity, or gut microbiome dysbiosis. This information will then help us determine correct therapies, which may include dietary changes, breathing and exercises, regenerative stem cell therapies, neuropeptides, hyperbaric oxygen therapy, and others.
There are many ways the gut microbiome can be out of balance. One study proposes that a cascade of events starting in an unbalanced gut microbiome drives the production of toxins or antibiotics that target and damage mitochondria. This then activates the innate immune system, which causes inflammation that leads to the neurodegeneration in the Enteric and central nervous systems and that ultimately leads to PD. On the other hand, balancing the relationship between the gut microbiome and its hosts (that’s us) could be crucial in preventing and treating not only various gut disorders, like Ulcerative Colitis and Irritable Bowel Syndrome, but also central nervous system disorders, such as PD and Alzheimer's.