To navigate and educate us on the connection between our gut and mental health, we tapped Dr. George Byrnes, whose wellness center is in Woodland Hills, California. In our Q&A, he shares his knowledge on imbalance in your gut—both physical and mental, food and behavioral recommendations, and why it’s important to listen to your body. It turns out that your gut may have more to do with influencing your mood than your brain. Read the full interview with Dr. Byrnes below.
We know that the gut affects so much of the body. What’s the connection between the GI tract and the brain?
“Since this is a subject that I frequently present on, I will try and distill something that is infinitely complex into digestible (pardon the pun) concepts. First, the gastrointestinal system and the brain are neurologically connected bi-directionally like a two-lane highway. The gut has its own separate nervous system known as the enteric nervous system (ENS), which is a vital part of our autonomic (think autonomous or automatic) control of our body. The ENS comprises over 500 million neurons that communicate with our brain. That’s five times the amount in our spinal cord alone and is why the ENS has been coined as our ‘second brain.’ There is a tremendous amount of information being relayed from our brain to our gut, and more importantly, from our gut back to our brain. If you’ve ever felt queasy after hearing bad news or having stage fright, then you were experiencing this connection firsthand, and thus the phrase ‘gut feeling’ will make more sense to you.
The truth is, the internal environment of our gut is responsible for monitoring and modulating so much of our physiology including immune function, brain chemistry, hormones, mood, insulin metabolism, antioxidant production, fat metabolism, and of course, all aspects of digestive function. Now you know why we need so many neurons! The communication is happening via circulating neurochemicals and hormones and immune messengers known as cytokines, as well as activation of the vagal nerve pathway. The vagal nerve is a long nerve originating in our brain stem that sends projections into our pharynx, lungs, heart, and all areas of the gut. The return projections from the gut to the brain, interestingly, comprise 80-90% of vagal information. Research shows us that the gut is loaded with receptors, not unlike our other sensory organs such as taste buds, smell, stretch receptors, etc. Amazingly, it is through the complex interaction of our intestinal microbes (microbiome) and these neural projections that information can be conveyed in a matter of milliseconds! For many of us, that information relaying from the gut to the brain is inflammatory and distinctly unhealthy.”
How did we first discover this connection?
“Hippocrates (the father of modern medicine) proclaimed over 2,000 years ago that “All disease begins in the gut.” I think we are now beginning to see just how right he may have been about much of our suffering. It was Pavlov, however, who demonstrated through his now-famous experiments with dogs and ringing a bell that there was definitely a connection between the brain and processes of digestion. More recently, neurogastroenterologist Dr. Michael Gershon wrote a pioneering book entitled The Second Brain in 1998. It was through his 30 years of groundbreaking work demonstrating the vital brain-gut connection that research further blossomed. The Human Microbiome Project was initialized in 2007 and received major funding by the NIH to further investigate and characterize this exciting new science.”
Tell us a little about the microbiome in the gut and why it’s important.
“The microbiome is, perhaps, the most fascinating part of this entire discovery. Our bowels are home to a complex ecosystem of microbes in staggering numbers. Most of these microbes are bacteria totaling over 10,000 species and over 100 trillion in number. Each has its own DNA that interacts with our DNA. For every human gene, there are at least 360 microbial genes with the vast majority living in our digestive tract. This is really how we can change a great deal of our own genetic expression by having healthy interaction and influence of microbes on our own cells. We can witness this type of relationship in the world around us every day: from rainforests to pristine mountain lakes and of course, the ocean. A perfect example currently is the massive amounts of Sargassum (floating sea algae) that is plaguing the Caribbean corridor of Mexico. It is now at levels that are catastrophic for tourism, and the proposed causes are everything from agricultural fertilizer runoff to climate changes. The point is, there is always a cost for upsetting the balance of a perfect ecosystem, and that is precisely what is happening in our bodies. We assault this balance with poor dietary and lifestyle choices, exposure to environmental toxins, medications, and chronic stress, which in turn creates stress hormones that generate imbalance and inflammation in our guts and eventually the brain itself.
Our diverse microbes generate metabolites that influence such things as mood, libido, weight, immunity, hormones, and even the perception of the world around us. When our gut is exposed to anything that creates an alarm reaction, the immune system is activated and inflammation is the result. When this inflammation remains long enough, there will be alteration of normal bowel flora as well as damage to the gut lining (mucosa) that results in the all-too-common condition of leaky gut. This condition allows small holes to develop and things that should only be held within the gut lumen will migrate out and disrupt vagal nerve communication to the brain and even move into the brain itself. A perfect example of this is a substance in the cell walls of our gut bacteria called LPS (lipopolysaccharide). LPS that crosses from the gut into the enteric nervous system and systemic circulation becomes a potent toxin that is being implicated in various diseases including autoimmunity, obesity, cardiovascular disease, and more recently Alzheimer’s. LPS was literally found in the brain of Alzheimer’s patients and is now being seen as a probable cause. This is primarily because LPS can disrupt the blood-brain barrier, which would normally protect us from potential neurotoxins … the end result is everything related to neurodegeneration. We see not only cognitive decline but also things such as depression and anxiety.”
What are some signs you have an imbalance in your gut—both physical and mental?
“Well, the most obvious signs or symptoms relate to your bowel function: bloating, gas, heartburn, abdominal pain, constipation, or diarrhea. However, since we have elucidated the overwhelming control that the gut microbiome has on our health, we can see that signs and symptoms reach far beyond the locality of the bowels. Any autoimmune disease is immediately implicated, and we have seen an enormous increase in disorders such as Hashimoto’s thyroiditis in the past several years. This is not a coincidence. Any inflammatory disorder including chronic pain syndromes in joints and muscles, brain fog, diabetes, chronic fatigue, headaches, memory loss, allergies, stubborn weight issues, sleep issues, and psychosomatic illness including depression and anxiety also can have their origin in an unhealthy microbiome and gut-brain connection. Of particular note is the fact that the gut microbiome manufactures at least 30 neurotransmitters, and as much as 90% of serotonin, for instance, is created in the gut. This certainly should make the psychiatric profession take note and reconsider some of their strategies for treating some of these disorders. It turns out that your gut may have more to do with influencing your mood than your brain.”
What nutritional changes/tactics do you recommend?
“This is of course is the most difficult thing to give a generalized recommendation for as each person is so unique in their presentation and microbiome. In our practice, we can do specific tests to assess the beneficial flora status as well as pathogens (bad microbes) that are overpopulating the gut and match with appropriate effective remedies. Anyone with a serious microbiome problem and a leaky gut will be given a specialized temporary diet while they go through the initial phase of care. This diet will eliminate all high-allergen foods such as gluten, dairy, eggs, and soy as well as all grains, legumes, nuts, seeds, and nightshades (potatoes, tomatoes, peppers, eggplant, and goji berries). The reason for this is that research shows that a compromised and inflamed gut lining is much more susceptible to the negative effects of lectins, a compound in these foods that is a built-in toxin that protects the plant from being eaten in the wild. Lectins can wreak havoc on a compromised mucosal lining and can promote further inflammatory and immune responses. This diet would be followed for four to eight weeks and would focus on all other plant-based foods along with wild-caught smaller fish, poultry, etc. All alcohol, refined sugar, trans fats, and processed food should be completely avoided during this time. It is important to stick to organically grown foods as much as possible due to the tremendous problems seen with GMO and glyphosate (Roundup) poisoning. Both glyphosate use on grains, vegetables, and fruits as well as GMO corn and soy use started a massive and exponential increase in diseases associated with a compromised brain-gut axis, including cancer of the liver, kidney, bladder, and thyroid as well as approximately 20 other diseases. It’s vital to educate yourself on this subject and avoid known sources. Probiotics can be used in this phase, and I tend to favor spore-forming probiotics. However, they are not a panacea, and ingesting prebiotic foods may be even more important in the long run (fermented foods such as raw sauerkraut, kimchi, etc.). A good collagen supplement can help during the repair process as well as targeted gut repair formulas that have L-glutamine, slippery elm, DGL, N-acetyl glucosamine, butyrate, etc. Bone broth can help in the healing phase and can even be used initially to acclimatize to short fasts. There is also often a need to replace trace minerals and magnesium to activate cellular function.”
What behavioral changes/tactics do you recommend?
“Remember that bidirectional highway of communication between the gut and the brain? This means that stress physiology can have an inflammatory effect on our microbiome. High levels of stress hormones (catecholamines) have been shown to cause inflammation and even immune dysregulation in the brain-gut axis and change the balance of the microbiome, which in turn then affects the brain in a vicious cycle. Using meditation techniques and entrainment technology (heartmath.com) along with yoga and diaphragmatic breathing techniques can have a profound effect on quelling this damage. Mindfulness should be practiced daily. Additionally, one of the top causes of increased stress hormone production is simply not getting enough sleep. Try to follow the circadian rhythm of our day/night cycle as closely as possible and begin winding down when dark occurs. This generally means an earlier bedtime and shutting off electronic devices one and half to two hours before sleep. Aim for at least seven to eight hours of quality sleep, and taking a good magnesium supplement at bedtime can help relax the nervous system significantly. It has been found that electrical stimulation of the vagus nerve helps drop the inflammatory response of the gut. You can do some of this yourself by simply doing slow deep belly breathing, deep humming, and even splashing cold water on face and forehead first thing in the morning. Another powerful technique that we sometimes recommend is to do deep aggressive gargling of water a few times per day for at least a minute or two. These are all effective techniques for vagal stimulation. Another very promising approach to healing the gut is the use of fasting techniques such as intermittent fasting. When we don’t eat, we turn up the ability of the body to heal itself profoundly over time and even change gene transcription. Suffice to say, it is an approach that is being heavily researched and shows great promise for healing the gut and the brain!”
Tell us a little bit about anxiety and how it is connected to gut health.
“Since the gut bacteria produce a variety of neurotransmitters like GABA, serotonin, dopamine, and modulators such as BDNF (brain derived neurotrophic factor), anxiety and depression can both be linked to the health of our microbiome. Several studies have shown a correlation between these disorders of mood and altered gut flora. For instance, one course of antibiotic therapy has been shown to cause serious disruption of the microbiome for six months to two years! The result is often … anxiety! If you have experienced a seemingly sudden onset of anxiety at a point in your life, it is prudent to see if there were any antibiotics used around the time you developed symptoms. A group of antibiotics known as fluoroquinolones (originally tied to tendon ruptures) have now been implicated in directly being responsible for the sudden onset of anxiety and insomnia as well as depression. Remember, antibiotics destroy beneficial flora and thus can have a multitude of negative health consequences.”
What foods can help with anxiety? What foods exacerbate it?
“It is popular on the internet and in magazines to simply list certain foods as beneficial for anxiety and/or depression. If only it were that simple! Yes, there are foods that are higher in certain nutrients and thus may offer some nutritional boost, but in a damaged gastrointestinal biome, these foods can cause more inflammation initially. Foods that are commonly recommended such as chia seeds, yogurt, and even almonds can be too challenging for a sensitive gut during the initial healing phase. Along with the dietary advice already given, some foods that can be helpful during this phase would be wild-caught salmon (beneficial EFAs for neurotransmitters); foods high in folic acid such as deep leafy greens, watercress, asparagus; avocado (beneficial fats and vitamin B6 for neurotransmitters); turkey (source of tryptophan, a precursor to serotonin); and berries, especially wild organic blueberries (rich in antioxidants such as vitamin C) and camu berries (highest food source of vitamin C, which has been shown to help regulate mood). Foods that can exacerbate anxiety would be, of course, processed foods and foods high in hydrogenated oils or trans fats, foods high in refined sugar, deep-fried items, cereal grains, and for many people gluten and casein (the protein in dairy).”
What foods help with depression? What foods make it worse?
“The same mechanism of brain-gut disruption is responsible here, so pretty much the same recommendation. One item that may be good to add would be sweet potatoes as there was an Italian study that correlated low carotenoid levels with depression. Also, sweet potatoes provide a prebiotic source along with even higher sources such as sunchokes, chicory, garlic, leeks, and onions. The same avoidances would be recommended here.”
Is there anything else you’d like to educate our readers on the topic?
“Unfortunately, we are being faced with an expanding epidemic of autoimmune disorders as well as brain disorders. We have treated hundreds of children in our practice, and the most common concerns of parents today is ADHD, ADD, autism and spectrum disorders, and chronic immune dysfunction including allergies and skin disorders. It is no coincidence that the numbers are growing at an alarming rate. I have seen the profound difference in our children just over the past two decades of practice. I know I haven’t mentioned it thus far, but this is now being fully implicated as damage to the gut brain and microbiome as well. When serious damage has occurred, people need help navigating this extremely complex problem. Finding a knowledgeable functional medicine doctor can be invaluable in helping you as well as your children. I think we get the terrific results we do because we not only provide a complete guided functional approach to healing, but we also treat the nervous system directly and very specifically with neurologically based receptor work (specific low-force chiropractic adjustments) and auricular medicine. There is more and more research coming out showing just how powerful this approach is in changing the brain rapidly and creating neuroplastic reorganization (rewiring the nervous system’s response to stress). My heart goes out to all the families in need, and we are constantly looking for more effective ways of delivering treatment options. I encourage those that have more severe chronic problems to not try going it alone, as it can be very frustrating and confusing. However, with the right team in place, you can completely change your life. Fortunately, there is a growing and educated army of us out there to help.”