The Hidden Dangers of Proton Pump Inhibitors

Proton Pump Inhibitors (PPI’s), which include popular brand names Omeprazole and Nexium, are among the 10 most widely used medications in the world.(1) They are prescribed to treat a range of acid-related conditions including stomach ulcers and Gastro-oesophageal-reflux-disease (GORD). PPI’s work by interfering with a system known as the “proton pump” in the cells of the stomach lining; actively reducing acid production. (2) The drugs are very effective and for many can bring relief from the chronic upset of GORD and other acid-related conditions.

So what’s the issue?

As with many medications, PPI’s are intended for short-term use only. Or to quote the NHS guidance: “PPIs should be initiated ONLY where clearly indicated and for the shortest duration that is appropriate, in order to minimise adverse effects.” (3)

Despite this, many patients end up taking PPI’s for years or even decades. This is partly because PPI’s do not cure the conditions they are prescribed to treat (and so the problem returns as soon as use is discontinued) and partly because they can cause a condition called ‘rebound acid hypersecretion syndrome’ – whereby the stomach cells overcompensate for low acid levels and go into overdrive. In both cases, coming off PPI’s often means returning to the chronic pain and misery of acid reflux disease.

So why not stay on PPI’s indefinitely?

As mentioned, the NHS advises that PPI’s should only be taken for the shortest possible time in order to minimise potential ‘adverse effects’. These include:

  • Clostridium difficile infection
  • Increased risk of bone fractures
  • Increased mortality in older patients
  • Chronic Kidney disease
  • Hypomagnesaemia
  • Vitamin B12 deficiency
  • Community acquired pneumonia

And while the risk of developing these side-effects is relatively small in the short-term, the risk increases exponentially with long-term use.

How PPI’s make reflux WORSE

In addition to the adverse effects listed above, PPI’s can wreak havoc on your body’s natural digestive processes. After all, the acid is there for a reason. Not only does hydrochloric acid help the body to break down, digest and absorb vital nutrients – it also plays an important role in the body’s defence system by eliminating bacteria and viruses to protect against infection.

Taken to the extreme, inhibition of the acid-secreting cells can lead to a condition called Hypochlorhydria (chronic deficiency of Hydrochloric acid in the stomach) which left untreated can cause damage to the gastrointestinal system, infections, and a number of chronic health issues. (4)

Low acid levels can also delay the passage of solid food through the stomach – a process known as ‘gastric emptying’. This is particularly troublesome from a reflux perspective as the longer food sits around in the stomach, the greater the pressure on the lower oesophageal sphincter (the valve that stops stomach contents re-entering the oesophagus) and the greater the chance of reflux occurring. (5) 

PPI cessation can lead to rebound reflux

Given the safety concerns and their adverse effects on digestion, reducing or stopping PPI use might sound like a good idea. But as mentioned, suddenly removing the drugs can lead to ‘rebound acid hypersecretion syndrome’ whereby the stomach cells produce an overabundance of acid. This can result in a rapid recurrence of reflux symptoms.

So what’s the answer?

The key to safely coming off PPI’s is to do so very gradually. This can be achieved by slowly reducing the dosage of the medication, or missing doses on alternate days. Another option is to replace PPI’s with a less powerful acid-blocking medication such as a H2 blocker (e.g. Zantac) which generally have less safety concerns with long-term use.

Important note: It is crucial to speak to your doctor before reducing or stopping any medication including PPI’s. For some conditions, the benefits of taking PPI’s may outweigh any potential side-effects. 

Natural Alternatives to PPI’s

What is most frustrating about the widespread use of PPI’s, is that in many cases they are prescribed unnecessarily, and that similar results can be achieved with simple diet and lifestyle changes. Switching to a whole-food diet, eliminating highly processed foods and taking care of your microbiome are generally much safer and more effective ways of beating acid reflux.

For a more in-depth look into the causes of Acid Reflux and how to cure the problem naturally, read our earlier blog post here: The Real Cause of Acid Reflux (and how to cure it permanently).

Whether you are able to eliminate PPI’s or not, one of the most effective ways to improve digestion and reduce reflux symptoms is to promote healthy stomach acid levels. As we have established, stomach acid is vital for the complete digestion and absorption of protein and other key nutrients and yet factors such as chronic stress, age, and a reliance on PPI’s, can dramatically reduce our production. 

Betaine HCL

A simple but highly effective way to increase acid levels is to take Betaine HCL (a supplemental form of stomach acid) before each meal. This may seem counter-intuitive given that acid causes the pain we associate with reflux, but this is only the case if acid makes contact with the delicate lining of the oesophagus. Our stomachs themselves are designed to withstand a highly acidic environment, with an optimal pH level being around 1.5, and it is usually only in the case of ulcers (most often caused by a bacterial infection of H-pylori) that acid can cause issues in the stomach. (6)

Warning: Betaine HCL should not be taken if you have an active stomach ulcer, active gastritis or esophagitis. If in any doubt, seek medical advice. Betaine HCL should not be taken on an empty stomach unless it is followed immediately by a substantial meal.

Apple Cider Vinegar

Apple cider vinegar is another great way to promote healthy stomach acid levels and boost digestion. Although ACV has been linked to a wide range of health benefits (many of which have little evidence to back them up) we do know that it’s naturally acidic and antimicrobial – both really helpful properties if you are suffering from low stomach acid. Much like Betaine HCL, ACV is best taken shortly before a main meal to re-establish an optimum gastric pH and stimulate the release of key digestive enzymes.

Conclusion

PPI’s are one of the most widely prescribed medications in the world. They are very effective in treating acid-related conditions such as Gastro-oesophageal-reflux-disease (GORD) but are intended for short term use only. This is because they are associated with a number of adverse health effects when taken long term. In addition to this, PPI’s can wreak havoc on the body’s natural digestive processes, raising the internal pH of the stomach and slowing gastric emptying. Although it may not be possible for some individuals to eliminate PPI use completely, addressing low stomach acid levels by taking a supplemental form of acid prior to each meal, can have a positive impact on digestion and potentially reduce the incidence of reflux.

(1) https://www.webmd.com/drug-medication/news/20110420/the-10-most-prescribed-drugs

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855237/

(3) https://www.barnsleyccg.nhs.uk/CCG%20Downloads/Members/Medicines%20management/Area%20prescribing%20committee/201803-04%20-%20APC%20Memo%20Enclosure%20-%20Guidance%20for%20Safe%20and%20Effective%20use%20of%20Proton%20Pump%20Inhibitors%20-%20March-April%202018.pdf

(4) https://www.healthline.com/health/hypochlorhydria

(5) https://pubmed.ncbi.nlm.nih.gov/20012198/

(6) https://sa1s3.patientpop.com/assets/docs/18418.pdf

How to Cure IBS in 5 Steps

Irritable bowel syndrome is a debilitating disorder that affects the digestive system. It is very common, impacting around 15% of the UK population. Symptoms vary from person to person but generally include:

  • Bloating
  • Diarrhoea 
  • Constipation 
  • Stomach Cramps

Despite its prevalence, it is not known exactly what causes IBS, though it has been linked with oversensitive nerves in the gut, stress, and gut motility issues.

Many Doctors consider IBS to be incurable – often prescribing medication to control the symptoms – and although this may be the case for some individuals, we firmly believe that IBS can be improved and even cured by making some key dietary and lifestyle changes. Below, we outline 5 simple steps to cure IBS naturally and permanently.

5 Steps to Cure IBS Permanently

1. Keep a Food Diary to Identify IBS Triggers

If you’re reading this article, chances are you know your main IBS triggers. Whether it’s fatty foods, or excessive alcohol consumption, there are certain things that will trigger symptoms without fail. What are more difficult to pin down are the less-obvious triggers – foodstuffs that may have crept into your life unnoticed. Is the tuna sandwich you eat every day for lunch actually flaring up your symptoms? Or perhaps it’s the splash of milk in your coffee? In either case, the only way to know for sure is to keep a food diary of everything you put in your mouth and record symptoms as they emerge. This might sound laborious, but by firmly identifying your trigger foods and limiting or removing them from your diet you will have made a crucial first step in curing your IBS for good.

Tip: Certain foods can cause a delayed reaction making it difficult to know what caused the flare-up, so be sure to record your symptoms throughout the day and keep an eye out for patterns as they emerge.

2. Start a Low-FODMAP Diet

There are many diets designed to improve IBS symptoms, but when it comes to evidence-backed results, the low FODMAP diet is king. In a recent review summarising the published clinical studies concerning the management of IBS, a team from the University of Otago, New Zealand concluded that up to 86% of patients found significant improvement in symptoms following a low FODMAP diet. (1) 

So what is a FODMAP?

FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols, which are short-chain carbohydrates that the small intestine has trouble absorbing. It is thought that some of these molecules are responsible for many common IBS symptoms including bloating, gas and diarrhoea.

The aim of a low FODMAP diet is to effectively eliminate all FODMAPS from your diet for a short period of time (around 2-6 weeks), and then gradually reintroduce them to determine which ones cause symptoms. Common high-FODMAP foods include:

  • Dairy-based products such as milk, ice cream and soft cheese
  • Wheat-based products such as cereal, bread and pasta
  • Legumes including baked beans, chickpeas and lentils
  • Some vegetables, including artichokes, asparagus, onions and garlic
  • Some fruits, including apples, cherries, pears and mango

(Full-lists of low and high FODMAP foods are readily available online.)

Although the diet is very restrictive in the short term, the good news is that most people only need to reduce or eliminate a small number of FODMAPs from their diet to see lasting results.

Important note: A low FODMAP diet is very restrictive and shouldn’t be undertaken for more than 6 weeks at a time. If you are underweight or have any pre-existing health conditions, you should speak to your doctor before commencing the diet.

3. Heal the gut with L-Glutamine 

Although the precise mechanisms that cause IBS are largely unknown, studies suggest that inflammation in the gut plays a major role. (2) Certainly with Inflammatory Bowel Disease (IBD) – a condition that is closely linked with IBS – chronic inflammation in the gut can lead to damage of the Gastrointestinal (GI) tract.

With this in mind, any attempt to improve or cure IBS should not be undertaken without first healing the GI tract and attempting to reduce inflammation. Fortunately there is one  miraculous compound that can do both: L-Glutamine.

L-Glutamine is a non-essential amino acid that is produced in the body but is also found in food. Not only is it a powerful anti-inflammatory agent, but a number of clinical studies have demonstrated its importance in maintaining GI mucosal barrier function. (3) In other words, the intestinal lining uses L-glutamine as fuel to create a strong surface for digestion and absorption.

If this wasn’t enough to convince you of its value, a number of studies have indicated that L-Glutamine also exhibits analgesic (painkilling) activity in the gut. (4) This may be another reason it seems to be so effective in treating IBS and IBD.

Tip: Supplement with 1,000mg – 5,000mg of L-Glutamine per day to help repair the gut and reduce inflammation in the GI tract.

4. Manage stress with lifestyle changes

To put it simply – stress can wreak havoc on your gut. To understand why, we need to understand the Sympathetic nervous system (SNS). The SNS is part of the autonomic nervous system – a crucial network that acts without conscious direction to regulate functions such as heart rate, blood pressure, sweating and digestion. 

Often called the ‘fight or flight’ response, the SNS acts to direct the body’s reaction to dangerous or stressful situations. It does this by releasing a flood of hormones into the body to improve alertness, increase heartrate and pump extra blood to the muscles. It’s a hugely important system and vital for survival but it does have one notable side-effect – it dramatically inhibits digestion. (5)

This is not necessarily a problem if the SNS is only activated occasionally. In theory, as soon as the dangerous situation has passed, another system called the Parasympathetic nervous system (PNS) takes over and encourages the body to ‘rest and digest’. The problem arises when stress and anxiety become an almost constant part of daily life. Although you may not physically be facing a Tiger at the office every day, when you’re overly stressed or anxious, your body thinks you are. It reacts by engaging the SNS and effectively shuts down digestion.

Aside from the benefits to your mental health and wellbeing, this is why it’s absolutely crucial to learn how to manage stress effectively. Here’s a few simple tips that we have found to be really helpful:

  • Practice mindfulness

Mindfulness is a simple concept that involves being intensely aware of what you are experiencing in the moment. Many of us spend far too much time planning, problem-solving, daydreaming or thinking negative thoughts – mindfulness is designed to snap you out of this pattern and allow you to be fully present in the moment. A simple mindfulness exercise might involve closing your eyes and focusing on your breath as it moves in and out of your body. Focus only on this, do not allow negative thoughts or worries to enter you mind. Even just a few minutes of mindfulness per day can make a major difference to your stress levels.

  • Exercise regularly 

Aside from its myriad of other health benefits, regular exercise is one of the most effective ways to relieve stress. Not only can exercise help to relieve stressful emotions as they occur, but there is growing evidence that regular exercise is associated with increased emotional resilience to stress. A study conducted by the Department of Psychiatry and Behavioural Neuroscience at The University of Chicago concluded that “that regular exercisers are more resistant to the emotional effects of acute stress, which in turn, may protect them against diseases related to chronic stress burden”. (6) In other words, if you exercise regularly, you are less likely to become emotionally stressed in the first place.

Tip: Aim for 150 minutes of moderately intense aerobic exercise, or 75 minutes of vigorously intense aerobic exercise per week. If time is a limiting factor, several short bursts of exercise (10 – 15 mins in length) spaced throughout the day can be a great way to help combat stress and stay positive. 

  • Limit alcohol and caffeine

Although alcohol might seem like a potent stress-reliever in the moment (and there’s no denying that it can temporarily take your mind off your troubles) as soon as Blood Alcohol Content (BAC) starts to drop, you may experience symptoms of depression and anxiety. This is partly because alcohol changes levels of serotonin and other neurotransmitters in the brain, with the net result being that you often end up feeling more stressed and anxious than before you started.

Caffeine is also something that should be used in moderation, particularly if you are prone to stress and anxiety. Adding caffeine to an anxious mind is like throwing fuel on a fire, with research showing that it can even trigger anxiety attacks. (7) It can also increase blood pressure and stimulate the Sympathetic Nervous System – which, as we established, is bad for digestion. Despite this, caffeine does have a wide range of health and mood-boosting properties so it’s certainly not something that needs to be completely eliminated. The key is to be aware of the effects that caffeine has on your body and to avoid it when you are already feeling stressed or anxious.

5. Address gut imbalance with diet and probiotics 

Your gut is home to trillions of bacteria. Collectively, this complex ecosystem is known as the microbiome and it’s responsible for a range of vital functions in the body from the obvious (digestion) to the less obvious (regulating the entire immune system). Among the trillions of bacteria, there are hundreds of competing and co-existing species, some of which are more beneficial than others, hence the widely used term ‘friendly bacteria’. 

Research has shown that many individuals suffering with IBS symptoms may have an imbalance in their gut bacterial communities. (8) It is not entirely sure why this is, but it thought that the dysbiosis may activate the gut immune system, causing a chain reaction of IBS symptoms.

So how do we address the imbalance?

The most effective way is to improve the quality of your diet. Specifically, by reducing or eliminating highly processed foods and incorporating a wide range of fibre-rich fruits and vegetables. Another option is to incorporate a quality probiotic supplement into your daily routine; effectively introducing billions of ‘friendly’ bacteria to your microbiome and hopefully readdressing the balance. There are many probiotic strains to choose from but our favourites for IBS management are Bifidobacterium Bifidum and Lactobacillus Acidophilus. 

Tip: Aim for a probiotic supplement that has at least 10 billion CFU’s (colony forming units) per serving and be wary of anything that claims to have ‘live’ bacteria as these are often killed by stomach acid before they make their way to the gut.

Shop Probiotic Superfoods

Summary

IBS is a debilitating condition that many doctors claim is incurable. This is largely because of its complex and multifaceted nature meaning that no single treatment is likely to be 100% effective. Despite this, there are several research-proven steps that you can take to improve (and even eliminate) IBS symptoms – from diet plans, to stress management, and probiotic supplementation. The key thing to note, is that tacking IBS is not a ‘one-size-fits-all’ endeavour, and that in following the steps outlined above it’s important to listen to your body every step of the way and find out what works for you.

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918736/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159811/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369670/
  4. https://link.springer.com/article/10.1007/BF01967621
  5. https://www.healthline.com/health/ibs-c/stress-and-anxiety#How-stress-may-trigger-IBS
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013452/
  7. https://www.cambridge.org/core/journals/advances-in-psychiatric-treatment/article/neuropsychiatric-effects-of-caffeine/7C884B2106D772F02DA114C1B75D4EBF
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039952/

Digestion and Immunity – 5 Tips to Boost Your Defences Right NOW

If the pandemic has taught us anything it’s the importance of a properly functioning immune system. But while there’s plenty of talk in the media about the link between immunity and supplements such as Vitamin D and Echinacea, the role of the digestive system is often overlooked – despite the fact that it plays an intrinsic role in the body’s system of defence.

Did you know, for example, that the gastrointestinal tract is home to a staggering 70% of your entire immune system?(1) In fact, some scientists believe that the two systems share a common origin, appearing early in the evolution of Metazoa to simultaneously fulfil the needs of defence and nutrition.(2) Despite this, little effort is made in the western world to improve digestion for the sake of immunity and although Doctors are finally waking up to the role that poor diet plays in the development of disease, the effect it has on digestion (and subsequently immunity) has yet to enter the narrative.

So what’s going wrong?

The answer to this lies deep in the open spaces of our large intestines, home to the fabled microbiome. This fantastically complex ecosystem plays host to trillions of bacteria, fungi and viruses, which collectively perform the unenviable task of regulating our entire immune system. As with any ecosystem there is a delicate balance of power, with hundreds of ‘helpful’ bacteria species competing for supremacy with less favourable organisms. The problem with modern lifestyles and diets is that they often inhibit the growth of ‘helpful’ bacteria, leading to a decline in both population density and species diversity.

As Dr Michael Mosely argues in his excellent book The Clever Guts Diet, one of the main issues is that we eat such a narrow range of foods. “Of the 250,000 edible plant species,” he explains, “we use less than 200. Seventy-five percent of the world’s food comes from just 12 plants and 5 animal species.”(3) With stats like these, it’s no wonder our gut bacteria are in decline – they’re living on a restricted diet!

The other major contributing factor to the decline of our microbiota is our obsession with ultra-processed foods. Defined as any food substance that has gone through multiple stages of industrial processing and/or containing large numbers of artificial additives, Ultra Processed Foods (UPF’s) have become increasingly popular over the past 30 years. In the 1980’s for example, the average UK diet consisted of 58% fresh ingredients and 26% ultra-processed foods, but by 2000 this ratio had virtually reversed with just 28% of the diet constituting fresh foods and 44% ultra-processed. In 2021 the situation is even worse, with UPF’s comprising nearly two thirds of the calories we consume.(4)

The Link between Ultra Processed Food, Poor Digestion and Immunity 

Ultra-processed foods are bad for digestion for 2 reasons. Firstly, they contain very little in the way of nutrition for friendly gut bacteria – being generally low in prebiotic fibre and derived from a limited number of industrial proteins, grains and fats. Secondly, they contain a large number of artificial additives – several of which (including emulsifiers) have been proven to actively inhibit microbial richness. (5) 

Given the vital role that the microbiome plays in regulating digestion and immunity it’s little wonder that increased consumption of UPF’s over the past 30 years has coincided with skyrocketing rates of obesity, digestive disorders and other non-communicable diseases.

So what can we do? 

Quite simply, we need to improve the health of our microbiome – specifically by promoting the growth of friendly bacteria and encouraging a diverse range of species to develop. 

Below, we outline our top 5 tips to naturally enhance microbial richness, improve digestion and subsequently give your immune system a much-needed boost.

5 Tips To Boost Digestion and Supercharge your Immune System

1. Avoid Ultra Processed Foods.

There are countless reasons to reduce the amount of ultra-processed food in your diet but its effect on your microbiome is among the most important. Eliminating UPF’s entirely may be a tall order given their prevalence in western culture but a diet focused mainly on whole foods (with plenty of fresh fruits and vegetables) is a great starting point. Common UPF’s include mass produced bread, breakfast cereals and most pre-packaged ‘ready’ meals.

Tip: Try to limit UPF’s to 10% or less of your total calorie consumption.

2. Add Diversity

It’s no coincidence that hunter-gatherer civilisations such as the Hadza tribe from Tanzania have some of the healthiest microbiomes on earth. Unlike most of us, they eat an incredibly diverse range of foods including foraged fruits, fibre-rich vegetables and wild fish and game. Notably, their processed food consumption is virtually zero. While it might not be possible to mirror the diets of the Hadza exactly, adding a little diversity (specifically by incorporating a wide range of fresh fruits and vegetables) can have a big impact on the health of your microbiome. 

Tip: Aim for 5-7 portions of different fruits and vegetables every day, choosing organic, locally grown produce wherever possible.

3. Exercise regularly (especially outdoors).

It’s well-established that regular exercise offers countless health benefits, but did you know that it can also enhance the number of beneficial bacteria in your gut? A recent study conducted by the department of Experimental Medicine in Naples concluded exactly that, stressing that exercise can even be used “as a treatment to maintain the balance of the microflora or to rebalance its eventual dysbiosis.”(6)

You can further enhance the benefit by exercising outdoors. Getting outside and away from sterile internal environments exposes your body to all sorts of helpful organisms that can positively impact your microbiome.

Tip: Exercise for at least 30 minutes 5 times per week. At least 2 of these sessions should be outdoors.

4. Limit alcohol (but don’t abstain completely).

We all know that excessive alcohol is bad for our health and unfortunately this extends to the microbiome as well. However, research from The American Gut Project at the University of California suggests that people who consume at least one alcoholic drink a week have a more diverse microbiome than those who abstain completely. (7)

As with food, the choice of alcoholic drink is important and anything mass produced is best avoided as it is likely to be heavily processed. Opt instead for small quantities of Organic red wine, locally distilled spirits or even home-brew beer and cider.

Tip: Limit alcohol to 3-4 drinks per week. Choose organic, small-batch alcohol wherever possible or even make your own!

5. Try Probiotics.

If you’re struggling to add diversity to your diet, or if you’ve tried the other steps without success, supplementing with probiotics is a great way to improve the health of your microbiome and support its role in regulating immunity. There are countless probiotic supplements on the market, each utilising different strains of bacteria, but our favourite species for immune support are: Bifidobacterium Bifidum and Lactobacillus Acidophilus.

Tip: Introduce a quality probiotic supplement as part of your daily routine. Opt for one that contains at least 10 billion CFU’s (colony forming units) per serving.  

SHOP Probiotic Superfoods

Conclusion 

The digestive system plays a vital role in the regulation of immunity and the prevention of disease. At the core of this system lies the microbiome, which can be both positively and negatively influenced by our diets and lifestyles. There is growing evidence that poor diets (specifically those low in plant-diversity and high in Ultra Processed Foods) are fuelling a sharp decline in the health of our microbiomes and subsequently the function of our immune systems. By addressing these imbalances and taking active steps to improve the quality of our diets, we can stimulate the growth of friendly bacteria species in our gut and limit our exposure to the epidemic of non-communicable diseases affecting modern society.

References:

(1)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/#:~:text=Indeed%2C%20gut%2Dassociated%20lymphoid%20tissue,bearing%20cells%5D%20reside%20in%20GALT.

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333870/

(3) Mosely, Michael. The Clever Guts Diet. Short Books. 2017. 

(4) https://www.dailymail.co.uk/health/article-9588967/What-month-eating-ultra-processed-food-did-me.html

(5) https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-020-00996-6

(6) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357536/

(7)https://www.researchgate.net/publication/335446113_Red_Wine_Consumption_Associated_With_Increased_Gut_Microbiota_a-Diversity_in_3_Independent_Cohorts

Testosterone and Gut Health

When it comes to male health and wellbeing, the importance of healthy testosterone levels cannot be overstated. Not only do healthy test levels contribute to libido and sex drive, but this crucial hormone also determines fat distribution, strength, muscle mass and the production of red blood cells.

There are many things you can do to optimise your testosterone levels, from regular weight training to supplementation, but as emerging research has shown, reducing inflammation in the gut –specifically by improving the health of the microbiome – is one of the most important steps you can take.

Inflammation and testosterone deficiency are linked

In a recent study by the University of South Australia and the University of Duisburg-Essen Germany, researchers found that acute inflammation could reduce testosterone production by as much as 30% in 6 hours. Their research also showed strong, positive correlations between chronic low-level exposure to inflammation and a reduction in testosterone levels.

But what has this got to do with gut health?

As gut expert Dr Vincent M. Pedre explains, diet-induced inflammation can dramatically affect the health of the microbiome and vice-versa:

“Inflammation sets off a chain reaction. The standard American diet (SAD) leads to obesity through inflammation by affecting your gut flora, reducing the presence of friendly bacteria, resulting in increased intestinal wall permeability (leaky gut syndrome), and allowing bacterial endotoxin (a bacterial cell wall component and potent activator of the immune system) to leak into your body. The trans-mucosal migration of endotoxin directly leads to lower testosterone levels by affecting its production in the testes.”

Vincent M. Pedre

In other words, a poor diet can reduce friendly bacteria in the gut, leading to increased inflammation and ultimately, reduced testosterone.

Low testosterone levels can actively damage gut health – leading to a vicious cycle of disease

To compound the problem, healthy testosterone levels directly contribute to the proper functioning of the digestive system, performing a number of important functions including:

  • Maintaining motility in the colon
  • Reducing pain in the digestive tract
  • Decreasing inflammation in the gut

Consequently, low testosterone levels can actively damage the gut, leading to higher levels of inflammation and even lower levels of testosterone – a vicious cycle that can slowly erode health and promote disease. The key message here is that gut health and testosterone production go hand in hand, and that by working to improve one you can help to optimise the other.

A nutrient-rich diet combined with Probiotics can reduce inflammation and boost testosterone

So what’s the answer?

As with so many aspects of healthy living it all boils down to diet and when you’re looking to improve gut health and boost testosterone, a nutrient-rich wholefood diet is king. As Dr Pedre explains:

“A nutrient-dense diet rich in healthy fats (like a ketogenic diet) coupled with intermittent fasting is a great way to lose weight, improve gut health, and optimize testosterone levels. I also recommend drinking filtered water, avoiding hormone disrupters such as bisphenol-A (or BPA), and taking a high-quality probiotic as research shows probiotic supplementation can even help prevent low testosterone in men.”

Vincent M. Pedre

Some of this may sound obvious. We all know we should be avoiding processed foods and maximising our intake of fruit and vegetables, but when it comes to putting it into practice, busy lifestyles can get in the way. If you’re looking for an easy way to boost your fruit & veg intake, whilst simultaneously incorporating a quality probiotic, our daily wellness shake Probiotic Superfoods can help you reach your goal. With 7 organic fruits & vegetables plus 10 billion gut-friendly bacteria per serving, it also contains Aloe Vera and L-glutamine – two powerful anti-inflammatory agents that have been proven to reduce gastro-intestinal inflammation, and in the case of L-Glutamine, actively protect the mucous membrane of the intestines.

Simply add one scoop (10g) to 250ml of water and mix well for a great-tasting gut-friendly drink.

Shop Probiotic Superfoods

Summary

Maintaining healthy testosterone levels is a challenging but crucial aspect of male health and wellbeing. Poor diets, with an over reliance on highly processed foods can negatively impact the health of the microbiome and lead to increased inflammation in the gut; something that has been linked with a significant reduction in testosterone.

Working to improve gut health, by focusing on nutrient-rich wholefoods, eating plenty of fruits & vegetables and introducing a quality probiotic supplement, can actively reduce inflammation in the body and help prevent low testosterone in men.

The REAL cause of Acid Reflux (and how to cure it permanently)

Acid reflux man holding flames over stomach

What is Acid Reflux?

Chronic acid reflux, known medically as Gastro-oesophageal Reflux Disease (GORD), is the most common digestive condition in the UK affecting around 1 in 5 adults(1). Causing a wide range of symptoms including a burning pain in the chest, sore throat, regurgitation and dental issues, GORD is a debilitating condition that can have a dramatic effect on the quality of life of its sufferers.

Conventional treatment centres around making basic lifestyle changes (avoiding overeating, stopping smoking etc..) and the prescription of acid-suppressing drugs known as Proton Pump Inhibitors (PPI’s) to reduce acid levels in the stomach and subsequently calm inflammation.

The problem with this approach is that PPI’s do nothing to address the root cause of the condition, and although they may be effective in the short term, symptoms almost always return as soon as treatment is discontinued. What’s more, due to their powerful effect on the body’s natural acid production, PPI’s are associated with a wide range of uncomfortable side effects including abdominal pain, gas and nausea(2).

what causes it?

Contrary to popular belief, acid reflux is not caused by excess acid. Rather, it occurs when acid escapes the stomach and comes into contact with the delicate tissue of the oesophagus. This happens when a key valve known as the Lower Oesophageal Sphincter (LOS) malfunctions and fails to properly close.(3)

A number of factors can lead to LOS malfunction including obesity, overeating and the presence of a hiatus hernia, but a growing number of doctors and functional medicine practitioners now believe that the main cause of LOS malfunction (and subsequently acid reflux) is actually an increase in Intra-abdominal pressure (IAP)(4). In other words, a build up of pressure in the stomach forces the LOS to open, allowing acid to escape and irritate the oesophagus.

Several lifestyle factors can contribute to an increase in IAP (including overeating and Obesity) but many now believe that for individuals where such factors have been excluded, the primary causes are:

  • Food Intolerances
  • Low Stomach Acid
  • Slow Gastric Emptying


food intolerances

Is it possible that food intolerances are the main cause of acid reflux in the UK? Unlike food allergies (which are fairly easy to diagnose as they have dramatic and obvious symptoms) food intolerances are much more difficult to pin down. The symptoms they cause may be very subtle, and may take many hours or even days to manifest, but over time the cumulative effect on the digestive system can be quite destructive.

So what exactly do we mean by a ‘food intolerance’? For the sake of this article, a food intolerance is defined as:

Any ingested substance that causes an adverse (but non-allergenic) response.

Classic symptoms of intolerances are bloating, gas, acid reflux, stomach cramps and diarrhoea, but less obvious signs are tiredness, headache, or even mild depression.

Unlike allergies, intolerances do not involve the body’s immune system. They arise from an inability to digest and absorb certain compounds.(5) One of the most common examples of this is Lactose intolerance, which according to some estimates affects up to 70% of the world’s adult population.(6) With lactose intolerance, the body does not produce a sufficient quantity of lactase, which is the enzyme for breaking down lactose. As such, undigested molecules make their way to the intestines where they ferment releasing gas.
As we know, excess gas can cause an increase in IAP, which is why acid reflux is one of the major symptoms of lactose intolerance.

Another common food intolerance, and one that is certainly worth ruling out, is a sensitivity to gluten. Unlike Coeliac disease, which is a serious condition affecting less than 1% of the population, gluten intolerance is very common and can cause a range of mild to moderate symptoms including bloating and acid reflux. Despite its prevalence there are no specific diagnostic tests for gluten sensitivity, although some researchers define it simply as “an improvement in symptoms when following a gluten-free diet”.(7)


Low Stomach acid

It’s well-established that healthy stomach acid levels are crucial to properly digesting key micro and macro-nutrients. By stimulating the release of pancreatic enzymes and bile into the small intestine, stomach acid plays a crucial role in metabolising carbohydrates and fats. (8) But in the absence of sufficient acid, these compounds are not properly absorbed; instead they become food for bacteria in the gut which can lead to the production of hydrogen gas. This can in-turn lead to increased IAP.

Furthermore, healthy stomach acid levels play a vital role in the function of the immune system, acting as a first line of defence against many pathogens. Without a highly acidic environment to kill them off, harmful bacteria can make their way along the rest of the digestive tract and wreak havoc on the gut. The end result is impaired digestion, excess gas production and – you guessed it – increased IAP.

So how do we end up with low stomach acid?

Stomach acid levels naturally decline as we get older (which is one reason why acid reflux is more common in the elderly) but other factors such as chronic stress and a reliance on PPI’s can also have a big impact on our natural acid levels.


Slow Gastric Emptying

Known medically as Gastroparesis, slow gastric emptying occurs when the stomach cannot empty in the normal way. Food passes more slowly into the small intestine and as such there is a build up of IAP in the stomach which ultimately leads to acid reflux.(9)

There are a number of health conditions that can cause gastroparesis, including nerve damage, viral infections and diabetes, but simply eating too much of the wrong foods can also delay gastric emptying in many people. This is one reason acid-reflux sufferers are often advised to avoid fatty foods and large portions of red meat – because our stomachs can take a long time to process these foods and they can linger for many hours after eating.

One effective treatment for gastroparesis (and subsequently acid reflux) is that of a prokinetic agent. (10) Prokinetics are a group of drugs that help strengthen the LOS and speed up the emptying of the stomach. They achieve this primarily by enhancing gastrointestinal motility; increasing the frequency and strength of peristaltic contractions to move food through the stomach faster. Popular prokinetic drugs include Metoclopramide and Domperidone.

Unfortunately, there is a major problem with prokinetics – they almost always come with a host of serious and potentially dangerous side-effects.(11) In fact, the side-effects of Metoclopramide are so serious that many doctors don’t recommend taking it for more than a few days!

HOW TO CURE ACID REFLUX IN 5 EASY STEPS

1. Determine (and eliminate) your food intolerances

This might seem an obvious point, but in order to eliminate your food intolerances, you first must determine what they are. There are many companies out there that offer DIY intolerance testing kits, claiming to check for everything from coeliac disease to the presence of heavy metals, but unfortunately there is little scientific evidence to back these tests up.

Fortunately, there is an easy and highly effective way to test for intolerances: an elimination diet. Quite simply, you eliminate a number of common trigger foods from your diet (e.g. gluten; lactose) and monitor the affects on digestion. You then re-introduce the foods one-by-one and see if your symptoms return. The best way to do this is by keeping a food diary and recording your digestive symptoms following each meal.

The good news is that even when you have determined your trigger foods, you don’t need to avoid them forever. Unlike people with allergies, those with food sensitivities tend to be able to tolerate small quantities of the offending food without too much trouble. The key is to find your limits and stick to them!

2. Promote healthy stomach acid levels

Given what we know about the importance of stomach acid and its role in digestion, it’s vital that we address any deficiencies in this area. This is particularly true for people who are taking, or have previously taken, acid-suppressing drugs such as PPI’s, or those with hectic lifestyles who are at risk of chronic stress.

The easiest way to boost stomach acid levels is by taking a supplemental form of Betaine HCL.* This is generally available in capsule form and is often combined with Pepsin which is a powerful enzyme to digest protein. Simply take 5-10 minutes before each main meal to gently increase stomach acid levels and promote healthy digestion.

Apple cider vinegar is another great option and comes with a host of positive health benefits including reducing body fat and helping to control blood sugar. Simply mix 1 tablespoon with 200ml of water and consume before each meal.

*Always consult your doctor before taking any supplements if you are taking medication. Never use HCL supplements if you have an active stomach ulcer.

3. Take a digestive enzyme supplement

As we have established, food intolerances generally stem from an inability of the body to digest certain compounds. Digestive enzymes address this issue by helping to break down these compounds and promoting healthy nutrient absorption in the small intestine. As a result, potentially troublesome molecules like lactose are prevented from reaching the gut intact and causing the uncomfortable symptoms associated with food intolerances.

In addition to targeting specific compounds, quality digestive enzymes also work more broadly, helping to break down carbohydrates, fats and proteins; assisting the body’s natural enzyme production and promoting overall digestion.

As with Betaine HCL and apple cider vinegar, digestive enzymes are best taken shortly before a meal to prime the digestive system for action.

4. Eat more ginger

Remember what I said about the dangerous side-effects of prokinetic drugs? Well the good news is there is one powerful, natural prokinetic that has been used for centuries and has no harmful side effects…

Ginger

In a 2008 study researching the effects of ginger on gastric emptying, 24 volunteers were given either ginger capsules or a placebo and then ingested a meal of soup. Their rates of gastric emptying were measured and the results compared. In the group that took the placebo, their stomachs emptied in an average time of 26.7 minutes but in the group that took the ginger this time was more than halved to just 13.1 minutes! (12)

In addition to its effect on gastric emptying ginger has also been proven to reduce flatulence and be an effective remedy for nausea, even outperforming the popular anti-sickness drug Dramamine in one leading study. (13)

To enjoy the full benefits of ginger, add one teaspoon of freshly grated root to a cup of boiling water and enjoy as herbal tea; introduce it at meal times (it’s prevalent in many popular Asian dishes) or find a quality ginger supplement that contains a minimum of 1000mg per serving.

5. Try Fermented Foods

Fermented foods, specifically fermented vegetables, are a great addition to any diet but are particularly beneficial to sufferers of acid reflux and other digestive disorders. Rich in enzymes and beneficial bacteria, fermented vegetables help promote a healthy microbiome, which is crucial not only for digestion, but also for the regulation of the immune system.

Some great examples of fermented vegetables to try are: Kimchi, sauerkraut and pickled ginger. Other fermented foods such as natural yoghurt and kefir may also be beneficial, but these are generally not recommended for acid reflux sufferers as they contain lactose.

Summary

Acid reflux is a debilitating condition that affects up to 1 in 5 UK adults. Conventional treatment centres on the administration of powerful acid-suppressing drugs, which come with a host of harmful side-effects and do nothing to address the root cause of the problem. What’s more, by suppressing acid production the drugs actually make digestion worse, reducing the body’s ability to absorb important compounds and jeopardising the effectiveness of the immune system.

Contrary to popular belief, the true cause of Acid reflux is not excess acid but a malfunction of the lower oesophageal sphincter, caused in-turn by an increase in Intra-Abdominal pressure. This can be triggered by a range of conditions but in otherwise healthy individuals may primarily be caused by food intolerances, low stomach acid and slow gastric emptying.

The good news is that through simple lifestyle changes, smart dietary choices and targeted supplementation, it is possible to naturally and permanently restore digestive health and enjoy life without the burden of chronic acid reflux.

Sources:

(1). https://gut.bmj.com/content/54/5/710
(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6829383/
(3). https://gutscharity.org.uk/advice-and-information/symptoms/heartburn-and-reflux/
(4). https://chriskresser.com/how-to-cure-gerd-without-medication/
(5). https://www.bda.uk.com/resourceDetail/printPdf/?resource=food-allergy-food-intolerance
(6). https://www.nutrition.org.uk/nutritionscience/allergy/lactose-intolerance.html?start=1
(7). https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/gluten-sensitivity/
(8). https://www.nutritionist-resource.org.uk/memberarticles/why-stomach-acid-is-so-important-to-your-health
(9). https://www.nhs.uk/conditions/gastroparesis/
(10). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496896/
(11). https://bnf.nice.org.uk/drug/metoclopramide-hydrochloride.html#sideEffects
(12). https://pubmed.ncbi.nlm.nih.gov/18403946/
(13.) https://pubmed.ncbi.nlm.nih.gov/17957907/