Some problems with coeliac disease

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Coeliac disease (CD) is not a minor ‘intolerance’ to gluten, it is an autoimmune condition in which the body’s immune system attacks the small intestine, reducing the ability of the body to absorb nutrients from food. If left undetected, CD has the potential to cause significant long-term health complications. CD is one of the most common lifelong disorders in north America and Europe and only one in eight coeliacs are ever diagnosed. These are disturbing facts.

Diagnosis of CD currently requires a positive blood test and then subsequently the detection of damage to the small intestine via an endoscopy. The first problem is that less than 50% of coeliacs are presenting with the classical symptoms of diarrhoea and abdominal cramping. The majority of coeliacs are ‘silent’ in their presentation – no overt digestive symptoms but signs and symptoms including anaemia, osteoporosis, arthritis, neurological degradation, depression, fertility issues, migraines and chronic kidney disease. This is likely to have a significant impact on whether testing for CD is even considered.

The next potential issue is with the blood testing itself. The standard NHS test for CD is good if you are presenting with significant damage to the small intestine and your immune system is functioning properly. We know, however, that damage to the small intestine is gradual and can take years or even decades to manifest; the immune system is often underperforming and the markers measured for are not broad enough. This can lead to very high rates of false negative results (up to 70%), which is dangerous if you are told it is fine to consume gluten when in fact it is not! Remember you have to be eating gluten and not taking any steroid or immune-supressing medication for any blood test to have half a chance of picking up an issue.

Finally, it is possible to have positive blood markers for CD and no small intestine damage – ‘latent’ CD (over and above the fact that the biopsies can often miss ‘damaged’ areas of the small intestine). Is it any wonder CD is such a poorly diagnosed and managed condition?

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com

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New heights

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As we fly into a new year, why not volunteer for your local air ambulance charity and make a difference locally?

A new year… have you made any resolutions? Well if yours included spending some time helping as a volunteer, then your local air ambulance would love to hear from you – and will give you some training as well.

Volunteers provide invaluable support to Hampshire & Isle of Wight Air Ambulance (HIOWAA) throughout the year, fulfilling many important and rewarding roles. From giving talks to local groups, to distributing donation pots, attending fundraising events and presenting two highly successful educational programmes, volunteers play a key role in the day to day activities of the charity.

HIOWAA is seeking to recruit a wide range of volunteers from across Hampshire and the Isle of Wight and is keen to hear from anyone interested in volunteering, regardless of how much time they can give. They also recently launched a popular Volunteer Training Programme, offering volunteers training in areas including public speaking, first aid, health and safety, compliance and inter-personal skills.

In particular, HIOWAA is looking for volunteers to help present LifeLines, the charity’s newly launched educational programme for young people aged between 11 and 18. The volunteer role would suit anyone with teaching experience, or anyone comfortable presenting to groups of youngsters.

“Our volunteers playing a vital role in helping to keep the Air Ambulance flying and saving lives, says charity manager Sherie Williams Ellen. “They provide an essential link to our local communities and we simply could not manage without them. Our volunteers have busy lives and often have to fit volunteering around several other commitments. We are keen to hear from those who want to volunteer on a regular basis as well as those who can help out once or twice a year. Volunteering provides the perfect opportunity to support our life saving service and is also a great way to learn new skills and be a lot of fun.”

To find out more information on how you can help your local air ambulance, please visit www.hiowaa.org

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How to deal with uninvited gas

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The digestive system is about 30ft in length from entrance to exit and consists of the following major sections in order from top down: the mouth, throat, stomach, small intestine (duodenum) and large intestine (colon).

As I have mentioned many times previously, the digestive tract is home to a complex community of bacteria  (approximately 100 trillion), which should not only be in balance for health and well being, but also should have the largest number of bacteria residing in the colon.

Sometimes, the small intestine gets overgrown with bacteria due to conditions such as low stomach acid, pancreatitis, diabetes, diverticulitis and coeliac disease. This is called Small Intestinal Bacterial Overgrowth or SIBO. These bacterial overgrowths produce either hydrogen and/or methane gas.

The small intestine has the surface area of a tennis court and is crucial to the efficient absorption of nutrients from the diet. SIBO disrupts the ability of the small intestine to efficiently absorb nutrients (the bacteria end up competing for the nutrients that the body is trying to absorb) often resulting in a broad range of micronutrient deficiencies (including iron, calcium, and vitamins B12, A, D, E and K) and symptoms including nausea, bloating, vomiting, diarrhoea, malnutrition, weight loss, joint pain, fatigue, acne, eczema, asthma, depression and rosacea.

SIBO is typically treated with antibiotics. Research suggests, however that certain herbal and lifestyle interventions are just as effective at treating SIBO.

In clinic, a multifactorial approach delivers the best results. This typically involves a combination of changing how much and how often you eat, what you are eating, adding in certain strains of probiotics, targeted supplementation, the use of herbs and essential oils and managing stress levels using techniques such as meditation, mindfulness, yoga, tai chi or deep breathing.

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com

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Digging deep

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Peter Anderson chats to history buff and television star Sir Tony Robinson.

Q. What sparked your interest in history; was it Baldric as Blackadder went through the centuries?!
“It goes back to when I was a child and my dad told me of his time in World War II. He was posted to Scotland, met up with some Canadian soldiers and spent the war touring in a Canadian dance band. That made me think of him as a child learning what his father had done, and his father before him – the continuum of history.”

Q. Of all the stories of folklore, why do you think King Arthur has lasted so well?
“The Dark Ages are shrouded in mystery, but the stories of King Arthur held a romantic appeal. They were also seized upon by the Norman Kings keen to use their lineage from King Arthur to legitimise their claim to the throne. They sought to publicise all the stories that came out regarding King Arthur’s time.”

Q. What’s the significance of Round Tables?
“The Round Tables were a common item at tournaments as everyone could be equal in standing and speak. There is an example at York where guests sat in niches around the table and stepped forward to speak. But the best thing to compare is the corporate boxes around modern-day sports grounds like Wembley, where a lot of networking can be conducted alongside the sport or entertainment.”

Q. Did your time with the experts on Time Team,
including Jonathan, prepare you for this next event?
“Jonathan impressed me when he appeared on Time Team, and we have been friends ever since. He is an archaeologist, but specialises in standing archaeology, a lot of the work in Time Team was looking at holes in the ground and assessing what had been there; his expertise is looking at buildings still standing. He can look at a building and then guide you through clues he has spotted to all the various phases of construction within it. It is a remarkable skill.”

Q. Do you have a favourite period of history and would you fancy travelling back to it?
“I think Ellen Degeneres was right when she said now is the best time. There are so many things we take for granted now that were not available. However, from a point of intellectual curiosity I would love to go back to the time of King Alfred I. I find it so intriguing that someone could go from a small kingdom in the South West of England and in the space of a couple of years take on the invading Vikings, beat them and have the leader of the Vikings paraded through the streets wearing white and converting to Christianity. I would so love to find out how he achieved it.”

Q. Is there anything from history you’d still like to do a programme or talk on?
“So many! But the main one would be a programme that shows wars were not won so much by fighting on the battlefield but by organisation, the ability to move troops and equipment quickly, to supply them. I was lucky enough to film out in the middle of the Sahara Desert, in the middle of nowhere, the shifting sands had cleared to reveal a metalled road thrown up quickly by the Germans in World War II to move equipment. Now taken back and covered by the desert sands…”

Q. Who would be your perfect dinner party guests?
“King Alfred, Archbishop Asser, Oliver Cromwell, Sir Francis Walsingham, William and Robert Cecil. We are a little light on the ladies, so I think Eleanor of Aquitaine; rumour has it she was the one who was running the country.”

Q. Is there anything we could learn today from the Age of Chivalry?
“Definitely: the Chivalric Code held people together in times of crisis. It was a code of politeness, being honourable, with honesty and courtesy.”

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Leaky gut

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We will consume between three and seven tonnes of food and drink in our lifetimes, which has to be broken down and then the nutrients absorbed across the gut barrier, before they can be utilised by the body. The size of a tennis court, the gut barrier of the small intestine is made up of a single layer of cells that not only regulate the flow of nutrients and water into the body, but also play a central role in how our immune system responds to the dietary proteins and microbes that are ingested on a daily basis.

Nothing put into the digestive system is, technically speaking, inside the body until it has been absorbed across the gut barrier. It is the gut barrier that decides what to both let in and keep out of systemic circulation.

Research shows that the integrity of the gut barrier is fundamental to health and wellbeing. If the gut barrier is compromised by ‘leaking’ between and/or through the cells (para and/or trans cellular hyperpermeability), unwanted substances might permeate through and provoke unwanted immune responses – fuelling chronic inflammation, which is the route cause of all chronic disease and is a recognised key factor in the development of autoimmunity. Some of the conditions directly associated with ‘leaky gut’ include: coeliac disease, type 1 diabetes, rheumatoid arthritis, psoriasis, spondylitis, Parkinson’s disease, endometriosis, eczema, Crohn’s disease, colitis, multiple sclerosis, chronic fatigue syndrome, depression, anxiety and schizophrenia.

Leakiness between the cells of the gut barrier is controlled dynamically by a protein called zonulin. The higher the levels of zonulin, the greater the leakiness between the cells. The zonulin pathway is initiated by either the presence of pathogenic bacteria and/or gluten in the gut. Dysbiosis (imbalances in the micro ecology of the gut) and leaky gut usually co exist.

The presence of either or both of these conditions will drive a state of chronic inflammation. Fortunately, you can repair ‘leaky gut’ and rebalance the micro ecology of the gut, regaining control of health and wellbeing.

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com

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Feel the Byrne

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Jonathan Lovett chats to comedian, actor, writer and dad of two Ed Byrne, 45, who has just embarked on his biggest ever tour to date, Spoiler Alert, following a sell-out success at this year’s Edinburgh Festival

Q. What is Spoiler Alert about…or is answering that a bit of a spoiler in itself?!
“Well, I called it that partly because if there were any bad reviews people wouldn’t read them because it would say ‘Spoiler Alert’ at the top! But it’s mainly because the theme of the show is the notion of how spoilt we are in general and how we’ve become quite mollycoddled as a nation. Stuff like having to push a button to start a car rather than turn a key because it’s such a great drudgery to turn a key these days. And how it’s the trivia stuff we act really spoiled about, whereas with the big stuff, such as politics, we seem to just accept how bad things are. There was a big women’s march after Trump was elected and some people were like ‘Uhhh. What are they complaining about? We don’t live in Saudi Arabia,’ with the implication being ‘Shut up, luv. We’re not stoning you to death, what are you bothered about?!’”

Q. If you had the opportunity to say something to Donald Trump what would it be?
“If I ever did have such a marvellous opportunity I’d have to look him straight in the eye and say, ‘You really are an awful person, aren’t you?’ or maybe I would just scream ‘STOP PAINTING YOURSELF ORANGE…YOU LOOK RIDICULOUS!’”

Q. You’ve just begun an epic tour. Do you love touring this much, Ed?
“If you are really famous you can just go and play the main cities and people from little towns will come into the big cities to come and see you. Whereas if you are just ‘that bloke on Mock the Week’ you have to go to those small towns. People from Evesham can’t be bothered to go to Birmingham to see me. So I have to go to Evesham.”

Q. What was your worst gig ever done and does it still haunt you? “I’m sometimes hired to do corporate gigs and now and it can be a real struggle. On occasions there is just no laughter at all and you’re up there in front of an audience who are just there for their own thing and perhaps you’re just not the right comedian for that particular crowd. I mean, Metallica are a great band, but if I booked them to play at my in-laws’ golden wedding anniversary it might not go down particularly well. I have been on stage in the past and just wished ‘God. I wish I was a stripper’ because I would’ve got a far better response from that audience then I ever would as a comedian!”

Q. I can testify you are very funny on stage. Were you the funniest kid in your class?
“I was the classic case of having to be funny to avoid being bullied, but even at school it was bigger, louder kids that were considered funnier. My humour was a bit nerdier. So at school I would be reciting Monty Python sketches and I would be met with a kind of, ‘What the flip are you on about?’ I was probably a little more ‘niche’ as a school kid than I am now and I used to play Dungeons & Dragons even as a teenager. My cousin and I were proper little geeks and I would go into school with a spring in my stride on a Monday morning having got my wizard to Level 14 the night before.”

Q. We’ve just seen you and best mate Dara O Briain on TV in Dara & Ed’s Road to Mandalay, a follow-up to Dara & Ed’s Great Big Adventure in which you travelled the Pan-American Highway. Where next for the intrepid duo?
“Well, if they do ask us to do another one, we are both quite keen on travelling through the Nordic countries. I think there will be a lot of mileage in that. We have a tendency to think of everyone up there as Swedish but it would be really interesting to get under the skin of these places and go, ‘Swedes are like this, and Danes like this, and the Finnish do this etc’… And, if we could get Abba to reunite, that would be good. I was talking to this guy in New Zealand who reckons he saw them all living and working together in this house in New Zealand and I was like ‘Really?!’”

Q. What’s the best thing or worst thing about Dara?
“I tell you what the most interesting thing is about Dara… he doesn’t know about spoons! If you showed him a spoon and said, ‘Now, is that a soup spoon or a dessert spoon?’ he’d be like, ‘It’s a bloody spoon!’ He knows big spoons and small spoons but in-between he doesn’t know anything about them! He only knows ‘spoon’ or ‘not spoon’.”

Visit www.edbyrne.com

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Chronic fatigue, fibromyalgia and energy production

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I regularly see clients with chronic fatigue syndrome (CFS) – fatigue so debilitating that they are virtually unable to function. Often CFS presents as fibromyalgia, which is chronic fatigue with the added burden of widespread pain and stiffness all over the body.

It is believed the pain associated with fibromyalgia is caused when the mitochondria (the energy production plants in our cells), desperate to supply energy to the body, switch from efficient aerobic (using oxygen) to inefficient anaerobic (no oxygen) metabolism. Anaerobic energy production creates large amounts of lactic acid.

Lactic acid, as anyone who pushes themselves when exercising knows, causes muscle pain, which dissipates after a short rest. This pain, however, does not dissipate with fibromyalgia, as the body is unable to break lactic acid down, due to mitochondrial dysfunction. The excess acid can also cause damage to muscle tissue, presenting as very sensitive areas. This process can feed on itself as the damage releases lots of free radicals (destructive molecules), which can cause additional damage if antioxidant status (the ability to neutralise free radical damage) is low. So mitochondrial dysfunction is one of the key areas when it comes to helping move the body back into balance with CFS and fibromyalgia. Healthy mitochondria require a raft of key nutrients for optimal performance, including but not limited to magnesium, B vitamins, essential fats, CoQ10, carnitine and alpha lipoic acid and must not be bathed in toxins. There are often multiple systemic imbalances going on, including but not limited to digestive dysfunction, poor antioxidant status, immune system dysregulation, chronic inflammation, viral infections, food and/or environmental sensitivities/allergies, thyroid and adrenal dysfunction and micronutrient deficiencies. Nothing exists in isolation. Once again looking at the body from a functional and holistic perspective is key.

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com

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The gut and mental health

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It is not a new concept that a ‘gut brain’ axis exists and I have touched on this subject before in previous columns.

Serotonin is a neurotransmitter that regulates mood, appetite and sleep; when there are appropriate levels in the brain we feel relaxed and positive. This is the principle behind selective serotonin reuptake inhibitor drugs (SSRIs), to increase levels of serotonin available to the central nervous system. It is the gut, not the brain, however that is responsible for over 90% of total serotonin production.

In the gut, serotonin controls how ‘regular’ you are and it is the balance of the bacterial species in our gut that appears to play a significant role in the amount of serotonin produced. This might well explain not only why a significant relationship exists between individuals presenting with irritable bowel syndrome (IBS) and depression, but also why when doctors prescribe SSRIs for depression, those presenting with IBS often see improvements in digestive function.

A new study has found evidence in humans (not rodents as was the case until now) that our emotional responses, including anxiety and depression vary considerably depending on bacterial balance in the gut. The results not only suggest a strong link between the bacterial composition of our guts and feelings, but that the balance may change the physical structure of the brain by either growing the frontal cortex or shrinking the hippocampus – areas of the brain involved in problem solving, emotional regulation and consciousness. Understanding that gut microflora can play such a huge role in chemical balance of the brain is one thing, but that these microbes might initiate physical changes in the brain is another! This may well be why in clinical practice I often see clients’ overall mental health and wellbeing improve as we identify and eliminate key food and environmental sensitivities and support overall gut health.

Call Mark BSc (Hons) BA (Hons) mBANT CNHC on 01183 219533 or visit www.entirewellbeing.com

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