Usman Microbiome, Helminths, and Biofilmsnac.nationalautismassociation.org/.../05/Usman_Microbiome-Helmint… · Anju Usman, M.D. True Health Medical Center Page # 3 the health of

GI Biology, Pathology, and Treatment Strategies

©2011 True Health Medical Center

Anju Usman, M.D. True Health Medical Center

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Microbiome Depletion, Helminths, Biofilms and more

AnjumUsmanSingh,MD,FAAFP,FMAPS,ABIHM,Hom-CTrueHealthMedicalCenter

Naperville,Illinois

©TrueHealthMedicalCenter

Disclaimer

• Information is for educational purposes only • The alternative view presented has not been established as standard care or practice

• Clinical trials have not yet been conducted • Not to be taken as specific medical advice • Dr. Singh is Medical Director and owner of True Health Medical Center, Pure Compounding Pharmacy and True Health Naturals




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Nature Reviews Neuroscience 2012




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the health of the microbiome (the trillions of microbes that inhabit the human host) plays an important role in maintaining the health of the host and that disruptions in the microbiome may play a role in certain disease processes.

the composition of the gut (enteric) microbiome (GM) in at least a subset of individuals with autism spectrum disorder (ASD) deviates from what is usually observed in typically developing individuals.

specific changes in the GM could be causative or highly associated with driving core and associated ASD symptoms, pathology, and comorbidities which include gastrointestinal symptoms

manipulation of the GM could potentially be leveraged as a therapeutic approach to improve ASD symptoms and/or comorbidities, including gastrointestinal symptoms.




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Gut Microbial Flora

• Bacteria major component of colonic material • Metabolism

•  Digestion and absorption of nutrition •  Production of B vitamins •  Destruction of toxins •  Blood Sugar Regulation

•  Immunity and Inflammation •  Repression of pathogenic microbial growth •  Prevent allergy •  Prevent inflammatory bowel disease and inflammation

•  Monoaminergic Regulation (neurotransmitters) •  Thru the Vagus Nerve

The Colon has an obligate need for bacterial fermentation products or SCFA, short chain fatty acids.




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Microbial Diversity

Abundance (High Levels)

Abundance (Low Levels)

Bacteroides-phylum

Bacteroidetes prevotella

Low diversity IBD Obesity

Bacteroidetes vulgatus

Low diversity Autism Celiac

Barnesiella spp. Immune modulation

Odoribacter spp. Inflammation IBD

Prevotella spp. Low diversity IBD Obesity

Autism


Microbial Diversity



Firmicutes phylum

Anaerotruncus colihominis

Metabolic Syndrome High BMI High Triglycerides

Butyrivibrio crossotus Richness Weight Gain

Clostridium spp. Low diversity Autism

Coprococcus eutactus Richness Autism Disaccharide deficiency

Faecalibacterium prausnitzii

Richness Improves inflammation Protects from NIDDM Helps Insulin Resistance

Lactobacillus spp. Richness IBS

Pseudoflavonifractor spp. Richness




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Microbial Diversity



Firmicutes phylum

Pseudoflavonifractor spp. Richness

Roseburia spp. IBS- constipation NIDDM, RA, IBD

Ruminococcus spp. Lower diversity IBD, UC, Crohns Autism

Veillonella spp. Richness Autism

Bifidobacterium spp. Richness Immune modulation

IBD, IBS, NIDDM Allergy Autism Weight Gain


Microbial Diversity

Abundance (High

Levels)


Actinobacteria phylum

B. longum Richness Weight Loss

Collinsella aerofaciens NIDDM IBS

Proeobacteria phylum

Desulfovibro piger IBD, IBS Autism Obesity

Esherichia coli IBD IBS Obesity

Oxalobacter formigenes

Oxalate metabolism Oxalate Kidney Stones




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Microbial Diversity



Euyachaeota phylum

Methanobrevibacter smithii

Richness Colon Cancer UC Diverticulitis Anorexia

Obesity

Fusobacteria phylum

Fusobacterium spp.

Colorectal CA Appendicitis Cirrhosis Peridontal Dx IBD, Obesity

Verrucomicrobia phylum

Akkermansia muciniphila Richness

Autism, IBD, Crohns, Pre-diabetes, Obesity


Microbiome Diversity

•  Lackofdiversityinthemicrobiomemayleadtoimmuneissues• Overabundanceofsome“good”bacteriadiminishdiversityandmaypromoteinflammationandautoimmunity

•  Bacteroidetes•  Clostridiasp•  Desulfovibriopiger

•  Scarcityofsome“good”bacteriamayleadtoadysregulatedimmuneandnervoussystem

•  Lowbifidobacteria•  Lowlactobacillus•  Lowenterococcus

Sympatheticdominance,dysautonomia,adrenaldysfunction,anxiety•  Prevotella-autism•  Coprococcus-autism•  Veillonella-autism•  Oxalobacter-kidneystones




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Lactobacillus and Bifidobacteria

• L. casei, bulgaricus, and acidophilus increase macrophage and enhance phagocytosis

• Decrease gut permeability • Exert antimicrobial activities • Secrete antimicrobial proteins (activate mucin, MUC2 and MUC3 genes)

• Increase T helper cells, Th2 • Decrease Th1, and allergic response • Increase IL 10, TGF-beta • Bifido lowers pro-inflammatory cytokines


L. acidophilus and salivarius may help with pain perception

• Oral administration induced a sustained release of the expression of analgesic opioid and cannabinoid receptors in humans.

• Direct contact of NCFM with epithelial cells is able to induce, through the NF kappa beta pathway, MOR1 and CB2 expression and contribute to the modulation and restoration of the normal perception of pain.




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www.thehealthyhomeeconomist.com/probiotic-strains-matched-by-health-problem/





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www.globalhealingcenter.com/natural-health/lactobacillus-gasseri-the-health-benefits-of-probiotics/




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Restoring the Microbiome

• Probiotics• Prebiotics• Helminths• FMT• THMCGutBiofilmProtocol-4STEPS• CleanUptheGut

• DietaryInterventions•  PlantbasedDiets• HighFiberDiet•  LowRefinedCarbohydrates

• AvoidAntibiotics• AvoidGlyphosate• AvoidPharmaceuticals-NSAID,OCPs• AvoidAntibacterialHandSanitizers




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ProbioticConsidersations

• D-lactate-un-useableformoflacticacid,avoidinpatientswithMito,somebadandsomegoodbacteriaproduceD-lactate

•  AvoidLactobacillusrhamnosus

• Histamineintolerance(HDC,HNMT,DAOenzymes)•  GoodBacteriaThatProduceHistamine

•  Lactobacilluscasei•  Lactobacillusrheuteri•  Lactobacillusbulgaricus

•  BadBacteriaThatProduceHistamine•  Klebsiellaoxytoca•  Citrobacterfreundii•  Enterobactercloacae

•  GoodBacteriaThatDegradeHistamine•  Bifidobacteriumlongum•  Bifidobacteriuminfantis(antiviral)•  Lacobacillusplantarum(wine)

• Probioticsdonotcolonize•  LactobacillusrhamnosusGGmaycolonize

https://www.isotrope.com/probiotics/


PrebioticsFeedGutBacteriaGoodandBad

http://probioticdigest.com/probiotics/




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PrebioticConsideratons

• EnterocytesarefueledbySCFA(shortchainfattyacids)whichareproducedbyfermentationoffiberorundigestablecarbohydrates

•  Butyrate•  Acetate•  Propionate

• FOS-Fructo-oligosaccharides-chicory,inulin,blueagave• GOS-Galacto-oligosaccharides-lactosebased• MOS-Mannan-oligosaccharides• InsolubleFiber-causesfermentationandcolonization• SolubleFiber-pectin,gum




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Hygiene Hypothesis

• Decreased exposure to bacteria in childhood • Over use of antibacterial agents • Inadequate development and maturation of the immune response

• May be responsible for growing epidemic of asthma and allergic disorders

Evolution, Medicine and Public Health, 2013




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Helminths: A Missing Essential Link?

• Until recently, humans and all wild animals had helminths as an integral part of their microbiome.

• Formerly thought of as parasites, it is now believed that some species of worms and protozoa have a symbiotic relationship with the host.

• Allergy, autoimmunity and inflammation are very uncommon in non-industrialized society and in wild animals.

• The extraordinary rise of diseases stemming from a hyper-reactive immune system parallels the implementation of sanitization (along with other things)

• Westernization annihilates the fauna

• Plastic containers, shoes, car travel, refridgeration, septic and sewer, toilets, water treatment, food irradiation, less contact with animals and soil

Reconstituting the Depleted Biome to Prevent Immune Disorders Article By William Parker, Duke University

“The light of evolution points toward reconstitution of the biome as the only reasonable therapy for a wide range of immune-associated disorders, including allergy, autoimmunity and perhaps autism.”




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Conditions Associated with Biome Depletion (helminth depletion)

Highly Probable � Asthma, Food Allergies, Hay Fever, Rhinitis, � Multiple Sclerosis, Eczema, Lupus, Type 1 Diabetes, IBD � Colorectal cancer, infantile colic, obesity � C diff infections Probable � Appendicitis, Graves Disease, Celiac disease, gluten-enteropathy,

Migraines, Urticaria, Schizophrenia, Dandruff � Autism associated with autoantibodies Suspected � ADHD, Autism in general, Bipolar disorder, Anxiety, OCD, Depression

Evolutionary Biology and Anthropology Suggest Biome Reconstitution as a Necessary Approach Toward Dealing with Autoimmune Disorders William Parker and Jeff Ollerton. Evolution, Medicine, and Public Health [2013]


Effectiveness of Helminthic Therapy

• Multiple Sclerosis (multiple studies) • Autism (Albert Einstein College of Medicine) using Trichuris suis • Asthma (Brazil) • Helminthic therapy shows potential for application as anti-

inflammatory agent. Several human diseases can be treated by helminths (i.e. inflammatory bowel disease, asthma, multiple sclerosis and autoimmune diabetes).

•  Trichuris suis ova (TSO) show strong immunomodulatory properties. Authors hypothesize that TSO could be useful in addressing ASD immune dysregulations. TSO could be a novel therapeutic option for ASD management

•  HDC Possible use of Trichuris suis ova in autism spectrum disorders therapy. Siniscalco, Dario et al. Medical

Hypotheses , Volume 81 , Issue 1 , 1 - 4




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HDC = Hymenolepis diminuta cysticercoid




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Donor Criteria




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http://www.essentialprobiotics.com/game-of-microbes-support-kingdom/


Treating Dysbiosis/Co-infections

• Clostridia • Yeast • Bacteria and Strep • Parasites • Viruses • Lyme and Co-infections




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True Health Medical Center Gut Biofilm Approach

•  Step 1 Lysis/Detachment – empty stomach •  Step 2 Microbial Killing – 15 min later or

simulataneously with step 1 •  Step 3 Clean up – 2hr later or at night •  Step 4 Rebuilding/Nourishing the Gut Lining


Step 1: Lysis/Detachment- options

•  Enzymes

•  Polysaccharidase, Disaccharidase, xylanase– break down mucus

•  Fibrinolytics- serrapeptase, nattokinase, lumbrokinase

•  May use pineapple, papaya or enzyme rich food for sensitive patient

•  Disodium EDTA (oral only) or Apple Cider Vinegar •  Lactoferrin (especially for Pseudomonas, do not give if

dairy allergy) •  Natural Iron Chelators (green tea, rice bran IP6,

curcumin, myoinositol) •  Polyphenol Rich Nutrients (essential oils, herbs)




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Step 1: Lysis/Detachment

•  Works best on an empty stomach •  Consider rotating various biofilm busters •  Do not give Enzymes on an empty stomach to

patients with severe GI issues •  Do not give Lactoferrin to patients with dairy

allergy •  Avoid giving Iron, Calcium or Magnesium with

an hour or two of protocol •  Careful with sensitive patients or weak

patients •  Careful with patients with severe

autoimmunity


Step 2: Killing

•  Consider natural Antimicrobials(herbs/oils) first •  Vary agents depending on microbiology,

mycology and parasitology testing •  Dysbiosis may seem to worsen initially •  Watch for die off, treat accordingly •  Consider the use of antibiotics or antifungal

meds if organisms remain persistent •  Start low and go slow •  It is not always about killing the bugs, it is

more important to re-establish the gut microbiome so the bugs donʼt grow!

•  Low carb diet is crucial




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Never, Never, Never Give Up…

-Winston Churchill


Clostridia Issues

Symptoms • Aggressive • OCD •  Temper • Agitation •  Irritable • Very foul stools • Mucus in stools • Severe diarrhea following

antibiotic use

Treatment Options • Probiotics, High Potency • Saccharomyces Boulardii (high

dose) • Antibiotics

• Vancomycin • Metronidazole (Flagyl)

• Herbals(Bayleaf, Thyme) •  Immune modulators (LDI) • HBOT •  L. Carnitine • Oxidative Therapies •  Fecal Microbial Transplants




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Yeast Issues

Symptoms • Spacey • Foggy thinking • Inappropriate laughter • Sugar cravings • Poor sleep • Frequent diaper rash • Frequent urination • History of frequent antibiotics

Treatment Options •  Limit carbs, sugar, yeast • Probiotics/Enzymes • Sacchromyces Boulardii •  Zinc, Molybdenum, Biotin, MCT oil • Antifungals

•  Drugs •  Nystatin, Ampho B •  Fluconazole •  Itraconazole •  Ketoconazole

•  Herbals •  Grapefruit Seed Extract •  Oil of Oregano, Pau dʼArco •  Garlic, Samento, …

• Enzymes • Essential Oils (thyme, oregano)


Bacteria(Strep) Issues

Symptoms • Ritualistic • Repetitive • Verbal tics • Obsessive • Compulsive • Verbal stims

Treatment Options • Probiotics/Enzymes • Xylitol • Manuka Honey • Antibacterial Herbs

•  Goldenseal •  Neem •  Berberine

• Essential Oils •  Grapefruit •  Lemon, Lime •  Peppermint •  Eucalyptus

• Drugs •  Penicillins, Cephalosporins •  Zithromax

•  Immune Modulators /LDI • Homeopathics




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Parasites: Treatment Options

Treatment • Antiprotozoa

• Metronidazole, Tinidazole • Paromomycin • Nitazoxanide

• Antihelminths • Mebendazole, Albendazole,Pyrantel,

Ivermectin, Praziquantel • Natural Remedies

• Wormwood(artemesia) • Black Walnut, Neem, Mimosa Pudica • Pumpkin Seeds, Clove, Cryptolepsis

• Homeopathics • Essential Oils- clove, peppermint

Consider Full Moon and New Moon protocols


Step 3: Clean Up / Binding Agents

•  Soluble Fiber, inulin, (prebiotics) •  Pectin, guar gum, ground flaxseeds, psyllium husks,

acacia seeds •  Activated Charcoal if needed for severe die off •  Alginates, Brown Algae, Clay •  Modified Citrus Pectin •  Slippery Elm, Yucca •  Burbur •  Chlorella, Cilantro/Chinese Parsley •  Zeolites •  Microsilica •  Chitosan/Cholestyramine •  NEW FAVORITE: Castor Oil

•  Very important step!!! •  Helps prevent symptoms of die off and detox




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Step 4: Rebuilding/ Nourishing the Gut Lining

•  Probiotic/Prebiotic Rich Foods •  Healing, nutritious, non-toxic foods •  Green Juicing •  Bone broths/Collagen •  Fermented Foods •  Supportive Supplements

•  Chondroitan Sulfate •  Sodium Butyrate •  Colostrum




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Documents

Usman Microbiome, Helminths, and Biofilmsnac.nationalautismassociation.org/.../05/Usman_Microbiome-Helmint… · Anju Usman, M.D. True Health Medical Center Page # 3 the health of