Toxic Stress is Causing Leaky Gut and More In practice, I could have three different people with rheumatoid arthritis.

They all have autoimmunity, i.e. rheumatoid arthritis, and each person’s response is a result of so many factors – genetic issues, lifestyle issues, compliance issues, and so on. There are so many variations and they each can have different responses to treatment. I’m not saying this is easy, so the goal is just to meet people where they’re at, try to focus on the priorities, and see how they respond to certain things and be flexible enough, have enough adaptability to just keep steering the ship a little bit and get them on the right course and give them the tools to work with so that they can control this.

Clinical Pearl: Quieting the Immune System, Not Curing Autoimmunity, Is How to Manage Autoimmune Disease Progression – There’s one thing I need to make clear – if you have been diagnosed with an autoimmune condition, you have to understand that there is no cure for autoimmunity. The real goal is to calm down the immune response, an aggressive immune response. If the immune system is aggressive, there’s going to be a lot of tissue destruction.

I’ll give you a personal example – my mom. My mom some years back – she’s passed away now, but years back – she literally woke up and was in what’s called a thyroid storm, meaning she woke up and her autoimmune thyroid had just turned on aggressively and was destroying her thyroid so quickly that it was dumping a lot of thyroid hormones, T3s, into her circulation, which was causing her heart to pound out of her chest. And so she had to get rushed to the hospital and they had to radiate her thyroid and kill its output, which was appropriate because without that, she ran the risk of having a heart attack. In that specific case, she had to move on and take the medications and all that required.

So the one thing I wanted to at least message in this chapter is: How does this really happen? How do we get these autoimmune conditions? So let me begin by saying to you that what we have is a barrier system. For example, when you think about your skin, your skin is a barrier to the outside world. And if you had a
cut on your arm, you would clean it. You’d put a bandage over it, and then after a week let’s say you’d take the bandage off and look to see if the the skin is healing over. If it is, okay, that’s good. You put the bandage on now –why? Because you don’t want an infection. You don’t want something, a pathogen, getting in.

Clinical Pearl: Cortisol Stress a Leading Factor For Intestinal Permeability and Root Cause of Autoimmunity – What are the factors that really contribute to that barrier system breaking down? Well, they’re numerous. But if I can say one thing that really is at the top of the list, it’s stress. When we experience stress, we upregulate a stress hormone in the body called cortisol. Our adrenal glands pump out cortisol, and we need it. Don’t get me wrong, cortisol is important. We need the right amounts at the right time. When we have chronic stress, ongoing stress, prolonged stress, we’re producing a lot of cortisol. And one of the things cortisol is going to do is beat down on this immune barrier system and contribute to gut permeability. So if you don’t get a handle on stress, you’re never going to have an easy time trying to mend this.

Well, we also have an internal barrier system. Your sinus cavity, your bronchials, your lungs, your entire GI tract, and your bladder is a barrier system, but instead of skin, think of it as a hollow cavity. Not sterile, but hollow, as opposed to organs, which are dense. Think of a food particle, or a pathogen, inside a cave. It always sounds strange when I say to patients: When you eat food, when you drink fluids and breathe in air, it goes into the internal cavity. It’s not actually in you yet. Patients are like, “Well, that doesn’t make any sense.” Well, the food is in the cavity. It’s not actually in your blood stream until it passes through the lining of that cave, that cavity, and gets into circulation. That is known as your mucosal barrier, and there are a lot of specialized immune cells in there that are checking every entity and particle that comes into it’s environment. Is it friendly or is it foe? We want to let the good things pass through, like the nutrients, and we want to keep the infected agents out and we want to excrete the environmental chemicals out and pollutants out, and even what we call undigested proteins. We want them out. We don’t want undigested proteins getting into circulation.

So the best analogy, although the mucosal barrier system itself is very complex, but to simplify, the best analogy is like the screen on a window. If it’s a warm night and you open the window, the screen is there and lets the air come in and keeps the bugs out. What would happen if I started poking some holes in that screen? And if it’s a hot, muggy day, the mosquitoes are going to show up and they’re going to be able to penetrate through. And before you know it, I’m scratching. I’m all bitten up by mosquitoes.

Clinical Pearl: How Toxins Permeate and Cause Leaky Gut – If our barrier system begins to breach, generally because of cortisol stress, if toxins permeate the gut, we refer to that as leaky gut. It’s really intestinal permeability, but the term leaky gut means the barrier system is breaching, breaking. It’s allowing for passage of everything from endotoxins to bacteria to metals to environmental pollutants to move into circulation. It also means that nutrients are not being properly dissembled before moving into the blood stream.

Now as it moves through circulation, at some point it’s going to start binding to different tissues. And that’s how the protein structure of that organ or tissue is now changed because these chemicals are bound to it and they’re able to permeate through. And at some point the immune system sees that. That tissue looks different. So really the entry point of autoimmunity is through a breakdown in these barrier systems.

But the point is that even if we do things to get the barrier system back in shape, if the pathogen has already entered, it’s already come in. And if the immune system is already reacting to what’s come in, it’s already reacting. So again, a lot of people talk about fixing leaky gut, but that’s not enough because the inflammatory response that the immune system is creating is already happening. So we’ve got to do both. We’ve got to regulate the immune system, but we’ve also got to fix the leaky gut so we don’t keep bringing more stuff in.

Dr. Doug Pucci is a functional medicine practitioner who was honored in 2020 to receive both The Best Of 2020 Awards for Functional Medicine in Oradell, NJ, and entry into Trademark Publications’ Who’s Who Directory, Honors Edition, for his pioneering work. He provides comprehensive testing for health biomarkers, advanced discovery into brain/body well-being and personalized nutrition for a diversity of people and symptoms.

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