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DIGESTIVE FREEDOM EAT YOUR WAY TO INTESTINAL WELLNESS NOTE: THIS BOOK IS NOT EDITED YET BUT WANTED TO GIVE YOU AN IDEA A COMPREHENSIVE BODY/MIND/HORMONE/GUT GUIDE BOOK NATURAL APPROACHES TO HEAL & PREVENT DIGESTIVE DISORDERS WHY, WHEN & HOW TO GO GLUTEN FREE INCLUDES THE UNAPPRECIATED ROLE OF HORMONES AND THE GUT 6-WEEK PROTOCOL TO HEAL LEAKY GUT 4-WEEK DETOX GUT BOOT CAMP BY DR. DEVAKI LINDSEY BERKSON Introducing the genre – Nutritional Gastroenterology For both practitioners and the public Leaky Gut Syndrome, Nutrients and Hormonal Factors Affecting Gut Barrier Functionality, New Spectrum of Gluten-Related Disorders, Gas, Diarrhea, IBS, GERD, Stomach acid deficiency and pregnancy, New Spectrum of Inflammatory Bowel Diseases, New Approaches for Ulcerative Colitis, Recurrent & Smoldering Diverticulitis, Crohn’s disease, Role of Sex Hormones and the Gut, Oxytocin and the Vagal Gut, Must Managements After Gallbladder Removal or Avoiding Surgery, Food Allergies, Gut Microbiome, Microgenderome, and more… Dr. Berkson's original book - Healthy Digestion the Natural Way - is used to train integrative medical doctors by the American Academy of Anti-Aging Medicine (A4M)– the largest institute for holistic MDs reaching 120 countries. “ Dr. Lindsey Berkson is a leading authority on nutritional gastroenterology, offering some of the most effective, natural protocols available.” Dr. Pamela Smith MD MPH EVIDENCE & CLINICALLY BASED PROTOCOLS MANY DOCTORS DON’T KNOW SUCH AS THE FIBER & DIVERTICULITIS MYTH BUSTED, WHY FOLIC ACID CAN BE DANGEROUS ESPECIALLY IF YOU HAVE A HISTORY OF POLYPS, BATHROOM ERGONOMICS, SITTING IS THE NEW SMOKING ESPECIALLY FOR THE GUT, NUTRIENTS THAT HEAL GUT IMMUNE SYSTEM, ROOT CAUSE AND INDIVIDUALIZED APPROACH IS A MUST TO HEAL, AVOID SURGERY & LIFE LONG MEDICATIONS, AND MORE It is frightening being told you have a chronic or serious illness that requires a lifetime of medication or invasive surgery. But what if there were natural answers to put these conditions in your rear-view mirror? Welcome to a new world. The gut is the “outside” world in the center of our bodies. It’s two parallel universes, the “outside” and our ‘inside,” that live together from birth to death. How well we get along creates the basis for gut health, hormonal health, emotional and systemic health. This book is about helping you become an ally with this amazing world inside you so you can live a pain free, energetic and hopeful life. I have learned that the body is designed to heal. But a practitioner that has TIME and TOOLS to identify the root causes of illness is needed to allow that healing to take place. An in-depth intake is needed to listen and “master the patient’s story” so their life tapestry that led to this disease is uncloaked. There is a continuum of health to wellness to illness and then back to health again. This process must be individualized. The nurse practitioners in the office are frustrated with me when they bump into me in the hallways and ask for algorhythms to treat GERD. I answer that I have to know the patient’s story first. They think I’m withholding information. Not so. I am honoring the the unique person in front of me, body, mind and spirit. This book offers in-depth natural protocols using food, nutrients, herbs, diet, menus, specific use of nutrients, food factors and hormones such as oxytocin and estrogen receptor beta boosters to heal leaky gut, reduce inflammation, and increase absorptive capacity, along with some integrative pharmaceutical and interactive information where pertinent. When I got to functional medicine conferences I am often amazed at how the role of digestive enzymes or hormones or specific manual medicine is often minimized or not even discussed. Thus, while many of my colleagues are now retired resting on a beach, I have spent some of my golden years in front of a computer writing this down for YOU. DEDICATION To my patients, for giving me the honor to be part of their healing village. To Janet Steinberg, my best digestive aid for the non-nutritive goulash of the world. To Karen Wooley-Stewart, for starting out as a patient and moving away geographically but becoming a sister of the heart energetically. To Health Seekers everywhere, may this book help you achieve Great Guts. Foreword by David Brownstein MD Dr. Lindsey Berkson has written a wonderful book that is packed full of muchneeded useful information. I am moved to even call it a fantastic book. Digestive Freedom – eat your way to intestinal wellness, is a one of a kind priceless guide to gut and total health healing. This book describes in easy-to-read format, why so many people are suffering from health issues and gives solutions that are safe and effective. We are facing a crisis in medicine today. More and more people are suffering from chronic illness. Physicians treat too many patients with ineffective medications that do not address the underlying cause of their illness. In fact, most prescription drugs work by treating the symptoms of the illness, not the underlying cause. Digestive disorders affect far too many people. The local drug stores are packed with over-the-counter medications such as antacids that may provide symptom relief but do not provide life-long positive changes patients are hungry for. Digestive Freedom provides the information you need to not only overcome illness but to achieve your optimal health. Dr. Berkson describes the inner workings of the gastrointestinal system and why things can go awry. She covers many common issues that are causing so many people to be ill including celiac disease, reflux esophagitis, constipation, diarrhea and gall bladder disease. This book makes it clear that we are not suffering all these illnesses due to a lack of prescription drugs. What is causing all these problems? Many different issues can cause gastrointestinal problems such as food allergies, lack of digestive enzymes, and eating a poor diet. Dr. Berkson provides the reader with the information they need to first understand why they are ill and then explains what they need to do to begin healing. She makes it clear that it is vitally important to eat healthy diet. This cannot be emphasized enough. Simple recommendations such as eating fermented foods and correcting nutrient deficiencies are just two ways to improve one’s health. Patients are often unaware that many commonly prescribed medications can cause gastroesophageal reflux disease. This book provides the information about which drugs may be the culprit and what you can do about it. Perhaps the most interesting part of the book (at least for me) was the chapter about how the sex hormones—testosterone and estrogen affect the gut. Dr. Berkson describes the microgenderome and how the gut can be feminized and masculinized. I have been using bioidentical, natural hormones for over 20 years. I can assure you that a healthy hormonal system has beneficial effects on the gut. And, vice versa; a healthy gut has positive effects on the hormonal system. Dr. Berkson describes these relationships so that everyone can understand how connected the human body is and why it is important to look at all the systems of the body. Estrogen is reviewed in detail. Dr. Berkson dispels many myths about naturally occurring estrogens, including the myth that bioidentical natural estrogens promote breast cancer. Estrogen is an incredibly powerful and needed hormone for both men and women. Similarly, testosterone is also important for not only hormonal balance, but gut health as well. Testosterone therapy can help heal gut inflammation and treat inflammatory bowel disorders. DHEA, another androgen hormone is also reviewed here. I have been practicing holistic medicine for over 20 years. Over these years, I have seen countless patients with digestive problems. Digestive Freedom is a wonderful tool that provides clear reasoning on why digestive disorders develop and provides simple, safe and effective natural therapies to not only reverse illness but promote health. As a society, we cannot continue down the same path of taking more and more ineffective and dangerous medications that do not treat the underlying cause of illness. Digestive Freedom provides you with a pathway to health. I will recommend this book to all my patients and I hope this book becomes standard reading for all medical students. David Brownstein, M.D. www.drbrownstein.com Author of 12 books including Iodine: Why You Need It, Why You Can’t Live Without It and Dr.Brownstein’s Natural Way to Health Newsletter TABLE OF CONTENTS (still morphing a bit) Foreword Dr. Jonathan Wright Foreword Dr. David Brownstein Foreword by Next person not ready yet Introduction Part I Gut Health Is Now Center Stage 1 2 3 4 Basics All Gut Owners Should Know What Shape Is Your Digestion In? The “New” Gut & 6-week Healing Leaky Gut Protocol The New Microbiome, dysbiosis, SIBO, Neurotransmitters, LPS & Probiotics 5 Why and How To Go Gluten Free For All Chronic Gut Issues 6 Are You Confused About What’s Left to Eat? 7 Fiber: Separating Fact From Fiction 8 The Role of Sex Hormones in the Gut (the new microgenderome), AntiInflammatory and Gut Wall Rebooting Hormone Protocols 9 The Gut/Brain Link And How To Reset It Part II Natural Answers for Specific Digestive Diseases 10 11 12 13 14 15 16 17 18 19 20 Celiac Disease and Non-Celiac Gluten Sensitivity Gas, Bloat, Burping, Nausea, Butyrates Heartburn, Dyspepsia, and GERD Constipation Diarrhea Gallbladder Disease New Liver Diseases and Food Prevention and Cure of Hemorrhoids Innovative Treatments for Peptic Ulcer and Inflamed Stomach (Gastritis) The New Irritable Bowel Syndrome (IBS), Functional Gut Disorders, FODMAP Diet, and Other Causes Of Gut Pain Spectrum of Inflammatory Bowel Diseases 21 22 23 Intestinal Invaders The Candida-Related Complex Colon and Rectum Cancer, Polyps, Folate vs Folic Acid & AIDS Part III Assessing & Fixing the Basics 24 25 26 27 Identifying and Avoiding Food Allergies – Essential For Gut Healing Self-Assessing Specific Digestive Enzymes Recipes: Fermented Foods, Nut Pate’s, Nut/Seed Yogurts & Puddings, and more healing foods. 4-Week Gut Boot Camp: Bowel Detoxification And Rebuilding Programs to Really Get Well Appendix A: Easy Glance List of Symptoms Suggesting Inadequate Levels of Nutrients Appendix B: Self-Analysis of Nutrient Deficiencies Appendix C: Self-Help Acupressure Points For Immediate Gut Relief INTRODUCTION “The gut is the new epicenter of health” Since I wrote my earlier book on treating digestive disorders almost 20 years ago, the recognition of the gut as the epicenter of many facets of human health and disease has skyrocketed. The gut is a major terrain where mainstream medicine and contemporary integrative medicine overlap. The gut has rightfully come center stage. This book is about treating a wide variety of gastrointestinal diseases naturally, but it is also about getting your gut in gear to get the whole of you well. From prestigious universities and labs around the country we are learning that systemic health starts in the gut. The University of Maryland Pediatric Gastroenterology and Nutrition Department is linking disruption of gut health to autoimmune diseases like type-1 diabetes and multiple sclerosis. The Cleveland Clinic, a multi-specialty academic medical center in Ohio, is showing that gut bacteria can woo food to hurt us or harm us, especially our hearts. Integrative neurologists and cardiologists are teaching us that preventing and treating brain and heart diseases start with improving the health of the gut and going off glutencontaining grains. Colorado State University scientists are posing the concept that consuming wheat is like smoking was in the 50’s—everyone was doing it but it still wasn’t safe. My first book on gut health, Healthy Digestion the Natural Way, is now used as a teaching guide by the American Academy of Anti-aging Medicine, for the gastroenterology module to train physicians of all licenses around the world who are learning to become integrative doctors. Why? Everyone cares about our gut now, not just gastroenterologists and health food nuts. Emergent scientific research is looking at gut health being intimately linked to all parts of our bodies: heart, hormonal, mood, skin, energy, immunity, weight control, social and community interactions, and more. This makes sense. The gut is the outside of the world in the center of our bodies, two worlds in the same orbit. How we deal with these foreign molecules has a huge impact on digestive and systemic health. The Human Microbiome Project, initiated by The National Institutes of Health in 2007 has been demonstrating that we have an unappreciated organ of 4-6 pounds of diverse bacteria inside our gut that acts as an influential translator between these two universes. The intestinal tract is one of the most complex organs of the human body. It has multiple job descriptions, with the biggest job being to absorb nutrition out of our food. But we now know for a fact that the gut has conversations, cross-talk, with the brain and the immune system and is, in fact, a major pillar of overall health. The stomach even produces estrogen that it shunts to the liver to help in its many job descriptions. Most of us don’t think about our digestive tracts unless we have problems with it, let alone consider the link of our gut to issues such as Hashimoto’s thyroiditis (autoimmune thyroid disease), stroke, heart disease, eczema, depression, neurologic disease, dementia, obesity, autism and more. Many folks who have other health problems silently have issues with their guts, but they or their doctors are not aware of the significant bridge between the two. As we learn more about how our guts reign over the kingdom of our health, the American gut is under attack. The following statistics come from the U.S. Department of Health and Human Services: 60-80 million Americans suffer with gastrointestinal disease 48 million visits to doctors for gut woes per year 21 million hospitalizations per year 250,000 deaths yearly from severe gastrointestinal disease 12% of all inpatient procedures are related to gut issues (5.4 million per year) $141 billion dollars was spent in 2004 on gut illness Pharmaceuticals Many drugs used to treat even common gut issues have turned out to be nasty pharmaceutical players. A good example is the overuse of acid-blocking medications: 100 million prescriptions a year are written for Proton Pump Inhibitors (PPIs are a class of acid-blocking meds) like Prilosec, Prevacid, and Nexium (the purple pill). $14 billion dollars a year are spent on these meds! Did you know that the FDA has placed two black box warnings on proton pump inhibitors because these meds damage the ability of the body to hold magnesium and thus, calcium, and have been linked to increased fractures? PPIs have also been linked to vitamin B-12 deficiencies, which put the brain at risk of dementia and increase the risk of nerve issues and anemia. In the Journal of the American Medical Association (December 2013) researchers found that people taking PPIs for more than two years had a 65% increased risk of B-12 deficiency. The authors of a study in the International Journal of General Medicine (June 2013) stated that patients receiving PPIs should be followed closely for magnesium deficiency, which could cause or worsen heart issues and set the scene for fractures. Many of my patients are shocked to learn that their bone loss and fractures are linked to their years of being prescribed PPIs. Even short-term use of PPIs has been linked to a 39% increased risk of pneumonia and PPI’s are now a well-appreciated risk factor for small intestinal bowel overgrowth (SIBO). SIBO is a serious disruption of bacteria in the small intestines that can make a person feel mysteriously awful, is difficult to diagnose and treat, and happens more frequently to folks on these meds. It is caused by achlorhyrdia, not enough stomach acid, the side effect of the PPIs. How often do doctors that prescribe PPIs tell you about these side effects or suggest you take back-up supplementation with magnesium, vitamin B12, digestive enzymes and probiotics? How often do doctors try to figure out why you are having heartburn or reflux in the first place? These medications completely block stomach acid production, when in a significant portion of the time the cause of heartburn or reflux is not excess acid but rather too little stomach acid, or food allergies, or overeating junk food, or excessive alcohol intake, or underlying health issues like a benign growth on the parathyroid gland (called primary hyperparathyroidism), or thyroid issues, iron deficiencies, or diabetes. I have had many patients who have been “living” on PPIs for years. Then they developed other issues, like anxiety or chronic pain. Or inflammatory bowel disease. They were put on yet more medications to treat these newer side effects until we figured out that these issues were secondary to the PPIs. Once the cause of their original heartburn or reflux was identified and addressed—naturally—these people got rid of all of their symptoms and were medication free, too. All too often we learn about the dark side of medications long after you or your loved ones have been on them. Natural Remedies This book is about searching for the root cause of intestinal problems and healing them naturally. It is also about how intestinal un-wellness may be playing a role in your other chronic health issues. Natural remedies are safer, cheaper, and often increase the quality of your life in diverse ways. A natural approach to healing helps you develop an awareness of what works for your body and what doesn’t. Natural healing highlights awareness and mindfulness, and develops a way to inventory your gut, body, mind, and emotions, to figure out what is going on, what is going wrong, and how to achieve dynamic health and energy, much of the time without medication. Integrative medicine is using whatever you need to help heal you, with the goal to get you well in the long term without meds that you might need in the short term. It is the combination use of medications and or procedures, if needed, with nutrients and herbs and improvement in lifestyle. Sometimes we need both approaches for a while. That’s integration. But looking at your lifestyle and diet (getting the bad stuff out of “you” and the good stuff in) and using gentle natural methods can often alleviate many intestinal problems, such as heartburn, GERD, or gallbladder disease, and even improve or put into many years of remission of inflammatory bowel disease, recurrent diverticulitis, parasitic infections, and more. It makes absolute sense to try alternative healing regimes before resorting to drugs (emergencies excluded) or to work with a physician and taper off your meds while you are using the natural protocols. An example that comes to mind is from one of my dear patients, a woman in her mid60’s. She is HIV positive and needs to take her HIV therapeutic pharmaceutical cocktail vigilantly that is successful in keeping her disease in remission. But the meds caused very severe heartburn and reflux (GERD), so much so that she couldn’t garden, exercise, bend over, or be the athlete she had been for much of her life. And since PPIs (that her docs had given her for her severe GERD) bind up magnesium, this was contributing to her severe fatigue, muscular pain and headaches, and was even slowing down her response to her life-saving medications. A cousin bought this woman a surprise gift of a cruise. She longed to be symptom-free and enjoy the trip, and she dreamed of taking daily exercise classes on the ship’s deck with the rising sun on her face. With a few natural herbs, identifying her stressor foods, and specific dietary guidelines (which you will learn inside this book), she was able to be drug-free and symptom-free within one week. She went on the cruise, took classes every morning, and was able to get rid of her headaches, have less pain and more energy, all without the reflux meds while maintaining her HIV meds. In This Book As a society we continue to be exposed to multimillion-dollar advertising campaigns for medications for many digestive diseases. We need to become aware of which foods are our “friends” or “foes,” and figure out if our lifestyle habits are the source of our problems. I have many patients who have kept their colons and healed their recurrent diverticulitis even though their gastroenterologist told them that the “only” choice they had left was to remove part of their colon. I have many patients who have saved their gallbladders because they discovered which digestive enzymes they were deficient in and which foods were inflaming the gallbladder. I have had patients who got rid of swallowing issues when they went off gluten-containing foods. I have patients that no longer have long-time constipation and related cystic breasts after they replaced their deficient stomach acid and added specific guthealing foods. I have had patients that were put into permanent remission from autoimmune diseases when they changed their diet, treated their underlying, hidden gut infections, and learned how to boost their immune system. If you are still ill, don’t give up. You just haven’t found the answer . . . yet. This book will help you examine your stools and figure out if you have a problem. You will learn the value of digestion and how to home test your stomach acid production. You will learn how detoxification is moving mainstream and why and how you should do it. After Healthy Digestion the Natural Way came out, I wrote Hormone Deception, which was one of the early breakthrough books on endocrine-disrupting pollutants in our air, food, and water. I demonstrated the science behind the chemical soup we now find ourselves in. I helped inform the public about how many of these chemicals are clogging up not only hormones, but mucous membranes of our gut walls and cells within our digestive organs (like the liver) or in critical proteins that receive messages from hormones. Besides needing government regulation to lower the legal chemical limit of environmental pollutants, I believe we need detoxification to remove many chemicals that are threatening our cells and to rebuild our gut lining. In this book you will learn how to detox and rebuild your gut and it’s supportive organs. Now that I have been in practice for decades (over four), been a peer-reviewed published scientist, inventor, teacher, author, and most of all patient (my mother, when pregnant with me, was given a drug that was later found to be a powerful carcinogen and I have had to live with the consequences all my life), I have learned beyond a doubt that the body continues to heal and even grow well into our 80’s and 90’s. It is never too late to be well! This book is: Evidence-based science, and A combination of clinical pearls from decades of working with patients and my many mentors Science and experience clearly show that it is often possible to get off the very medications that you have been told you will need to take for life, or to get rid of the chronic illness you were told would never go away or avoid losing parts of your digestive tract. Doctors speak about snipping out a piece of your digestive tract as though it’s “no big deal.” It is a very big deal and it can go very south. I want you to dare to hope to be well. My life and decades of service and research in the health field have given me a fierce awareness and appreciation that the body is designed to heal, no matter how serious the name of what you’ve been diagnosed with, or how many years you have suffered or how old you are. It is my wish that this book and protocols, gifts you the tools that you need to grasp your life by the tail and make sure your dreams come true. When you heal your gut you can change your brain and your life.