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International Journal of Human Nutrition and Functional Medicine

www.IntJHumNutrFunctMed.Org

2015 Final PDF

Personal Experience

I did not become an expert in dysbiosis entirely by choice; I had

to become so in order to literally save my own life and preserve

my own health. The year was 1995, the idea of "leaky gut" was

new and ridiculed (in contrast to its wide acceptance today), and

the entire concept of functional medicine had only been

announced just a few years prior. Thanks to mostly to

Metchnikoff, the naturopathic profession, a handful of

allopathic doctors, and a few scattered and vintage medical

articles, we had some vague ideas about dysbiosis but very few

details with which to understand it better, let alone treat it

effectively. In this case, I am discussing gastrointestinal

dysbiosis, which is the prototype but obviously only one of the

eight location-based subtypes of dysbiosis.

I remember the exact day and moment that it all started. What

began with the typical "brain fog" later progressed to physical

inertia, multiple chemical sensitivity / environmental

intolerance (MCS/EI), and progressive immediate-onset food

allergies, most of which were frustratingly unidentified except

for soy lecithin—of note, 1996 was the first year of genetically

manipulated (GM) soy in the US. I was also progressively

lymphopenic and had remarkable responses to parenteral

vitamins, especially vitamin B12 (improved mental clarity) and

folic acid (resolution of progressive lymphopenia). At this time,

I was finishing chiropractic college, starting naturopathic

college, and harvesting gems from every seminar, book, and

audiocassette I could find, notably from Bland, Galland, Gaby

and Wright. With new access to the internet, I scoured the earlier

versions of Medline and spent my evenings and weekends in the

medical libraries at Oregon Health Science University in

Portland and University of Washington in Seattle. I started

compiling and publishing articles, and my main research

interests at the time—other than studying everything nutrition

and trying to find solutions to my own mysterious illnesses—

were rheumatology and hemochromatosis.

7

Following graduation and licensure, I opened a clinical

practice in Seattle, and later I was also invited to teach

Orthopedics and Rheumatology at Bastyr University. The

responsibility of teaching these courses gave me reason to dive

even deeper into the research and to begin articulating and

giving structure to what almost always starts as inklings and

impressions. Slowly, I started to understand dysbiosis, its

various permutations, and the variances of effect that different

microbes could have, either in isolation or in combination—

what I would later elucidate as

combinatorial dysbiosis

8

and

continue to refine on an almost daily and regular basis.

9

With effort and reflection, obscurity morphed into clarity. If

all we had to work with is the laboratory result above, this alone

would have been sufficient to explain and solve all my health

problems

within hours

; I have this level of understanding now,

but only after studying the topic—not simply for academic

reasons or in a cursory manner, but with some sense of personal

urgency—for twenty years. The main findings of the results

above are the

Citrobacter freundii

and the

Klebsiella

pneumoniae

, and additional finding on this same result was that

of markedly elevated fecal beta-glucuronidase. With years of

trial and error and a high degree of certainty based on personal

experience backed by a massive review of the research

literature, I would interpret the above results as follows:

The mental and physical fatigue

I experienced were due

mostly to hydrogen sulfide (H2S) produced by the

Citrobacter freundii.

H2S is a mitochondrial toxin and thus

a neurotoxin, thereby explaining the fatigue, and it also

chelates cobalamin, thereby explaining the response to

vitamin B12, indicative of vitamin B12 deficiency, which

was also contributing to the fatigue. Constipation was

another problem that was not only miserable, but which also

promoted the persistence of the dysbiosis and which was

caused by the gut-paralyzing effect of H2S.

The multiple chemical sensitivity / environmental

intolerance (MCS/EI)

was due to impaired cytochrome

p450 detoxification secondary to endotoxin in general and

the O antigen of

Klebsiella pneumoniae

in particular.

Additively and synergistically, the elevated fecal beta-

glucuronidase was deconjugating whatever little cytochrome

p450 detoxification was taking place, leading to the inability

to clear

and thus the accumulation of

ambient chemicals and

internal toxins that could not be oxidized for conjugation;

notice the dual effect of endotoxin-mediated blockade of

cytochrome p450 along with increased enterohepatic

recycling due to the elevated fecal beta-glucuronidase. The

folate deficiency and resultant lymphopenia are presumed

due to a combination of malabsorption and increased

utilization; at this time I also had an increased

lactulose:mannitol ratio and dramatically elevated caffeine

clearance with horrid benzoate conjugation.

Immediate-onset food allergies

were due to the increased

intestinal permeability and immune activation, both of which

can be blamed on elevated gastrointestinal endotoxin.

During this time, I gained personal

physician heal thyself

experience with practically innumerable nutrients, botanicals,

and a few antimicrobial drugs; I also appreciated—and was

ultimately cured by—my (in)famous vitamin C purge: first-

morning consumption of two cups of coffee (peristalsis

stimulant) and ~30 grams of vitamin C with the resulting

osmotic laxative and exaggerated migratory motor complex

providing gastrointestinal housecleaning

par excellence

.

Conclusions

With the compilation of personal experiences and ongoing

research from thousands of clinicians and basic scientists, we

collectively have the knowledge and tools available to assess

and alleviate dysbiotic illnesses in their various forms. The

twilight of the idiopathic era and the dawn of new possibilities

in health and healthcare continue to be progressively

illuminated.

10

Dr Vasquez's test results from ~1996

: Everything is obvious

when you know the answer; sample study guide and CE exam

questions are available:

http://ow.ly/O15vd