The Gut, Inflammation, and Low Testosterone Connection

Uncovering the Link: Bacterial Endotoxin LPS is a factor for low testosterone in men

Testosterone, the primary male sex hormone, plays a critical role in numerous aspects of men's health, including muscle mass, bone density, sexual function, and overall well-being. While factors such as aging and lifestyle choices can contribute to declining testosterone levels, emerging research suggests that bacterial endotoxin lipopolysaccharide (LPS) may be a significant factor for low testosterone in men. In this article, we explore the intriguing connection between LPS and testosterone levels, shedding light on the impact of gut health on hormonal balance.

Understanding Bacterial Endotoxin LPS

Bacterial endotoxin LPS is a component of the outer membrane of Gram-negative bacteria. When these bacteria die or undergo lysis, LPS is released into the surrounding environment, including the gut. LPS is known to trigger an immune response and can have wide-ranging effects on the body.

The LPS-Testosterone connection

Recent studies have shown a relationship between LPS and testosterone levels, particularly in men. Here are key findings that establish the link:

1. Inflammation and Testosterone: LPS triggers an inflammatory response in the body. Chronic inflammation can interfere with Leydig cell function in the testes, leading to decreased testosterone production. Research has shown that higher levels of LPS-induced inflammation are associated with lower testosterone levels in men.

2. Gut Permeability and LPS: An unhealthy gut can develop increased permeability, often referred to as "leaky gut." This allows LPS to enter the bloodstream and circulate throughout the body. Elevated levels of LPS in the bloodstream can disrupt hormonal balance, including testosterone production.

3. Obesity and LPS: Obesity is associated with higher LPS levels due to changes in gut bacteria composition and increased gut permeability. Elevated LPS levels contribute to systemic inflammation and can impact testosterone levels.

4. Metabolic Syndrome and LPS: Metabolic syndrome, a cluster of conditions including obesity, insulin resistance, and high blood pressure, is linked to low testosterone. Studies suggest that LPS-induced inflammation may be a contributing factor, as LPS is known to promote metabolic dysfunction.

What to do next?

• Test

  • Testing for LPS will help identify if this is a contributing factor in your health journey. If positive, the longer-term solution is finding the root cause for the dysfunction in the gut! (We recommend Cyrex Labs Array 2, a blood test. Please ask our office or your health care provider about this test.)

• Support

  • Promoting a healthy gut environment is key to addressing LPS-related factors affecting testosterone levels. Consider the following strategies:

1. Balanced Diet: Consume a nutrient-rich diet that includes antioxidants, and anti-inflammatory foods. Emphasize fruits, vegetables, lean proteins, and healthy fats to support a healthy gut microbiome.

2. Stress Management: Chronic stress can contribute to gut dysbiosis and inflammation. Adopt stress-reduction techniques such as mindfulness, meditation, regular exercise, and adequate sleep to support hormonal balance.

3. Minimize LPS Exposure: Avoid or reduce exposure to potential sources of LPS, such as processed foods, excessive alcohol consumption, environmental toxins, and address underlying infections.

The bottom line

The impact of bacterial endotoxin LPS on testosterone levels highlights the intricate relationship between gut health and hormonal balance in men. Understanding the connection between LPS-induced inflammation, gut permeability, and low testosterone is crucial in addressing and managing testosterone-related concerns. By nurturing a healthy gut environment through dietary and lifestyle choices, we can support optimal testosterone production and overall well-being. Empower yourself with the knowledge to optimize your hormonal health and live your best life.

References:

1. Bhatia S, et al. (2016). Low testosterone and high lipopolysaccharide levels are associated with inflammation in the gut, the hypothalamic-pituitary-gonadal axis, and metabolic syndrome in postmenopausal women. doi: 10.1016/j.jamda.2015.12.098.

2. Zhang Y, et al. (2020). Association of gut microbiota-derived lipopolysaccharide with low-grade inflammation and depression in older men. doi: 10.1007/s12020-020-02433-w.

The Hidden Culprit: Parasites as a Root Cause of Chronic Symptoms

Have you ever considered that the persistent, unexplained symptoms you're experiencing might be rooted in an unlikely source? While many chronic symptoms are attributed to various factors like lifestyle choices, environmental factors, heavy metals, mold, and others, one frequently overlooked possibility is the presence of parasites. Yes, those tiny (and sometimes not so tiny 😊) organisms that thrive at the expense of their host. In this article, we delve into the fascinating world of parasites and explore their potential as a root cause for chronic symptoms.

Parasites and Us

Parasites are organisms that live on or inside another organism (a host), and rely on it for their survival. These organisms can be divided into three main categories: ectoparasites (external parasites, like ticks and lice), endoparasites (internal parasites, such as intestinal worms and protozoa), and parasitic fungi.

Contrary to popular belief, parasites are not limited to tropical or developing countries. They can be found worldwide and affect people from all walks of life, regardless of socioeconomic status. In fact, some studies suggest that a significant percentage of the global population may be harboring parasites without even realizing it! At our rural Kansas practice, we frequently ask patients how often they deworm their dogs, cats, and cattle?! And then remind them, they are living in that same environment.

Parasites and Chronic Symptoms

Parasitic infections often go undetected for extended periods due to their ability to adapt and evade the host's immune system. While acute infections can cause immediate and severe symptoms, chronic parasitic infections may manifest in a more insidious manner, leading to persistent, vague, and difficult-to-diagnose symptoms. Here are a few ways in which parasites can contribute to chronic symptoms:

• Digestive Disturbances: Parasites that reside in the gastrointestinal tract can cause a range of digestive issues, including abdominal pain, bloating, diarrhea, constipation, and nausea. These symptoms are often mistaken for irritable bowel syndrome (IBS) or other gastrointestinal disorders.

• Fatigue and Weakness: Some parasites consume nutrients intended for the host, leading to malabsorption and nutrient deficiencies. This can result in chronic fatigue, weakness, and a general feeling of lethargy. Sometimes a perceived anemia is actually due to a parasitic infection!

• Allergies and Skin Conditions: Certain parasites release toxins or trigger an immune response in the host, which can manifest as skin rashes, hives, itching, and other allergic reactions. Chronic skin conditions such as eczema and psoriasis may also be exacerbated by parasitic infections.

• Weight Fluctuations: Parasitic infections can disrupt the host's metabolism and alter their appetite, leading to unexplained weight loss or weight gain.

• Mental and Emotional Disturbances: It has been suggested that some parasites can affect neurotransmitters in the brain, and contribute to symptoms like anxiety, depression, mood swings, and cognitive impairments.

Quick Symptoms Checklist:

• Anxiety

• Bloating

• Brain Fog

•  Chemical Sensitivities

• Fatigue/Lethargy

• Food Sensitivities

• Itching, Esp rectal itching at night

• Mood Disorders

• Stomach pain, tenderness, or cramping

• Teeth Grinding

• Unexplained aches and pains in either joints or muscles

• Weight loss

What Do I Do About It?

Traditional medical treatment options for parasitic infections usually involve anti-parasitic medications specific to the particular type of parasite (if they are even detected…there are currently no great lab testing options for parasites). Additionally, adopting healthy lifestyle habits, including proper hygiene, clean food and water sources, and avoiding exposure to potential vectors (e.g., mosquitoes and ticks), can help prevent future infections.

Alternatively, there are great and effective options with herbal combinations. These herbs, combined with supporting an efficient route out of the body, and ensuring there is enough energy to help eliminate them from the body, can be paramount in addressing parasites and their symptoms. Our recommendation is to start by taking stock in your symptoms (listed above), then working to open up drainage pathways and upregulate your energy pathways that help the body detox these buggies. Sometimes this may take some time and consistency -- that is okay!

While parasites might not be the first thing that comes to mind when considering the root cause of chronic symptoms, their presence should not be disregarded. Chronic parasitic infections can lead to a myriad of persistent and often confusing symptoms, affecting multiple aspects of an individual's health.

If some of this resonates with your health journey up to this point, let’s work together!

The trouble with grains...

By: Mackenzie Nix, health coach

People have been eating grains for thousands of years, so why are we now hearing they are bad for our bodies? I mean, of all things, the food pyramid we learned in grade school was built with grains as the foundation. Grains are an easy way to ingest calories, and are easily converted to glucose. Grains have been the basis of many population’s diets since the advent of civilization. Because they are easy to harvest and easy to store, they quickly became a staple in our modern way of life. But is this the best for us?

 When looking at grains, we have choices such as “refined” and “whole-grain.” Many people think that whole grain would be beneficial, but that is not always the case. Whole grains contain more anti-nutrients, making them potentially worse for people who have sensitivities. Legumes, on the flip side, have more nutrients and less anti-nutrients compared to whole grains. The downside to legumes is their high carbohydrate load and digestive irritation.

(photo credit: The Alternative Daily 1)

“Grains” includes wheat, corn, rice, and cooking grains (barley, millet, rye, oats, etc.). Then we count all derivatives, such as bread, pasta, crackers, cereals, snack foods, cookies, cakes, candies, and assorted other types of processed, packaged, frozen, and fresh-baked goods. Legumes include beans, lentils, peanuts, peas, and soy products. The four main anti-nutrients discussed in conjunction with grains are lectins, gluten, phytates, and saponins.

Lectins are natural phytochemical toxins that plants manufacture to defend against UV radiation, insect predators, and disease-producing microorganisms. As humans, we have been consuming lectins since the advent of modern civilization, but certain forms of lectins can still have a toxic effects when ingested. That may include suppressing immune function, interfering with normal protective gut barriers, and promoting systemic inflammation.

Lectins can bind to insulin receptors, bind to our intestinal lining, attach our stomach lining, and cause resistance to leptin – a hormone produced to suppress appetite.

Gluten is a form of lectin, found mainly in wheat, but also in rye and barley. It is the part of the dough that makes it stretchy and gives it elasticity. Many people have a gluten sensitivity but don’t realize it. Symptoms of gluten sensitivity include GI irritation (IBS, IBD, leaky gut, etc), constipation, gas, bloating after meals, and colitis. Other common symptoms associated are allergies, inflammation of the skin, achy joints, and brain fog.

Phytates are an indigestible antioxidant found in whole grains, legumes, nuts and seeds. Before you start thinking “wait…I thought nuts were healthy!” (like I did myself), consider this:

According to Chris Kresser, author of Your Personal Paleo Code, humans can tolerate a moderate amount of phytic acid with no ill effects—around 100 mg to 400 mg per day. However, phytates in large amouts have been shown to make minerals unavailable to be processed in our bodies. Phytates combined with grains can lead to Vitamin D deficiency and Calcium deficiency.  It’s not all bad though…phytates in moderation have shown to have an antioxidant effect on our body.

Saponins are mainly found in legumes and grains, such as quinoa. Most plants contain saponins but they are usually concentrated to the seed. The problem with saponins is they are a mix of water and fat soluble components. Because of this feature, they can create holes in the cell membrane that line our gut, creating holes for other gut substances to enter the cell (this is the mechanism of “Leaky Gut”). When the cell wall is damaged, the cells cannot transport needed nutrients to the blood stream. This permeability in our gut lining can become irreversible if enough damage is done.

There is so much information at our fingertips regarding grains. I think the most important thing to remember is what works for your neighbor might not work for you. In general, our bodies don’t agree with grains because of our innate inability to process them fully. Changing components of your diet can seem overwhelming and sometimes impossible. Here are a few tips to hopefully make a change seem more manageable:

• Wheat/gluten is a common additive, so check food labels

• If you are concerned you might have a grain sensitivity, try avoiding all grains for 21 days and track your symptoms. Things to take note of are mood, energy levels, brain function/concentration, GI function, and body composition during those 21 days.

• You can have a lab test done to assess sensitivities to gluten, other grains, nuts, beans, and many more foods and additives spanning all major food groups (see our labs page here).

• If you need help with meal ideas, grocery shopping, and/or staying accountable, contact our office for a free consultation with me, the resident Health Coach at Prairie Sage.
  

  Not everyone needs to eliminate all grains from their diets, but this may be a missing link if you have not yet explored it. There are so many ways to manage limiting grains, it doesn’t have to be hard! And you DON’T have to do it alone!

1 https://cdn.thealternativedaily.com/wp-content/uploads/2013/02/foodpyramidwrong1.png

Inflammatory Bowel Disease

By: Dr. George Stanton

In 2015, an estimated 3 million U.S. adults had inflammatory bowel disease (IBD).1 Two common conditions include:

•         Crohn's disease

•         Ulcerative colitis

Continue on to learn more about IBD; or you can skip to the bottom of this article to learn what you can do to address IBD conditions.

Crohn’s disease is an inflammatory bowel disease characterized by chronic inflammation of the gastrointestinal tract. Symptoms are a later step to a disease process, so once you are experiencing discomfort or pain, it is safe to say this has been going on for a while in the body, and is not just one instance of GI disturbance.  

The GI tract is from the mouth to the anus, and includes the esophagus, stomach, small intestine, large intestine. These organs are crucial to help to break down food into usable nutrients, energy, aide in nutrient absorption, immune system function, and helping to rid the body of metabolic waste. When it is chronically inflamed, the intestines/organs are damaged and can lead to “leaky gut” (which can spiral into a myriad of issues).

Crohn’s most often affects the ileum (the last part of the small intestine) and the beginning parts of the colon (large intestine), but has the potential to affect anywhere in the GI tract (remember – mouth to anus). It can traverse through the layers of the intestine, where as other IBD’s usually only affect one layer. It has “skip” lesions, meaning it can affect one part of the GI tract, then skip to a different area, rather than be continuous.4 Ulcerative Colitis is also a long-term inflammatory bowel disease, but unlike Crohn’s, it is only in the colon. Crohn’s is more prevalent in the age groups of 16-25, whereas Ulcerative colitis is more prevalent in the age groups of 30-40.3

Possible Complications from IBD (taken from Mayo Clinic’s website)5:

Bowel obstruction. Crohn's disease affects the thickness of the intestinal wall. Over time, parts of the bowel can scar and narrow, which may block the flow of digestive contents. You may require surgery to remove the diseased portion of your bowel.

Ulcers. Chronic inflammation can lead to open sores (ulcers) anywhere in your digestive tract, including your mouth and anus, and in the genital area (perineum).

Fistulas. Sometimes ulcers can extend completely through the intestinal wall, creating a fistula — an abnormal connection between different body parts. Fistulas can develop between your intestine and skin, or between your intestine and another organ. Fistulas near or around the anal area (perianal) are the most common kind.  When fistulas develop in the abdomen, food may bypass areas of the bowel that are necessary for absorption. Fistulas may occur between loops of bowel, into the bladder or vagina, or out through the skin, causing continuous drainage of bowel contents to your skin. In some cases, a fistula may become infected and form an abscess, which can be life-threatening if not treated.

Anal fissure. This is a small tear in the tissue that lines the anus or in the skin around the anus where infections can occur. It's often associated with painful bowel movements and may lead to a perianal fistula.

Malnutrition. Diarrhea, abdominal pain and cramping may make it difficult for you to eat or for your intestine to absorb enough nutrients to keep you nourished. It's also common to develop anemia due to low iron or vitamin B-12 caused by the disease.

Colon cancer. Having Crohn's disease that affects your colon increases your risk of colon cancer. General colon cancer screening guidelines for people without Crohn's disease call for a colonoscopy every 10 years beginning at age 50. Ask your doctor whether you need to have this test done sooner and more frequently.

Other health problems. Crohn's disease can cause problems in other parts of the body. Among these problems are anemia, skin disorders, osteoporosis, arthritis (Joint pain), and gallbladder or liver disease. [The bold ones are some common symptoms we see in our office.]

Medication risks. Certain Crohn's disease drugs that act by blocking functions of the immune system are associated with a small risk of developing cancers such as lymphoma and skin cancers. They also increase risk of infection. Corticosteroids can be associated with a risk of osteoporosis, bone fractures, cataracts, glaucoma, diabetes and high blood pressure, among others. Work with your doctor to determine risks and benefits of medications.

Diagnosis:

Diagnosis of IBD is a little tricky and involves mostly ruling everything else out first. There are, however, a few blood markers to evaluate:

• IgA and IgG antibodies for Saccharomyces Cervevisiae – nearly 80% of Crohn’s disease patients are positive for either the IgA or IgG markers of these

• Atypical ANCA – this is positive in a significant percentage of UC patients

• P-ANCA antibodies – found in 50-70% of UC, but only 20% of Crohn’s patients.

Other testing includes colonoscopy with biopsy, X-rays of the abdomen, Barium enema, and upper endoscopy. At this time, there is not one test that is conclusive for the diagnosis of Crohn’s or UC, but the combination of present symptoms and testing is the best course to follow for a diagnosis.

According to the CDC, “IBD is the result of a defective immune system”2. This is due to autoimmunity, which means your body is mounting an immune attack against your colon. It basically thinks the colon is a bacterial infection and is fighting it. Refer to the chart below from a study reviewing causative factors of IBD.3

What can be done about IBD?

Traditional treatment includes:

• Aminosalicylates – an aspirin-like compound

• Corticosteroids (such as prednisone)

• Immunomodulators (which will cause an inability to maintain an inflammatory response)

If the condition becomes severe enough, a possible course of treatment is bowel resection. Realize that there are many long-term complications to corticosteroids (such as osteoporosis and more, which will be left for another blog post), so this option isn’t ideal.  Generally, traditional treatments are often trading one problem for another, and not addressing the causes of the disease process.  We must look deeper into these issues to find relief.

At Prairie Sage, we believe in identifying and addressing the root cause of an issue. We need to ask:

• What is causing this immune system confusion?

• How can we bring the body back into balance?

• How can we modulate the inflammation without compromising other organs and systems?

With any autoimmune condition, there are 3 things we need to address:

1.  Genetics – There is a gene that is switched on that was normally off. When the right environment presented itself, the gene expressed itself (this is called epigenetics).

2.  “Leaky gut” (intestinal permeability) – This is a precursor to autoimmune conditions. Basically, it is the intestine letting molecules through the lining which are normally not able to do so. This process is causing inflammation.

3.  Triggers – This is where it gets more individual. Triggers can be anything from stress, infections, food intolerances, blood sugar imbalances, heavy metals, environment (chemicals, plastics, mold, etc), and more. Identifying triggers is a process and usually it takes time to get to the bottom of these. In most autoimmune conditions, multiple triggers are involved. We educate our patients and walk them through protocols to help rid the body of toxins and infections. We also educate and provide proper lifestyle recommendations to help bring balance to the body and keep the immune system in check.

It is important to assess every case individually and proceed according to each patient’s specific needs. Assessments in our office includes tests like:

• Stool testing for microbes, inflammation, and occult blood. Organisms like Klebsiella and Mycobacterium may be contributing to gut disruption and leading to autoimmunity.6,7

• Urine Organic Acids testing (OATs) for yeast/fungal overgrowth, bacterial, and mitochondrial function

• Blood tests to evaluate underlying inflammation, anemias, electrolytes, infections, and other patterns of dysfunction

• Hair mineral analysis to assess the heavy metal burden

• IgG/IgA food sensitivity testing to identify the inflammatory burden on the intestine

We also utilize symptom questionnaires, as there is currently no reliable testing for parasites, and they can contribute to intestinal and systemic dysfunction as well.

While waiting on test results, we can begin addressing the drainage pathways (check out our post on drainage here). We also work on reducing inflammation and developing a more specific protocol together once we have more information. Remember that UC and Crohn’s are multifactorial3, which means that there are multiple issues that are contributing to the autoimmune condition – So don’t give up on your health journey!

If you or someone you know is struggling with Crohn’s, Ulcerative Colitis, Colitis, IBS, or any other digestive issues, share this article with them and give our office a call. We can set up a consultation to discuss whether Prairie Sage can help improve the health of your family, your friends, and you!

1. https://www.cdc.gov/mmwr/volumes/67/wr/mm6706a4.htm?s_cid=mm6706a4_w

2. https://www.cdc.gov/ibd/what-is-IBD.htm

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4734944/

4. https://www.crohnscolitisfoundation.org/what-is-crohns-disease

5. https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315

6. https://www.ncbi.nlm.nih.gov/pubmed/26474349

7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3678459/

Drainage vs Detox

Detox is a hot topic in the field of health and wellness. How many different detox programs are you exposed to when you get on the internet or your social media? With promises of better health, loss of weight, less joint pain, better skin, on and on, it all sounds great…but there is often a step that is overlooked. We need to look at what drainage is first, and why that should be optimized before ever thinking of detoxing.

Drainage – The pathway/mechanism through which unwanted substances leave the body.

Detox – Pulling toxins and offending agents out at the cellular level. 

You can understand how these two work together, but one without the other is not very efficient, especially if done out of order.

It is important that the drainage systems are functioning properly -- that they actually drain. This is why addressing drainage prior to detoxing is so important! If the body cannot drain what it detoxes out of the cells, those substances will recirculate in the body and could leave a person feeling no different, or even worse than they did before.

Drainage pathways include:

• Colon – This is the primary drainage pathway. If the body is not eliminating waste via bowel movements, this backs up the entire system and requires the other pathways to pick up its slack. In cases like this, there can be some adverse symptoms along the way.

• Liver and Bile Ducts – The liver processes blood and removes toxins from it, which are then put into the bile. When these get backed up, toxins build up and spill over into the bloodstream. There is then accumulation in the lungs, kidneys, and skin. It can lead to damage to the lining of the lungs and kidneys, as well as itchy/red/irritated skin.

• Skin – It is important to note that skin needs to be an open pathway for drainage via sweat. If a person does not sweat, that is another sign their drainage pathways are compromised.

• Lymphatic System – This drains fluid from the tissues throughout the body, after it has filtered out viruses, bacteria, and toxins. There is also a Glymphatic system, in which the brain drains into the lymphatic system.

Image credit: Cellcore Biosciences

Once these drainage pathways are up and running efficiently, then the power of detoxification can be realized. This is one way we help usher patients onto a new plane of health at Prairie Sage, and very often is the first step we take!

The Sleep and Gut Connection

Who thinks of their gut as a problem when they can’t sleep? Probably not many of us. However, gut health is very important to a host of body processes, including neurotransmitter (NT) and hormone production. (A neurotransmitter is just a chemical that tells the brain to do something.)

An example of a NT is serotonin, most associated with positive mood, but also appetite and digestion, sleep, memory, sexual desire and function. An example of a hormone produced primarily in the gut is melatonin, often associated with sleep or the sleep/wake cycle.

Keeping those 2 compounds in mind, consider this:

• 400x more Serotonin is produced in the gut than is in the brain

• 500x more Melatonin is produced in the gut than in the pineal gland of the brain

This is an important concept to remember; even though they aren’t made in great amounts in the brain, compounds made elsewhere can still have a heavy impact on the brain. In fact, studies have shown symptoms of IBS-D (Irritable Bowel Syndrome with Diarrhea) were worse the mornings following a night of poor sleep. Conversely, following a night of quality sleep, IBS symptoms were decreased. There are many studies suggesting the importance of a good night’s sleep for improved gut symptoms, and vice versa.

So, if you are having trouble sleeping at night, whether that’s falling asleep, staying asleep, or not feeling rested in the morning, look to your gut as an important step in your journey to health.