Interview with Dr Natasha Campbell-McBride, MMedSci in Neurology and Human Nutrition
What is the principal behind Gut And Psychology SyndromeTM? What drew you to this research?
I am a mother. When my child was diagnosed with a severe form of autism at the age of three, I was thrown into a steep learning curve to find a solution to his problem. I am very fortunate to say that I found the right solution. As a result I am now the proud mother of a healthy and happy 19-year-old, who is leading a perfectly normal life; he drives a car, has a nice girlfriend and is going to university. The fact that he once had autism now seems an unlikely fairy tale.
As a result of working with my own child and helping other families Gut And Psychology SyndromeTM was born. My book with the same name is now in its second edition and GAPS Nutritional ProtocolTM has a large following around the world. This book focused on mental and psychological conditions, such as autism, ADHD/ADD, dyslexia, dyspraxia, addictions, eating disorders, depression, obsessive-compulsive disorder, bipolar disorder, schizophrenia and epilepsy. Since the book was first published in 2004 thousands of people have been able to regain their health and the health of their children though the GAPS Nutritional Protocol. I am working on the second GAPS book: Gut And Physiology Syndrome, which will cover physical conditions, such as autoimmunity (multiple sclerosis, diabetes type one, rheumatoid arthritis and other), allergies, asthma, eczema, various forms of arthritis, chronic cystitis, chronic fatigue syndrome, ME, fibromyalgia and various other chronic degenerative conditions.
GAPS establishes a connection between the functioning of the gut and the functioning of the rest of the body. Our digestive system holds the roots of our health; if the gut is not healthy, nothing in the body can be healthy. When food does not get digested and absorbed properly, the person develops multiple nutritional deficiencies. The digestive system in GAPS patients, instead of being a source of nourishment for the body, becomes a major source of toxicity. Hundreds of very toxic substances are produced in the gut of these children and adults, absorbed into the blood stream and distributed around the body. Wherever these toxins get to they cause problems from abnormal brain function to various physical symptoms. The damaged gut wall in GAPS patients lets through various partially digested foods; the immune system finds these substances in the bloodstream and reacts to them; hence the person develops food allergies and intolerances. Autoimmunity is also born in the gut wall, bringing its own damage in the brain and the rest of the body. The whole concept is described in detail in my book and on www.gaps.me
Are your beliefs/research accepted by the wider medical community? If not, why? Why do they find it hard to accept that what goes into the body can affect the mind and behaviour?
The tide is turning! I have just trained 160 Certified GAPS Practitioners in the USA amongst whom there are many medical doctors. As far as the larger medical community is concerned, the history of medicine shows that it takes on average 50 years to introduce and establish any new idea. It took hundreds of years to convince medical doctors to wash their hands before operating on patients! I am sure that establishing the GAPS concept will take much less time as we live in a world of abundant and freely available information. Today patients do not just accept the word of a doctor as a gospel; they go and research it online instead. Doctors have to move with the times, and many of them have already embraced the change.
Is there any bonafide research being done around this? Or is it still empirical?
There is no research on GAPS yet. However, studies are now coming out to show a connection between the function of the gut (and the composition of the gut flora) and the function of the brain.
In your experience what are the main difficulties when treating a child who has some of the GAPS issues?
GAPS children are very often fussy with food, which makes it difficult to implement any diet. So in many cases we have to change the child’s eating habits first. There is a chapter in my book, called It’s Feeding Time. Oh, No!, where I describe an effective approach to introducing foods into a fussy eater’s menu. Following the structure in that chapter you can make any child start eating healthily. On my website there is a mother’s story which demonstrates the whole process very well. On top of that I am working on a new book, called GAPS Stories, where we will publish stories of recovery from people, written in their own words. Amongst the stories which have already been submitted, there are many about fussy eaters and how the parents managed to remove that issue.
Why are some people more sensitive to triggers, such as gluten and dairy, than others?
Because gluten and dairy are just a small part of the whole picture. The GFCF diet is inappropriate for these people! Their gut flora is abnormal, producing potent toxins; their gut lining is damaged and letting through not only improperly digested gluten and casein, but all other proteins and food substances. Yes, removing these two proteins out of the equation may help, but it is not enough, and in many children other undigested food substances are causing much more damage than gluten or casein. And what about all the toxins produced by pathogens in their abnormal gut flora? They are being absorbed through the damaged gut lining and causing brain dysfunction and many other symptoms. The treatment has to focus on healing and sealing the gut lining, on restoring the gut’s ability to digest food and absorb it properly, on driving out pathogens and establishing normal gut flora. This is what the GAPS Nutritional Protocol does.
What changes do you think need to occur in our society to help prevent the continued increase in kids with GAPS? What are the implications for our society if this is not addressed?
Autism, ADHD/ADD, dyslexia, dyspraxia, bipolar disorder, ODD, depression and other learning, behavioural and social problems in our children have reached epidemic proportions. 15-20 years ago we were diagnosing 1 child in 10,000 autistic, now in some counties in the UK and in some states in America we are diagnosing 1 child in 60-70. If this is not an epidemic, than what is? This catastrophe is based on another epidemic – an epidemic in abnormal gut flora. Let me explain.
Before examining the child it is very important to look at the health history of the parents. Whenever the parents are mentioned people immediately think about genetics. However, apart from genetics there is something very important the parents, mother in particular, pass to their child at the time of birth: their unique gut micro-flora. After studying hundreds of cases of autism in children and adults, a typical health picture of these children’s mothers has emerged.
A typical modern mother was probably not breast fed when she was a baby because she was born in the years when breast-feeding was out of fashion. Breastfeeding is essential for the development of normal healthy gut flora; bottle-fed babies develop abnormal gut flora. Having acquired compromised gut flora from the start, a typical modern mum had quite a few courses of antibiotics in her childhood and youth. Antibiotics wipe out the beneficial strains of bacteria in the gut. At the age of 16 and sometimes even earlier the modern mum was put on a contraceptive pill, which she took for quite a few years before starting a family. Contraceptive pills have a devastating effect on the beneficial (good) bacteria in the gut. One of the major functions of the good bacteria in the gut flora is controlling thousands of species of pathogenic (bad) microbes. When the beneficial bacteria get destroyed the pathogens get a special opportunity to grow into large colonies and occupy large areas of the digestive tract. A modern diet of processed and fast foods provides perfect nourishment for these pathogens, and that is the typical diet a modern mum had as a child and a young adult.
As a result of all these factors a growing number of modern mums have seriously compromised gut flora, and that is what they are passing to their newborn babies. Indeed clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with autism and other neurological and psychiatric conditions. The problem is that this situation is getting worse with every generation of women who are having children now, which is reflected in the epidemic of childhood learning disabilities. The majority of these children are GAPS children, they are ill because of their abnormal gut flora. A baby with abnormal gut flora is very vulnerable to being damaged by vaccinations, infections, bottle-feeding, inappropriate weaning foods, chemicals and pollution in the environment.
The way our modern world functions ensures that the epidemic of learning disabilities will continue getting worse until humanity learns the lesson and starts making changes in the way we treat our planet and our bodies.
What have you learned in your work that amazes you about the mind-gut connection?
The way children recover! The human body has an amazing ability to recover at any age, but children are particularly good at recovering their bodies. As soon as you start nourishing them properly and remove the environmental poisons and toxins coming from the gut flora, children recover quite quickly. In order to heal the brain we have to heal the gut! There is no doubt about it.
What is the best and the simplest way to explain GAPS to the average person? Do you have a good analogy?
The health of a tree is ensured by the health of its roots: if the roots are not healthy the tree is not going to thrive. The health of the roots relies on the health of the soil around those roots; it is the soil that provides nutrition and support and protection for the roots. The same happens in the human body; the roots of our health are in our gut, and the soil around those roots is our gut flora. If you look at the microscopic picture of the gut lining you will see a strong resemblance with the picture of the plant roots: the gut lining has long protrusions, called villi, which look very much like roots. Those villi are imbedded in their own soil - the gut flora, which feeds them, looks after them and protects them. In GAPS patients the ‘soil’ in their gut is sick and is unable to look after their ‘roots’, in fact it poisons the ‘roots’ and makes them sick and unable to function. A tree with sick roots cannot thrive and neither can the human body.
Does your dietary protocol help all everyone or just those with GAPS issues?
As our gut flora has such a fundamental role to play in our health, it is hard to define what problems are not GAPS, at least partially. I find that GAPS Nutritional Protocol helps people with all sorts of conditions, from autism to allergies, from asthma to diabetes type one, from celiac disease to schizophrenia. Even in children with genetic conditions, such as Down Syndrome, their physical state improves so much that they become much easier to look after; they feel well and can function and learn much better.
Are all children with GAPS issues being helped by following your dietary protocol or does it only work for a percentage of children?
It works for all children. However, the degree of the improvement depends on many factors, the age of the child being one of the most important (the younger is the child the quicker they recover). It is impossible to predict how quickly the child is going to benefit, some children recover quickly, others take much longer. Children are all different.
If gut dysbiosis causes GAPS, then why do these imbalances manifest differently – in some cases autism, others ADHD?
Our gut flora is unique in every one of us. Depending on what kind of pathogens the person has in the gut, the mixture of toxins being absorbed into the bloodstream will be different. We are also all different genetically and constitutionally, so our reactions to those toxins will be different. That is why GAPS can manifest with a different set of symptoms in every person.
Is there one condition that seems to respond best to this dietary protocol?
No. It is not the condition that we are treating, but the person, and every person is different. People with seemingly devastating disorders, such as polyneuropathy or multiple sclerosis can recover quite quickly, while a person with mild hay fever may struggle to get rid of this condition for longer. The reasons for that can be very individual.
Interview with Karl Landers, Compounding Pharmacist
As a pharmacist, you have chosen an unusual path that focuses more on Nutritional Medicine or Biomedicine. Can you explain why?
We live in an ever challenging environment whereby our bodies are challenged in 2 specific ways; malnutrition and toxicity.
In spite of all the food we consume, so many of us are malnourished due to a combination of poor diet and nutrient-low foods due to depleted soil from poor farming practices.
At the same time, we are constantly being exposed to many toxins, from the ‘air’ we breathe to the ‘food’ we eat, from the ‘water ‘we drink and bathe in to the radiation we are exposed to. Even our ‘medicines’ have a level of toxicity that can have major adverse implications on the health of our bodies. So how do we help protect ourselves from these toxins? How do we treat those that have developed acute and chronic diseases as a direct or indirect result of exposure to environmental toxins? This is where Biomedicine comes in. Sometimes other names are used such as; Functional medicine, Orthomolecular medicine, Nutritional medicine and Integrative medicine.
Some people have trouble absorbing and metabolising nutrients. Some people are more sensitive to toxic exposures such as infants and children or people with genetic susceptibilities. Some people have poorly developed immune systems; gut dysbiosis, leaky gut, heavy metal overload and many other conditions. It’s a bit of the ‘chicken and egg’ scenario – toxic susceptibility causing the disease state or the disease state making one more susceptible. A critical aspect of treatment is not to further burden our body with toxins as part of their treatment. While pharmaceuticals have their place in medicine, they are commonly associated with a wide range of adverse reactions.
Biomedical treatments however involve the use of therapeutic doses of minerals, vitamins, amino acids, essential fatty acids, antioxidants (and other ingredients either not foreign to the body or that occur in nature such as phytonutrients) that are specific to the requirements of the person’s biochemistry. In this way we are supporting the body’s ability to heal itself by supplying the proper nutrients at the right levels.
So Biomedicine is really about balancing the body’s natural biochemistry through supplements?
The actual definition of biomedicine is the study of diseases of the human body caused by biological, chemical, physical, and psychosocial elements. Supplementation of nutrients is central to Biomedicine, but the approach also takes into consideration how a physical injury or emotional trauma can impact on biochemistry and effect all body systems such as the metabolic, immune, and nervous or digestive systems.
How can you determine what is right for the individual?
The most straightforward way to determine appropriate nutrient levels is through diagnostic testing that might include blood, urine, stool, hair and/or saliva samples. A skilled biomedical practitioner will take a thorough case history, assess symptoms and recommend necessary tests. The key here is a practitioner truly trained in Nutritional Medicine who has a solid understanding of the body’s biochemistry, how all the body systems interconnect and the need for therapeutic doses of nutrients.
For example, a child might present with a range of symptoms that include poor concentration, picky eating, moodiness, erratic sleep and chronic constipation. Hair and blood tests might reveal extremely low nutrients such as zinc, magnesium, iodine, B6, B12, calcium and so on. A skilled practitioner might first address digestive and metabolic problems recognising that there is an overall malabsorption problem. Once this is addressed the child can get many of their nutrients from food and then complement diet with the appropriate compound of minerals, vitamins, amino acids and more.
Many parents have been amazed at how concentration, appetite, mood and sleep can improve simply by improving digestive health and nutrient levels.
Can’t our GP run these diagnostic tests for us?
More and more GPs are understanding the value of nutritional medicine and as they do I believe we will see more progress in the area of disease prevention as well as treatment.
At this stage the vast majority of GPs just do not have the training required to select appropriate tests or determine therapeutic doses of nutrients. Medical schools (and pharmacy schools) have done a great job in training physicians in acute care with drugs but most doctors have only ever taken one term of nutrition. There is plenty of research proving the benefits of biomedicine for disease prevention and our overall health. Changing a belief structure is another matter.
Specialised testing is also unique for a Biomedical practitioner. These tests are specific for biomedical diagnosis and are primarily used by practitioners appropriately trained in their interpretation. By measuring specific metabolites in the urine, blood or hair the practitioner can identify from the biochemistry which biochemical pathway is malfunctioning and recommend appropriate treatment.
Finally dosages are considerably different, usually much higher than an over the counter supplement or in a form not commercially available. These doses/forms can only be prescribed by a practitioner and consistent patient monitoring is essential. The thought of prescribing 100mg of zinc to a patient would not occur to most allopathic practitioners as they are not trained to assess therapeutic dosages on an individualised need nor are they knowledgeable of how that fits into an individuals biochemistry. There is a fear that such high doses may be detrimental to a patient’s health but this is not based on any evidential platform. RDI’s (recommended daily intakes) have nothing to do with individual requirements! In fact, RDI’s appear to be so low that they do not serve to prevent disease yet alone protect DNA according to Professor Michael Fenech of the CSIRO.
How did you, a pharmacist, wind up working with nutritional medicine?
After several years of conventional pharmacy practice both in England and in Australia the one consistency I experienced was that patients were taking more and more pharmaceutical medicines but not improving their quality of life. ‘Poly-pharmacy’ as it’s called where more medicines are prescribed to counteract the side-effects of the original medicine was rife. A chance discovery of an article on compounding was the first major breakthrough for me. Being able to tailor doses and modify formulations to potentially minimise side-effects was just what I was looking for. My good friend Tony Mazzei then introduced me to Biomedicine and taught me how to compound nutrients. The overlap was perfect and I had the best of both worlds. By 2006 we had combined our compounding practice and moved to our stand alone compounding pharmacy in Brookvale.
What is a ‘Compounding Pharmacist’ versus a ‘Pharmacist’? Is there a big difference?
A compounding pharmacy is unlike the traditional retail pharmacy. It’s more a ‘micro-manufacturing’ facility with all the quality controls you would expect from a pharmaceutical manufacturer but on a much smaller scale, with individual personalised medicines made instead of mass produced with a one dose fits all approach. In order to provide biomedical treatments one requires individualised combinations of ingredients to be tailor-made or compounded into an appropriate dosage for a particular patient.
What are the advantages of compounding, and what exactly can be made?
We find the greatest advantage is compliance, especially among children. By customising all the needed nutrients into one capsule, a child might be asked to take 2 or 3 capsules versus 8 or 9.
Kingsway Pharmacy has developed an expertise in Autism, ADHD and neuro-biological illness. What are the most common issues you see?
The most common condition we see when a patient is first presented to us for ‘Nutritional’ compounding is the faecal compaction with associated ‘leaky gut’. Addressing this as a priority is critical to the long term success of any biomedical treatment. This usually involves a ‘clean out’ phase followed by maintenance and gut support that can range from 3 months to 2 years depending on how soon it is treated. As an example we had one child that started the ‘clean out’ and his mother found a small plastic toy in his stool that she remembered him swallowing 3 years previously! Some children (and adults) will see dramatic improvement in the first few weeks as more of the gut wall is exposed for vitamin and mineral absorption
The most common mineral deficiencies we see are zinc as number one followed by magnesium and calcium. Zinc is so important for good health and many critical enzymatic reactions in the body will just not occur if one is zinc deficient. There are many reasons why one can become zinc deficient; low stomach acid, poor absorption, low essential fatty acids, poor diet, other minerals competing and poor supplementation Zinc picolinate is one of the best absorbable forms of zinc and the form we recommend orally.
Vitamin B6 (Pyridoxine) and Mb12 (Methylcobalamin) are the most common vitamin deficiencies we encounter. Some people have difficulty absorbing B6 or converting to its active form Pyridoxal-5-Phosphate.
We see many patients with high Pyrole levels (or ‘Mauve Factor’) causing a range of symptoms such as poor morning appetite, white spots on nails, stretch marks, acne, stress intolerance, explosive anger and paranoia just to name a few. Zinc and B6 deficiency is directly related to Pyrole disorder. A tailored high dose zinc and B6 compounded formula such as the Prime Pyrole can alleviate this condition.
Poor methylation is another common condition we encounter with many of our patients. Methylation is simply the addition of a ‘methyl group’ to a molecule that causes a biochemical reaction to start and its removal stops the reaction, i.e. turning on and off reactions. It is critical for detoxification, learning, focus and attention, gene expression and more. Methylcobalamin (Mb12) is an active ‘methyl doner’ and integral to the Methionine/homocysteine pathway to the production for the body’s most potent detoxifier Glutathione. We get some ‘wow’ moments from our compounded concentrated (25mg/ml) Methylcobalamin subcutaneous injection as per Jim Neubrander's protocol some children go from no speech to sentences in a week on Mb12. Most patients (~80-85%) respond positively to some extent.
Key Benefits of Biomedicine
Treats the cause not the symptom
Treats the individual based on their needs
Works w scientific testing to accurately treat-blood, hair, urine, stool
Supports the body’s natural ability to heal with nutrients
Key Benefits of Compounding
Formulates therapeutic doses & combinations specific for a particular individual
Change the form, taste and texture of a commercially available medication
Reduce the number of doses for easy management and compliance
Combine multiple preparations into 1 product
Is free of any colourings, preservatives and artificial flavourings
Contain as many active ingredients as necessary in one preparation
Use only pharmaceutical grade raw materials when possible
Have the lowest levels of heavy metals possible
Come in many forms – capsules, transdermal cream, liquids, nasal sprays, and injections etc.
Reintroduce ‘discontinued’ medicines no longer commercially available
Interview with Dr Nancy O’Hara
Nancy O’Hara, US pediatrician and featured speaker at the upcoming Mindd Forum shares her views on the rise of childhood illness in modern society.
1. Asthma, ADHD, Allergies, Autism; are at epidemic levels. Has there been exponential growth or is it just that there is better diagnosis?
As you may well know, it is not just better diagnosis. There have been a series of factors including a more toxic environment, poor nutrition and a genetic predisposition in these kids for the chemicals, toxins, metals and "junk" to negatively impact their development and health. This predisposition is a lack of a key molecule (an antioxidant called glutathione) that helps all of us to detoxify and efflux (get rid of these toxins). In children who lack this or have a deficient amount (or energy systems that are not working right) then they are more susceptible and thus more affected”.
2. Is our health system to blame - with too much focus on pharmaceuticals and not enough on prevention and cellular health?
“Prevention at the fetal level, before moms get pregnant is key. It is not just big pharma, but our insurance industry, our medical system in general. Doctors get paid to fix disease not to insure wellness”.
3. Why is it so hard for the conventional medical paradigm to accept the nutritional and integrative model? Do you think this is changing?
“There are some minor changes; some increased understanding of the dangers of fish consumption in pregnancy, the need for essential fatty acids and the increase in food allergies - but nutrition is a very small (only 1/2 hour in 4 years of medical school) part of a doctors training. There is very little understanding of food as the best "drug". The food industry (Kraft, Nabisco...) is as much to blame for this. We all want a quick meal, a quick fix and what we are teaching and preaching is not quick”.
4. Is there any new research out that helps support the nutritional/integrative paradigm? Or is it only empirical at this stage?
“There is a plethora of research on the effects of diet on glutathione and autoimmune disease (where the body is attacking itself), on mitochondrial dysfunction (where the energy cells of the body are working) and on immune dysregulation (where due to all fo these factors our ability to live healthfully is compromised). But as this research is not backed by big pharma, it does not get the press it deserves. At the conference we will be presenting all of this data, not just anecdotal information.
5. How does food and nutrition affect the brain?
“Food is the fuel for the brain. How it is absorbed and digested by our guts affects how our immune system sees it and how we can process it for use by the brain. If the gut is not working right or is inflamed, then the immune system will see foods as they are abnormally absorbed as foreign and react against it. Also most of our diets are devoid of the basic things we need like b vitamins, zinc, essential fatty acids and probiotics”.
6. What are the main concerns for you when you see children with autism going through the mainstream medical system, medication, special schools etc?
“Many children with autism have medical problems that are being overlooked because they have autism. They may have IBD, iron deficiency, other mineral and vitamin deficiencies (vitamin D, zinc, for example). They may have chronic infections or problems with their energy systems. Because they have the label of autism their other problems are ignored or overlooked”.
7. Do you believe this scenario is avoidable for many of these children?
“Treatable yes and in some cases preventable. Prevention is key – that is what we try to do with our moms having more kids”.
8. Many of these alternative treatments are not government funded and special diets are hard for working parents and also expensive. What would your main advice to these parents be?
“You have to start with diet. I think casein and gluten free is a good place to start but it needs to be healthy, not replacing gluten carbs and junk with gluten free junk. The diet needs to be full of protein with lots of veggies and fruits and fewer carbs and no junk. This does not have to be that expensive and can make a big difference”.
9. Do nutritional and integrative treatments help all kids or only some? In your experience what would the percentages be?
“All kids can be healthier, 25-30% will recover, and 30% will get moderately better”.
10. Do you believe the origin of these conditions are genetic or environmental, or both?
“There is a genetic predisposition and then environmental triggers in the fetal period or early neonatal period. Then there is a tipping point where the body cannot handle further insults...”.
11. What do you believe would be the ideal outcome for treatment support for families with kids on the spectrum, with adhd, learning delay…?
“The whole family needs to be supported in being healthier in all ways. This includes, diet, relationships and stress management. It is a heady undertaking but one that is necessary and doable for the health of all of us and all of our children”.