Research is showing that some causes of neurodegenerative diseases including dementia start in a good gut gone wrong. Why? The health of the gut and the brain are intimately intertwined. The cells of your gut and brain start out as the exact identical clump of developing fetal cells that divide in half and then travel forward to form the gut and cranial brains. As we move across months, years and time of our lives, each brain continues to bi-directionally influence each other’s vulnerability to wellness or loss of it.
In the brain, at the tips of nerve cells (neurons) are specialized compartments (presynaptic terminals) that contain alpha-synuclein proteins. These are abundant in a healthy brain. They help produce dopamine, a critical neurotransmitter for controlling the start and stop of movements (both voluntary and involuntary).
Alpha-synucleins are produced and driven by SNCA genes. But these genes can go “bad”. Ten percent of people with PD have family members that have PD so the patient probably inherited mutated SNCA genes from their family. SNCA mutated genes block the production of adequate amounts of alpha-synucleins so not enough dopamine is made (Wiad Lek. 2016;69(3 Pt 1):328-32). The result is that movements get thwarted, tremors show up and PD unravels.
Aside from genetic imput, by their lonesome, normal alpha-synucleins can go rogue. They can fold and distort. Clumped, they act abnormally. They clump so much they are referred to as clumping proteins. Misfolded clumped alpha-synucleins are a major component of Lewy bodies. These are abnormal deposits that appear in specific brain nerve cells (in a part of the brain called the substantia nigra) in those with Parkinson disease. Lewy body disease is a cognitive disease with many Lewy bodies and clumped proteins inside the brain. My mother had this and I lived with her in a lock-down dementia unit for the last 6 months of her life.
What causes these abnormal alpha-synucleins? An unhealthy gut. And our toxic world.
Altered gut dynamics (dysbiosis, local inflammation out of control, or a wired-tired gut enteric nervous system) initiates the production of clumping and aberrant alpha-synucleins which are directly implicated in Parkinson’s disease, Lewy body Disease and multiple system atrophy (Cold Spring Harb Perspect Med. 2012 Feb; 2(2): a009399 doi: 10.1101/cshperspect.a009399, (J Fluoresc. 2016 Jun 30, (Mol Psychiatry. 2016 Jun;21(6):738-48. doi: 10.1038/mp.2016.50. Epub 2016 Apr 19, Biores Open Access. 2016 May 1;5(1):137-45. doi: 10.1089/biores.2016.0010). These diseases are thus sometimes called Synucleinopathies.
How might genetic SNCA glitches form (besides inheriting them from your genetic legacy)?
- Gut. In future it may be determined the genetic SNCA glitches can occur from aging, from an aging gut, and from an ill gut (Front Aging Neurosci. 2014 Oct 15;6:276. doi: 10.3389/fnagi.2014.00276).
- Methylation(and thus nutrient) glitches. These are very responsive to nutraceutical and some pharmaceutical interventions (Neurobiol Aging. 2015 Dec;36(12):3334.e7-11. doi: 10.1016/j.neurobiolaging.2015.08.028, J Neurol Sci. 2014 Feb 15;337(1-2):123-8. doi: 10.1016/j.jns.2013.11.033)
- Toxins. Endocrine disruption from polluting compounds in our air, food, water, and meds, may damage these genes (like the flame retardants we sleep and sit on that protect our lives by inhibiting fires, but unfortunately can also disrupt these and other genes) (Toxicology. 2015 Feb 3;328:152-9. doi: 10.1016/j.tox.2014.12.019).
This is only one of the many reasons why gut and receptor detoxes are helpful in so many conditions, in this case gut and gray matter diseases. Detoxes MUST move mainstream. My book Sexy Brain gives a detailed unique receptor detox or you can work with an in-the-know environmental functional medicine practitioner, hopefully trained appropriately, for example by my environmental medicine guru, Dr. Walter Crinnion. Check out getting a subscription to CrinnionOpinion environmental health newsletter.
When I had breast cancer 22 years ago, my life long adopted brother Dr. Alan Gaby sent me a sweet card in which he had drawn a cartoon of boobs. He wrote on the card, “Let’s protect these. Come stay with me and we’ll detox with Walter.” So we did. I slept on his couch and each day we drove the hour through traffic to the detox center. We did saunas, herbs, water contrast hot and cold baths, and pre and post blood chemical testing. And that was one part of my journey of healing! A deep thanks always to both W and A.
Alpha-synucleins are now considered the hallmark of PD, AD, and Lewy Body disease. This is a powerful statement. A large number of peer review articles are publishing this finding. This fact inherently says; many cases of brain neurodegeneration start directly in the gut.
Danish researchers originally found alpha-synuclein clumping pathology in the gut of Lewy body patients. Lewy body disease is hard to tell apart from Alzheimer’s disease. One article title says it all: Direct evidence of Parkinson pathology spread from the gastrointestinal tract to the brain in rats (Acta Neuropathol. 2014 Dec;128(6):805-20. doi: 10.1007/s00401-014-1343-6. Epub 2014 Oct 9.) They demonstrated active transport, via the vagus nerve from the gut to the brain, of damaging abnormal alpha-synuclein proteins.
The gut to brain journey takes time. From 10 to 20 years. Travel along the vagal highways of abnormal clumping proteins is happening many years before outright cognitive disease presents. This gives us hope. It means that all this while we can initiate natural answers and life style proactive changes to reverse it. But it means we have to regard these symptoms weighty enough to be acknowledged, addressed and hopefully fixed.
Prodromal stage. Alpha-synucleins are transported over ten to twenty years from the gut to brain. This long time period of an ill gut and silent initiation of traveling and damaging proteins, which can ultimately lead to neurodegenerative disease, is called the “prodromal stage”. (Prodromal Stage. (Ann Neurol. 2016 Jun;79(6):940-9. doi: 10.1002/ana.24648. Epub 2016 Apr 9, (Rev Neurol (Paris). 2016 Aug 5. pii: S0035-3787(16)30070-4. doi: 10.1016/j.neurol.2016.07.001).
Prodromal (early) symptoms suggest that abnormal alpha-synucleins are forming. These include: severe chronic constipation, severe GERD, chronic esophageal reflux, loss of smell, neuropathies that do not have a known cause, difficulty swallowing, non-responsive restless leg syndrome, chronic non-responsive skin problems, difficult to treat bladder problems, chronic fatigue and intermittent irritable bowel syndrome (IBS).
Gut disorders, like IBS, can be the first sign of future brain disease (Curr Opin Neurol. 2016 Aug;29(4):467-73. doi: 10.1097/WCO.0000000000000348). If positive action is taken during the prodromal stage, such as detox, nutraceuticals, exercise, mindfulness, these may drive positive epigenetic change that re-tweaks mutated genes. But epigenetics goes either way. Unhealthy life style choices can worsen a gloomy genetic tale.
Severe chronic constipation is a warning. It is not to be taken lightly. Italian medical and neurologic researchers discuss that chronic severe constipation is potentially a highly sensitive clinical biomarker of the prodromal phase of the PD. They suggest colonic biopsies may, in the future, identify the presence of early diagnostic alpha-synucleins, (once the link is confirmed by larger studies) and prove them to be early diagnostic biomarkers for future PD (Eur J Neurol. 2016 Jul 22. doi: 10.1111/ene.13082).
While clumping synuclein proteins travel up the vagus nerve, the largest nerve second to our spinal chord that connects much of our body to our brain, they can kill nerve cells in both the brain and throughout the spinal chord. This can give rise to diverse symptoms such as restless leg, tingling (paresthesias) and neuropathies. All these symptoms can suggest your body is forming dangerous synucleins.
Later clinical manifestations of gastrointestinal dysfunction in PD include malnutrition, oral and dental disorders, sialorrhea (excessive drooling), dysphagia (trouble swallowing), gastroparesis (faulty contractions of stomach leading to delayed emptying, bloating and pain), constipation, and elimination dysfunction (World J Gastroenterol. 2016 Jul 7;22(25):5742-52. doi: 10.3748/wjg.v22.i25.5742, PLoS One. 2015 Nov 5;10(11):e0142164. doi: 10.1371/journal.pone.0142164, World J Gastroenterol. 2015 Oct 7;21(37):10609-20. doi: 10.3748/wjg.v21.i37.10609, Mov Disord. 2015 Sep;30(10):1351-60. doi: 10.1002/mds.26307).
Swallowing and gastric emptying issues lead to serious complications. They cause inadequate absorption of oral medications typically used to treat PD. Or even nutraceuticals. I have found that often getting the reactive foods “out” and digestive supportive players and gut bandage gel “in”, these issues go away rapidly. But this is the new nutritional gastroenterology, not the typical allopathic form.
if swallowing issues are not fixed, these problems make getting adequate medication dosages difficult to achieve to get the best benefit from those meds. This is especially the case with levodopa pharmacokinetics and gastric emptying in patients with PD. In such cases, alternative routes of administration or drug delivery systems may be required such as topical or suppository. In walks center stage our marvelous compounding pharmacists!
Parkinson’s disease patients often have a history of long years of constipation, GERD, and serious gut pain. But they were prescribed acid-blockers and other meds, like anti-depressants, to merely tamp down the symptoms but not address the root cause problems.
Parkinson’s disease (PD). This disease produces gradual loss of movement control. It develops due to degeneration of a part of the brain called the substantia nigra. Damage to this area causes decreased production of a neurotransmitter called dopamine. It was long thought that PD was due to inheriting mutated genes or exposure to toxic compounds.
But in contemporary medicine, there is now an established link between alpha-synucleins gone bad, altered gut microbiome and stressed gut enteric nervous system, and PD.
This highlights that any patient with chronic constipation or heartburn or the other mentioned symptoms, should be thoroughly evaluated by a practitioner that respects these symptoms may be systemically significant. And knows what tests to order, such as SIBO breath tests, comprehensive stool tests, or assessing parietal cell efficiency digestive enzyme players and a complete hormone panel.