“I've got a gut feeling about this”
Mind Altering Microbes: How your gut microbiome may influence your mood. While we have certainly heard that appetite and digestion are controlled by the enteric nervous system (also known as “the master control panel in your gut”), who would've thought that the gut might also control your emotions and mood? It's no wonder the old sayings, like “I've got a gut feeling about this“, “That movie was gut-wrenching“, or “Come on, gut it out!” ring so true. In fact I'd venture to say when we are trusting our intuition we associate it with having a “gut feeling” about something.
From the research it is now clear that gut microbes have an affect on inflammation, pain, eating behaviors, food cravings, mood and other seemingly unrelated symptoms, such as depression or uncontrolled anxiety. In addition, it is common for depression and anxiety to co-exsist with disorders such as IBS (irritable bowel disorder).
It goes both ways…
Yes, it's true! Did you know the gut-brain axis provides a way of communicating both directions using signals, such as neurotransmitters, hormones and cytokines? This means that your gut bugs actually talk to your brain to influence emotions. Equally important the emotions you feel and neurotransmitters produced by the brain have a profound effect on the gut as well. We know that dysfunction in this communication between gut and brain can lead to various diseases, including depression and anxiety. Who knew that the composition of your gut microbes could play such a great role in your mood? The next time you get angry at your spouse or are overcome with sadness making you want to curl up in bed you can simply say, “Don't blame me…It's my gut microbes's fault!” and you may be right on target!
The human gut is populated by more than 100 trillion microbes, which means there is more bugs in your gut than cells in your body. And the genetic material contained by microbes in your gut is 150X that of the genetic material from human origin. Most experts agree we have more than 1000 different species in our gut and over 7000 different strains. We know that as we are exposed to stress, chemicals, antibiotics, and toxins, the diversity of the microbiome decreases and we know that the less diverse or microbiome, the more susceptible we are to illness and disease.
A baby's colonization of the gut first occurs at birth with vaginal exposure to the mother's microflora. Did you know that c-section baby's have gut microbes more akin to skin flora than gut flora after birth? And some studies show that throughout the entirety of life, they may never regain the normal diversity of vaginally delivered infants.
These are just a few of the functions of these bugs residing in your gut:
- Development of your immune system function
- Assisting with bowel movements and gut motility
- Maintaining intestinal cell barrier integrity (keeping the the good stuff in and the bad stuff out)
- Aiding in digestion and absorption of specific vitamins and minerals
- Controlling fat absorption and distribution
Pathways involved in communication between the gut microbes and brain.
Microbes and Stress
What is increasingly clear is that there is bi-directional communication between our gut microbes influencing the central nervous system and brain… and the reverse; communication between our brain influencing microbial composition. Did you know that stress affects the gut microbes, too?
These are the top 3 ways that chronic stress affects the gut:
- Increases the levels of inflammatory cytokines (IL-6, TNF-alpha) which can changes gut microbe populations.
- Increases permeability of the gut lining, which is linked to many autoimmune diseases (Hashimoto's thyroiditis, lupus, rheumatoid arthritis, multiple sclerosis and many others).
- Allows bacteria to cross over into the bloodstream where the bacterial coating (LPS) can trigger an intense inflammatory response in the body.
So how do the gut microbes contribute to anxiety and depression?
Here are some of the mechanisms by which the gut microbes influence the brain and emotions:
- Altered microbial composition: Both probiotic (“good guys”) administration and harmful infectious bacteria (“bad guys”) have both shown to have an effect on the brain and emotions. One study showed supplementation with probiotics decreased anxiety.
- Immune Activation: Bacteria in the gut have been shown to activate the immune system and increase production of harmful pro-inflammatory cytokines. There are many studies showing a link between increase in certain cytokines and depression (see below if you want to read more)
- Vagus nerve: This is one of the main controls of the parasympathetic system that calms our fight or flight response and allows our body to relax and feel calm. Activation of the vagus nerve and release of acetyl-choline has been shown to have a profoundly calming and anti-inflammatory effect on the body. Most of the effects of gut microbes on the brain and body have been shown to be dependent on vagal nerve activation.
- Tryptophan metabolism: Tryptophan is an extremely important amino acid and the raw material needed to make serotonin (think “the happy neurotransmitter”) by the body. There is a pathway, called the kynurinine pathway that involves metabolism of tryptophan and accounts for nearly 95% of the stores of tryptophan in the body. In the case of pathogenic microbial infections in the gut (bacteria, yeast, or parasites) this pathway may be activated and “steal” from your body's tryptophan stores. This leads to depletion of serotonin stores and may result in insomnia and depression.
- Microbial metabolites: Bacteria in the gut help produce bile acids and short chain fatty acids (SCFAs) which are essential for human physical and mental health.
- Neurometabolites: Crazy but true… bacteria have the ability to produce many neurotransmitters and metabolites that have direct action on brain and thought. Did you know studies show microbes can even influence your food cravings?!
- Bacterial cell wall sugars: Perhaps most fascinating of all, the outer coatings of bacteria contain sugar molecules that can directly signal immune and hormonal systems into action. This is the mechanism thought to be responsible for the healthy effects of probiotics on the gut and brain.
The bottom line is there is a growing body of evidence that suggests gut microbes play a large role in regulation in behavior and brain chemistry and are relevant to development of depression and anxiety.
So perhaps the best antidepressant is a healthy whole food diet and a high potency probiotic to fuel a healthy gut microbiome!
Check out Part II – Six Simple Steps to Treat Depression
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Further Reading:
- Psychoneuroimmunology Meets Neuropsychopharmacology: Translational Implications of the Impact of Inflammation on Behavior
- Inflammatory Cytokines in Depression: Neurobiological Mechanisms and Therapeutic Implications
- Cytokine variations and mood disorders: influence of social stressors and social support
- Increased IgA and IgM responses against gut commensals in chronic depression: Further evidence for increased bacterial translocation or leaky gut
- Mind-altering microorganisms: The impact of the gut microbiota on brain and behaviour
- Stress and the Gut
28 Comments
Hi Jill. First thanks for a great post. A lot of what you have written about really resonates with me. It is totally aligned with some of the work that i do here in Australia. Second, it was great to watch the movie about your story, it’s a testament to a great mindset and the willingness to find a way to recover despite the diagnosis.
Hi Bill,
Thanks so much for taking the time to comment – it means a lot!
best to you
Dr Jill
Hi Jill, I also think what a great post, I watch the video of you with Sean Croxton, you mention that 5htp dose not work. I have been suffering from insomnia for a long time, I don’t think it is all due to stress.I can not work it out !
Hi Simon,
5HTP does work! However, there are a small percentage of patients with IDO enzyme pathway unregulated for whom it does not. You might try theanine, phosphatidyl serine, or gaba for insomnia
warmly
Dr Jill
Hi Jill,
Will you do a phone consultation or email.on how to help us get better?.and on what cost.?
Thank you Mrs. Ten.Brink
Hi Jo-El
All information about consultations can be found in the “About” section of the website. I require patients to come in person for the initial visit.
warmly
Dr Jill
Hi Jill,
As I wrote above asking if you did phone and emails consultation .I apologize for not looking closely at some of your other patients letters that you had helped over the phone. I was a patient of Dr.Rose Hauser of caringmedical.com in Chicago when he was doing the same treatment as you and his is Christian believe are high like yours.I love him to death for saving my life but he no longer is doing that kinds of practice .but his other duties can help others if you look at his site so now I am looking for another doctor like him but this time I found a female that actually been through it all and that is you.Your date of illness are the same as mine but at the age of 6yr old 1972 when spinal meningitis was an epidemic how long with measles I lost my hearing paralyzing last night down I was supported by my father who was the athletic director to be able to function to be a normal child and a great athlete.after having my first child I still was in the beat shape at 33 yr old when I got pregnant 2001 was 41/2 month I had misscarrage.never did the doc give me a DNC.clean me out. This hit me two days after with pay in joints was only 5% body fat still whipping tennis balls and softball but that week of the misscarrage. All joint hurt me .finding out after all these doctor sent me here to there found my self in death bed until four of my sister took me to dr Hause, found out I had Candida A because I had a two yr old husband in military trying to keep a job carrier mail in USPS. As I looked back wishing I focus on nothing but what Dr.hasuer was telling me then doing what others say try this or your nutcase.telling me Dr.Hauser was a joke until doc said I need you to get pregnant or you will die. I did and it help utill after I had my beautiful son. My leak candida started creeping back in my blood stream has to return to work .doc wanted me to try to get out of stress works and Fouse on my health and baby but had to retry. But need up getting SSA I told my self no I don’t want to live that sick life take shots drug and money out of pocket at the time was killing my family .so I had to return to them medical drugs that I know its killing my organ .I still have not found that right doc I once had. This might be a miracle I had a friend sent me your website. I been dealing with this for 12 yr. I want to get better to play sports with my teenager and my ten yr old son not have my husband worried about my health if he gets sent off to wars zone as he did both wars .I want to see my grand baby’s..likes you said prays .I been lucky to be on earth again at six yr old and I want to stay longer on earth. God I know god gave us body parts to heal not to be destroy by medication but by his food his love at his cost. Please can you answer my prays to help me beat this RA !
No more drug please! There away there a will.
Thank you for your time.
And God Bless.
Jo-EL.
My son was diverted via emergency C-section due to my placenta previa. He has some occasional digestive issues, so this article was of interest to me. What are the best probiotics for helping to restore or build good guy bacteria? I am using Green Me Up Jonny, and believe it helps.
Hi Lisa, for infants, I prefer Klaire Ther-biotic Complete powder 1/4 tsp daily. You can order direct from manufacturer (Prothera, Inc) using code: 618.
blessings
Dr Jill
What happens if you’ve had a vegatomy/pyloraplasty? How do you heal the gut? I now have Hashimotos and high cortisol problems. I just can’t find enough information to know what’s best to do besides being gluten free
That would likely alter motility so you are at risk for SIBO or other pathogens. Find a functional medicine doc in your area to help you find causes to your symptoms and heal your gut.
warmly
Dr Jill
Jill, your explanation of the IDO enzyme pathway that can cause anti-anxiety supplements to be counter-productive was SO helpful. I haven’t come across anyone in the UK with this depth of knowledge and expertise. Thank you! In my case, the SIBO symptoms manifest primarily as anxiety/depression, & you mention above that one study has shown that supplementation with probiotics decreased anxiety. Are there particular probiotic strains that can be used when battling against SIBO, as many GI specialists seem to think SIBO bacteria feed on the good probiotics as well?
Hi Tony
Thanks so much for your feedback! You are correct that sometimes lactobacillus species make SIBO worse. One of the species used in the anti-anxiety studies was lactobacillus rhamnosus. I like Klaire Ther-biotic Detox Support, which you can order direct from Prothera with code: 618. However, if you have bloating or worsening symptoms, then something like Thorne Bacillus Coagulans may be better. Thorne code for ordering is HCP1004064. Sometimes its trial and error as to which probiotic is best for each individual but certainly those with SIBO must use caution.
warmly
Dr Jill
Dear Dr.Jill
Thanks for sharing this valuable knowledge. I’ve been diagnosed with Autoimmune disease ( Pemphigus Vulgaris ) and since then have been on prednisone for 10 years.
Recently I have been taking oregano oil in softgel capsules which was said to help in the process of programmed cell death eradication and still hoping for best outcome.
Based on what you have shared is there anything that you can suggest to ease my condition ?
Thank you very much ,
Richard
Hi Richard,
Best to test, not guess… find a functional medicine doctor who can order a stool profile and organic acids to diagnose and treat any dysbiosis you may have present in the gut
warmly
Dr. Jill
Dr. Jill,
Is Pyroluria a real disorder that can cause anxiety? My doctor wants to run a urine test because I have anxiety and because she said it can affect hemoglobin synthesis and I have extremely low iron stores (a ferritin of 5) but my hemoglobin is at the top of the range (a result of 14.6 on a range of 12-15) and I don’t live in high altitudes or smoke. Do you feel this test is needed? Is it even a real disorder? I’m very hesitant to get the test done. Genetic testing makes me nervous because my insurance acts like it won’t pay for prexisting conditions. But I do think it’s odd that my ferritin is so low but my hemoglobin is at the top of the range and I’m a woman in my early 20’s.
Thanks so much,
Kaitlyn
Hi,
I have pyroluria and yes it is real. I was diagnosed in 2000 at Dr. William Walsh’s Clinic in Illinois and, seriously, it saved my life. I get very sick after a couple days of not taking the supplements. I take Zinc, B6, and Borage Oil because they are depleted in the disorder. It was recently determined pyrolurics also need biotin, so I take that. There are other supporting supplements you will need to take because supplements work together, so I take vitamins A, C, E, Thiamin, Riboflavin, B5, NAC, and Magnesium. The thing is that the disorder was discovered in the 1960’s by Drs. Hoffer, Pfeiffer and Osmond, which is fairly recently. There is very little money to be made from giving people supplements, so their research is not very well respected by doctors who want to use drugs. There is clinical research that is supportive of treatment. The list of symptoms for Pyroluria is huge. If people are not properly diagnosed, they can be chasing symptoms and taking drugs to figure out what is wrong endlessly. You can be diagnosed with ADD, ADHD, anxiety, depression, anger disorders, learning disabilities, digestive problems, sleep disorders on and on. Drug companies could make a fortune from your misery if you are not diagnosed properly. You may end up with Schizophrenia or bi-polar disorder, let alone the joint problems and physical problems you could have from the deficiencies. It has been thought of as hereditary, but now some practitioners who treat it have found it associated with microbial infection, so possibily the mother contracts it and passes it to her baby too. Dr. Klinghart claims it is associated with Lyme disease and the co-infections. Dr. Natasha Campbell-McBride, who developed the GAPS diet also says it is caused by microbes. She claims it is from dysbiosis in the gut, the gut lining needs to be healed, and digestion repaired so that the proper microbes reside in the gut to eliminate the production of pyrroles. Please do get the test done, it will be very helpful for you if you have pyroluria. My question here for Dr. Jill is what is the role of prebiotics, probiotics, inulin, fodmaps, resistant starch, other diets and supplements etc. in the role of strengthening the digestive process and which microbes and supplements are best.
Hi Dr. Jill!
What kinds of things do you recommend testing for someone who has severe anxiety and OCD? Do you believe that in some people it’s simply genetic like some people are born without enough serotonin or do you believe there’s always something causing it?
Hi Jenna
I typically order labs, including blood work, comprehensive stool profile for digestion, and urinary organic acids.
warmly
Dr Jill
Hi Dr. Jill
What would you recommend for a 34 adult who was born by c-section and has IBD and a full colectomy and jpouch? ?
Find a functional medicine doctor near you and schedule a consultation. http://www.functionalmedicine.org
Hi Dr. Jill,
What can cause a ferritin of 0 with no explanation and a normal hemoglobin level?
malabsorption
Dear Dr. Jill,
I have been diagnosed with autoimmune thyroid disease, Hashimotos hypothyroidism. I have severe swelling all over my body. My legs, feet, arms, abdomen, and back are swollen. I have been checked me for myxedema, and I don’t have that. I’ve had a CBC and CMP done that looked normal. There is no pitting to the swelling, but there’s obvious swelling. You can see it hanging off my legs. Is there something that you can think of that could be causing this? Oddly enough, sometimes the swelling doesn’t look as bad and sometimes it looks really bad.
Inflammation and elevated cytokines may cause swelling. So can congestion heart failure, kidney disease and a host of other illnesses. Work with your doctor to get testing and find the reason you are having so much edema.
Dr. Jill,
Is severe anxiety always physiological rather than psychological? Are there some people just born with a Serotonin deficiency in their brain or is the anxiety always related to the gut and physical causes like nutritional deficiencies, thyroid, and other things?
There are many reasons for anxiety, some physical and some psychological
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