RSSArchive for August, 2019

The link between Chronic Kidney Disease and Coeliac Disease

https://www.fau.eu/2017/08/07/news/research/important-messenger-substances-in-the-immune-system/

Coeliac Disease might not be one of the first things that comes to mind when we hear the term “Chronic Kidney Disease”, but there are some interesting links between the two diseases, and the increasing incidence of Coeliac Disease globally makes this a topic worth discussing, especially for those of you who have been diagnosed with either disease, or have a family history of them.

 

Coeliac Disease is on the rise…

The estimated rate of Coeliac Disease worldwide is 1%. That’s 1 in every 100 people. The fact that this rate is increasing and that there is a strong genetic link suggest that we can expect this figure to rise. The fact that we do not understand the mechanisms responsible for this increase means there is not a lot we can do at this stage to prevent it.

 

CD vs CKD…

Coeliac Disease is a complex and as yet not well understood autoimmune disease, however the predisposing factors are clear. Sufferers must experience a combination of genetic, immune and environmental factors for the disease to develop. It cannot develop without dietary exposure to the protein gluten, and can only be managed by removing this trigger.

 

Chronic Kidney Disease, although the majority of cases can be attributed to high blood pressure and diabetes, can develop as a result of many different factors, including autoimmune conditions, urinary tract infections, congenital malformations (meaning they are present at birth), physical obstructions of the urinary tract or prostatitis, and many other inflammatory and genetic conditions. Diet and nutrition can be of great benefit in reversing kidney disease as we know, but it is rarely the direct cause of the condition.

 

The conditions do not appear related do they? But a cohort study published by Nephrology Dialysis Transplantation, which investigated the link between any form of glomerulonephritis, dialysis treatment and kidney transplantation and Coeliac Disease, has found statistical significance associating CD with an increased risk of Glomerulonephritis and renal failure.

https://academic.oup.com/ndt/article/21/7/1809/1821933

On the surface, the 2 diseases appear to be completely unrelated, so let’s look below the surface…

 

What are the links between the diseases?

In a nutshell, it appears that immune characteristics are at the core of the connection between these 2 common and very serious diseases.

There is currently a lot of scientific interest in the gut (our gastrointestinal tract), it’s mechanisms of immune regulation and that factors of modern life that present a threat to the delicate balance that it serves to maintain. In the gut resides the gut-associated lymphoid tissue, or GALT. This makes up around 70% of our body’s immune cells – 70%! If this balance is compromised therefore, so is our immune system and its’ ability to protect us from disease. I will not go into too much depth about the role of GALT in this article, and to be honest there is still an awful lot we do not yet know about what goes on in there! But here is what we do know about the gut, and the similarities that have been found between Coeliac Disease and Chronic Kidney Disease sufferers.

 

Activated Immune System 

The mucosal immune system exists in the lining of the gastrointestinal tract and serves as our first line of defence against harmful pathogens, just as our skin does. It is an entire ecosystem made up of a complex network of immune cells and beneficial bacteria. Like any ecosystem, it relies on adequate nutrition, hydration and other factors to thrive and maintain homeostasis, or ‘balance’. When this barrier is compromised, protective mechanisms are initiated, one of which is the production and secretion of Secretory Immunoglobulin A (IgA). Almost 100% of Coeliac Disease patients have these antibodies present, and it appears that this same mucosal immune mechanism is also active in many forms of glomerulonephritis.

https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2249.1992.tb07947.x

https://www.frontiersin.org/articles/10.3389/fimmu.2016.00240/full

Gut permeability 

Tight junctions are part of the structural component of the mucosal immune system in the gut wall. They prevent toxins and harmful bacteria from entering the blood stream. Essentially, it’s what separates our internal environment from the outside world, so it’s pretty important! If these tight junctions are damaged, unwanted pathogens enter the systemic circulation and cause inflammation and oxidative stress throughout the body. This has been linked, as both a cause and effect, to generalised autoimmune diseases including Coeliac Disease.

Studies have shown that a loss in kidney function can also reduce the effectiveness of the intestinal barrier, allowing pathogens to enter the bloodstream and potentially increase the decline of kidney function. Conversely, an impaired intestinal barrier can potentially lead to autoimmune kidney diseases in susceptible individuals due to the inflammation and oxidative stress caused by the failure of the body’s first line of defence.

 

Image source: https://uncexchanges.org/2017/04/03/leaky-gut-a-potential-contributor-to-the-brain-gut-microbiota-axis/

https://academic.oup.com/ndt/article/16/3/513/1823041

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6071212/

Auto-antibodies 

What are auto-antibodies you ask? These are similar to the antibodies our immune systems produce to fight invading pathogens, but autoantibodies are produced when the immune system mistakenly identifies its’ own tissue as the foreign invader. Auto = Self. This is what happen in autoimmune disease. Being an auto-immune condition, auto-antibodies are raised in Coeliac Disease, and studies have shown the same auto-antibodies to be present in renal disease.

https://www.karger.com/Article/PDF/13497

What are the main threats to our internal environment?

  • Overuse of antibiotics and mediations
  • Stress
  • Chemicals in our food, water and environment
  • Pathogenic bacteria from food water and the environment
  • Poor diet
  • Genetics
  • Methods of birth and infant feeding

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483960/

 

In Conclusion…

As with CD, the incidence of end stage kidney disease is on the increase globally, the underlying causes of which are still largely unknown. Many other chronic, autoimmune and immune related conditions are also on the rise. There are of course theories which speculate on this phenomenon, such as industrialisation, the hygiene hypothesis, overuse of antibiotics, the quality and preparation of the modern diet, stress and infections to name a few, but at the end of the day there are no definitive answers and therefore no definitive solutions.

With the growing body of evidence linking the gut to a myriad of health conditions, looking after our internal ecosystem seems like a pretty logical place to start in preventative health and disease management though. Don’t you agree?

http://www.worldgastroenterology.org/publications/e-wgn/e-wgn-expert-point-of-view-articles-collection/the-global-village-of-celiac-disease-and-its-evolution-over-time

 

 

Preventing and Treating Urinary Tract Infections – Naturally

Urinary Tract Infections, or UTI’s, are one of those annoying and embarrassing things that people don’t really like to talk about too much, but they are surprisingly common. In fact they are estimated to affect around 150 million people worldwide every year!

I would like to discuss how to prevent UTI’s because as well as being extremely uncomfortable, they can pose a threat to the kidneys. Even in an uncomplicated UTI (that is one where there are no other abnormalities of the urinary system), there is a likelihood that the bacteria will travel further up the urinary tract into the kidneys, but in complicated UTI’s (where there are other issues relating to the urinary system including renal disease), infections become more likely.

The most common symptoms of a UTI are feeling like you need to urinate more often, a painful burning feeling after urinating, getting up during the night to urinate, and smelly or cloudy urine. If there is fever, shakiness or lower back pain, this may indicate the infection has spread to the kidneys, in which case urgent medical attention is needed.

 

Image source: https://www.healthnavigator.org.nz

 

Often, antibiotics are prescribed to treat UTI’s, which usually gets rid of the infection and symptoms, but unfortunately antibiotics also negatively affect the good bacteria which actually help protect us from unwanted bacteria. This imbalance in bacteria then creates an environment that is favourable to drug-resistant pathogens, and so recurrence of UTI’s can become a vicious cycle.

Sometimes antibiotics cannot be avoided, but here are some tips and strategies to give you the best chance of avoiding needing them , and hopefully avoiding contracting a UTI I the first place:

Tips & Strategies 

Hygiene – UTI’s are more prevalent in women which is why some of these tips are specific to women’s hygiene.

  • Wiping from front to back after using the toilet
  • Empty the bladder fully
  • Wearing cotton underwear and avoiding tight clothing around the area
  • Always urinate as soon as possible after intercourse

 

Protect and support the microbiome – Several strains of probiotics have been researched and shown to be beneficial by promoting resistance to UTI’s by stimulating immunity. There are many different brands and combinations of strains available now, but look out for these strains on the bottle:

  • Lactobacillus plantarum HEAL9
  • Lactobacillus paracasei 8700:2
  • Lactobacillus rhamnosus LGG
  • Saccharomyces cerevisiae
  • Bifidobacterium animalis spp lactis.
  • Lactobacillus rhamnosus GR-1
  • Lactobacillus reuteri B-54

 

Herbal Medicine – There are many herbal medicines that can help support immunity and prevent and treat UTI’s. Herbal teas can be extremely effective as well as they go straight to the place we want them to! Try your local health food store to see if any of these are available.

  • Astragalus – Immune enhancing and diuretic, this herb supports the immune system and increases urine flow to eliminate bacteria.
  • Echinacea – This well-known herb can be used to help support the immune system as well as reduce inflammation and soothe irritated tissues in the urinary tract.
  • Corn Silk – This herb soothes the mucous membranes of the urinary tract as well as increasing urine flow. Even using the silk straight from a cob of corn steeped in hot water can help in an emergency!
  • Couch Grass – Another wonderful soothing and diuretic herb to help prevent bacteria accumulating and promote healing.
  • Buchu – Buchu is a urinary antiseptic which gives is amazing properties from preventing and treating UTI’s.
  • Shepherd’s Purse – Another urinary antiseptic, this herb also has anti-inflammatory properties which make it a valuable treatment.
  • Medicinal mushrooms – Not all mushrooms are created equal! These varieties enhance immunity and help prevent recurrent infection. Some of the best are Reishi, Cordyceps and Coriolus.

 

Support immune health through diet –

  • Vitamin C and zinc help decrease the severity and duration of an infection as well as help heal the tissues and prevent scarring. Citrus fruits, kiwifruit, capsicum, nuts and seeds are some of the best wholefood sources of these nutrients, but you may also want to supplement during periods of illness to support healing and recovery.
  • Avoid sugar! Sugars and refined carbohydrates can impair immune function and feed bacteria. Sugar also created an acidic environment that bacteria thrive in.

 

Prevent bacteria from adhering and colonising –

  • The bacteria that is present in a UTI thrives in the acidic environment. Keeping the urine alkaline during an infection will help stop the bacteria from colonising and spreading. There are commercial urinary alkalisers available, but in an emergency you can also drink ½ – 1 teaspoon of bi carb soda (not baking soda), in a glass of water 3-4 times per day.
  • Cranberry – Another herbal medicine that has been shown to prevent the bacteria from adhering to the wall of the urinary tract is Cranberry. You can take this in juice form, but avoid juices with sugar added (cranberry is quite tart!) as the sugar will feed the bacteria. If you are prone to UTI’s or kidney stones, you might want to take a quality cranberry tablet regularly instead as a preventative measure.

 

Flush toxins out of the urinary system –

  • As simple as it sounds, drinking enough water is the most important thing you can do to help prevent and resolve a UTI. Without adequate water, the bacteria will simply not leave the urinary system. How much you need to drink depends on several factors including body size, climate and whether or not you are a dialysis patient, in which case you need to discuss this with your doctor. For those who do not have a restriction on their water intake though, at least 2 litres per day is a good amount to focus on.

 

**As with any herbal medicines, make sure you talk with your doctor or pharmacist if you are taking any other medications.