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In the quest for mental wellness, many of us focus on the obvious—therapy, medication, and mindfulness practices. However, there’s an often-overlooked player in the mental health game: our gut. The gut microbiome, a bustling community of trillions of bacteria living in our intestines, plays a crucial role in our mental well-being. This “forgotten organ” is intimately connected to our brain, influencing everything from our mood to our cognitive function.
The Gut-Brain Connection
Our gut microbiome and brain are in constant communication, primarily via the vagus nerve. This bidirectional interaction is part of what’s known as the gut-brain axis. The gut microbiome produces various neuroactive compounds, including serotonin and short-chain fatty acids (SCFAs), which significantly impact brain health. SCFAs, such as butyric acid, are vital for maintaining the intestinal barrier and supporting brain health by reducing inflammation.
How Gut Health Affects Mental Health
A healthy, diverse gut microbiome contributes to an intact gut barrier, which is crucial for overall wellness. Conversely, a lack of microbial diversity can lead to dysbiosis, a state of imbalance associated with increased gut permeability, inflammation, and various mental health issues, including depression and anxiety. Research has shown that inflammation and chemical mediators produced by pathogenic bacteria can worsen mental health symptoms, underscoring the importance of maintaining a healthy gut.
The Impact of Substance Use on the Gut Microbiome
Substance use, including alcohol, can severely disrupt the gut microbiome. Alcohol, in particular, can damage the intestinal mucosa and disrupt the balance of beneficial bacteria, leading to an overgrowth of harmful bacteria. This imbalance, or dysbiosis, can increase gut permeability, allowing toxins to enter the bloodstream and cause systemic inflammation. Chronic alcohol use can exacerbate these issues, leading to a vicious cycle of gut damage and mental health deterioration. Studies have shown that alcohol-induced gut dysbiosis is linked to increased rates of depression and anxiety, highlighting the need for gut health interventions in substance use disorder treatments.
Gut Microbiome Recommendations in a Nutshell
Here is the typical advice I give patients on this topic, in order of importance: (I always give patients the following list in writing and tell them verbally that Vitamin D is important as well. Every visit I will spend a few minutes checking to see our status/progress.)
- Focus on eating more plants, vegetables, and fruits. Avoid ultra-processed foods and reduce meat, egg, and dairy consumption. A plant-based diet helps foster a diverse and healthy microbiome.
- Take a fiber supplement. Guar gum is ideal because it boosts levels of bacteria that produce butyrate. Butyrate is food for the cells that line your gut and brain, helping to heal and preserve this barrier. Butyrate is also associated with weight loss. Two options for Guar gum fiber include Perfect Pass and Sunfiber.
- Take a polyphenol or polyphenol-like supplement. These bioactive compounds reduce body inflammation and mitigate the impact of processed foods and meats on your gut bacteria and body. Examples include Apigenin (celery), Urolithin (Pomegranates), Fisetin (Strawberries), Quercetin (various fruits and vegetables), and EGCG (green tea). My favorites are Meriva Curcumin (best absorption curcumin) and Urolithin A (best absorption polyphenol-like compound). Apigenin and Urolithin A show impressive data in reducing the risk of Alzheimer’s Dementia, particularly when combined. If cost is a concern, Curcumin is a cheaper option.
- Take a probiotic. There are many good options here, but my favorite is Akkermansia by Pendulum Health. Unfortunately, they have a patent, making it expensive. In general, more organism colonies are better.
- Eat fermented foods and vegetables. Examples include sauerkraut, kefir, kombucha, and kimchi. (Maybe skip yogurt unless specially made, as many store yogurts contain too much sugar and haven’t shown the benefits hoped for.)
Conclusion
Understanding and nurturing our gut microbiome can have profound effects on our mental health, especially for those dealing with substance use disorders. By making informed dietary choices and incorporating supplements, we can support a healthy gut and, in turn, a healthier mind. Remember, small changes can lead to significant improvements, so start with one recommendation above (ideally the first one) and gradually incorporate more of them for the best results.
If you have a medical concern, consult with your healthcare provider. This blog does not serve as a substitute for medical advice from your individual provider(s). If you are experiencing a medical emergency, call 911 immediately.
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