Psoriasis Is Caused By Bad Digestion: The Gut-Brain Axis

Gut health, stress and psoriasis all go hand in hand. Bad digestion is one of the most common causes of chronic health problems including psoriasis.

We all know that stress can significantly impair the blood flow throughout the body. I published the blog posts and mostly video about this issue and how it relates to psoriasis before.

 

Adrenaline as a fight-or-flight hormone redirects the blood flow from digestive organs into the brain and muscles in order to do the best to resolve the acute threat.

However, living in stress on a daily basis means that you won’t absorb nutrients from food and low output of pancreatic and intestinal enzymes leave a lot of food (starches and disaccharides) for bacterial and fungal fermentation. Pancreatic (mal)function was suspected to be involved in psoriasis pathogenesis in the past. Today, everybody should know already that psoriasis has many underlying causes (nutritional deficiency, dental infection, yeast infection,…) and it is only the final processes of pathogenesis which are common in everybody (ANS dysfunction, microorganisms induced inflammation of the skin,…)

What is Mesenteric blood flow?

A blood flow into the gut (small intestine, colon, pancreas) in medical books is called a mesenteric blood flow.

 

Low blood flow = low oxygenation of the tissues = low ATP (energy production) = decreased production of the digestive enzymes and other molecules = SIBO and Candida infections = inflammation.

 

OK, now those of you who like to oppose everything will argue that there is a lot of other causes of SIBO and Candida infections of the gut.

Well, after you finish this blog post you should know why mesenteric blood flow is heavily involved in digestion, SIBO, Candida and overall health.

Image Source: J. H. Meurman J. H. Meurman E. Siikala M. Richardson M. Richardson R. Rautemaa R. Rautemaa. Non-Candida albicans Candida yeasts of the oral cavity. Jan 2007. Downloaded from ResearchGate.net

 

But one of the most important things you should realize is that if you have not enough oxygen in the cells of digestive organs you can eat anything and you will still struggle digesting that food. If you had your small intestine or pancreas working just about 10% of their relative normal healthy performance then you would loose weight, had SIBO, Candida and other problems because the undigested food would ferment in your gut.

The Brain-Gut Axis and chronic inflammation

The scientific paper from 2011 – “Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options” – mentions the following six effects of stress on gut physiology:


1) alterations in gastrointestinal motility;
2) increase in visceral perception;
3) changes in gastrointestinal secretion;
4) increase in intestinal permeability;
5) negative effects on regenerative capacity of gastrointestinal mucosa and mucosal blood flow;
6) negative effects on intestinal microbiota;
” [8]

 


Exposure to stress results in alterations of the brain-gut interactions (“brain-gut axis”) ultimately leading to the development of a broad array of gastrointestinal disorders including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other functional gastrointestinal diseases, food antigen-related adverse responses, peptic ulcer and gastroesophageal reflux disease (GERD).
” [8]

Endotoxins decrease the blood flow in the gut

When you live in stress and your body is switched in fight-or-flight instead of rest-DIGEST-repair you slowly progressing into a state when bacteria and yeast overgrow in your intestines.

More bacteria and yeast means more endotoxins and toxins which place a burden on liver, nervous and immune system.

 

The scientists proved that LPS (endotoxins) decrease the mesenteric blood flow (blood flow in the gut). And even though it was previously reported that adrenaline tolerance decrease the mortality in endotoxic shock this study from 1999 proved that adrenaline tolerance does not prevent decrease at least in mesenteric blood flow.[1]


Endotoxic shock is associated with release of catecholamines as well as decreased mesenteric vascular perfusion, which is thought to cause remote organ injury. Adrenaline tolerance was reported to decrease mortality in endotoxic shock and have cross-tolerance with endotoxin tolerance. Our aim was to investigate the effect of these two tolerance conditions on the lipopolysaccharide (LPS)-induced decrease in mesenteric blood flow (MBF).

Adrenaline tolerance was developed by injecting 0.03 mg/kg adrenaline to Swiss-albino mice, gradually increasing the dose to 2 mg/kg over 5 days. Endotoxin tolerance was developed by injecting saline for 4 days and LPS 1 mg/kg at the fifth day. Control animals were injected with saline for 5 days. At 72 h after completion of injections, half of the animals in each group were challenged with saline and the other half with 20 mg/kg LPS, at 0 h. Mesenteric blood flow was measured at 4 and 24 h.

Neither endotoxin nor adrenaline tolerance prevented an LPS-induced decrease in MBF.

A low dose of LPS prior to a higher dose does not prevent an LPS-induced decrease in MBF and may actually prime for a decrease. Also, catecholamines are not primary mediators of LPS-induced decreases in MBF.
” [1]

 

So what should we learn from this study?

Endotoxins (LPS) do decrease the blood flow in the gut (intestines).[1, 11]

How to avoid this decrease in blood flow?

The best idea is to avoid the stressful situations.

If you are not a PTSD survivor then this should be relatively easy compared to those with PTSD.

 

There are many supplements which are able to improve the blood flow and decrease the detrimental effects of stress and endotoxins on the gut but I am going to mention just two of them here – Rhodiola and Melatonin.

 

Dopamine is able to increase the superior mesenteric artery blood flow and renal function.[4]

Both of these functions affect the overall health of an individual for sure.

This may be the reason why Rhodiola as a dopamine boosting supplement affect so many bodily functions including the physical performance.

 

Some of you might hear that melatonin is not only a “sleep hormone” but also a potent anti-inflammatory supplement.


Additionally, melatonin an important mediator of brain gut axis has been shown to exhibit important protective effects against stress-induced lesions in the gastrointestinal tract.
” [8]

Melatonin may block or reduce the endotoxin induced TNF-alpha production (at least in mice).[2]

Crohn’s disease and impaired mesenteric blood flow

The scientists found a correlation in resistance index and pulsatility index (both are used to assess the blood flow) in non-operated and non-complicated Crohn’s disease patients when measured by Doppler sonography. [3]

What does that mean?

The blood flow in the gut is impaired in Crohn’s disease patients.

It is not just about the decreased blood flow; some parts of the gut may have increased blood flow the other parts have decreased blood flow. It is still about the balance because when some part of the body have increased blood flow (like due to inflammatory reaction) the other parts may have problems because they will lack that blood.

 

The another study concluded that blood flow measurements “in the superior mesenteric artery are closely related to clinical but not endoscopic disease activity in patients with Crohn’s disease”.[5]

And there is a lot of studies like this and the authors say that “SMA Doppler blood flow measurements can be used to assess disease activity in patients with Crohn’s disease”.[6, 7]

Hypoxia in Psoriasis

I am saying that for years that psoriasis is caused (directly and/or indirectly) by low oxygenation of the tissues.

And not only psoriasis…

Rheumatoid arthritis is strongly linked to hypoxia.


Joint hypoxia plays a central role in the progression and perpetuation of rheumatoid arthritis (RA).
” [9]

In my opinion endotoxins (or possibly also something else like other bacterial and yeast toxins) cause systemic inflammation even though usually it is almost subclinical inflammation when – liver enzymes, C-Reactive Protein (CRP), erythrocyte sedimentation rate (ESR) – all are in normal values.

 

So, you may ask “Why the heck the doctors use immunosuppressive drugs for inflammatory conditions?”

Because the cells of the immune system induce the inflammation.

Having the blood test results which showed no inflammation does not mean that there is no inflammation.

 

Maybe it would be better to check the TNF-alpha levels in blood.

 

The reason why it is not done routinely is the complexity of the tests. The TNF-alpha have a short half life (about 18 minutes) and TNF-alpha itself induces the production of other inflammatory molecules.[10] And some of those other inflammatory molecules may have and have longer half-life.

This leads to long-term inflammation when there is a bunch of immune cells pre-programmed by inflammatory molecules to continue in inflammatory response.

 

So, for now medical system is stuck with general blood tests which show nothing specific other than there is some kind of problem.

Not mentioning the fact that in a lot of people with psoriasis liver enzymes, ESR, CRP, ASLO (anti-streptolysin O) – test for Streptococcal infections – all will be in normal ranges.

 

We really need much better tests measuring the levels of TNF-alpha, IL-6, NF-κB, IFN-gamma, IL-17,…

Not that the test like that would cure anybody but at least it would show something – how much inflammatory molecules are produced.

 

Whether you take methotrexate, ciclosporin or biologic drugs their work is to decrease the inflammation whatever way those drugs do it:

 

References:

1) Baykal A, Iskit AB, Kaynaroglu V, Guc MO, Sayek I, Sanaç Y. Effects of adrenaline or endotoxin tolerance states on mesenteric blood flow in endotoxaemia. Aust N Z J Surg. 1999 Feb;69(2):134-7.

2) Baykal A, Iskit AB, Hamaloglu E, Guc MO, Hascelik G, Sayek I. Melatonin modulates mesenteric blood flow and TNFalpha concentrations after lipopolysaccharide challenge. Eur J Surg. 2000 Sep;166(9):722-7.

3) Karoui S, Nouira K, Serghini M, Ben Mustapha N, Boubaker J, Menif E, Filali A. Assessment of activity of Crohn’s disease by Doppler sonography of superior mesenteric artery flow. J Crohns Colitis. 2010 Sep;4(3):334-40.

4) Voelckel WG, Lindner KH, Wenzel V, Bonatti JO, Krismer AC, Miller EA, Lurie KG. Effect of small-dose dopamine on mesenteric blood flow and renal function in a pig model of cardiopulmonary resuscitation with vasopressin. Anesth Analg. 1999 Dec;89(6):1430-6.

5) Ludwig D, Wiener S, Brüning A, Schwarting K, Jantschek G, Stange EF. Mesenteric blood flow is related to disease activity and risk of relapse in Crohn’s disease: a prospective follow-up study. Am J Gastroenterol. 1999 Oct;94(10):2942-50.

6) van Oostayen JA, Wasser MN, van Hogezand RA, Griffioen G, Biemond I, Lamers CB, de Roos A. Doppler sonography evaluation of superior mesenteric artery flow to assess Crohn’s disease activity: correlation with clinical evaluation, Crohn’s disease activity index, and alpha 1-antitrypsin clearance in feces. AJR Am J Roentgenol. 1997 Feb;168(2):429-33.

7) Andrade TG, Fogaça HS, Elia CC, Pitrowsky MT, Souza HS. Crohn’s disease activity assessed by Doppler sonography: the role of aortic flow parameters. Clinics (Sao Paulo). 2013 Apr;68(4):457-62.

8) Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011 Dec;62(6):591-9.

9) Ajay Rajaram, Seva Ioussoufovitch, Laura B. Morrison, Keith St Lawrence, Ting-Yim Lee, Yves Bureau, and Mamadou Diop. Joint blood flow is more sensitive to inflammatory arthritis than oxyhemoglobin, deoxyhemoglobin, and oxygen saturation. Biomed Opt Express. 2016 Oct 1; 7(10): 3843–3854.

10) Oliver JC, Bland LA, Oettinger CW, Arduino MJ, McAllister SK, Aguero SM, Favero MS. Cytokine kinetics in an in vitro whole blood model following an endotoxin challenge. Lymphokine Cytokine Res. 1993 Apr;12(2):115-20.

11) A. Erdem, A. M. Sevgili, F. Akbiyik, P. Atilla, N. Cakar, Z. D. Balkanci, A. B. Iskit, M. O. Guc. The effect of taurine on mesenteric blood flow and organ injury in sepsis. August 2008, Volume 35, Issue 2, pp 403–410

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