Oh my goodness, it just hit today! I had a little breathing room after starting my new position and the writing bug hit me! I’m in a bit of BreakFree Medicine blog withdrawal! I’ve been so busy geeking out, in fact I literally read 60 publications today with my research supervisor, that I haven’t had time to sit back and write on some of my favorite noteworthy topics this week.

I’ve got to scratch this writing itch a bit!

What has been in the back of my mind is how three recent studies on multiple sclerosis, all with seemingly different topics, could be explained by one my favorite subjects- our belly bugs! I can’t help myself! The science on how these microbes that reside in the lining of our various body parts impact so many aspects of our health is exploding! These buggy inhabitants of ours are offering new insights and new treatment perspectives on many health conditions and uniting various health specialists to all agree on an important component of health- our gut.


Of Microbes & Men/Women

One of the major roles of these microbes is the impact they have on balancing our immune response. The American Autoimmune Related Diseases Association reports that the NIH’s (National Institute of Health’s) estimate of 23.5 million people suffering with autoimmune disease is a gross underestimate. Multiple sclerosis is an autoimmune condition of the nervous system. According to a 2014 article in Scientific American:

Multiple sclerosis (MS) is an electrical disorder, or rather one of impaired myelin, a fatty, insulating substance that better allows electric current to bolt down our neurons and release the neurotransmitters that help run our bodies and brains. Researchers have speculated for some time that the myelin degradation seen in MS is due, at least in part, to autoimmune activity against the nervous system. Recent work presented at the MS Boston 2014 Meeting suggests that this aberrant immune response begins in the gut.

Eighty percent of the human immune system resides in the gastrointestinal tract. Alongside it are the trillions of symbiotic bacteria, fungi and other single-celled organisms that make up our guts’ microbiomes. (1)

Previously, I discussed the three components that are believed to be the underlying mechanisms of an autoimmune disorder, such as multiple sclerosis (MS). These are a genetic predisposition, a trigger (such as an infection, chemical insult, or other stressor), and intestinal permeability. What often contributes to “leaky gut” can be an imbalanced microbiome that releases inflammatory signals and contributes to the breakdown of the thin lining of the gastrointestinal tract.


The following is an expert interview on Medscape with one of the authors who connected MS to changes in the microbiome.

Dr Jangi: In many autoimmune diseases there has been a lot of recent interest in trying to determine how what we eat, how the kind of bacteria that live in our gut, might influence the immune system. Eighty percent of the immune system is in the gut and is probably shaped by what grows in the gut. For example, in rheumatoid arthritis and inflammatory bowel disease, we’ve seen that the gut microbiome probably makes a difference and alters the expression of those diseases.

So it seems that our work initially supports the idea that the gut in MS patients contains bugs that drive inflammation and are low in the types of bacteria that control inflammation. This is consistent with work in rheumatoid arthritis and inflammatory bowel disease. (2)


Now let’s look at how coffee, nutrient deficiencies and H. pylori are all connected to the microbiome shifts in multiple sclerosis.


Coffee On the Brain of MS

PageLines- forms-icon.pngThe following is an excerpt from the American Academy of Neurology’s press release on the link between coffee and MS risk:

For the study, researchers looked at a Swedish study of 1,629 people with MS and 2,807 healthy people, and a U.S. study of 1,159 people with MS and 1,172 healthy people. The studies characterized coffee consumption among persons with MS one and five years before MS symptoms began (as well as 10 years before MS symptoms began in the Swedish study) and compared it to coffee consumption of people who did not have MS at similar time periods. The study also accounted for other factors such as age, sex, smoking, body mass index, and sun exposure habits. The Swedish study found that compared to people who drank at least six cups of coffee per day during the year before symptoms appeared, those who did not drink coffee had about a one and a half times increased risk of developing MS. Drinking large amounts of coffee five or 10 years before symptoms started was similarly protective.

In the US study, people who didn’t drink coffee were also about one and a half times more likely to develop the disease than those who drank four or more cups of coffee per day in the year before symptoms started to develop the disease. (3)


What’s the link to the microbiome?

It’s all about the polyphenols, baby! It’s true; caffeine content can modulate brain health in some studies. However, coffee also has an impact on overall immune balance by feeding the good belly bugs that mitigate inflammation and intestinal stress. This results in a more healthy microbiome!


Nutrients and Gut Bugs

Medical News Today reports:

PageLines- forms-icon.pngA new study finds that, compared with healthy individuals, women with multiple sclerosis may have lower intake of anti-inflammatory and antioxidant nutrients, including food folate, vitamin E and magnesium…

For their study, Dr. Cassard and colleagues enrolled 57 women aged 18-60 with a body mass index (BMI) of 30 kg/m2 or less who were part of a vitamin D supplementation study. Of these women, 27 had MS and 30 were healthy controls.

Prior to undergoing vitamin D supplementation, all participants were required to complete a food frequency questionnaire, which gathered information on their diet and nutrition intake over the past 12 months.

The researchers found that on average, the women with MS had lower levels of five anti-inflammatory and antioxidant nutrients – food folate, vitamin E, magnesium, lutein-zeaxanthin and quercetin – compared with the healthy controls.

In detail, the women with MS had an average daily intake of 244 mcg of food folate, compared with an average intake of 321 mcg of dietary folate for the healthy controls. The daily recommended daily intake of dietary folate for adults is 400 mcg, so both groups failed to meet recommendations. (4)


What’s the connection to belly bugs?

Our gut bugs assist with assimilation and digestion. They also help manufacture B vitamins. With chronic inflammation from an imbalanced microbioime, nutrient deficiencies can occur.


What about H. pylori?

Read about it here.

Girl on phone


(1) Stetka, B. Could Multiple Sclerosis Begin in the Gut? Scientific American. October 3, 2014.

(2) Steka, B. Multiple Sclerosis and the Microbiome: What’s the Connection? An Expert Interview With Sushrut Jangi, MD. Medscape Neurology. October 01, 2014. http://www.medscape.com/viewarticle/832385

(3) American Academy of Neurology. Can Coffee Reduce Your Risk of MS? Press Release. February 26, 2015. https://www.aan.com/PressRoom/Home/PressRelease/1349

(4) Women with MS may ‘have lower levels of antioxidant, anti-inflammatory nutrients’. Medical News Today. February 20, 2015. http://www.medicalnewstoday.com/articles/289604.php

(5) A common gut bacterium may protect women against MS, study finds. Medical News Today. January 20. 2015. http://www.medicalnewstoday.com/articles/288247.php

Original article link: British Medical Journal

(6) Sheh A, Fox JG. The role of the gastrointestinal microbiome in Helicobacter pylori pathogenesis. Gut Microbes. 2013;4(6):505-531. doi:10.4161/gmic.26205.

Images courtesy of istockphoto.com