Goodbye Summer, Hello Fall. Yesterday at 10:59 AM EST was the Autumnal Equinox, marking the beginning of Autumn. The word equinox comes from the Latin “aequus” meaning equal and “nox” meaning night. The Earth’s axis is neither tilted toward nor away from the Sun, the center of the Sun being in the same plane as the Earth’s equator. The equinox is a time of balance, the length of the days and nights are equal. As we move through the Fall towards Winter, the light will wane as the days shorten and the nights lengthen.
The autumnal equinox is celebrated by the Pagan holiday Mabon (pronounced May-bon). It is a time that is associated with Deep Mystery, our connection to the Spirit world, and giving thanks for the fruits of the harvest. It is often traditional to eat spicy warming ginger at this time, a root that is very soothing for digestion.
Digestion, and the Gut-Brain connection are a central Deep Mystery in my life, and in the lives of some of my patients. The more I learn, the more awed I am at its complexity, and the more I appreciate that one size does not fit all, and not even most.
I have felt an increased pressure to integrate my thoughts about all of this, as I am going to do a workshop on digestion at Emerson Hospital in Concord, MA next month. How do GAPS, FODMAPS and Histamine Intolerance fit together? My working hypothesis is that all of them share a common pathophysiology of enterocyte dysfunction. Enterocytes are the important cells that comprise the mucosa that lines the intestinal tract. They provide both a mechanical barrier and are also metabolically active. They are both essential to the integrity of the gut wall and for the metabolism and absorption of nutrients. When damaged, not only do substances which belong inside the gut leak out into the periphery causing inflammation in the body and the brain, but the cells cannot carry out their essential functions of metabolizing and transporting our food. They cannot produce the necessary enzymes to metabolize short chain carbohydrates in those individuals sensitive to FODMAPS, and cannot effectively deal with ingested or endogenous histamine release, resulting in Histamine Intolerance. I believe that both FODMAPS and Histamine Intolerance are not primary conditions, but rather secondary manifestations which have resulted from gut inflammation and damage via dysbiosis.
What does this mean for treatment? I recommend implementing the GAPS Healing Protocol to deal with the underlying gut damage and inflammation. If an individual shows no improvement, and is continuing to have adverse reactions to permissible GAPS foods, then certain FODMAPS foods and/or foods resulting in Histamine Intolerance need to avoided. This can only be determined by careful detailed self observation, as everyone is so different, and even the same individual may also react differently over time.
A food diary is an essential tool to track your responses to your diet. It requires dedication and detective work, and can be tedious, but there is no better way to pinpoint which foods need to be avoided, until the gut has had more time to heal. There is also a good i-Phone informational app called “Food Intolerances“. Over time and with healing, many foods previously not tolerated, should be able to be eaten again without adverse response. Dr. Natasha recommends introducing fermented foods very very slowly (such as a half teaspoon of sauerkraut juice) for those people with an adverse response, a sort of incremental exposure therapy. These individuals presumably have histamine intolerance, as histamine is produced by the fermentation process.
The typical FODMAPS and Histamine Intolerance diet are both high in grains and the Histamine Intolerance diet includes legumes as well. My thinking at this point is that these food would potentially feed the pathogenic microflora in the gut, and thus exacerbate or at least support the ongoing damage to the enterocytes. These diets may provide symptom relief, but would not heal the underlying inflammation. The GAPS diet is recommended to heal the primary inflammatory process. All of my thinking is a work in progress and thus provisional, as I try to sort through this perplexing and confounding Deepest of Mysteries.
At this powerful turning point of the year, I wish all my readers health and joy in the new season.