[HN Gopher] Gut-Brain axis
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       Gut-Brain axis
        
       Author : yamrzou
       Score  : 123 points
       Date   : 2023-06-25 13:04 UTC (9 hours ago)
        
 (HTM) web link (en.wikipedia.org)
 (TXT) w3m dump (en.wikipedia.org)
        
       | tibbydudeza wrote:
       | The microbiome for the baby comes from the mother as it passes
       | through the birth canal or in the case c-section to a lesser
       | degree via breast feeding - bootstrapping us for healthy
       | digestive tract.
        
         | deepsquirrelnet wrote:
         | Of note - it is common for mothers to receive antibiotics
         | during delivery for a great many reasons. This can delay the
         | development of the gut microbiome in babies, and is potentially
         | linked to colic.
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170024/
        
       | Vaslo wrote:
       | I always wondered how much conjecture this was but a few years
       | ago I had severe IBS problems when I would get very nauseous
       | about 30 mins after I ate among some other gut stuff Ill spare
       | you details on. Got every test done, saw multiple specialists who
       | willing to try anything to help me. Nothing was helping.
       | 
       | Finally went to a specialist who said "I think I know what's
       | wrong with you. Take these 2 tests and if both are negative for
       | another condition i have a medicine to start you on. "
       | 
       | Tests came back negative and he prescribed something called
       | Nortriptyline. It's a 1970s anti depression medicine they dont
       | usually prescribe anymore because of the side effects at the dose
       | to affect mood (150-200mg). However, at small doses (25 mg) it
       | can solve a lot of pain and gut malfunction problems. When I
       | started it, I immediately got positive results almost like taking
       | an ibuprofen for a headache. I was 5'11'', 130 lbs before and
       | from the pill, lifting weights, and fight training I got to 200
       | lbs and in the best shape I've ever been.
       | 
       | My sister in law is also on it for her back at a low dose and
       | it's the only thing that helps her.
       | 
       | This cheap pill was a miracle for me. I now believe in the axis
       | and see the real connection between the brain and the gut.
        
         | seiferteric wrote:
         | Now you got me thinking about the idea of "gut brain"
         | depression just like our normal brains can get depression...
        
           | MarkMarine wrote:
           | An interesting thing to think about, science isn't really
           | sure why SSRIs work the way they do on depression [0]. The
           | effect of the SSRI on brain serotonin is immediate, but the
           | drugs take 3-4 weeks to actually have an effect on depressive
           | symptoms.
           | 
           | There is a suspicion that SSRIs may change the gut
           | microbiome, and that's why it has an effect and why there is
           | a time delay.
           | 
           | [0] https://www.discovermagazine.com/health/how-
           | antidepressants-...
        
             | meindnoch wrote:
             | Actually SSRIs usually have an immediate _worsening_
             | effect, which then gradually resolves by week 3-4.
        
             | mahathu wrote:
             | Are there any other credible hypotheses for why SSRIs take
             | weeks to affect mood according to the literature, when
             | their effect on the serotonin is immediate?
        
               | rubicon33 wrote:
               | Yes, another is that they cause an increase in BDNF in
               | the hippocampus, which stimulates neurogenesis there.
               | This process of literally growing neurons takes weeks,
               | even months.
        
         | fire wrote:
         | do you happen to know what the other two tests were / what the
         | other condition being tested for was?
        
         | kimbernator wrote:
         | The same drug also had immediate effects for me when I was
         | getting daily migraines a few years ago.
        
         | e40 wrote:
         | What's the idea for why it helps your sister's back problem?
        
           | xgb84j wrote:
           | I cannot speak for OP's sister, but I personally feel gut
           | problems in my back. There is no medical explanation for
           | that, that I am aware of. But when I eat certain foods, I
           | have intense back pain the next day.
           | 
           | The only reason I think it is related to gut problems is
           | because the back pain is perfectly correlated with certain
           | foods (e.g. large amounts of gluten, smoked meat) and has 0
           | correlation with normal reasons for back pain.
        
             | [deleted]
        
             | afandian wrote:
             | It could be inflammation making the joints unhappy. You
             | could do worse than get some blood tests done for CRP.
        
           | Vaslo wrote:
           | My answer would be trash because I don't quite understand it,
           | except to say it seems to regulate some common chemical
           | pathways in the body. The way it was explained to me is that
           | it clears up a bad signal between the brain and nerves,
           | particularly in the gut. My gut was just overreacting to any
           | food put in it and the pill helps restore normal "talk"
           | between the brain and the gut. Every other doc was trying to
           | treat my gut to make it better which is logical - this other
           | specialist used my brain to fix it.
           | 
           | I know the back thing isn't gut brain axis but I just figured
           | I'd mention it.
        
             | amelius wrote:
             | The gut also has a nervous system, it's like a second
             | brain. So the drug might have targeted just the "brain
             | cells" of the gut, and your recovery might have nothing to
             | do with an "axis" between gut and real brain. Note, IANAMD.
        
           | manmal wrote:
           | Nortriptyline is used for neuropathic pain.
        
         | rubicon33 wrote:
         | > I was 5'11'', 130 lbs before and from the pill, lifting
         | weights, and fight training I got to 200 lbs and in the best
         | shape I've ever been.
         | 
         | Very curious about this.
         | 
         | What were your IBS symptoms before taking Nortiptyline?
        
       | randcraw wrote:
       | This article asserts that the gut-brain axis model theory is more
       | than just a theory. But AFAIK, this has yet to be demonstrated
       | medically, via FDA-approved therapies that treat the brain by
       | changing the gut. Thus the idea is intriguing, but IMHO, unproven
       | where it counts, in treating and curing sickness.
        
         | 23B1 wrote:
         | It's good to be skeptical, but my wife works in this field and
         | I can tell you that there's a lot capital flowing to this area
         | of research, and a substantive body of research that supports
         | it.
        
         | captainbland wrote:
         | I believe the opposite is actually applied in practice, e.g.
         | prescribing antidepressants to people with IBS for instance
         | where the physical cause of the bowel symptoms isn't obvious/is
         | suspected to be neurologically related.
         | 
         | From the point of view of somebody with IBD, negative cognitive
         | effects in the middle of a flare seem pretty "common sense"
         | obvious but it could also be down to dehydration etc... But
         | that's in the case where there is a specific physical gut
         | disease process in progress. I imagine that treating mental
         | health conditions by altering the gut in people who have
         | healthy bowels is probably a dead end.
        
         | gavinray wrote:
         | I'll challenge that, to me this is a no-brainer with mountains
         | of evidence.
         | 
         | You can look at research about using antibiotics or fecal-
         | matter transplants and outcomes on both physiological and
         | psychological health.
         | 
         | Too many to list for antibiotics and host health:
         | 
         | https://scholar.google.com/scholar?hl=en&as_sdt=0%2C10&q=ant...
         | 
         | Here's one about treating metabolic syndrome with fecal-matter
         | transplants to cause a shift in host microbiome
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045147/
         | "The human gut microbiome is recognized as an independent
         | environmental modulator of host metabolic health and disease.
         | Research in animal models has demonstrated that the gut
         | microbiome has the functional capacity to induce or relieve
         | metabolic syndrome."
        
           | fluoridation wrote:
           | How is that different from saying that there's an arm-brain
           | axis, because breaking your arm causes psychological effects,
           | and treating the fracture alleviates these effects?
           | 
           | The question is if you can treat the brain by doing something
           | to a healthy arm, or vice versa.
        
         | echelon wrote:
         | I certainly hope it's more than a hypothesis! [1]
         | 
         | If true, this could potentially provide breakthroughs against
         | Alzheimer's, Parkinson's, autism, and a whole host of other
         | diseases.
         | 
         | [1] I know hope isn't science. But let's give the investigators
         | plenty of money to continue this research. This is the most
         | promising new line of thinking we've had towards solving these
         | diseases in my entire lifetime. beta amyloid, tau, and the rest
         | haven't gotten us anywhere.
        
           | piyushpr134 wrote:
           | We also know that science doesn't do a very good job when it
           | comes to long term effects on human beings. They took awfully
           | long time to declare that smoking is bad, despite plenty of
           | evidence. Same goes for alcohol. They have still not figured
           | out fat, carbs, sugar etc.
           | 
           | I feel, science when it comes to directly observable and
           | measurable systems works pretty well and is accurate.
           | However, when same is applied to systems which are not lab
           | controlled/controllable (like human diet) then it really hard
           | to prove of disprove anything. We are better off believing
           | things which are proven in practice than believe bigpharma
           | funded studies which can be (and are) manipulated by fudging,
           | manufacturing and/or simply twisting data.
        
             | TeMPOraL wrote:
             | I'd cut scientists some slack here. People often forget
             | that almost all of the actually useful and used medicine is
             | less than 100 years old; that almost all that goes into
             | items of everyday life is less than 100 years old too.
             | Cigarettes in the form we recognize today are less than 200
             | years old, and for most of the time since then 'till now,
             | neither medicine nor biological sciences knew shit about
             | anything, or had any useful equipment to measure anything.
             | 
             | The exponential progress of technology isn't just the
             | Internet and rockets and GDP. It's all knowledge and all
             | tools derived from it, many of which are necessary to make
             | further scientific advances. Arguably, all that's useful
             | has been invented or refined in the last 200 years, with
             | the distribution leaning heavily towards the present.
             | 
             | So yeah, it took scientists a while to declare that smoking
             | is bad. There were many reasons for it, but a major
             | contributing factor was that they had neither good models
             | nor good tools until very recently.
        
             | Klinky wrote:
             | Science is a method/study, not an isolated entity. Who is
             | "they"? You mean "scientists"? Which ones? The ones paid
             | off by Big Tobacco? Often the negative issues we face are
             | ignored due to conflicts of interest, bias, and
             | societies/economies valuing certain things (wealth of few)
             | over other things (health of many). That is not the fault
             | of "science".
        
         | [deleted]
        
         | edgyquant wrote:
         | It cites multiple studies though. E.g.
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/
         | 
         | Just because there are not currently any FDA approved medicines
         | doesn't mean it isn't science. I also would push back at anyone
         | asserting government approval is required for science to be
         | accurate.
        
           | piyushpr134 wrote:
           | 100%. FDA approval is nonsense. FDA plays in arms of big
           | pharma to provide you good advice which also makes money.
           | They hardly peddle any advice which doesn't make money. For
           | instance, linkage of cancer, heart disease, kidney disease
           | etc with processed foods, sugar, fructose (fruit juice, corn
           | syrup) etc despite tonnes of contrary evidence
        
           | wswope wrote:
           | Nah bro, this is just like all rare cancers and orphan
           | diseases, which are also fake. If they were real, the FDA
           | would be on top of that.
           | 
           | Get a load of this literature review on the gut brain axis
           | from pages 88-137, 49 pages listing over 1694 totally bogus
           | citations: https://journals.physiology.org/doi/pdf/10.1152/ph
           | ysrev.0001.... There's clearly no epistemological basis for
           | this stuff!
           | 
           | (\s)
        
       | parentheses wrote:
       | I know someone who has crippling anxiety at a level that requires
       | medication. She has always stated that when she has any stomach
       | issues, it increases the risk of any panic events. Additionally,
       | she found that consuming a daily probiotic reduces her baseline
       | anxiety.
       | 
       | The more we learn about it (this article included), and change
       | variables in our lives, the more certain we are that all types of
       | non-gut-health metrics can be improved by improving gut
       | microbiome.
        
         | alexcaza wrote:
         | I developed a panic disorder over the pandemic. Did all the
         | things--meditation, therapy, vitamins, minerals and medication,
         | in that order. All of them took more and more of the edge off,
         | but it wasn't until I started an SNRI that I was able to better
         | pull the signal from my gut. It turns out I have at the very
         | least non-celiac gluten intolerance. Once I went on a strict
         | gluten free diet practically all of my physical and mental
         | symptoms have vanished.
         | 
         | Now, when I consume something with gluten accidentally, I'm met
         | with pretty much all of the fun depression, anxiety and
         | physical pain I was feeling before. Our gut health influences
         | _a lot_ more than we probably realize.
        
       | turtledragonfly wrote:
       | People are wowed by animals that have multiple brains (eg:
       | octopus' arms), perhaps not realizing that humans do too, in a
       | sense -- the enteric nervous system (described in the article).
       | 
       | It's the reason you can still digest food if you're a
       | quadriplegic, for instance.
       | 
       | The enteric nervous system has about the same number of neurons
       | as a cat brain, for point of reference.
       | 
       | Sometimes I think of the activity of my guts as my little cat
       | brain, taking care of things down there, so I don't have to (:
        
         | turtledragonfly wrote:
         | Also, if you're interested in what intestines look like
         | squirming about in real time: (beware! NSFW, medical gore,
         | blood/guts/etc)
         | https://old.reddit.com/r/medizzy/comments/ttz995/peristalsis...
         | 
         | Gross, but fascinating too.
        
           | vram22 wrote:
           | >beware! NSFW, medical gore, blood/guts/etc
           | 
           | Same for a human brain, or heart, whether pumping or not.
           | Comment based on seeing a NatGeo photo of a human brain (not
           | a diagram), and a real human heart in the hand of a medical
           | student friend of mine, at his college exhibition.
           | 
           | The brain photo grossed me out more than the real heart;
           | don't know why. :)
           | 
           | Edit: the heart didn't gross me out at all, actually.
        
           | mock-possum wrote:
           | Wow that's great! Reminds me of the Cerebretes in StarCraft,
           | long fleshy undulating coils
        
         | readthenotes1 wrote:
         | I am 100% positive that is the gut brain that is listening to
         | my microbiota saying that yes I should buy those chocolates in
         | the grocery store and no I will not eat them all in one
         | sitting. My head brain knows better but with that confident
         | voice speaking differently what am I to do?
        
       | agumonkey wrote:
       | You could also layer the emotional / sexual subsystems on top of
       | the gut one.
        
       | gavinray wrote:
       | What I always thought was interesting was that when you take
       | psychedelics, despite whether it's mushrooms, LSD, or 2C-B (and
       | what have you), you can feel this little ball of energy in your
       | stomach (particularly noticeable when starting to come up) that
       | persists for most of the trip.
       | 
       | My woo-woo theory is that there's some kind of serotonergic
       | activity happening in the gut (which is responsible for some ~95%
       | of the body's serotonin production) that is so profound you can
       | physically feel it.
        
         | pazimzadeh wrote:
         | The main receptor for LSD is the 5-HT2A receptor. There is a
         | ton of 5-HT2A receptors in the gut, mainly an enterochromaffin
         | cells.
         | 
         | The amount of 5-HT2A receptors expressed in the intestine
         | increases as you go down the length of the intestine.
        
         | Gibbon1 wrote:
         | Your gut has it's own nervous system and sensory nerves
         | including taste buds. I think the burden of proof would be on
         | explaining why it's doesn't trip balls.
        
           | wunderlust wrote:
           | How do/would we know it doesn't?
        
       | deepsquirrelnet wrote:
       | I'm not sure I have anything too enlightening to add, but my
       | anecdotal experience with IBS resonates with this.
       | 
       | I have gotten my IBS under control through a variety of ways, but
       | perhaps my first realization of this was around 15 years ago. I
       | had not received much help from my doctor or gastroenterologist,
       | and back then, gastroenterologists did not like to approach IBS
       | at all, because it's a tricky syndrome and their training at the
       | time didn't have much to offer.
       | 
       | At some point, I noticed that it was a two way street between
       | anxiety my IBS. If I was having anxiety, then I'd often start
       | having digestive problems. If I started having digestive
       | problems, I'd also have increased anxiety. This was first
       | apparent to me around traveling, because all of the hustle and
       | bustle of getting through airports was an anxiety trigger, and I
       | w was simultaneously disrupting my diet, causing an IBS flair
       | every time I went somewhere.
       | 
       | Back then, I had been reading about the potential positive
       | effects of cognitive behavioral therapy for IBS. So I began to
       | practice awareness and some simple CBT, anticipated by knowing
       | I'd be anxious about traveling.
       | 
       | Much to my surprise, it helped immensely in that particular
       | scenario. It's hard to have that level of emotional awareness all
       | the time though.
       | 
       | In case it helps anyone, I've tried a ton of things over the
       | years. The things that have helped me most are - probiotics
       | (histamine degrading), soluble fiber supplementation (acacia
       | root) and low histamine diet.
        
         | nness wrote:
         | Similar experience, IBS + anxiety combo knowing me out on the
         | daily. CBT was also the only thing I've tried which I would say
         | had a positive long-term and measurable improvement.
         | 
         | (In the UK, CBT is a common treatment for IBS and free with the
         | NHS. It was never recommended to me in Australia, and had I
         | known, I would've sought it our far earlier in life.)
        
       | potomak wrote:
       | My mother is a dietitian and she started a podcast this year
       | where she's talked a lot about the microbiota and how it affects
       | our organisms in a lot of different ways.
       | 
       | For instance, did you know that bacteria in our guts help us
       | "digest" and expel heavy metals?
       | 
       | In the third part of the episodes about the microbiota[0] she
       | talks about the gut-brain axis:
       | 
       | > l'intestino puo comunicare al cervello uno stato di disagio o
       | disbiosi procurando, oltre al gonfiore, anche un possibile stato
       | d'ansia o abbassamento dell'umore
       | 
       | that translates more or less to:
       | 
       | > the gut can communicate with the brain a dysbiotic state
       | causing, in addition to swelling, a state of anxiety
       | 
       | The podcast is in Italian, but the transcriptions can be easily
       | translated in English.
       | 
       | [0] https://dietista.it/2023/03/29/e-la-pancia-non-c-e-piu-
       | terza...
        
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       (page generated 2023-06-25 23:01 UTC)