The importance of a healthy diet and eating “clean food” has been reiterated dozens of times in previous articles, both to keep the load on the body’s immune system as low as possible and to maintain a healthy nutritional status. We would be remiss, however, if we did not point out the fact that many mold-harmed patients are eating a healthy diet, are avoiding problem foods, but are still having both significant gastrointestinal symptoms and demonstrable nutrient deficiencies as indicated on testing. Because the gut, which you may recall is the lining of the small intestine, is a living and vital organ, it is particularly vulnerable and susceptible to becoming impacted by mold, mycotoxins, environmental chemicals, and chronic infections. Likewise, hydrochloric acid, which is produced in the lining of the stomach can be affected by these toxic influences as well; this, as I will explain, can further complicate and exacerbate gastrointestinal and other symptoms throughout the body.
Symptoms of Maldigestion and Poor Absorption
There are several symptoms that lead us to suspect that poor absorption or maldigestion is taking place before the first test is ever even done. These may include bloating, burping, upset stomach, diarrhea, gas, a desire to eat when not hungry, indigestion, undigested food in the stool, fatigue, brittle nails and hair, hair loss, numbness and tingling in the extremities, muscle aches, cramping, and fatigue.
To help explain why symptoms of maldigestion and poor absorption may occur and where things can go awry, it helps to take a deeper look at the digestive process as a whole. As food is chewed and swallowed, the release of amylase occurs in the saliva to help begin to process carbohydrates. Then, when food enters the stomach, it is held for a few hours as hydrochloric acid is secreted by the cells lining the stomach wall. This acid is essential for beginning the breakdown of proteins and some fats as well as the continued processing of carbohydrates. The stomach chamber can actually become quite acidic, and this low pH then signals the muscular valve at the base of the stomach to open, allowing the passage of the food slurry into the upper small intestine.
In the small intestine, the pancreas secretes necessary enzymes, amylase, and lipase, to continue carbohydrate, protein, and fat breakdown. The gallbladder also adds bile salts to the process to continue to help with fat breakdown. The purpose of all of this breakdown being to transform the food that you ate into a structure that allows nutrients to be absorbed by the blood vessels housed throughout the small intestine.
The Purpose of Stomach Acid
There is a level of acidity required to absorb certain vitamins and amino acids, and if it is sufficiently low, then deficiencies can present even if these nutrients are being consumed. An example of this is Vitamin B12, probably one of the most commonly deficient vitamins that practitioners see in their patients. In non-vegetarian or non-vegan patients, usually, enough B12 is consumed through meat protein but it requires an acidic enough environment along with something called “intrinsic factor”, formed in the stomach lining, to be absorbed and utilized by the body. Severe Vitamin B12 deficiency, referred to as pernicious anemia, can have some very serious health impacts, ranging from neuropathy (tingling and numbness in the extremities), glossitis (very red and swollen tongue), to neuropsychiatric symptoms. Prior to getting to this degree, however, B12 deficiency can present as fatigue, depression, lethargy, and mild nerve symptoms. I mention B12 because it is one of the more recognizable vitamin deficiencies, but there are many others that happen on lower, less noticeable levels; the symptoms can range from mild to severe. This is the reason poor nutrient absorption and maldigestion must be addressed when evaluating health and wellness on any level!
Stress, Mold, and Poor Digestion
Going back to the reasons that chronically ill or mold exposed patients may have digestive insufficiency and poor absorption issues is best understood by realizing how toxins and inflammation can impact the normal function of the stomach, pancreas, gut, and liver. Starting with the stomach, a decrease in stomach acid can occur by the direct impact of illness or toxins on the acid-secreting cells of the stomach lining. It can become an endless chicken or the egg debate about which occurred first, in that the lower acid causes more susceptibility to infections, and the infections or exposures cause lower stomach acid. Either way, it is problematic for proper digestion and nutrient absorption.
A combination of factors, including stress, environmental exposures, illnesses, and medications can also start a digestive issues cycle. A common and often missed diagnosis is helicobacter pylori (H. Pylori), a spirochete bacterium, that can infect the stomach lining and dramatically decrease acid production. The lower acid then allows H. Pylori proliferation. Interestingly, many people who have H. Pylori have reflux and what they term “acid stomach”, but the fact is that often the true acidity is LOW. Then, the meds taken such as acid reducers and proton pump inhibitors to make one feel better temporarily are really just affecting maldigestion, not over-acid production. Over time, using these meds may make things worse! A takeaway here is that “acid stomach” may be anything but that, and chronic use of digestive medications, whether by prescription or over-the-counter may be doing more harm than good. Thus, my advice with reflux or acid stomach symptoms is to always look for the cause! If you are going after and treating the cause, you will then be doing MORE to alleviate your symptoms in a much more long-term fashion.
The pancreas, which is responsible for amylase and lipase production for fat and protein breakdown is heavily impacted by stressors of every kind–physical, emotional, environmental. Enzyme production is a very energy-requiring process. When the body is overly stressed, in an effort to conserve energy, the pancreas may decrease its enzyme production just to protect itself and the body in general. Unfortunately, this may lead to worse problems, like malabsorption that leads to nutrient deficiency, and body balance spins further out of control. The stress on the body of a significant environmental illness very often leads to these pancreatic insufficiencies.
The liver and gallbladder are necessary for the digestive process because they produce and add the bile salts that are essential for the emulsification of fats. When the liver becomes overly taxed due to having to process increased toxins from mold, from other environmental exposures, or from illnesses, bile salt production can greatly increase or decrease. Too much bile and diarrhea will result. Too little and constipation can ensue, or then progress to diarrhea simply because fats are not being broken down and react in a very stimulatory way to the colon lining. Symptoms may lead us to perform certain tests that will help to identify the severity and specificity of the reasons why those symptoms are occurring.
How to Know if Digestion Has Been Impacted
As yucky as it may sound, take a look at your stool in the toilet bowl. Is there undigested food? Is there an oily skim on the toilet water? Is stool exceptionally light and pale or extremely dark? What about explosive gas? If any of these are present, then there is maldigestion.
Helpful Testing
The following tests can be helpful in determining if maldigestion is impacting you:
– Blood levels of amylase and lipase are quite easily done and are not expensive tests. While many will find that their results are “normal”, where these numbers fall within the “normal range” is important. We find that if these levels are in the lower third, then there is likely a deficiency.
– B12 levels are also easy to do and inexpensive. Any B12 level below 400 is likely deficient regardless of the lab normal range.
– Helicobacter pylori, the bacteria that can bore into the stomach wall can be detected by an antibody test also done on blood. However, these antibody levels are only helpful if you have never been treated for it, as they do not normalize once the bacteria are eradicated. And, keep in mind that helicobacter pylori eradication can take much, much longer than the two weeks of treatment commonly prescribed. It may need months of specific therapies. Particularly if there has been a mold or mycotoxin exposure that has led to decreased immune protection in the gut; this must be addressed to be able to completely eradicate the pathogens!
– “Comprehensive Digestive Stool Analyses” are tests that can look at everything from the amounts of pancreatic enzymes, pathogenic bacteria, parasites, and yeast, pH of the stool, and markers of immune function and inflammation all done from stool collections.
– The organic acids test done from urine can show the byproducts of bacterial and yeast activity and give an excellent insight into the degree of malabsorption and nutrient deficiency that may be present.
Doing any of these tests, however, should be done after taking a thorough patient history to determine what is truly necessary. Also, but MOST importantly, the first order of business should always include ensuring that the air you are breathing and the food you are eating is clean and free of toxins.
Helpful Digestive Interventions
If you feel that you are in a mold-free environment and have a non-inflammatory diet, but are still having digestive issues and want to try some self-treatment before tests, then there are a few things that can be quite helpful.
1. One is the use of digestive enzymes. These are taken with the first few bites of food at each meal. We think of each capsule as being a “little pancreas” that is helping to break down the food that you are ingesting so that nutrients can be extracted, and digestive symptoms are avoided. Some prefer to start this before adding in additional stomach acid in the form of HCL, but the combination works quite well. The product, Digest Assist, by Micro Balance contains both and is gentle and affordable.
2. Restoring the lining of the gut to its needed integrity can be accomplished using probiotics, such as Microflora Balance, and immunoglobulins, like IgG Gut Protect. IgG Gut Protect is designed to heal the immune lining of the gut and prevent toxins from entering the bloodstream. Your practitioner can help you determine whether to do all of these at once or use a step-by-step process.
3. Promoting healthy bile flow and secretion can also be helpful if your gut feels sluggish and you have been impacted by a high amount of toxins. Digestive bitters and liver detoxification supplements, like MycoDetox Liver Support, can aid the body in igniting proper function and detoxification again.
As you can see, a properly functioning digestive system not only feels better but can lead to stronger immunity and a healthier you!
Susan Tanner has practiced medicine for over 33 years, concentrating primarily on chronic illness and the impacts on the individual, the family and the community. Her driving curiosity into why people are made ill caused her to pursue education in Environmental Medicine, completing coursework, exams, and necessary practice years to earn board certification in this area in 2009. Her own struggles with mold-related illness drove her desire to teach those similarly affected. While in clinical practice, Dr. Tanner wrote and contributed to a number of publications on environmental health, prepared narratives for understanding in legal matters, and researched new techniques for modulating the body’s ability to clear toxins and infections. She now has a fitness and health website www.thebodynexus.com, where she writes articles and shares education on utilizing the various body systems into improve overall health.
Your articles are very well written for people without medical understanding I would love to be treated. By you, but I’m pretty sure you may no longer practice. Thanks for all you do in Educating people for a better understanding of certain illnesses.
I believe I put the wrong email on my first comment to you.
So glad to read this article by you, Dr. Tanner. You treated me back in 2007. I appreciate all you did for me. I look forward to reading all your articles. Thank you for your knowledge and expertise.
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Your articles are very well written for people without medical understanding I would love to be treated. By you, but I’m pretty sure you may no longer practice. Thanks for all you do in Educating people for a better understanding of certain illnesses.
I believe I put the wrong email on my first comment to you.
Dr. Tanner does still practice. You can contact her through her website http://www.thebodynexus.com. She does in-person and virtual consults.
So glad to read this article by you, Dr. Tanner. You treated me back in 2007. I appreciate all you did for me. I look forward to reading all your articles. Thank you for your knowledge and expertise.
Thank you for writing! I hope you are well.
Thank you very much for this article. Very informative.
Thank you! I appreciate the feedback. :-)