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posted: 12/24/2012 6:00 AM

Chronic depression could have ties to 'leaky gut syndrome'

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Is it possible that the key to depression is linked to bacteria in the bowels? Numerous studies over the past five years have suggested that the root of chronic depression may be associated with a specific medical condition known as leaky gut syndrome. Correcting this medical condition can result in significant improvement in chronic depression.

If you were to ask 10 physicians if leaky gut syndrome exists, probably all would say no. Well, leaky gut syndrome is mentioned in my medical textbook from 25 years ago. I actually remember the lecture, in medical school, that described leaky gut syndrome and the specific diagnostic test.

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Basically, leaky gut syndrome is a problem with intestinal permeability. Toxins and possibly bacteria are able to get past the intestinal wall cells, causing an increased immune response. This enhanced immune response is may lead to chronic inflammation ultimately increasing the risk for a number of illnesses -- theoretically. In addition, some of the toxins produced by bacteria and yeast are very toxic, especially to the nervous system. One specific toxin is lipopolysaccharide. LPS is so toxic that even in minute doses, death is almost certain. It is believed to be one of the main pathologic factors in septic shock (an often fatal medical condition caused by serious bacterial infections).

Since 2007, there is good medical research to indicate that a person's immune response to LPS may increase the risk of chronic depression. From this research, the question arose "where does LPS come from?"

Research over the past four years has demonstrated that the source of LPS is the bacteria in the bowel in association with an increase in bowel permeability -- a leaky gut.

One specific, 2008 Belgian study demonstrated that serum levels of two specific immunoglobulins, IGA and IgG, were diagnostic in fatigue, bowel irregularity and the feeling of chronic, low-grade infection. This study also showed that there was intestinal cell dysfunction and an increased amount of LPS -- rich bacteria were getting through the bowel wall. They postulated that this "leaky gut" has an important role in depression. Correcting the leaky gut using a combination of dietary supplements and diet significantly improved gut function and reduced levels of depression.

Although antidepressants are one of the top-selling prescription medications on the market, they are probably over prescribed. This is driven, to a large degree by consumer-direct advertising by pharmaceutical companies. Paradoxically, medical studies suggest that antidepressants are no more effective than other, nondrug-based therapies including exercise, acupuncture, stress reduction and even placeboes. Antidepressant use is associated with significant side effects, some of them permanent, and in children the side effects seem to be even more profound.

Although there are good reasons for prescribing antidepressants, their use has increased by a whopping 400 percent since the 1980s. Given current American lifestyles and diet, checking for (and treating) leaky gut syndrome before prescribing antidepressants seems prudent and has no serious side effects. This approach may result in real cures, saved lives and, potentially, reduced medical costs by billions of dollars per year.

Patrick B. Massey, M.D., Ph.D is medical director for complementary and alternative medicine for the Alexian Brothers Health System. His website is www.alt-med.org.

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