RossellaHealth Nutri

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INTESTINAL PERMEABILITY

It’s tempting to reach for quick-fix protocols when Intestinal Permeability (IP) is suspected or tested for, such as supplementing with extra zinc, glutamine and probiotics, but if the evidence-based risk factors are not addressed and the correct levels of supplementation are not known then protocols are less targeted and therefore less effective.

In his IP protocol, the first of its kind, Dr Leech sets out prescriptive protocols based on the scientific literature. This type of guidance is long overdue and will certainly benefit any practice.

The terms IP or leaky gut are interchangeable, other terms may include mucosal damage or barrier dysfunction. It is important to recognise that IP is not a condition but a reaction, and a normal homeostatic mechanism. For instance, IP is normal during pregnancy to enable immune system development of the foetus. Therefore, noting a client’s number of full-term pregnancies, for example, is relevant. IP is also an important defence reaction required to wash out pathogenic bacteria entering the digestive tract.

IP occurs when the intracellular proteins holding together the tight junctions of the gut epithelial wall disassemble, caused by the release of zonulin. Zonulin is the only physiological mediator known to regulate IP.

Acute IP is potentially life threatening, and is recognised medically and may accompany, for example, sepsis. Whereas low- grade chronic IP is non-life-threatening and presents frequently in clinical practice.

Addressing underlying disease states directly addresses IP and this should therefore be a practitioner’s main objective. IP is both important for overall systemic health and is directly associated with a number of diseases such as autoimmune diseases, and metabolic conditions, such as type 1 diabetes. It is also associated with disease severity and quality of life.

Some disease treatments are known to improve IP such as the use of prednisone for Crohn’s disease. Addressing Hashimoto’s disease naturopathically with doses of selenium at 200mcg/day not only results in thyroid antibody improvement within 3 months, but also addresses IP.

Additionally, Dr Leech suggests supplementing with curcumin at 500mg twice per day, glutamine at 5g three times per day and colostrum at 900mg twice per day to support training. Although these are higher doses than most practitioners would supplement, his treatment plan is evidenced based and not sufficiently effective at lower doses.

Medication-induced intestinal permeability, for example when NSAIDs (non-steroidal-anti-inflammatory drugs) are taken may be addressed directly by paying attention to other lifestyle factors such as sleep hygiene or suggesting therapeutic yoga to ameliorate symptoms of pain, and supplementing with fish oil and curcumin to address inflammation, and/or by taking PEA (palmitoylethanolamide) supplements at 300mg per day, or Lactoferrins at 250mg twice per day five days prior to the use of NSAIDs as prevention.

Risk Factors for IP
Dr Leech’s research has identified a number of risk factors for IP. Some of the strongest risk factors include elevated levels of proinflammatory markers, dyslipidemia, hyperglycemia, insulin resistance, and anthropometric measurements resembling obesity. These factors can lead to damage in the intestinal lining and promote inflammation, resulting in increased permeability. Additionally, advanced disease severity, comorbidity, and the consumption of a Western-style diet have been identified as significant contributors to altered intestinal integrity. When combined with multiple disease states or other environmental risk factors, the risk of IP becomes even higher. It is noteworthy that several of the identified risk factors, such as anthropometric measurements and biomarkers, are not directly related to intestinal health but rather indicate a metabolic-like condition that may also impact gut integrity.

Other variables to consider, include:
Modifying the diet, as a Western-style diet high in fat, sugar and fructose and low in fibre diet predisposes towards IP. Focus would therefore be on reducing alcohol, gluten and dairy (ref 1). Challenge clients to eat 30 different fruits and vegetables, nuts, seeds and grains each week.
Avoiding acoustic stress where possible as a loud noise environment may contribute towards IP.
Rebalancing the gut microbiota, stool tests are invaluable to analyse the gut microbial profile and gut health can be supported through dietary changes and targeted supplementation.
Addressing psychological stress and suggesting protocols to ameliorate stress including breathwork, managing workload, appropriate exercise, yoga and meditation and suggesting appropriate supplements, such as L theanine or adaptogenic herbs such as ashwagandha or rhodiola rosea.
Further, the level of advanced degree severity appears to be exacerbated by the presence of dysbiosis, inflammation and glucose metabolism disorders which can be directly addressed. Approximately 1 in 3 individuals experience intestinal permeability in conditions such as autoimmune diseases.

When testing for IP, it is important to understand that there is no gold standard, but the two most useful tests to use are measuring the levels of zonulin in stools and measuring the ratio of lactulose to mannitol in urine. Please note that zonulin is released by many cells in the body, including liver and heart cells, so stool zonulin levels rather than blood levels are a more targeted and accurate assessment of IP. In the lactulose/mannitol test, mannitol is readily absorbed whereas lactulose is poorly absorbed, so where IP is present lactulose levels will rise, reflected in the recorded ratio between the two sugars. Both tests may be used together. Stool zonulin is elevated in early disease development as it is an acute phase reactive protein and may be a useful aid to detect early disease state, and the lactulose/mannitol test may be used if a disease state is already identified.

Other tests include the lipopolysaccharide (LPS) test. Lipopolysaccharides are derived from the cell walls of gram-negative bacteria and can be measured in the blood and stool. Look for specific bacteria such as hexa-LPS producing bacteria, such as citrobacter freundii and klebsiellae, amongst others, which are more pro-inflammatory than other LPS compounds.

Food sensitivity testing is a useful measure of IP as a high number of foods with an elevated IgG antibody immune score on a report indicates a high degree of gut permeability. A beneficial protocol involving the selective removal of elevated foods, whilst also addressing nutritional and supplement repair protocols to the gut wall, can improve both tolerance to foods and directly address inflammation and IP. Testing prevents clients being on unnecessarily restrictive diets, which is of vital importance to gut microbiota balance and diversity.

Improving the health and function of the protective mucus barrier, will directly address IP. This can be achieved through testing and removing those foods that are stimulating an immune response while focusing on functional foods and supplements that support the enrichment of the mucus barrier. Strategies may include the use of multi strain prebiotics, FOS (Fructo-Oligosaccharides), GOS (Gluco-Oligosaccharides), resistant starches including cooked and cooled potatoes and rice, and supplementing with vitamin A, vitamin D, zinc and glutamine.

A varied, high fibre diet is essential. If there is insufficient fibre from plant sources, then specific microbes such as akkermansia municiphilia will feed on mucin as a food source and degrade the mucin layer. Actively selecting functional foods, such as chestnuts, pomegranates and blackberries high in ellagic acid, will support anti-inflammatory probiotic species such as 3-indolepropionic acid producing bacteria (IPA).

Testing for IP provides accurate diagnoses so protocols may be evidence-based. Of a survey of 589 adults, 90% of participants wanted to be tested and 93% stated that if tested they would be more likely to adhere to suggested protocols. Engaging in open communication with clients will determine their desires and expectations and result in a frank discussion regarding financial costs in the short term for long term health benefit.

In his protocol (please scan above), Dr Leech focuses on 8 recognised domains of treatment for clients with IP, whilst detailing the evidence behind their use, their efficacy, and potential benefits and harm.

These include the use of essential fatty acids, of minerals, vitamins, colostrum, plant-based amino acids, the grouping of prebiotics, probiotics and symbiotics, and dietary choices.

Based on his protocol, Dr Brad Leech provides practical evidence-based recommendations, such as reducing alcohol to no more than 10 standard alcoholic units per week and no more than 4 units per day, as opposed to a typical recommendation of simply ‘reducing alcohol consumption’.

If a client is clinically obese then restricting the diet by intermittent fasting, may in the short-term be a practical strategy to support IP management. Helping a client reduce their BMI from 43 to 36 has been evidenced to improve IP.

Clients with IP may be able to tolerate gluten, but only small, prescribed amounts and all clients should be low gluten as a rule due to its disruptive effect on zonulin.

Saccharomyces Boulardii has the most profound effect of the probiotic supplements but only if taken for a minimum of 3 months. With regards to other probiotics, good food sources containing multiple species may be recommended such as kefir, kombucha, live yogurts and other fermented foods.

With regards to key amino acids, the research suggests the use of lactoferrin and glutamine at relevant dose levels and the mineral zinc.

In conclusion, a detailed client history will establish underlying health conditions that predispose towards IP and can be directly addressed. Measuring IP with relevant testing supports patient compliance, and identifying and addressing risk factors contributing towards IP will direct targeted treatment recommendations.

REFERENCES
Leech, B., Schloss, J., & Steel, A. (2019b). Treatment Interventions for the Management of Intestinal Permeability: A Cross-Sectional Survey of Complementary and Integrative Medicine Practitioners. J Altern Complement Med, 25(6), 623-636. doi:10.1089/acm.2018.0374
Visser, J., Rozing, J., Sapone, A., Lammers, K., & Fasano, A. (2009). Tight junctions, intestinal permeability, and autoimmunity: celiac disease and type 1 diabetes paradigms. Ann N Y Acad Sci, 1165, 195-205. doi:10.1111/j.1749-6632.2009.04037.x
Leech, B., McIntyre, E., Steel, A., & Sibbritt, D. (2021). The Subjective Well-being and Health-Related Quality of Life of Australian Adults with Increased Intestinal Permeability and Associations with Treatment Interventions. The Journal of Alternative and Complementary Medicine. doi:10.1089/acm.2021.0202
Costa, R. J. S., Snipe, R. M. J., Kitic, C. M., & Gibson, P. R. (2017). Systematic review: exercise-induced gastrointestinal syndrome-implications for health and intestinal disease. Aliment Pharmacol Ther, 46(3), 246-265. doi:10.1111/apt.14157

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Test you food intolerances this July to naturally lose weight and heal your gut!

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WHAT DOES A NUTRITIONIST DO EXACTLY?
Most people get – on a conceptual level at least – that they should probably eat a bit better than they do, they should probably move more and take the time for more ‘me time’ to live a long and happy life.
‘Life’ seems to get in the way of achieving that. Many of us are juggling jobs and the complexities of modern relationships, leaving little time to dedicate to the business of ‘being healthy’. Convenience often wins. It’s not that that’s wrong per se, but here’s the thing: all the time we are not eating or moving or living as well as we know to do, we are silently getting sicker. That may actually be going-to-hospital sick or it may just mean having health niggles that bother us greatly but that we have learned to cope with. I’m talking here about things like IBS or other tummy troubles, PMT, arthritis, stress or anxiety, haywire hormones, or possibly weight that has crept on over the years and you can’t seem to shift it, no matter what you try.
What I want to share with you today is that the food you eat matters more than you can possibly imagine. And that, in many cases, simply by making changes to your diet, the symptoms of some of these conditions can be improved so markedly that there is a really profound shift in how you experience life.

WHAT IS NUTRITIONAL THERAPY?
Nutritional therapy used to be referred to dismissively as ‘alternative medicine’. It’s only now that the science of what to eat is getting the recognition it deserves and is being actively promoted by a small number of well-known and recently enlightened medical doctors, like Dr Rangan Chatterjee and Dr Michael Mosely.
Essentially, nutritional therapists apply the latest hypotheses and research in nutrition and health sciences to you and your symptoms and they come up with a diet, lifestyle and (sometimes) supplement plan to support those needs. They might bring in some coaching to help you put the ideas into practice in a meaningful way or break through whatever barriers have held you back in the past.

PERSONAL SERVICE
It’s a very personal approach. You might hear practitioners talk about people being ‘biochemically unique’. That means that there isn’t a single way of eating that is right for everyone. Sandra might have PMS and you want to lose weight, for example. Sandra might have a history of antibiotic use, while you had your appendix out when you were 14. Sandra might have an intolerance to dairy, while you hate strawberries. I could go on, but you can imagine the thousands of different permutations here. And the fact is that your DNA, previous medical history, and any current symptoms as well as what you like and don’t like, not to mention your personal circumstances are all important when a nutritionist creates a plan for you.
It is personalised just for you. That takes both time and skill. You could download something from the internet – if you knew what you were looking for – but it is not the same. A nutrition practitioner may also work with supplements targeted to a specific condition or your own health goal. This can be a minefield – potentially dangerous and inevitably costly – if you don’t know what you’re doing.

WHY DOESN'T EVERYONE SEE A NUTRITIONIST IF THE RESULTS ARE SO GOOD?
It’s unfortunate that so many people don’t understand what a huge effect a personalised food and lifestyle programme can have on the symptoms they have or how they experience their life.
Newspapers are full of soundbites about the latest foods, but they don’t really join the dots, and it’s difficult to see what might be possible for you. The vast majority of doctors – even those being trained today – have next to no current knowledge or practical experience of what their patients should be eating or how they might integrate the theory into their lives. They live in a world, by and large, where the solution presented during your 10-minute session lies in a prescription.
Some – like Chatterjee – are taking on training in something much bigger called Functional Medicine. This is a framework for considering that the symptoms you are experiencing are a result of imbalances in your body and, rather than treat the specific symptoms themselves, nutrition professionals try to understand the root cause of the problem and base their programme around that. If you think about it: nearly all medications merely suppress symptoms. Only very few are an actual cure – antibiotics come to mind here. The exclusively pharmacological approach conventional medicine so often employs does nothing to uncover the root causes. Metformin lowers blood glucose – but why is it high in the first place? Statins lower cholesterol – but why is it elevated? Non-steroidal anti-inflammatory drugs (NSAIDs) numb pain – but why are you in pain? These are the questions nutrition professionals will ask before embarking on a quest to find out to then be able to address the root cause.

WHAT HAPPENS IN A NUTRITION CONSULTATION?
Your first consultation will last up to 90 minutes. You will have been asked to complete and send back a nutritional therapy questionnaire before you visit. During the session, we’ll go into your medical history, your health goals and any other challenges you’re facing, what you generally eat, what you like to eat, what you hate to eat and how you have to eat (on the bus, in a rush at your desk, and so on). There’s no judgement and anything you share with me is kept in confidence.
Nutritional therapy sessions are usually sold in programmes that run over 12 weeks. This is because it is rarely helpful for anyone to leave without the knowledge that they have at least 10 to 12 sessions in place to help them implement the programme, make changes at a pace that suits them, and to deal with any challenges or questions that come up along the way.

WHAT IF I ALREADY KNOW WHAT TO DO?
Knowing what you should be doing is only part of the problem if you are unhappy with an aspect of your health. Staying motivated is the hardest part of any plan. The single best way to stay in the zone is to have a buddy or coach who can give you a nudge or call you out if you start to go off piste. I’d say this is the single biggest thing that makes the difference between reaching your goal and actually staying there. That’s where health coaching comes in. It keeps you accountable will ensure all that good work doesn’t go to waste.

Amazing, tasty and cleansing beetroot paleo hummus with crudités - ideal afternoon snack to prepare our gut for dinner and a smooth digestion! ✨😋🤩

Newsletter - Food Intolerance Testing Edinburgh

Dear all,
June news available on my website at this link!
https://www.rossellahealth.com/newsletter/. Make sure you make the best of June's Offer totally dedicate to NHS staff! To thank them for all the work they have done so well to keep us safe!

rossellahealth.com June 2020 OFFER 20% discount on Food Intolerance Testing or Adrnal Fatigue Testing Consultations for all NHS staff! (Consultation appointment is via Zoom & must be taken in June 2020) The test kit will be posted out to your home address for self take. You will also receive a video for the finger pri...

Hello everyone, we at RossellaHealth (courtesy of Zest4Life) are about to embark in an activity to boos our health for the whole family at national level. Each of us will be broadcasting in our group short videos from 27th April 2020 for 4-6 weeks to help the public take maximum care of themselves.
Each week we'll share activities, recipes, advice to keep community going and keep each other strong at this difficult time.
Watch this space...more soon!

FREE class of yoga and breathing to support community!
Monday 27th April 5-6pm via zoom.
Register for the zoom link: https://www.rossellahealth.com/product/yoga-and-breathing-class-for-immunity/
🧘‍♀️🧘‍♂️

1 Yoga and Breathing Class - Food Intolerance Testing Edinburgh

Join us 3 times per week to do 1 hour of yoga and breathing to help maintain health and calm during lockdown. Class cost £3.
For community support.
https://www.rossellahealth.com/product/2178/

rossellahealth.com 1.5 hours course of 10 classes at general level. This is suitable for beginners or for people who have had some experience.

We are going through an unprecedented time of worry and fear for our health at a global level. Our immune system is the most powerful weapon you have against disease.
Strong immunity means we are better able to fight off viruses and illness and also develop immunity naturally against pathogens.
I have worked really hard in the last few day putting together a very useful booklet with my top tips for support of family, friends and clients.
Message me your email if you want me to send it to you. I hope to spread this as far as possible so people can have some support.
Email me on [email protected] or message me through Facebook.
Take care and stay strong and safe! We’re going to get through this together.
🤩🥰🤗

Hello healthy ladies and gents, :)
as I have not been feeling too great the last two days I will start the group course tomorrow.
Please remember this is a work and discussion group around keeping safe and surviving this time together so we can get out of it healthier and stronger.
Just to start the discussion, so I get one more overnight to get better, one question for you:
What s the very first thing you are going to do once lockdown is over?
My answer is cook an amazing dinner for my family and friends!!
See you tomorrow for the first tip on how to strengthen our and our children's immunity at this time!

Join me here: https://www.facebook.com/groups/425983428058182/

RossellaHealth Nutri

Top Tips to Reinforce Your and Your Children's Immunity

I hope you are all keeping safe. These are unprecedented times where we need to hold on to community more than ever and keep connected to each other. And thank God for the use of internet we can do that face to face on by voice wherever we are in the world.

Let's hold on to each other and we'll get through this.

Join me in my FaceBook groups: https://www.facebook.com/groups/425983428058182/

One of the area that some of us may be wanting to do more work right now is our children's immunity. With a diet which is far from rich in all minerals, phytonutrients and probiotics we need to develop our immunity in a healthy way to stay safe through illness, especially at this time.

I'll paint a picture for you: the average parent thinks their kids are eating well, or so they hope. But do they? Are you feeding your children always the same foods, week in week out? Have you found a formula which keeps your work easy and know that some pasta, some meat or fish and a few veggies will keep them healthy?
I would call this diet far from being healthy and varied. A child on this type of diet is bound to have an immature immunity which will not serve him/her well at times like this.

You will have noticed how all shelves at the supermarket have become empty on the same foodstuff: pasta, rice, flour, eggs and, unbelievably, alcohol. It is exactly at this time that people panic and buy exactly the wrong foods, those that will easily feed and satisfy.

Tomorrow I am starting a new group work on health habits to thrive while at home. We will discuss together what is best to buy and how it is best to cook. It won't require any more money than usual, just smart choices.

We will work together on strengthening our immunity exactly at the right time when we need it. Let's stop panicking (did you know that fear and panic are the best way to raise inflammation?). Instead let's Talk, Discuss and eat well to survive this crazy moment we are all living together.

Join me in my FaceBook groups:https://www.facebook.com/groups/425983428058182/

TIP 1 for tonight: something easy. Let's up our water to at least 1.5 litres per day.

Tops Tips to Reiforce Your and Your children's immunity

Starting tomorrow. Join me in this FaceBook groups: https://www.facebook.com/groups/425983428058182/

Top Tips to Reinforce Your and Your Children's Immunity

I hope you are all keeping safe. These are unprecedented times where we need to hold on to community more than ever and keep connected to each other. And thank God for the use of internet we can do that face to face on by voice wherever we are in the world.

Let's hold on to each other and we'll get through this.

Join me in my FaceBook groups: https://www.facebook.com/groups/425983428058182/

One of the area that some of us may be wanting to do more work right now is our children's immunity. With a diet which is far from rich in all minerals, phytonutrients and probiotics we need to develop our immunity in a healthy way to stay safe through illness, especially at this time.

I'll paint a picture for you: the average parent thinks their kids are eating well, or so they hope. But do they? Are you feeding your children always the same foods, week in week out? Have you found a formula which keeps your work easy and know that some pasta, some meat or fish and a few veggies will keep them healthy?
I would call this diet far from being healthy and varied. A child on this type of diet is bound to have an immature immunity which will not serve him/her well at times like this.

You will have noticed how all shelves at the supermarket have become empty on the same foodstuff: pasta, rice, flour, eggs and, unbelievably, alcohol. It is exactly at this time that people panic and buy exactly the wrong foods, those that will easily feed and satisfy.

Tomorrow I am starting a new group work on health habits to thrive while at home. We will discuss together what is best to buy and how it is best to cook. It won't require any more money than usual, just smart choices.

We will work together on strengthening our immunity exactly at the right time when we need it. Let's stop panicking (did you know that fear and panic are the best way to raise inflammation?). Instead let's Talk, Discuss and eat well to survive this crazy moment we are all living together.

Join me in my FaceBook groups:https://www.facebook.com/groups/425983428058182/

TIP 1 for tonight: something easy. Let's up our water to at least 1.5 litres per day.

Top Tips to Reinforce Your and Your Children's Immunity

I hope you are all keeping safe. These are unprecedented times where we need to hold on to community more than ever and keep connected to each other. And thank God for the use of internet we can do that face to face on by voice wherever we are in the world.

Let's hold on to each other and we'll get through this.

Join me in my FaceBook groups: https://www.facebook.com/groups/425983428058182/

One of the area that some of us may be wanting to do more work right now is our children's immunity. With a diet which is far from rich in all minerals, phytonutrients and probiotics we need to develop our immunity in a healthy way to stay safe through illness, especially at this time.

I'll paint a picture for you: the average parent thinks their kids are eating well, or so they hope. But do they? Are you feeding your children always the same foods, week in week out? Have you found a formula which keeps your work easy and know that some pasta, some meat or fish and a few veggies will keep them healthy?
I would call this diet far from being healthy and varied. A child on this type of diet is bound to have an immature immunity which will not serve him/her well at times like this.

You will have noticed how all shelves at the supermarket have become empty on the same foodstuff: pasta, rice, flour, eggs and, unbelievably, alcohol. It is exactly at this time that people panic and buy exactly the wrong foods, those that will easily feed and satisfy.

Tomorrow I am starting a new group work on health habits to thrive while at home. We will discuss together what is best to buy and how it is best to cook. It won't require any more money than usual, just smart choices.

We will work together on strengthening our immunity exactly at the right time when we need it. Let's stop panicking (did you know that fear and panic are the best way to raise inflammation?). Instead let's Talk, Discuss and eat well to survive this crazy moment we are all living together.

Join me in my FaceBook groups:https://www.facebook.com/groups/425983428058182/

TIP 1 for tonight: something easy. Let's up our water to at least 1.5 litres per day.

It is now possible to pre-order Covid-19 rapid tests through your health professional. The test must be administered by a health professional (with full protection of mask and gloves) and it takes 10 minutes to test whether you have IgG or IgM immunity to the virus. The test's RRP is £49. The consultation time costs £30.

The test is approved and only distributed through healthcare professionals.

Please enquire directly with me on [email protected] to pre-order the test and make an appointment for the test itself.

Testing your intolerances has never been so important as at this unprecedented time! Only a strong immunity can make it against this new virus - intolerances heighten your inflammation and weaken your immunity!
A dietary change can empower your immunity!
Get a test kit from here and meet me online for a consultation.
https://www.rossellahealth.com/shop/

Want to read a bit about Thyroid Health and get a seasonal recipe? Come and grab the March Newsletter here:
https://www.facebook.com/groups/425983428058182/.
😘🙋‍♀️

Once again it is the end of the month - we're in March on Sunday! I will be posting my Newsletter for March 2020 for my FB group.

It will have as usual seasonal recipes and curiosities, an article on thyroid health and some spring offers.

Join the group community here: https://www.facebook.com/groups/425983428058182/