Antibody Testing for COVID19
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In the midst of the COVID-19 pandemic, as accurate testing for the virus is in short supply across the globe, there is a significant opportunity to provide information to patients and healthcare providers about exposure and infection timelines through antibody testing.
To add to the problem, nasopharyngeal (NP) swabs – considered the gold-standard for diagnosing the infection – which are tested for RT-PCR (a type of RNA test for the viral genetic material) are notoriously inaccurate when collected and stored/transported improperly, and can average an accuracy rate of only 63.45% when collected within the first 14 days after infection and that can drop toonly about 52% accurate after day 14. [1]
That means that NP swab alone misses an average of 36.5-48% of patients with COVID-19 infections, depending on what time-point in the infection they are tested…that’s almost half!
Perhaps it is time to include additional testing methods in the standard diagnostic procedures for COVID-19 infections. And antibody tests may just be the answer to this problem. But, you may be unfamiliar with what antibodies are, and why they are potentially the most valuable tool in a healthcare provider’s toolbox during this time.
Also, as we will see, not all antibody tests are created equal.
Types of AntibodiesThere are five main types of antibodies, also referred to as immunoglobulins, in the human body that are relevant to disease, infections, or inflammatory response. This article will deal only with the three that are considered definitely relevant to the COVID-19 viral infection.
The two most well-studied antibody types specific to COVID-19 are IgG and IgM. At this time, Vibrant America is the only laboratory actively investigating the role that IgA antibodies may play in diagnostic utility for COVID-19 immune responses, more about that later.
IgGIgG antibodies are the most abundant in your blood, making up approximately 75% of the total amount of immunoglobulins/antibodies your body has floating around at any given time.
There are four sub-types of IgG antibodies, each with their own slightly different mechanism of action (aptly name IgG1, IgG2, IgG3, and IgG4).
IgG antibodies look like this:
These antibodies have mechanisms that allow them to perform the following actions:
Specific to COVID-19This study from China, published Apr 10, 2020 looked at 67 patients diagnosed with COVID-19 through either nasopharyngeal (NP) swab RT-PCR or chest x-ray and found that when antibodies were measured on a colloidal gold-based immunochromatographic (ICG) strip assay (one of the tests referred to as ‘rapid tests’) showed that sensitivity of IgG antibodies was:
This study from China, conducted in Jan-Feb 2020 followed 23 patients with diagnosed COVID-19. With respect to viral shedding, they found:
This also highlights the importance of testing patients at multiple time-points of infection, if an initial test finds positive antibody levels. Without a retest of the patient at least 10-14 days after the initial positive antibody result, it may be difficult to determine at what point the patient has overcome the infection.
IgMIgM antibodies have antiviral action, among other mechanistic purposes. They are considered an acute antibody, meaning they are one of the first antibody types to elevate in response to an infection, and generally only last approximately 5-10 days after initial presentation of their response (their half-life is considered to be 5 days).
IgM antibodies look like this:
They are generally not detected after an infection is no longer active, usually once it is not ‘contagious’ by most medical definitions, however, we do not yet have very solid data on this specific to COVID-19, but that is the prevailing theory among researchers at this time.
However, because IgG antibodies are the primary antibody associated with viral neutralization and infection resolution [3], it is not yet known if IgM antibody levels can be used to definitely determine infectious course.
Some important functions performed by IgM antibodies are:
IgAIgA antibodies are also involved in the antiviral response when it is present in mucosal surfaces. Mucosal surfaces are found throughout the body in:
IgA antibodies look like this (this is a dimeric form of IgA, which is its most common form in the blood, but it can also exist as a monomer):
Specific to COVID-19Because a primary target of the COVID-19 virus is the alveoli of the lungs, which are a major mucosal surface, it would stand to reason that IgA antibodies may have some relevance or diagnostic utility.
Vibrant America has included this antibody on its ImmuneCheck COVID-19 panel as an investigative assay to determine if this antibody should be included in standard antibody assessments of immune response to this virus.
So far, data about IgA antibodies to COVID-19 is limited or non-existent, but Vibrant’s validation study found that this antibody is:
ReferencesGary R. Klimpel. Medical Microbiology. 4th edition.Baron S, editor.Galveston (TX): University of Texas Medical Branch at Galveston; 1996
Kelvin Kai-Wang To, MD, Owen Tak-Yin Tsang, FRCP, Wai-Shing Leung, FRCP, Anthony Raymond Tam, MRCP, Tak-Chiu Wu, FRCP, David Christopher Lung, FRCPath, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. The Lancet, Infectious Diseases, Published:March 23, 2020, DOI:https://doi.org/10.1016/S1473-3099(20)30196-1
Pan Y, Li X, Yang G, Fan J, Tang Y, Zhao J, Long X, Guo S, Zhao Z, Liu Y, Hu H, Xue H, Li Y. Serological immunochromatographic approach in diagnosis with SARS-CoV-2 infected COVID-19 patients. J Infect. 2020 Apr 10. pii: S0163-4453(20)30175-4. doi: 10.1016/j.jinf.2020.03.051. [Epub ahead of print]
Yang Yang, Minghui Yang, Chenguang Shen, Fuxiang Wang, Jing Yuan, Jinxiu Li, Mingxia Zhang, Zhaoqin Wang, Li Xing, Jinli Wei, Ling Peng, Gary Wong, Haixia Zheng, Mingfeng Liao, Kai Feng, Jianming Li, Qianting Yang, Juanjuan Zhao, Zheng Zhang, Lei Liu, Yingxia Liu. Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections. medRxiv, BMJ Yale.https://doi.org/10.1101/2020.02.11.20021493
FDA Required Regulatory Statement:
This test has not been reviewed by the FDA. Negative results do not rule out SARS-CoV-2 infection, particularly in those who have been in contact with the virus. Follow-up testing with a molecular diagnostic should be considered to rule out infection in these individuals.Results from antibody testing should not be used as the sole basis to diagnose or exclude SARS-CoV-2 infection or to inform infection status. Positive results may be due to past or present infection with non-SARS-CoV-2 coronavirus strains, such as coronavirus HKU1, NL63, OC43, or 229E.
-—————————————————————-
To add to the problem, nasopharyngeal (NP) swabs – considered the gold-standard for diagnosing the infection – which are tested for RT-PCR (a type of RNA test for the viral genetic material) are notoriously inaccurate when collected and stored/transported improperly, and can average an accuracy rate of only 63.45% when collected within the first 14 days after infection and that can drop toonly about 52% accurate after day 14. [1]
That means that NP swab alone misses an average of 36.5-48% of patients with COVID-19 infections, depending on what time-point in the infection they are tested…that’s almost half!
Perhaps it is time to include additional testing methods in the standard diagnostic procedures for COVID-19 infections. And antibody tests may just be the answer to this problem. But, you may be unfamiliar with what antibodies are, and why they are potentially the most valuable tool in a healthcare provider’s toolbox during this time.
Also, as we will see, not all antibody tests are created equal.
Types of AntibodiesThere are five main types of antibodies, also referred to as immunoglobulins, in the human body that are relevant to disease, infections, or inflammatory response. This article will deal only with the three that are considered definitely relevant to the COVID-19 viral infection.
The two most well-studied antibody types specific to COVID-19 are IgG and IgM. At this time, Vibrant America is the only laboratory actively investigating the role that IgA antibodies may play in diagnostic utility for COVID-19 immune responses, more about that later.
IgGIgG antibodies are the most abundant in your blood, making up approximately 75% of the total amount of immunoglobulins/antibodies your body has floating around at any given time.
There are four sub-types of IgG antibodies, each with their own slightly different mechanism of action (aptly name IgG1, IgG2, IgG3, and IgG4).
IgG antibodies look like this:
These antibodies have mechanisms that allow them to perform the following actions:
- initiating phagocytosis via macrophages (phagocytosis is ‘cell’ ‘eating’ – referring to the ability of macrophages to essentially engulf a target cell such as bacterial or viral cells and destroy them)
- agglutination (IgG antibodies ‘clump’ to an antigen such as a virus or other foreign body/protein and create a glob-like mass that is then usually phagocytosed by macrophages
- antibody-dependent cell-mediated cytotoxicity – the IgG antibody activates natural killer cells (NK) to target and neutralize a cell, such as a tumor cell or virus using cytotoxic compounds
- neutralize toxins – toxins come from other organisms such as venom or endotoxins from bacteria. IgG antibodies grab these at their active site so that the toxin cannot bind to any other cells or proteins
- activating complement – an additional inflammatory response cascade to foreign antigens
Specific to COVID-19This study from China, published Apr 10, 2020 looked at 67 patients diagnosed with COVID-19 through either nasopharyngeal (NP) swab RT-PCR or chest x-ray and found that when antibodies were measured on a colloidal gold-based immunochromatographic (ICG) strip assay (one of the tests referred to as ‘rapid tests’) showed that sensitivity of IgG antibodies was:
- 3.6% in patients within 1-7 days of infection
- 57% in patients within 8-14 days of infection
- 96.8% in patients at 15+ days of infection
- a cumulative average of 54.7% sensitivity of antibody detection of patients with confirmed infection
- 340 total samples were tested for 4 antigens (S1 Spike protein, (RBD)Receptor Binding Domain, S2 Spike protein, Nucleoprotein) for the presence of IgG antibodies
- a cumulative average of 94.29% sensitivity of IgG antibody detection of patients with confirmed infection
This study from China, conducted in Jan-Feb 2020 followed 23 patients with diagnosed COVID-19. With respect to viral shedding, they found:
- Anti-SARS-CoV-2-NP or anti-SARS-CoV-2-RBD IgG levels correlated with virus neutralization – reduced viral load = reduced IgG antibody levels = increased viral shedding
This also highlights the importance of testing patients at multiple time-points of infection, if an initial test finds positive antibody levels. Without a retest of the patient at least 10-14 days after the initial positive antibody result, it may be difficult to determine at what point the patient has overcome the infection.
IgMIgM antibodies have antiviral action, among other mechanistic purposes. They are considered an acute antibody, meaning they are one of the first antibody types to elevate in response to an infection, and generally only last approximately 5-10 days after initial presentation of their response (their half-life is considered to be 5 days).
IgM antibodies look like this:
They are generally not detected after an infection is no longer active, usually once it is not ‘contagious’ by most medical definitions, however, we do not yet have very solid data on this specific to COVID-19, but that is the prevailing theory among researchers at this time.
However, because IgG antibodies are the primary antibody associated with viral neutralization and infection resolution [3], it is not yet known if IgM antibody levels can be used to definitely determine infectious course.
Some important functions performed by IgM antibodies are:
- activating complement
- agglutination of antigens – just like IgG antibodies can form a ‘clump’-like structure with an antigen in order to render it inert and then allow macrophages to destroy it, IgM antibodies can do this as well
- 11% of patients within days 1-7 of infection
- 78% of patients within days 8-14 of infection
- 74% of patients past day 15 of infection
- a cumulative average of 55% sensitivity of antibody detection of patients with confirmed infection
- 340 total samples were tested for 4 antigens (S1 Spike protein, (RBD)Receptor Binding Domain, S2 Spike protein, Nucleoprotein) for the presence of IgM antibodies
- a cumulative average of 91.43% sensitivity of IgM antibody detection of patients with confirmed infection
IgAIgA antibodies are also involved in the antiviral response when it is present in mucosal surfaces. Mucosal surfaces are found throughout the body in:
- the gut
- the lungs
- the nasopharyngeal tract
- the genital tract
IgA antibodies look like this (this is a dimeric form of IgA, which is its most common form in the blood, but it can also exist as a monomer):
Specific to COVID-19Because a primary target of the COVID-19 virus is the alveoli of the lungs, which are a major mucosal surface, it would stand to reason that IgA antibodies may have some relevance or diagnostic utility.
Vibrant America has included this antibody on its ImmuneCheck COVID-19 panel as an investigative assay to determine if this antibody should be included in standard antibody assessments of immune response to this virus.
So far, data about IgA antibodies to COVID-19 is limited or non-existent, but Vibrant’s validation study found that this antibody is:
- overall 65.7% sensitive to detecting exposure to the COVID-19 virus across four different antigens tested: SARS-CoV-2 Nucleoprotein (NP), SARS-CoV-2 Spike Glycoprotein (S1), SARS-CoV-2 Spike Glycoprotein (S2), SARS-CoV-2 Receptor Binding Domain
- 97.1% sensitivity (how frequently Vibrant’s test detects the COVID-19 virus when it is known to be present)
- 98.3% specificity (how frequently Vibrant’s tests correctly identifies the COVID-19 virus as opposed to detecting another similar virus that is not COVID-19 and reporting a false positive)
ReferencesGary R. Klimpel. Medical Microbiology. 4th edition.Baron S, editor.Galveston (TX): University of Texas Medical Branch at Galveston; 1996
Kelvin Kai-Wang To, MD, Owen Tak-Yin Tsang, FRCP, Wai-Shing Leung, FRCP, Anthony Raymond Tam, MRCP, Tak-Chiu Wu, FRCP, David Christopher Lung, FRCPath, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. The Lancet, Infectious Diseases, Published:March 23, 2020, DOI:https://doi.org/10.1016/S1473-3099(20)30196-1
Pan Y, Li X, Yang G, Fan J, Tang Y, Zhao J, Long X, Guo S, Zhao Z, Liu Y, Hu H, Xue H, Li Y. Serological immunochromatographic approach in diagnosis with SARS-CoV-2 infected COVID-19 patients. J Infect. 2020 Apr 10. pii: S0163-4453(20)30175-4. doi: 10.1016/j.jinf.2020.03.051. [Epub ahead of print]
Yang Yang, Minghui Yang, Chenguang Shen, Fuxiang Wang, Jing Yuan, Jinxiu Li, Mingxia Zhang, Zhaoqin Wang, Li Xing, Jinli Wei, Ling Peng, Gary Wong, Haixia Zheng, Mingfeng Liao, Kai Feng, Jianming Li, Qianting Yang, Juanjuan Zhao, Zheng Zhang, Lei Liu, Yingxia Liu. Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections. medRxiv, BMJ Yale.https://doi.org/10.1101/2020.02.11.20021493
FDA Required Regulatory Statement:
This test has not been reviewed by the FDA. Negative results do not rule out SARS-CoV-2 infection, particularly in those who have been in contact with the virus. Follow-up testing with a molecular diagnostic should be considered to rule out infection in these individuals.Results from antibody testing should not be used as the sole basis to diagnose or exclude SARS-CoV-2 infection or to inform infection status. Positive results may be due to past or present infection with non-SARS-CoV-2 coronavirus strains, such as coronavirus HKU1, NL63, OC43, or 229E.
-—————————————————————-
imagine most people have heard of the taking probiotics for intestinal health. This is a good practice to balance the microbiome, the various beneficial bacteria, virus and yeast in the intestinal tract. However, it is high time to give it a lot more consideration and respect. Rebalancing your gastrointestinal microbiome may be the most important thing we ever do for our health. These organisms outnumber our cells by 10:1. Their DNA exceed our DNA by nearly 100:1. They perform over 6000 biochemical processes that we are physically unable to do and would die if absent, like make vitamins K and B12, turn up or down our immune system, control how much fat we store, and communicate with our brain. Some medical circles are now calling this community of organisms inside us as the Forgotten Organ. It may have more control over our health, physical and mental, than any other organ in our body. No wonder we feel a variety of symptoms if the balance and quantity is not optimal.
According to numerous well-designed, peer-reviewed studies on rodents and humans, an unhealthy microbiome appears to be a major contributor to obesity, diabetes, heart disease, atherosclerosis, hypertension, asthma, rheumatoid arthritis, colon cancer, ulcers, inflammatory bowel disease, lymphoma, PCOS and hormone imbalances, liver cancer, alzheimers/dementia, psoriasis, and more. It very well may be that they have command over us, not the other way around. A good article in The New Yorker called The E.Coli Made Me Do Ithighlighted the effect these microbes have on our mental health.
Unfortunately, many of the lifestyle habits in industrialized countries are destroying the balance of species in our gut. Cesarean birth, taking antibiotics, eating foods with glyphosate/Round-Up, using antibacterial soaps and cleaning supplies, eating processed foods and genetically modified foods, chronic stress, poor sleep, drinking excessive alcohol, taking NSAIDS, and NOT eating enough good foods devastate this critical part of our bodies.
The more we feed them, the more they thrive. There are thousands of different strains of microbes living within us. Some are more beneficial to us and some are quite detrimental if given the chance to propagate into large numbers. Studies have found that the most beneficial strains eat very different things than the harmful ones. Bacteroidites, a group that does lots of valuable things for us, like lose weight, lower inflammation, and prevent cancer, like to eat fibers and polyphenols from fruits and vegetables and tubers. Another major group, Firmicutes, thrive more on sugars, grains, and things we find in processed foods. When the Firmicutes outnumber the Bacteroidites they cause sugar/carb cravings, weight gain, inflammation and moods swings. One study transplanted the gut bacteria from obese mice (high in firmicutes) to normal mice and it caused the normal mice to gain weight. We knew our epidemic of obesity and chronic disease is from the standard American diet and now we are starting to understand the intricacies of why.
Switching out Firmicutes to Bacteroidetes, starving the ‘bad’ can cause some symptoms if done rapidly and drastically. Remember, these guys outnumber us by 10:1! When we begin starving out a certain group, they will protest. If you have been feeding them sugars, starches and processed foods for years, the types that eat those foods have become the largest colony and will object and remonstrate their demise. It is also important to know that other areas in your body are basically addicted to sugars and starch and stopping may cause withdrawal. (Many grains and sugars actually do activate the opiate receptors, but that is a whole different article.) Symptoms may include sugar and junk food cravings, mood swings, headaches, strange aches and pains, etc. Don’t let this stop you! The health benefits are imperative! In time your taste buds and desires will change. Your cravings will go away. You will start to savor healthy vegetable dishes. You will lose unhealthy fat and build lean muscle. You will sleep better. You will be happier and appreciate life.
The bacteria have a very short lifespan. They are constantly reproducing voraciously but a single one truly only lives for about 20-30 minutes. This is why it is so important to keep replenishing good species and giving the right guys enough food to keep reproducing. We know that different cultures across the globe have very different combinations of microbes. The science on this is very new and we are learning more daily. The best strategy is to consume a wide variety of organisms in their most natural state possible like our ancestors did.
How to build a healthy microbiome:
o Eat some fermented foods daily. Just a couple bites or a few sips- ideally a couple different kinds -a few times per day. Get creative and make your own! It is easy and inexpensive! Fermented foods available in stores: Sauerkraut -true fermented, kim chi, kombucha, kefir- coconut or dairy, tempeh, fermented coconut water, fermented pickles – Bubbies brand, apple cider vinegar -with the ‘mother’ -Braggs brand, and RAW, organic, KOSHER cheeses – 5 Spokes brand. (If fermented foods seem to make you worse, it could be an histamine intolerance. This requires other measures be taken.)
o Eat large amounts of colorful vegetables and fruits.
o Eat jicama, chicory, sunchokes, and other foods with Inulin fiber in them to feed the beneficial bacteria. Other foods for the beneficial flora are asparagus, carrots, garlic, leeks, okra, onion, radishes, and tomatoes, turmeric and cinnamon. (If eating these makes you feel worse, ei: bloated, painful, increasing constipation or diarrhea- call me asap to get tested for SIBO)
o Avoid processed foods and eat very little or zero grains (limit breads, pasta, cookies, cakes, tortillas, crackers, rice, etc).
o Avoid alcohol. More than two drinks can cause intestinal cells to ‘open’ more than they are supposed to and this allows some parts of the detrimental bacteria to get through into the bloodstream. Having polyphenols from color-rich foods can help halt this. Alcohol in general tends to breakdown the lining of the gut so its best to avoid it or at least no consume on a regular basis.
o Avoid food additives like artificial flavors and colors, artificial sweeteners, carrageenen, trans fats, preservatives, MSG, and high fructose corn syrup.
o Avoid NSAIDS like ibuprofen, aspirin, and naproxen. Also avoid chemicals in your environment. Perfumes, dryer sheets, phthalates, PBA, ... Visit www.EWG.org or www.skindeep.org to analyze your personal care and cleaning products.
o Take a probiotic with many strains/variety of bacteria. Look for ones that are at least 50% bifido species and ideally that have some bifidobacterium lactis HN019.
o Eat bitter foods more often – endive, dandelion greens, arugala, dill, sesame, etc.. Or take a supplement that has bitters in it – berberine, gentian, goldenseal, oregon grape, turmeric, etc.
o Go Organic and GMO-free!!!!! New research is now telling us that GMO foods can alter our DNA as well as our microbiome’s DNA.
o Get plenty of good sleep! Getting less than 7 or 8 hours of sleep a night deprives us of the parasympathetic/relaxation sleep cycle to fully repair high-energy gut tissue.
o Practice stress management techniques like meditation, yoga, or HeartMath. Stress can unbalance the microbiome by altering hormones and chemicals.
o Eat slowly, chew well, be calm and happy while eating. The entire digestion process starts in your mind and your mouth. RELAX, have gratitude for the wonderful things in your life. FOCUS ON THE GOOD THING
According to numerous well-designed, peer-reviewed studies on rodents and humans, an unhealthy microbiome appears to be a major contributor to obesity, diabetes, heart disease, atherosclerosis, hypertension, asthma, rheumatoid arthritis, colon cancer, ulcers, inflammatory bowel disease, lymphoma, PCOS and hormone imbalances, liver cancer, alzheimers/dementia, psoriasis, and more. It very well may be that they have command over us, not the other way around. A good article in The New Yorker called The E.Coli Made Me Do Ithighlighted the effect these microbes have on our mental health.
Unfortunately, many of the lifestyle habits in industrialized countries are destroying the balance of species in our gut. Cesarean birth, taking antibiotics, eating foods with glyphosate/Round-Up, using antibacterial soaps and cleaning supplies, eating processed foods and genetically modified foods, chronic stress, poor sleep, drinking excessive alcohol, taking NSAIDS, and NOT eating enough good foods devastate this critical part of our bodies.
The more we feed them, the more they thrive. There are thousands of different strains of microbes living within us. Some are more beneficial to us and some are quite detrimental if given the chance to propagate into large numbers. Studies have found that the most beneficial strains eat very different things than the harmful ones. Bacteroidites, a group that does lots of valuable things for us, like lose weight, lower inflammation, and prevent cancer, like to eat fibers and polyphenols from fruits and vegetables and tubers. Another major group, Firmicutes, thrive more on sugars, grains, and things we find in processed foods. When the Firmicutes outnumber the Bacteroidites they cause sugar/carb cravings, weight gain, inflammation and moods swings. One study transplanted the gut bacteria from obese mice (high in firmicutes) to normal mice and it caused the normal mice to gain weight. We knew our epidemic of obesity and chronic disease is from the standard American diet and now we are starting to understand the intricacies of why.
Switching out Firmicutes to Bacteroidetes, starving the ‘bad’ can cause some symptoms if done rapidly and drastically. Remember, these guys outnumber us by 10:1! When we begin starving out a certain group, they will protest. If you have been feeding them sugars, starches and processed foods for years, the types that eat those foods have become the largest colony and will object and remonstrate their demise. It is also important to know that other areas in your body are basically addicted to sugars and starch and stopping may cause withdrawal. (Many grains and sugars actually do activate the opiate receptors, but that is a whole different article.) Symptoms may include sugar and junk food cravings, mood swings, headaches, strange aches and pains, etc. Don’t let this stop you! The health benefits are imperative! In time your taste buds and desires will change. Your cravings will go away. You will start to savor healthy vegetable dishes. You will lose unhealthy fat and build lean muscle. You will sleep better. You will be happier and appreciate life.
The bacteria have a very short lifespan. They are constantly reproducing voraciously but a single one truly only lives for about 20-30 minutes. This is why it is so important to keep replenishing good species and giving the right guys enough food to keep reproducing. We know that different cultures across the globe have very different combinations of microbes. The science on this is very new and we are learning more daily. The best strategy is to consume a wide variety of organisms in their most natural state possible like our ancestors did.
How to build a healthy microbiome:
o Eat some fermented foods daily. Just a couple bites or a few sips- ideally a couple different kinds -a few times per day. Get creative and make your own! It is easy and inexpensive! Fermented foods available in stores: Sauerkraut -true fermented, kim chi, kombucha, kefir- coconut or dairy, tempeh, fermented coconut water, fermented pickles – Bubbies brand, apple cider vinegar -with the ‘mother’ -Braggs brand, and RAW, organic, KOSHER cheeses – 5 Spokes brand. (If fermented foods seem to make you worse, it could be an histamine intolerance. This requires other measures be taken.)
o Eat large amounts of colorful vegetables and fruits.
o Eat jicama, chicory, sunchokes, and other foods with Inulin fiber in them to feed the beneficial bacteria. Other foods for the beneficial flora are asparagus, carrots, garlic, leeks, okra, onion, radishes, and tomatoes, turmeric and cinnamon. (If eating these makes you feel worse, ei: bloated, painful, increasing constipation or diarrhea- call me asap to get tested for SIBO)
o Avoid processed foods and eat very little or zero grains (limit breads, pasta, cookies, cakes, tortillas, crackers, rice, etc).
o Avoid alcohol. More than two drinks can cause intestinal cells to ‘open’ more than they are supposed to and this allows some parts of the detrimental bacteria to get through into the bloodstream. Having polyphenols from color-rich foods can help halt this. Alcohol in general tends to breakdown the lining of the gut so its best to avoid it or at least no consume on a regular basis.
o Avoid food additives like artificial flavors and colors, artificial sweeteners, carrageenen, trans fats, preservatives, MSG, and high fructose corn syrup.
o Avoid NSAIDS like ibuprofen, aspirin, and naproxen. Also avoid chemicals in your environment. Perfumes, dryer sheets, phthalates, PBA, ... Visit www.EWG.org or www.skindeep.org to analyze your personal care and cleaning products.
o Take a probiotic with many strains/variety of bacteria. Look for ones that are at least 50% bifido species and ideally that have some bifidobacterium lactis HN019.
o Eat bitter foods more often – endive, dandelion greens, arugala, dill, sesame, etc.. Or take a supplement that has bitters in it – berberine, gentian, goldenseal, oregon grape, turmeric, etc.
o Go Organic and GMO-free!!!!! New research is now telling us that GMO foods can alter our DNA as well as our microbiome’s DNA.
o Get plenty of good sleep! Getting less than 7 or 8 hours of sleep a night deprives us of the parasympathetic/relaxation sleep cycle to fully repair high-energy gut tissue.
o Practice stress management techniques like meditation, yoga, or HeartMath. Stress can unbalance the microbiome by altering hormones and chemicals.
o Eat slowly, chew well, be calm and happy while eating. The entire digestion process starts in your mind and your mouth. RELAX, have gratitude for the wonderful things in your life. FOCUS ON THE GOOD THING
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