The Dragontree

The human microbiome is the total collection of organisms that live on and in your body, and there’s a growing recognition among scientists that they have quite a lot to do with our health. Different organisms live in the armpit versus the toe creases. In fact, every part of the body – the ears, the mouth, the elbow crease, the navel, the forehead, the groin, the chest, etc. – has its own bacterial culture, each with different species that tend to live there. The emerging field that studies these microbes and how they affect us – microbial ecology – is poised to dramatically change medicine.

One of the most vital functions of these organisms is to help maintain the health and integrity of our epithelium. Epithelium, or epithelial tissue, forms the surfaces of structures throughout the body, as well as the linings of cavities. The skin, the respiratory tract, the digestive tract, the mouth, nostrils, genitalia, and other mucous membranes are all composed of different kinds of epithelium. And through the intelligence of the microbiome – and what’s now being called the gut-brain-skin axis – they are all connected.

Emerging research links health issues as diverse as depression, anxiety, acne, rheumatoid arthritis, allergies, fibromyalgia, and autism (to mention just a few) to a disruption of our microbiota (the microorganisms that constitute our microbiome). We’re beginning to understand that this is especially true of epithelial problems – respiratory problems, digestive problems, skin problems, etc. And most often, the disruption begins with the intestines.

This isn’t exactly new science. Two dermatologists, John Stokes and Donald Pillsbury, started proposing the gut-brain-skin connection in the early 1900s. But the medical institution can be a slow moving machine. Traditional medical systems, such as those of China and India, even without understanding the microbiome concept, have long viewed the digestive system as central to the health of the skin and the whole body/mind.

There are now numerous studies supporting the role of intestinal health in skin health. In particular, inflammatory skin conditions such as acne, rosacea, psoriasis, and eczema tend to occur in people with gut inflammation and imbalance of intestinal flora (microorganisms). And they almost always respond positively to administration of probiotics (beneficial microorganisms used to bolster those in the gut) and other nutritional measures for intestinal repair. When the gut is inflamed, unhealthy bacterial excretions can leak into the blood stream, causing inflammation elsewhere. Probiotics can reestablish a strong population of healthy bacteria that keep the unhealthy strains in check, and they also serve to stimulate repair of the intestinal lining.

Historically, people didn’t have capsules of bacteria to take for this purpose; they just ate cultured foods. Cultured foods should be a part of everyone’s diet. Some cultured foods include yogurt, crème fraiche, and kefir (“keh-FEER” – a sort of drinkable yogurt), pickled vegetables (cucumber, carrots, ginger, mushrooms, peppers, beets, cauliflower, tomatoes, eggplant, sauerkraut, kimchee, etc.), fizzy drinks such as jun and kombucha, miso, and tempeh.

If you buy these foods premade, be sure that they aren’t in jars that have a lid that “pops” when you open it. This means they’ve been heat-sealed, which likely killed the beneficial flora in there. By the same token, you shouldn’t cook these foods, since that, too, would kill them. Also, look for vinegar on the labels of pickled foods – it shouldn’t be there. Things pickled in vinegar generally don’t contain probiotics. Traditional fermentation is done in just water or vegetable juice (such as cabbage or celery) or the juice of the material that’s being fermented, plus some kind of starter culture or naturally occurring microbes.

Get some cultured foods, or better yet, make your own, and then incorporate a little bit with each meal. Sometimes a probiotic supplement can be of great help, especially when you are really out of balance. They’re available in liquid, power, and capsule form. When purchasing a probiotic, I recommend choosing one with a wide array of microorganisms, since not every strain “takes” well in every person’s gut. One of my favorites is Proflora Concentrate, made by Integrative Therapeutics. We carry it at our spas. Another good one is called Primal Defense.

Recently, skin care companies have started making topical probiotic preparations, which can be beneficial in inflammatory skin conditions. We carry some in the Epicuren line that are worth trying. However, they’re not a substitute for also getting your gut healed. In addition to using probiotics and/or cultured foods, if you have health concerns that you think might be gut-related, I encourage you to see a naturally-oriented healthcare practitioner who can help you identify foods or drugs that may be contributing to gut inflammation and recommend a more comprehensive gut healing plan.

Wishing you well, inside and out,

Dr. Peter Borten