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Gut bacteria, pain and anxiety connections: Klebsiella and ankylosing spondylitis

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We know about the gut-brain connection where the health of our microbiome impacts how anxious or depressed we feel, but we often forget that there is a gut-pain connection too and how addressing dysbiosis and bad bacteria in the gut can have far-reaching benefits.

An old work friend recently reached out asking for help for her husband who had been diagnosed with ankylosing spondylitis, ulcerative colitis and gluten sensitivity, and was not seeing results with conventional treatment. I did some digging for them and a colleague mentioned that they had addressed Klebsiella when they discovered that her husband had genes predisposing him to ankylosing spondylitis. Read on to see what I’ve learned.

Klebsiella as a precursor to ankylosing spondylitis

The paper shared with me: The relationship between Klebsiella infection and ankylosing spondylitis, discusses the HLA-B27 gene and the Klebsiella connection:

Klebsiella-reactive arthritis is the precursor stage occurring in the early and active phases of ankylosing spondylitis.

Let’s learn more about Klebsiella, ankylosing spondylitis, the anxiety connection and prevalence, the role of neuro-inflammation and genes, the problems of a high carb diet and the role the amino acids GABA, tryptophan and DPA play in pain and anxiety relief and being able to quit the carbs easily, plus provide sleep support.

In case you’re not familiar with Klebsiella, this excellent FX Medicine article describes it as follows:

Klebsiella pneumoniae (KP) is a type of gram-negative rod-shaped bacteria that can cause different types of infections ranging from pneumonia (lung), blood infections (septicaemia), wound or surgical infections, urinary tract infections, small intestinal bowel overgrowth (SIBO), ankylosing spondylitis, Crohn’s disease, ulcerative colitis and meningitis (brain).

Ankylosing spondylitis is an inflammatory disease of the spine

In case you’re not familiar with the condition ankylosing spondylitis (pronounced like this) the Mayo Clinic site provides this summary:

Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the vertebrae in your spine to fuse. This fusing makes the spine less flexible and can result in a hunched-forward posture. If ribs are affected, it can be difficult to breathe deeply.

Ankylosing spondylitis affects men more often than women. Signs and symptoms typically begin in early adulthood. Inflammation also can occur in other parts of your body – most commonly, your eyes.

They say there is no cure and the treatments include pain medications and physical therapy to ease symptoms (and surgery in some cases).

I’m all for physical therapy but you’ll notice there is no mention of gut health or Klebsiella. This is why we have to keep searching for root causes – and work with a functional medicine practitioner – no matter what the health condition, be it ankylosing spondylitis or anything else.

Prevalence of anxiety in ankylosing spondylitis

As with most physical conditions there is a connection with anxiety. This paper: Prevalence of psychological disorders, sleep disturbance and stressful life events and their relationships with disease parameters in Chinese patients with ankylosing spondylitis reports that

AS [ankylosing spondylitis] patients had more severe psychological disorders, sleep disturbance, and stressful life events.

Prevalence of anxiety, depression, and sleep disturbance was 31.6%, 59.3%, and 31.0% respectively.

We have to ask ourselves if we have anxiety, depression and insomnia because of the pain being experienced or because of one or more of the root causes that contribute to both pain and anxiety.

Microbiota disturbance, neuro-inflammation, and anxiety

Often the research focuses on the former but we know that there is Evidence for interplay among antibacterial-induced gut microbiota disturbance, neuro-inflammation, and anxiety in mice. In this 2018 animal study treatment with lactobacilli suppresses this neuro-inflammation.

Ankylosing spondylitis, Crohn’s disease, genes and a high carb diet

The above FX Medicine article shares the connection between ankylosing spondylitis, Crohn’s disease and ulcerative colitis, as well as the genetic susceptibility, together with the problems of a high carb diet:

Genetically susceptible people, such as those who have the HLA-B27 allelotypes and consume a high starch/carbohydrate diet, can trigger a growth in Klebsiella in the bowel, the starch becoming a main food supply for the Klebsiella.

The amino acids for pain, carb addition, anxiety and insomnia

The amino acids come into the picture again, helping to ease the pain, provide precursors for neurotransmitter production until the microbiome is balanced, and eliminate carbohydrate cravings so they can be given up without willpower.

As always figuring out your own imbalance and doing an amino acid trial is key. Here is a summary of how they may help in this instance, assuming you have low levels of GABA, serotonin and/or endorphins:

  • GABA helps with stress eating of carbs, eases physical anxiety, eases some pain.
  • Tryptophan helps with afternoon and evening carb cravings, eases mental worry-type anxiety and depression, and also eases some pain. Both GABA and tryptophan help with insomnia.
  • DPA boosts endorphins providing acupuncture-like pain relief and provides the emotional comfort that starchy treats often do.

The FX Medicine article has treatment and prevention tips for you to share with your functional medicine doctor, who will be able to run a functional stool test such as the GI-MAP offered by Diagnostic Solutions Lab.

Just because there are these gut bacteria, pain, anxiety, Klebsiella and ankylosing spondylitis connections, it doesn’t necessarily mean everyone with ankylosing spondylitis has Klebsiella or that everyone who has Klebsiella will go on to develop ankylosing spondylitis (as stated above) or even that everyone with ankylosing spondylitis will have anxiety. I’m simply connecting some dots so you can start to think outside the box.

I’d love to hear what has worked for you or a loved one with ankylosing spondylitis and/or if you’ve seen elevated Klebsiella on your stool test or have the genetic predisposition?

Have the amino acids and a low-carb diet helped the healing process and eased some of your anxiety while addressing the underlying Klebsiella infection?

The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes

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The individual amino acids glutamine, GABA, tryptophan (or 5-HTP), DPA and tyrosine are powerful for eliminating sugar cravings, often within 5 minutes. It seems that this wonderful benefit – over and above the anxiety-reducing and mood-boosting benefits – is often overlooked or poorly understood.

I recently posted this on Facebook: GABA for ending sugar cravings (and anxiety and insomnia) and I’m writing this blog today because it’s clear there is some confusion about this cravings aspect.

Let me first recap Melissa’s experience with Source Naturals GABA Calm during her family holiday trip (the link above has all the details):

I’m glad I bought it before travelling home for Christmas – I was cool as a cucumber at the airport and was much calmer when visiting family and friends compared to last year! I notice a general calmness and am sleeping well.

As well as the calming benefits of GABA, Melissa found this unexpected reduction in cravings for sweets, chocolates, truffles and ice cream after about a week of taking it:

I didn’t even realize this until I was grocery shopping and out of habit walked towards the ice cream – I stopped and realized I didn’t want ice cream. So I walked toward the chocolate – same reaction. For once in my life, I was not craving sweets. I made truffles for a NYE party and only ate two. But what is really shocking is that the leftovers are still in my refrigerator two days later and I haven’t touched them.

This is a very typical response that I see with my clients and when I shared the above blog, others on Facebook shared similar experiences and surprise about the connections. Kim found it fascinating and very timely saying:

I ran out of GABA a month ago. Not only has my anxiety been very difficult to manage but literally I haven’t been able to stop eating. Sugary, high carb, total junk has consumed my thoughts. I never realized the correlation.

April also seemed surprised to learn that GABA was also actually helping with her sugar cravings too:

I think my sugar cravings are down (not looking for something sweet every night after dinner, maybe I treat myself to once a week and not overindulge when I do) and when I think about it, I’ve lost a bit of weight as a result. Most of all it helps me sleep and reduces tension in my neck.

In the above examples, due to low GABA levels in these women, GABA was helped with both the anxiety and the stress-eating, leading to a calming effect and reduced sugar cravings. If you have low blood sugar cravings then glutamine is the amino acid to use; low serotonin cravings then tryptophan or 5-HTP will help; low endorphin cravings then DPA will do the trick; and low catecholamines then tyrosine is the amino acid to use.

The best way to figure it which neurotransmitter deficiency is affecting your sugar cravings is to do the amino acid mood questionnaire and also review this list for further clarification:

  1. If you have to eat sugar when you haven’t eaten in awhile it’s likely low blood sugar and glutamine on the tongue stops the sugar desire almost immediately and also helps with the low blood sugar symptoms of shakiness and irritability
  2. If you stress-eat your sugar cravings are likely due to low GABA, and GABA will stop the stress-eating and calm you down
  3. If you eat sugar or carbs to feel happy (and especially from late afternoon into the evening) then your sugar cravings are likely due to low serotonin, and tryptophan (or 5-HTP) stops the cravings and boosts mood and reduces anxiety
  4. If you are a comfort-eater then it’s likely due to low endorphins and DPA will stop that feeling of “I deserve-it” kind of reward-eating or comfort-eating and also give you a hug-like mood boost
  5. If you eat sugar for an energy boost or to give your focus then it’s likely due to low catecholamines and tyrosine will stop those cravings and give you a mood and energy boost, and help with mental clarity

It’s not uncommon for my anxious clients to have issues in all these areas and I have them address low blood sugar and each neurotransmitter deficiency one by one (for 2 through 5) and very methodically so they know exactly which areas are problematic for them.

When it comes to low blood sugar, addressing adrenal health is also key. And as always, we need to be making dietary changes, fixing gut health, addressing other deficiencies, removing toxins and more, using a complete functional medicine approach.

However, using the amino acids in a targeted way like this gets you results quickly while you’re figuring out everything else.

You may say “what exactly do you mean by quickly”?   When opened onto the tongue and used with the trial method, based on your unique needs, if you have low levels, you can expect to notice effects in as quickly as 5 minutes and sometimes up to 15 minutes in some cases! This is why I like to refer to them as the amazing amino acids! They truly are amazing for eliminating cravings, reducing anxiety and improving mood and even sleep – provided they are needed.

Last year I wrote a series of blog posts on each of the above-mentioned amino acids. If you missed them you may find them helpful for getting a better understanding, even though they are not specific about sugar cravings:

Have you found any of the amino acids to help you eliminate your cravings for sweets, chocolate, ice-cream and other high-carb foods? Were you pleasantly surprised to experience this lovely benefit when you were initially looking for anxiety-relief?

If you’re a practitioner, do you see similar cravings benefits with your anxious clients/patients?

Feel free to ask your questions and share challenges you’ve had too.

DPA for weepiness, pain and comfort and reward eating

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Today I’m reviewing DPA (or d-phenylalanine) for weepiness, pain and comfort and reward eating. This amino acid is a favorite with so many of my clients because it helps with the above by boosting your endorphins and when you chew a capsule you feel like you just got a big hug. It’s a really good feeling!

I’m also sharing some additional resources for you on DPA.

DPA and endorphins

DPA is an amino acid that destroys the enzyme that breaks down endorphins. Endorphins are feel-good chemicals that you experience with an endorphin rush when you go for a run or when someone gives you a big hug, when you show kindness to someone or someone does something nice for you. Taking the amino acid, DPA, helps to raise your endorphins.

Low endorphins and weepiness

With low endorphins you’re very weepy. You may be overly emotional. If you watched a TV ad or you watched a really sad movie, you may be more prone to crying than the average person.

It’s also known as the break-up pill and is very helpful when going through a relationship split.

It’s also extremely helpful after a stressful event. I spoke with a friend who was impacted by Hurricane Harvey and recommended DPA for the weepiness she was starting to feel a few days after the clean-up efforts. It’s one of the amino acids I recommend in my blog: Nutrition solutions for psychological stress after a natural disaster

Low endorphins and pain

As well as being sensitive to emotional pain (the crying and the weepiness), you also tend to be sensitive to physical pain when endorphins are low.

We know acupuncture raises your endorphin levels and eases pain. Using DPA helps physical pain in a similar way. Pain can be caused by low GABA and low serotonin, an inflammatory diet, a high oxalate diet or nightshades, something physical like a fall, osteoarthritis or an autoimmune condition like rheumatoid arthritis. If there is also a low endorphin aspect to your pain, DPA can provide some pain reduction.

Low endorphins and comfort/reward eating

Another symptom of low endorphins is comfort/reward eating. You may relate to the term emotional eating. It often goes like this: “This is my reward. This is my treat. I absolutely deserve it.”

And when you consume those carbohydrates – that bowl of ice cream, that bowl of cereal, that chocolate chip cookie, that chocolate cup-cake – you feel like “this is my reward, this comforts me.” When you use DPA you can literally take it or leave it. Really!

DPA is one of the amino acids that help you easily quit sugar without having to use massive willpower and without feeling deprived. The best way to figure it out is to do the amino acid mood questionnaire

Last week I provided a summary for you – here it is again

  • if you have to eat sugar when you haven’t eaten in awhile it’s likely low blood sugar and glutamine on the tongue stops the sugar desire on the spot
  • if you stress-eat your sugar cravings are likely due to low GABA, and GABA will stop the stress-eating and calm you down
  • if you eat sugar or carbs to feel happy (and especially from late afternoon onwards) then your sugar cravings are likely due to low serotonin, and tryptophan stops the cravings and boosts mood and reduces anxiety
  • if you eat sugar for an energy boost then it’s likely due to low catecholamines and tyrosine will stop those cravings and give you a mood and energy boost
  • if you are a comfort-eater or big emotional eater, then it’s likely due to low endorphins and DPA will stop that “I deserve-it-reward-eating” and also give you a hug-like mood boost

And remember it’s not unusual to need to address all areas. You can have low GABA anxiety and low endorphins too and low blood sugar. If this is the case I have my clients address one at a time.

If addressing low endorphins helps reduce or eliminate the reward eating and helps you eat less or no sugar it means less impact on your adrenals and more even blood sugar levels and therefore less anxiety too.

I have one DPA product I use with clients all the time:

  • Lidtke Endorphigen 500mg:  Riboflavin 5mg, Pyridoxal 5-phosphate 5mg (enzymatic form of vitamin B6), D-Phenylalanine 500mg. This is one of my top products that I recommend. This comes in a gelatin capsule and tastes quite pleasant when chewed – some people think it has a dark chocolate-like taste. A few people don’t like the taste at all but it can still be very effective when low endorphins are an issue.

As with all the amino acids, when using DPA:

  • Start low (500mg is a typical starting dose) and increase as needed.
  • Do a trial to determine if the emotional eating is due to low endorphins. I always do this with clients before starting any amino acid. Be sure to read how to do an amino acid trial. It has the amino acid questionnaire, the precautions and information on how to use targeted individual amino acids.
  • Take between meals and away from protein for the best effects

I do find that chewing it provides the quickest results and do find it much more effective than DPLA which I no longer recommend or use.

This blog post is part of the series of amino acid product reviews:

The resources in this blog and my other articles are intended to be used in conjunction with my book: The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings. If you do not have my book I highly recommend getting it and reading it before jumping in and taking the amino acid supplements:

There is a complete chapter on the amino acids and one for pyroluria, plus information on real whole food, sugar and blood sugar, gluten, digestion and much more.

You can find the DPA product and the others I recommend on this blog: The Antianxiety Food Solution Amino Acid and Pyroluria Supplements

 

I’d love to hear if DPA has worked for you and how it’s helped?

If you have questions please post them below or on the supplements blog

Additional Anxiety Resources
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