Heal The Core of Your Being with The 4 R Program

Today, as more and more research is being conducted on the gut microbiome, scientists are discovering an unbelievable connection between a healthy gut and the overall health of your body and mind.  That being said, 60 – 80% of your immune system resides in your gut and about 90% of your neurotransmitters such as serotonin which regulate your mood and temperament, are produced in the gut.  The ability to lose weight is also dependant on a healthy microbiome, and maintaining a good weight can have a positive effect on your overall wellbeing.   Therefore, a digestive system that functions correctly is crucial to good health.  Problems in your gastrointestinal (GI) tract can be the cause of many chronic illnesses such as rheumatoid arthritis, hashimoto’s thyroiditis, diabetes, chronic fatigue, depression and fibromyalgia, to name a few, as well as bloating, diarrhea, stomach pain and gas.  

Restoring and maintaining gut health is not as straightforward as you would think, as there are many different factors that can cause an imbalance.  Fortunately, the 4R Program which was formulated by Jeffrey Bland Ph.D. and his associates at the Functional Medicine Institute, restores balance and harmony in the gut and helps alleviate symptoms of certain diseases that emanate from an unhealthy GI tract.  The 4 R’s stand for remove, replace, re-inoculate and repair and although it can take a number of months or even years to heal the gut (depending on a person’s commitment), it is an extremely effective way of bringing relief to a number of illnesses when working together with your functional medical practitioner.

Step 1 – Remove

What needs to be removed? It is important to identify the various elements that contribute to an unhealthy microbial balance and compromises your intestinal health, including:

Stress:  – Everyday stress can wreak havoc on your system.  Finding ways to destress and relax your body can help calm the gut.  Sitting down when eating meals, eating slowly and at set times, aids digestion and can reduce the body’s stress level.

Allergens – An unhealthy gut is usually aggravated by allergenic and inflammatory foods.   Foods that you are allergic to should be eliminated from your diet entirely.  By removing foods that you are sensitive to for a period of time (usually a couple of months) and reintroducing them back individually every couple of days and monitoring the symptoms, it gives the gut time to heal and helps you become aware of which foods are not good for you.   The most common allergenic foods are wheat, dairy, eggs, corn, sesame, soy, nuts, refined sugar, alcohol, citrus and processed foods.  Developing an elimination diet specifically suited to your needs together your practitioner, is the first step in determining if you are allergic or sensitive to certain foods and to begin the healing process.  

Pathogens –  Parasites, candida, bacterial overgrowth, viruses and other fungi are all contributors to an unhealthy gut.  An overgrowth of candida promotes sugar and starch cravings and results in symptoms such as bloating, constipation, abdominal discomfort, excess hunger and weight gain to name a few.  Various tests, medication and natural remedies are available to help treat and remove these pathogens once diagnosed.   To remove unhealthy bacteria from your intestines, berberine, caprylic acid, garlic, grapefruit seed extract, oregano oil and wormwood are some of the supplements that are recommended.

Although removing the source of the imbalance and symptoms of an unhealthy gut is the first step in healing, the anti-aging functional medical approach continues as follows:

Step 2 – Replace

Once all allergens and pathogens have been removed, the next step involves replacing digestive secretions by adding back digestive enzymes, hydrochloric acid and lipotropic factors.  

Hydrochloric acid, which is produced in the stomach but diminishes with age, is crucial in activating your stomach’s digestive enzymes to help break down food effectively.   Low stomach acid is often the cause of heartburn, as the food is not pushed through your system at sufficient speed and the contents of your stomach reflux back up into the esophagus along with some acid, which tends to burn.  (However, an excess of acid can also cause heartburn and acid reflux.)  Supplement with 1,000 mg of hydrochloric acid with each meal or 1 tsp apple cider vinegar diluted with 5 – 6 tsp water.  Gradually increase the amount to 3 – 4 tsp of vinegar with the correct ratio of water with each meal.

Lipotropic factors are compounds which mobilize the breakdown of fats during metabolism in the body.  They are produced naturally and have the ability to reduce and prevent fatty deposit build-up.  Lipotropic factors assist with optimal liver function, helps get rid of toxins and breaks down transported fat into energy.  Lipotropic supplements stimulate the liver to produce more lecithin which helps liquefy cholesterol and dispose of it.

Digestive enzymes, which are found along the gastrointestinal tract, are vital in that they break down food into nutrients and waste, they enhance digestive health and reduce autoimmunity.  The recommended dose for additional supplements is 2-3 digestive enzymes just prior to or at the beginning of the meal. An example of a formula to use is 100,000 USP units of protease, 20,000 USP units of lipase and 100,000 USP units of amylase. Caution should be taken if you have suffered from ulcers or any kind of inflammatory bowel condition or if you take a medicine that contains papain.  

Age, disease, diet and medication all compromise proper digestion and by introducing these important compounds back into the gut, food can be more easily digested before it reaches the lower intestinal tract.    

Step 3 – Re-inoculate

The re-inoculation process involves establishing a healthy balance of microflora in the gut by means of diet and supplements.  

Fermented foods such as sauerkraut, kombucha, pickles, miso, yogurt and kefir are an excellent source of probiotics which help support the intestinal health.  They not only contain a variety of important nutrients, but they are also capable of drawing out a range of toxins and heavy metals.  

Prebiotics and probiotics are introduced at this stage to help increase the growth of microflora in the gut. Prebiotics is non-digestible fiber that nourish good bacteria in the intestinal tract and thereby promotes the growth thereof.  It is found in foods such as flaxseed, Jerusalem artichokes, asparagus,carrots, leeks and onions, to name a few.  Probiotics on the other hand are live bacteria such as lactobacillus and acidophilus which assist the digestive process and are found in pill form and foods such as yogurt and fermented foods.

Antibiotics destroy not only the bad bacteria in the gut,  but also the good bacteria.  It is important to replenish this microflora with a probiotic such as Saccharomyces a couple of hours after ingesting the antibiotic, to help restore the ratio of good to bad bacteria.

Step 4 – Repair

The fourth and final phase of this program is to repair the mucous lining in the intestinal wall by supplementing with herbs and compounds.  The most beneficial nutrients are as follows:

• An amino acid called L-glutamine has been shown to prevent and reverse intestinal mucosal damage. It stimulates intestinal mucosal growth, protects against mucosal atrophy and  helps regenerate the whole digestive system. It also has an impact on the immune system as it increases Interleukin-6 levels and lymphocyte function.  
• Butyric acid is another natural supplement that has been shown to repair and rejuvenate damaged intestinal cells, promote immune function and help heal inflammation.  It is a short chain fatty acid normally produced in the lower intestines when fiber is fermented by the bacteria within.  
• Quercetin is a bioflavonoid that is found in onion and blue-green algae.  The supplement is used as an antioxidant and for anti-inflammatory purposes by decreasing mast cells and basophil production.
• Curcumin is a powerful anti-inflammatory found in the turmeric spice.  It is very useful in treating gastrointestinal disorders.
• Omega 3 in the form of fish oil is an effective supplement to help reduce inflammation.  Animal studies have shown that omega 3 not only reduces gut inflammation, but also repairs mucosal tissues in the digestive system.
• Antioxidants decrease oxidative stress which is one of the main causes of intestinal damage.  Vitamins A, C, E, NAC, zinc, carnosine, selenium and carotenes are all included in this category.
• Demulcents are a group of soothing herbs that contain distinctive mucilage which provides a cooling and hydrating coating to reduce inflammation and soothe the intestines.  They also reduce the sensitivity of the digestive system to gastric acids, relax spasms, decrease leaky gut and ulcerations.  Examples of demulcents are marshmallow root – recommended dosage 100 mg a day, slippery elm bark – recommended dosage 200 mg a day, okra and fenugreek.
• Additional supplements that are also beneficial in this phase are boswellia, geranium, licorice root,  hydrastis, chelidonium, artemisia and aloe.  

For more information on repairing the microbiome in the gut, including supplement dosages, as well as formulating a diet specifically for you, please contact our clinic.