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Toxic Air II

Are you frustrated getting no answers to why you have chronic bloating and gas pain, diarrhea, achy joints, brain fog, and are always tired?

What if you eat a healthy, organic plant-based diet, grass-fed beef, wild caught fish, cage-free chickens and eggs, and still don’t feel well? Even when you took supplements, tried an antidepressant, practiced yoga and meditation, your health didn’t improve.

Patients often ask me why they got sick. Sometimes, it’s obvious. A pack-a-day cigarette smoker of forty years got lung cancer. A farm worker who had direct exposure to herbicides developed peripheral neuropathy. Tainted food caused severe diarrhea from Norovirus infection. A patient with severe vitamin B12 deficiency became extremely tired due to anemia. But much of the time, chronic illness is not so obvious, or even confusing to doctors.

Conventional doctors label illnesses without an apparent cause as non-specific, or of unknown origin. But what if your disease has a reason? A functional medicine doctor might call it stress-induced adrenal fatigue. But what if it’s not as simple as that? What if you don’t have adrenal exhaustion from chronic stress? What if your illness is brought on by 24-hour exposure to pollutants that over a lifetime wreck your internal environment by destabilizing your microbiome?

Air Pollution Triggers Inflammation

When microscopic particles in air pollutants get in the body, they track deep causing imbalances in the gut and respiratory microbiomes. Smog is known to cause asthma and chronic obstructive airway disease (COPD). But it is also linked to Crohn’s disease, appendicitis, and leaky gut syndrome.

Leaky gut syndrome may be more about what’s on our food than what’s in it. New research suggests that leaky gut may be the cause of many modern diseases.

Microscopic pollutants find their way into the body through the gastrointestinal tract in food and water. Once in the gut, friendly gut microbes turn them into toxic metabolites ready for excretion in the stool. But lots of these toxic metabolites stay in the colon. Over time, irritation builds up altering the function and texture of the gut lining making it more porous.

Changes in gut permeability, called leaky gut syndrome, allow toxic microbial products and particulate matter into the body where they interact with immune cells and drive systemic inflammation.

Trouble doesn’t stop there. A cascade of events follow.

Downstream Trouble in the Gut Leads to Other Diseases

The altered microbial community leads to immune imbalances and changes in metabolic processes. Short-chain fatty acid (SCFAs) production goes down, and non-beneficial metabolites increase. Butyrate production by gut microbes goes down. SCFAs and butyrate are products of gut fermentation by friendly bacteria. Abnormally low levels of SCFAs and butyrate increase the chance of intestinal permeability that leads to chronic inflammation.

Pollution alters the type and number of friendly bacteria in our gut. Researchers found that Actinobacteria levels were lower in volunteers exposed to high amounts of pollution. Actinobacteria are a common group of bugs that line a healthy lung microbiome, as well as populate the gut.

The part that these bacteria play in the body still confuses scientists. But researchers know that these bugs produce compounds that fight infection. Lower levels of Actinobacteria cause increased susceptibility to infections, as well to trigger asthma and allergies.

Another group of bacteria that can cause harmful respiratory infections, Moraxella catarrhalis, was found in higher concentrations in the lungs of people exposed to higher pollution levels. Other bacteria are likely involved. We’re just at the beginning of our understanding of how environment, including the air we breathe, causes microbial imbalances.

We know that the human gut microbiome is essential for life and health. Research confirms that lifelong exposure to air pollutions plays a significant role in how our immune system responds to the environment.

Imbalances in how the microbiome functions, like a reduced production of SCFAs, trigger chronic inflammation that sets the stage for nearly all modern diseases including chronic fatigue syndrome, autoimmune disorders, chronic infections, neurological conditions, and inflammatory bowel disease. And, leaky gut may be the common denominator of them all.

Test Your Gut Health

Microbiome genetics is a relatively new field. Most doctors were not taught clinical genetics in medical school, so find the information daunting. The temptation is to fit their patient’s symptoms into convenient generalities, like “I don’t know precisely what’s wrong with you, but it could be an imbalance in your microbiome.”

There are gut microbiome and probiotic tests, but they’re difficult to interpret in a way that makes sense to doctor and patient.

However, in my clinical experience, patients with chronic disorders have common abnormalities in their tests.

Patients with chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), autoimmune disorders like rheumatoid arthritis (RA), and leaky gut syndrome tend to have low levels of SCFAs and butyrate. These patients also have abnormal levels of Actinobacteria. Another common marker is an imbalance in the Firmicutes to Bacteroidetes ratio (F/B ratio).

In the human gut, 90% of the bacteria are in two main groups: Firmicutes (60–80%) and Bacteroidetes (15–30%). Firmicutes is a family of probiotic bacteria with more than 250 types, including Lactobacillus and Clostridium. In comparison, Bacteroidetes includes only about 20 species. Both bacterial groups produce beneficial SCFA from indigestible carbohydrates in the diet. Firmicutes mainly make butyrate and Bacteroidetes mainly produce acetate and propionate. The F/B ratio in a stool test is a gauge of overall gut microbiota balance.

Zonulin is a new marker for evaluating gut health. It is a multifunction protein that modulates intestinal barrier function. Zonulin is called the “doorway” to leaky gut. Excess Zonulin is associated with leaky gut syndrome. The two known triggers of Zonulin release are gluten and bacteria. Air pollution may also trigger Zonulin release.

Stool Testing Footprints Linked to Leaky Gut:

  • Low SCFAs
  • Low Butyrate
  • Low Actinobacteria
  • Imbalanced F/B ratio
  • Abnormal Zonulin levels

Another theory of how air pollution causes disease is that endotoxins enter the body triggering inflammation. Endotoxins are part of the outer membranes of bacteria. They are widespread in the environment. Some cause infections. Others are linked to chronic disease. The biological activity of endotoxins interacts with our immune system to trigger inflammation, and the proliferation of endotoxins is connected to air pollution.

Our gut is not the only place in our body with a community of microbes. Bacteria live in all parts of our body. The colon has the most significant number of bacteria, but the upper and lower respiratory tract has plenty. The lungs have its own set of microbes. Actinobacteria is one of nine major bacterial groups found in the lungs.

It turns out that air pollution is also linked to breast health and is a hidden cause of breast cancer. In Part III, I explore the link between air pollution and breast cancer.

Dr. J. E. Williams


Dr. Williams is a pioneer in integrative and functional medicine, the author of six books, and a practicing clinician with over 100,000 patient visits. His areas of interest include longevity and viral immunity. Formerly from San Diego, he now resides in Sarasota, Florida and practices at the Florida Integrative Medical Center. He teaches at NOVA Southeastern University and Emperor’s College of Oriental Medicine.

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