Concussions and Leaky Gut
The effects of a concussion can be far reaching and can even get worse after time passes. One of the areas that this is seen is in the GI Tract.
There is a gut/brain axis and this axis has received more attention in recent years as we search for reasons why some people have long lasting effects after head injuries while others are fine.
A connection has been made between head injuries and an ongoing process known as “Leaky Gut.”
What is Leaky Gut?
The term leaky gut means the intestinal barrier which should be tightly condensed opens up like a zipper and food particles and bacteria can get through and enters the bloodstream which irritates the immune system.
A traumatic head injury is also a trigger that causes intestinal damage. The gut gets very dysregulated after a traumatic head injury. Studies have even shown that within 72 hours of a head injury, the gastrointestinal tract breaks down.
The pivotal article we would like to highlight today is “Bidirectional Brain-Gut Interactions and Chronic Pathological Changes after Traumatic Brain Injury in Mice.”
We do not generally cite studies that use mice because the research doesn’t always translate to the world of humans, but in the world of Traumatic Brain Injuries, this kind of study is foundational to give us a framework to explain what is happening in mammals and then we understand human brain traumas better.
For this study, the researchers induced cranial impacts to the mice and then looked at a variety of the mice’s physiological states ranging from their gut health to their brain health. They examined them immediately and then over a process of 28 days. Additionally, they also after a period of time, infected the mice with a cr bacteria and then looked for additional changes in the brain or gut.
They found that “In the brain, secondary injury mechanisms initiated by trauma can continue for months to years, and include sustained neuroinflammatory processes that contribute to progressive neurodegeneration and neurological dysfunction.”
And also that, “Cause-of-death analyses of TBI patients who have survived beyond one year after injury demonstrate that these individuals are 12 times more likely to die from septicemia and 2.5 times more likely to die of digestive system conditions than matched cohorts of the general population.”
Septicemia is a bacterial infection in the bloodstream. This can be very dangerous because it carries the infection through the entire body. This infection causes the immune system to respond with a huge inflammatory response. It is not uncommon for people to often die from this infection. It has been found that much of the time, the source of this bacteria comes from the gut.
Vitamin C is widely encouraged to be used in fighting septicemia because it helps process and fight the infection. Vitamin C can also prevent the infection. Thankfully, more awareness of Vitamin C is being brought to this fact because septicemia is one of the leading causes of death for those hospitalized.
Let's check out the highlights from the rest of this study and note the relationship between what is happening in the gut and how that affects the brain. (The figures and their numbers come from the study linked above.)
SHAM- This study’s version of a control group. This is the original state of being before the head impacts.
CCI- Closed Cortical Impact. They would hit the heads of the mice in a way to give them a brain injury. Then they checked the brains and guts of these mice again 24 hours after the head trauma and then again after 28 days.
Note that the smooth muscles have thickened and the mucosa layer deepened after a head injury. Changes are happening in the gut. This is growth and thickening we don’t want.
Figure Two: Claudin 1 protein. Claudin is a tight junctional protein (one of the “zipper proteins” that hold the intestines tightly together) so we want this protein in our guts- it is a good thing. However, we see that the expression of claudin goes down after a head injury. By 28 days post head trauma, the amount of claudin has considerably reduced. We are not sure why this occurs.
Note the lack of red claudin spots in the picture below after 28 days. The gut lining is breaking down and food and bacterial particles are now able to enter the bloodstream.
The proteins that keep the gut sealed stop being expressed after a head injury.
There is also research showing that the gut breaks down immediately after a head injury because of a flood of adrenaline. Stress hormones can increase by 300% after a head injury. Doctors will sometimes even prescribe beta blockers after a head injury to help prevent this overdose of adrenaline.
It is worth noting that while our skin is several cell layers thick, our gut lining is only one cell layer thick and is surrounded by muscle and nerve tissue.
Doctors use GFAPs (glial fibrillary acid protein) as a biomarker for head injuries (usually in addition to doing an CT Scan. Sometimes, they also look for the S100 beta protein.)
GFAP is produced by the glial immune cells of your brain AND your gut because of the enteric nervous system which is in part, in your gastrointestinal tract.
For example, in people with Parkinson’s Disease, you can see the Parkinson’s biochemical process where they start laying down the Alpha-synuclein protein. Their Alpha synucleinopathy starts in their gut and builds which results in constipation. This is why one of the first symptoms of Parkinson’s Disease is constipation. As this biochemical process spreads up their gut then to their brain stem and finally to the top of their brain, it is breaking down the enteric nervous system. By the time this biochemical reaction reaches the top of their brain, they have lost 80% of their dopamine which results in the tremors, slow movement, balance issues, and stiffness typically associated with Parkinson’s. But this whole process starts in the gut.
Back to GFAPs- The higher the GFAP number is, the more traumatic the head injury because you go into high alert and produce the protein, Alpha-synuclein.
In Figure Three, GFAP is marked in green. Note the difference at 24 hours after the impact when GFAP goes down versus 28 days after the impact when GFAP seems to go crazy! You can see the GFAP coating the outline of the microvilli (the finger-like parts of the intestine that move food through your intestines.)
These high amounts of GFAP tell us that the enteric glial cells are really going into high alert from the head injury. This indicates the cross-talk between the gut and the brain.
Figure Six: Columns A and B are brain scans of mice.
CCI- Closed Cortical Impact
CCI+Cr - They added the Cr Infection
The brain injury is the red and white checkered patterns.
This added infection made the brain injury considerably worse and added inflammation to the guts of these mice.
We believe then that the gut heavily influences the degree of neurological inflammation.
If you have a head injury you will naturally have brain inflammation, but if you have a head injury and then add gut dysfunction your brain will be considerably more negatively affected.
Intestines become so porous that problematic foods get through, the immune system freaks out and launches an attack leading to system inflammation and probably more GFAP production and the area of the brain injury increases. We have even seen the patient develop concussion symptoms again after eating something problematic for them.
The researchers didn't just look for GFAP in the gut, they also looked at the brain. Note the difference in the mice brains, especially after the added infection. There is considerably more GFAP in the brain after the infection...which started in the stomach.
It is undeniable that gut health and brain health are intrinsically linked. It is a marriage for better or for worse. Here at Gates Brain Health, we work to make it a healthy, thriving, happy marriage between your gut and brain. We incorporate modalities like volumetric MRI, Diffusion Tensor Imaging, blood work, eye movement testing and more to bring to light what was invisible in the brain injury and concussion patients. We fully believe that our patient’s symptoms are not imagined and that there are root causes and physiological issues in the brain and the gut that need to be addressed and healed.
Similar to how a person would work with a personal trainer at a gym to determine the best specific exercises, diet, and lifestyle changes to meet their goals; our patients work with us to heal the gut, and rehabilitate and re-build the density of their brain through neuroplasticity exercises, diet, and lifestyle changes to reduce stress and promote healing.
When you are ready to begin your path to healing or if you have any questions, please contact us at (775) 507-2000 or email