Integrative Medicine Expert Reveals Links Between Gut Health, Immunity, and Wellness

• She began her career with a solid foundation in internal medicine — Dr. Moday pursued a fellowship in allergy and immunology, spending a decade in private practice addressing allergies, chronic asthma, and immune deficiencies. “I felt that I wasn’t using really all that I had learned, and there was a lot more to learn. It was not holistic enough for me,” she shared.¹

• Fellowship with Dr. Weil — This sentiment drove her to search for a more comprehensive understanding of health via an integrative medicine fellowship with Dr. Andrew Weil in Arizona and subsequent certification in functional medicine in 2014.

• Going beyond conventional immunology — This pivotal transition allowed Moday to expand her focus beyond conventional immunology, embracing a holistic framework that considers nutrition, behavior, and environmental factors as components of health. By bridging these disciplines, she now addresses chronic medical issues with a more nuanced and effective approach.

• Microbiomes are vital to your immune system — Moday explained how these trillions of microorganisms are not merely passive inhabitants but active participants in training your immune system and maintaining overall health. “[The microbiome] literally trains our immune system, but it also informs and acts as a go-between,” she said.²

• These microbes foster a balanced immune response — They help prevent conditions like chronic inflammation, autoimmune disorders, and metabolic diseases such as diabetes and obesity.

• We also discussed leaky gut — This is a condition where the epithelial lining of your digestive tract becomes permeable. This increased permeability allows unwanted substances like endotoxins (lipopolysaccharides, or LPS) and food antigens to enter your bloodstream, triggering immune responses that lead to autoimmune diseases. In fact, in most cases you cannot have an autoimmune disease unless you have some type of gut dysfunction.

• This oxygen gradient isn’t static — It requires a constant supply of cellular energy to maintain. If that energy supply falters, oxygen can seep in, killing off your beneficial bacteria. As beneficial bacteria dwindle in numbers, more harmful, oxygen-tolerant species gain ground. This imbalance then sets the stage for a range of other health issues.

• An overlooked aspect of gut health — Maintaining this oxygen gradient is one of the most important, yet often overlooked, aspects of gut health. It’s not just about what you eat, but about creating the right environment for your beneficial bacteria to thrive. This is where the importance of cellular energy production comes into play. Without it, the entire system can collapse.

• What do we have to thank for maintaining this system? — Some of the hardest-working cells in your body — colonocytes and goblet cells. Colonocytes line your colon walls, performing many vital functions. They’re like the bouncers at an exclusive club, deciding what gets in and what stays out. They also play a crucial role in maintaining that all-important oxygen gradient.

• Goblet cells are the maintenance crew — They secrete a mucus that acts as a protective coating, shielding your gut lining from harmful substances and pathogens. Colonocytes and goblet cells form a strong defense for your gut.

The health of these cells is directly linked to your overall gut health and, by extension, your general well-being. When they work well, they help build a strong gut barrier, absorb nutrients, and balance the microbiome. But when compromised, it can lead to many digestive and systemic health issues.

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• The importance of a balanced gut microbiota — This illustration depicts the delicate balance of gut microbiota and its impact on health. On the left, “Eubiosis” shows a healthy gut environment with beneficial bacteria, strong barrier integrity, and positive metabolic outcomes. On the right, “Dysbiosis” demonstrates how factors like antibiotics and an inappropriate diet can disrupt this balance, leading to inflammation and compromised gut health.

• Origins of the mitochondria — Interestingly, mitochondria themselves are believed to have originated from primordial bacteria through an evolutionary process known as endosymbiosis. While mitochondria are present in colonocytes, bacteria within your gut microbiome do not possess mitochondria and instead survive on glycolysis. This symbiotic relationship underscores the intricate connections between your cellular biology and microbial inhabitants.

• Environmental toxins harm your mitochondria — However, despite your colon’s naturally low-oxygen environment, modern-day exposure to environmental toxins threatens to disrupt this balance. We’re all exposed to a soup of environmental toxins, including microplastics, vegetable oils rich in linoleic acid and electromagnetic fields (EMFs).

These toxins act as mitochondrial poisons, impairing the energy production necessary for maintaining your colon’s oxygen-free state.

• What happens when mitochondria are compromised? — Colonocytes cannot effectively consume the limited oxygen, leading to an increase in oxygen within your colon. This shift creates an environment conducive to the growth of facultative anaerobes — oxygen-tolerant bacteria that are often pathogenic.

When your mitochondria don’t have enough energy, the colonocytes tend to not thrive, and the oxygen in your colon progressively increases. This leads to a decrease in beneficial bacteria and their replacement by pathogenic bacteria.

• Endotoxins, specifically LPS, are another factor in this equation — There’s a significant difference between endotoxins produced by obligate anaerobes and those from facultative anaerobes. The endotoxin from obligate anaerobes is much less pernicious and doesn’t kill you prematurely, but the facultative ones do.

Pathogenic facultative anaerobes produce more harmful LPS, which triggers chronic inflammation and contributes to various health disorders, including autoimmune diseases and metabolic syndrome.

• The primary obstacle lies in the fragility of these bacteria — They are highly sensitive to oxygen and require specialized protective capsules to survive the journey through the digestive tract.

• Currently available supplements often fail to deliver live bacteria to the colon — This renders them ineffective for recolonization purposes.

• HOMA-IR is an efficient detection tool — HOMA-IR involves measuring fasting blood glucose and insulin levels to provide a reliable indicator of insulin resistance. This method is both cost-effective and accessible, making it a valuable tool for early detection and intervention. Moday concurred, acknowledging its utility in her practice and emphasizing that most individuals exhibit some degree of insulin resistance.

• The dangers of oxidative stress — Oxidative stress, driven by an imbalance between free radicals and antioxidants, is another factor in cellular damage and disease progression. Our conversation highlighted the nuanced relationship between oxidative and reductive stress, particularly in the context of mitochondrial health.

Free radicals, such as superoxide and hydroxyl radicals, are highly reactive molecules that damage cellular components. Antioxidants neutralize these free radicals, preventing oxidative stress. However, I emphasized that in many cases, free radicals are generated from reductive stress, where an excess of electrons leads to the formation of harmful reactive oxygen species (ROS).

• Addressing environmental toxin exposure is a multifaceted endeavor — Moday recommended simple, actionable steps such as avoiding plastic containers, opting for stainless steel or glass alternatives, and minimizing the use of processed foods laden with additives and preservatives.

• Addressing lifestyle habits is crucial — While proper health care and nutritional guidance are vital, without addressing sleep, stress, and overall lifestyle, patients often struggle to achieve meaningful results. Health coaches provide the necessary support, accountability, and personalized strategies to help individuals navigate these changes effectively.

• Moday believes health coaching should be integrated into a comprehensive health care approach — By collaborating with health coaches, patients receive a holistic support system that addresses both physical and emotional aspects of health. This collaborative model enhances patient outcomes and fosters long-term well-being.

• The Good Friends Hypothesis — Moday expanded on this by introducing the “Good Friends Hypothesis,” which emphasizes the importance of maintaining a diverse and beneficial microbiome through appropriate microbial exposure. “In the ‘90s, someone came up with the idea that children should not be introduced to peanut antigens until they were 3 or 4 years old. But that was problematic,” she said.⁴

• An efficient strategy to reduce allergy risk — By not exposing children to these allergens during critical developmental periods, we inadvertently heightened their immune sensitivity. Current research supports early introduction as a strategy to promote immune tolerance and reduce the risk of allergies.