Michael E. Greer, M.D.
Holistic, Herbal & Homeopathic Lectures & Consultations
737 Olive Way, Suite 1804, Seattle, WA 98101
Tele (mobile): (206) 383-9072 Fax: (206) 971-7428 (Attn: Dr. Greer)
michaelgreermd@comcast.net www.michaelgreermd.com
Seminar Approach
Solutions for GI Health: Understanding the Second Brain
Hour-by-Hour Outline for CMU Certification: 12- Hour Seminar
Seminar Approach
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Gastrointestinal diseases are one of the most common reasons patients seek medical attention.
The gut mucosa, as well as the other mucosal surfaces, can be seen as an extension of our
sensory system, or a "sixth sense”. The GI system contains a very large amount of lymphatic tissue
and is the only organ in the body with its own independently working lymphatic and nervous
system. The mucosal surfaces deal with the largest amount of antigens confronting the body and
have a very specific anatomical configuration in order to fulfill the delicate task of distinguishing
between pathogenic bacteria and toxins, and the beneficial substances like food particles and
commensal bacteria.
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GI malfunction can be responsible for IBS, allergic and immune dysfunction such as asthma,
Rheumatoid arthritis, Type 1 diabetes, autism and Hashimto’s thyroiditis. A clear respect and
understanding of the interworkings of the GI system is essential to Chiropractic and Naturopathic
Health. Dr. Greer will explain the intricate details of the GI system and relate common issues such
as Celiac Disease and Gluten Intolerance and detail the “triggers” that activate these and other
related conditions.
Seminar Elements
Principles of Digestive Wellness (2 Hours)
Detoxification and Gut Elimination (2 hour)
Leaky Gut Intestinal Permeability (1 Hour)
Understanding Autoimmune Diseases ( 3 Hours)
Gluten Sensitivity – what is it? (2 Hours)
Celiac Disease (1 Hour)
Testing for Celiac Disease ( 1Hour)
Principles For Restoring Digestive Wellness (2 hours)
HOUR ONE
1.
Digestive Wellness
a. The Gastric Mucosa – The Sixth Sense
b. The Integrity of the Intestinal Mucosa
c. GI and its role in Immunity
d. Gastrointestinal Mucosal Barrier
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2.
e. GI Functions
f. Healthy Intestinal Microflora
Six Components of the Gut
a. Epithelial Barrier
b. Mucus layers
c. Probiotic Bacteria
d. The Immune System
e. The Endothelial wall
f. The Liver
HOUR TWO
1.
2.
3.
4.
3.
Th(0), Th1 andTh2 Explained
Oral Tolerance
The Immune System
a. Increased Intestinal Permeability
b. The Leaky Gut Syndrome
c. Leaky Gut Associated Diseases
d. Leaky Gut Causes
e. The Impact of Genetics
Probiotics
a. The First Line of Defense
b. Definition of Probiotics
c. Key Signaling of Intestinal Bacteria
d. Immunity Boosting of Probiotics
Digestive Wellness
a. Gastrointestinal Secretions
b. The Gastric Mucosa
c. The Integrity of the Intestinal Mucosa
d. Intestinal Defenses
e. Gastrointestinal Motility
f. Hepatic Function
g. Healthy Intestinal Microflora
Detoxification and Gut Elimination (2 hours)
HOUR THREE
1.
2.
3.
4.
5.
6.
7.
Overview of six principles
Optimize Digestion
a. Protease
b. Amylase
c. Lipase
d. Cellulase
Provide Soothing Gastric Support
Restore Healthy Intestinal Mucosa
Support Intestinal Defense
Promote Detoxification and Elimination
Reestablish Healthy Microflora
2
HOUR FOUR
1.
2.
3.
Optimize Digestion
a. Lactase
b. Sucrase
c. Maltase
d. Phytase
e. Alpha-Galactosidase
Provide Soothing Gastric Support
Restore Healthy Intestinal Mucosa
a. Antioxidant Support for the Intestinal Mucosa
i. Quercetin
ii. Ginkgo Biloba
iii. Gamma linolenic acid (GLA)
iv. Phosphatidylcholine
HOUR FIVE
1.
Products that Support Intestinal Defense
a. Broad Microbial Defense
v. Berberine Sulfate - found in goldenseal and Oregon grape
vi. Goldenseal extracts
vii. Garlic
viii. Black walnut extract
ix. Sweet Wormwood
b. Healthy Yeast Balance
i. Oregano Oil
ii. Thyme
iii. Pau D’Arco Bark
Detoxification and Gut Elimination
HOUR SIX
1.
2.
3.
Agents to Support Liver Detoxification Pathways
a. Vitamin E
b. Choline, Methionine, Inositol
Agents To Support Elimination
a. Flaxseed
b. Fenugreek
c. Slippery Elm
d. Marshmallow Root
e. Reestablishing Healthy Microflora
f. Lactobacillus – primary probiotics small intestine
g. Bifidobacteria- primary probiotics inhabiting the large intestine
h. Fructooligosaccharides
Prebiotics - promoting beneficial microflora in the large intestine
Leaky Gut – Increased Intestinal Permeability (1 Hour)
3
HOUR SEVEN
1.
2.
3.
4.
5.
6.
7.
Conditions associated with Leaky Gut
Celiac Disease
Inflammatory bowel disease
Ulcerative colitis
Crohn's disease
Food allergies
The Role of Gut Health
a. Bacteria
b. Gut Flora
c. Antibiotics Contributing to Leaky Gut Syndrome
d. Zonulin – a protein identified to be a critical regulator
e. Elevated Zonulin associated with:
i. Rheumatoid arthritis
ii. Inflammatory bowel disease
iii. Type I diabetes
iv. Celiac disease
v. Other multiple autoimmune diseases
Nutrient Insufficiencies (1 hour)
HOUR EIGHT
1.
2.
3.
Gut Basics
a. Teeth and Salivary glands
b. Acid Production
c. Stomach
d. Pancreas
e. Biliary Systems
Enzymes and Bile Salts
The Small Intestine
a. Brush border – Enterocytes
Understanding Autoimmune Diseases (3 Hours)
HOUR NINE
1.
2.
3.
4.
5.
6.
The Immune System
a. Function of the Immune System
b. Gut flora
c. Probiotics
d. Prebiotics
Food Sensitivities and Gut Function
Assessing Gut Function
Autoimmune Disease Prevention
Age Range of Autoimmune diseases
Frequency of Women - Autoimmune Diseases
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7.
8.
9.
10.
Genetic Factors playing a role in the development of autoimmune diseases
a. HLA – DQ 2 and HLA – DQ 8 to establish the possibility of celiac disease
Environmental trigger activating celiac disease and other auto-immune diseases
Environmental role in autoimmune diseases
Common Genes causing multiple immune diseases
Gluten Sensitivity – what is it? (2 Hours)
HOUR TEN
1.
2.
3.
4.
5.
6.
7.
8.
9.
Review of Gluten Intolerance, Sensitivity and Celiac Disease
Symptoms of Gluten Intolerance
Depression and Gluten – A close Association
Prevalence of Gluten Intolerance
Statistics on Gluten
The FDA definition of gluten free
Various Reactions to Grains
a. Gluten sensitive enteropathy or celiac disease
b. Wheat or grain allergy
Grain Intolerance
Increasing fiber on a gluten-free diet
a. Fruits
b. Gluten-free grains
c. Vegetables
Celiac Disease (1 Hour)
HOUR ELEVEN
1.
2.
3.
4.
5.
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10.
11.
12.
Frequency of population
Diagnosis of Celiac disease
Prevalence of Celiac Disease
Clinical consequences and adults.
Triggers of the Celiac population
The Importance of Celiac diagnosis and timing
Increased Incidence of type I diabetes
Increased incidence of auto immune thyroiditis
Celiac Disease and Associated Autoimmune Diseases: The Connection.
Celiac Disease – Dermatitis herpetiformis Association
Genetic and Immunological linkages with celiac disease and dermatitis herpetiformis
Increased Risk of developing one or more of the associated autoimmune diseases:
a. Addison's disease,
b. autoimmune chronic active hepatitis
c. Insulin dependent diabetes mellitus (type I)
d. Myasthenia Gravis
e. Pernicious Anemia
f. Raynauds Phenomenon
g. Scleroderma
h. Sjohren's Syndrome
i. Systemic Lupus Erythematosus
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j.
k.
l.
Thyroid disease – Graves' disease and Hashimoto's Thyroiditis
Celiac Disease and Its Effects on Fertility
Treatment of celiac disease
Testing for Celiac Disease (1 hour)
HOUR TWELVE
1.
2.
3.
4.
5.
6.
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8.
9.
10.
11.
12.
13.
14.
15.
Anti-gliadin antibody AGA
tTG-IgA
Total serum IgA
Anti-tissue transglutaminase antibody (T TG)
Anti-endomysial antibody (EMA)
Genetic tests
HLA DQ 2 and HLA – DQ 8 (reference PowerPoint slides, page 4 celiac sprue by Dr. George Koval
a. Test of sequelaea of celiac disease
TSH, ferritin, liver enzymes, vitamin levels, and bone density.
Who to test?
a. Iron deficiency anemia
b. Short stature
c. Dermatitis herpetiformis
d. Recurrent fetal loss
e. IBS
f. Diabetes type I
g. abnormal liver function tests
h. infertility
Endoscopic tests
Laboratory testing scenarios
a. Options
If you test negative on both IgG and IGA anti-gliadin
If you test positive on either the IgG or IGA anti-gliadin antibody
Complexity of the GI system
Closing remarks
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