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
Digestive Health & Gluten: Is it Really a Big Deal?
Hour-by-Hour Outline for CMU Certification: 8-Hour Seminar
Seminar Approach
A thorough and working knowledge of the GI system is essential to optimal wellness. The GI system
requires a total of one-third of all our daily calories to drive digestion and immunity while performing its
basic role of food intake and exit. 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. GI
malfunction can be responsible for IBS, and allergic and immune dysfunction such as asthma,
Rheumatoid arthritis, Type 1 diabetes, autism and Hashimtos 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 genetics of Gluten Intolerance and “triggers” that activate the condition.
Seminar Elements
Principles of Digestive Wellness (2 Hours)
Detoxification and Gut Elimination (1 hour)
Leaky Gut Intestinal Permeability (1 Hour)
Understanding Autoimmune Diseases ( 1 Hour)
Gluten Sensitivity – what is it? (1 Hour)
Celiac Disease (1 Hour)
Testing for Celiac Disease ( 1 Hour)
Principles For Restoring Digestive Wellness (2 hour)
HOUR ONE
1. 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
2. Overview of six principles
a. Optimize Digestion.
b. Provide Soothing Gastric Support
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c. Restore Healthy Intestinal Mucosa
d. Support Intestinal Defense
e. Promote Detoxification and Elimination
f. Reestablish Healthy Microflora
3. Optimize Digestion
a. Protease
b. Amylase
c. Lipase
d. Cellulase
e. Lactase
f. Sucrase
g. Maltase
h. Phytase
i. Alpha-Galactosidase
HOUR TWO
4. Provide Soothing Gastric Support
a. Deglycyrrhizinated Licorice (D GL)
b. Marshmallow root
c. Slippery Elm
d. D-Limonene
5. Restore Healthy Intestinal Mucosa
a. Antioxidant Support for the Intestinal Mucosa
i. Quercetin
ii. Ginkgo Biloba
iii. Glutathione precursor and antioxidant – N- acetyl L Cysteine (NAC)
iv. Gamma linolenic acid (G, LA)
v. Phosphatidylcholine
6. Products that Support Intestinal Defense
a. Broad Microbial Defense
i. Berberine Sulfate - found in goldenseal and Oregon grape
ii. Goldenseal extracts
iii. Garlic
iv. Black walnut extract
v. Sweet Wormwood
b. Healthy Yeast Balance
i. Oregano Oil
ii. Thyme
iii. Pau D’Arco Bark
iv. Caprylic Acid
Detoxification and Gut Elimination (1 Hour)
HOUR THREE
1. Agents to Support Liver Detoxification Pathways
a. NAC, Reduced Glutathione
b. Vitamin E
c. Choline, Methionine, Inositol
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2. Agents To Support Elimination
a. Flaxseed
b. Fenugreek
c. Slippery Elm
d. Marshmallow Root
3. Reestablishing Healthy Microflora
a. Lactobacillus – primary probiotics small intestine
b. Bifidobacteria- primary probiotics inhabiting the large intestine
c. Fructooligosaccharides
i. Prebiotics -promoting beneficial microflora in the large intestine
Leaky Gut – Increased Intestinal Permeability (1 Hour)
HOUR 4
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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
Gut Basics
a. Teeth and Salivary glands
b. Acid Production
i. Stomach
ii. Pancreas
iii. Biliary Systems
Enzymes and Bile Salts
The Small Intestine
a. Brush border – Enterocytes
The Immune System
a. Function of the Immune System
b. Gut flora
c. Probiotics
d. Prebiotics
Food Sensitivities and Gut Function
Assessing Gut Function
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Understanding Autoimmune Diseases (1 Hour)
HOUR 5
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2.
3.
4.
Autoimmune Disease Prevention
Age Range of Autoimmune diseases
Frequency of Women - Autoimmune Diseases
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
5. Environmental trigger activating celiac disease and other auto-immune diseases
6. Environmental role in autoimmune diseases
7. Common Genes causing multiple immune diseases
Gluten Sensitivity – what is it? (1 Hour)
HOUR SIX
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7.
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
8. Grain Intolerance
9. Increasing fiber on a gluten-free diet
a. Fruits
b. Gluten-free grains
c. Vegetables
Celiac Disease (1 Hour)
HOUR SEVEN
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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
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c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
Insulin dependent diabetes mellitus (type I)
Myasthenia Gravis
Pernicious Anemia
Raynauds Phenomenon
Scleroderma
Sjohren's Syndrome
Systemic Lupus Erythematosus
Thyroid disease – Graves' disease and Hashimoto's Thyroiditis
Celiac Disease and Its Effects on Fertility
Treatment of celiac disease
Testing for Celiac Disease
HOUR EIGHT
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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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