Hippocrates was famous for writing that "all disease begins in the gut" and commonly used diets to treat psychological illnesses. He was born in 460 BC, and is among the most influential of all physicians in history - commonly being hailed as the founder of the western medical tradition.
Yet nearly 2,500 years later, much of what he discovered and taught about the importance of the gut in preserving health and using food as a medicine is as revolutionary today as it was then. There is an incredible abundance of research demonstrating the gut's defensive role in preventing chronic diseases - from the microbiome being implicated in Irritable Bowel Syndrome (IBS) to association between Gut-Brain disharmony and depressive symptoms.
Gut health is important to neurotransmitter balance, and our gastrointestinal system serves roles in our nervous system which we do not yet understand. There is an incredible mystery in the interrelationship between our organs, and how they function to support, protect and regulate consciousness. In Ancient Chinese Medicine, each organ is associated with an emotional state - and imbalances in the psychological sphere are viewed as rooted in those organs. In ancient cultures throughout Asia, the gut was seen as a center of consciousness - in this exploration some hints of the deeper significance of this may be seen.
I explore the ways our gut protects our brain, is involved in consciousness through neurotransmitter regulation and what psychedelics like Ayahuasca teach us about the role of the gut in spheres which are thought mainly of as inquiries of psychology & neurology. The Gut is involved in processes that are not only related to digestion and excretion of toxins - but suggest that we can view it is a gatekeeper of consciousness itself.
The Gut-Brain Axis: Link Between Mind & Medicine
The gut-brain axis is essentially a term describing the link between the central nervous system, the enteric nervous system and the gastrointestinal tract. Simply put it is the communication system between our gut, and our nervous system - the "gut brain" as we naturopaths lovingly call it.
It is a two way highway, one road moving towards the nervous system from the gut, and the other road from the nervous system to the gut. All paths leading back to our mind, that mysterious phenomena which encapsulates all that we experience in the physical and psychic universe.
Expression we use illustrate that this connection between gut and brain is a deep intuition we have all experienced. When a friend loses their temper and chalks it up to being "hangry", when someone says they are "so hungry they can't even think straight", or even that old saying describing hunches as "going with your gut". What we eat effects out mood, we all know this after we slump into our beds with fatigue after a large feast, or that deep sluggishness after a full course fast food meal.
Those who have experiences with intermittent fasting, or more significantly with longer fasts - know that the connection between our mood, our cognition and even how we think is very linked with our intake of food. In my researches it is clear to me why conditions such as anorexia and bulimia are considered "psychiatric" conditions - not dietary ones.
The link between our nutrition and our mind state is so thoroughly obvious it is astounding, and that link seems to center in our gut brain, in particular with the state of our gut microbiome - that not so little colony of friendly (or not so friendly) microorganisms which seem to live rent free in our gut.
Yet without a healthy balance of these microorganisms, digestion becomes troubled and research suggests are implicated in disease processes such as Irritable Bowel Syndrome (IBS), Depression and all manner of chronic inflammatory conditions. Hippocrates smiles back at us through the centuries, as if to say "I told you so" and scientific research into this phenomena abounds in recent years, vindicating that lost knowledge and helping us to understand it to greater depths than ever before.
Referenced: Gao K, Mu CL, Farzi A, Zhu WY. Tryptophan Metabolism: A Link Between the Gut Microbiota and Brain. Adv Nutr. 2020;11(3):709-723. doi:10.1093/advances/nmz127
The Mystery of Serotonin, Tryptophan & DMT
One may be scratching their head as to how it is that the nutrients we intake can effect complex subjective phenomena such as our mood, and generally how we feel mentally. The research is young, and subject to much discovery and elaboration but this link seems to revolve around the serotonin system, and how the microbiota of the gut release compounds and metabolites which regulate neurotransmitters. From a nutritional standpoint the amino acid Tryptophan seems to be one of the crucial components of the functions of our Gut-Brain Axis. It is an important precursor for the neurotransmitters associated with wakefulness and sleep. But does research on the gastrointestinal connection to the brain suggest deeper mysteries of how it influences consciousness?
Look closely at this image below and note any compounds you recognize:
L- Tryptophan is the building block for both melatonin and serotonin, and those interested in psychedelics may have raised their eyebrows at the word tryptamine in that biochemical cycle. Serotonin is the neurotransmitter long associated with depression, and melatonin with insomnia of all types. These signaling neurotransmitters have an incredibly complex association in the functions of the nervous system, serotonin more for wakeful wellbeing and melatonin for restful sleep. This points out an important insight into why insomnia is a common symptom of depression, and how sleep deprivation effects mood.
It also is reminiscent of often heard sayings that several psychedelic compounds have a chemical structure similar to neurotransmitters, and the findings of DMT (Dimethyltryptamine) in the brains of mice. The latter suggesting that some psychedelic compounds may even be produced in human brains, particularly during experiences of extreme stress (near death experiences), sleep (vivid dreams) or certain altered states of consciousness produced by meditation or shamanic practices. This is difficult to prove for certain reasons which illustrate a fundamental difficulty in the study of the mind, particularly in reduction of mental states to measurements of neurotransmitter levels.
In the case of DMT or endogenous psychedelic compounds, if they do exist in the human brain, would be incredibly difficult to "catch". If they do exist naturally in the brain, do so only for a brief duration of time before they transform into other compounds or metabolites (breakdown products). This is in line with the typical DMT experience lasting about 5-10 minutes, and then people report feeling "normal" again due to the rapid metabolism these compounds undergo.
Add to this the fact that these compounds have substantial effects at microscopic doses, and must somehow be extracted from a living brain in those few moments of existing. All that we can say for now is we cannot prove it in humans due to the difficulty of this, and more importantly how unethical these experiments would be on human test subjects. Dead brains have little resemblance to living brains, the former a subject of anatomy and the latter a subject of physiology, neurochemistry, psychology and so on...
Even at doses far beyond anything which could be expected to occur endogenously in the brain - the peaks of these trips only last for moments. Voyages through reportedly indescribable worlds or experiences which seem beyond anything reminiscent of human experience - last for only minutes on the clock, after which they become faint memories and the normal waking consciousness returns as if never having left. Stranger still is those who "come down" fearful that they have been gone for so long that everyone they know is gone - because in their experience it was if they had been gone for years, or longer. Only to thank the heavens that wherever they were, only minutes had gone by - minutes which to them were like eternities.
DMT in high dosage in non orally active forms have a peculiar strangeness from every story I have heard. I personally have not had that experience, but when I hear that they are exponentially more drastic than the already earth shattering kinds of experiences had with the "classic psychedelics" like psilocybin mushrooms and LSD - I can only imagine. Near death experiences seem to have some deep resemblance to the out of body experiences reported by those who have used such psychedelics. Mircea Eliade summed up shamanism as the traditions with ecstatic practices - ecstatic literally meaning out of body, with a significant amount of these experiences being induced through no ingested substance whatsoever.
These all hint at a similar mystery, that of experience outside of the human body - that is possible while living. Is this a kind of reality, a subjective experience brought about my an unknown neurotransmitter released resembling DMT in the human brain - or perhaps both? Yet one of the rarely spoken functions of the gut is minimum metaphorically to protect us from this DMT experience, or any rapid fluctuation in neurotransmitters. In some sense to ground us in the physical realm by modulating neurotransmitter release? I recall after a particularly intense psilocybin experience, feeling equally thankful that I had this profound experience, and equally thankful for the normal state of consciousness that I had often taken for granted.
Neurotransmitters, Monamine Oxidase & Ayahuasca
The gut has an interesting role in preventing the psychedelic experience that can be caused by DMT, and on a more mundane level of regulating how foods and ingested substances effect our neurotransmitters. Let us explore the fascinating case of Ayahuasca, and how the DMT experience became possible through ingestion - something which our stomach and intestines normally prevent.
You may have heard that around 90% of the serotonin in our bodies is found in our gut, seeming to make a clear connection between gut and brain - but this simplification misses the fact that under normal conditions the serotonin in our guts can't get to our brain because of the MAO system of the gut, and the blood brain barrier. These are both marvels of survival and the eternal obstacle of both psychonauts and psychiatrists alike.
Some substances can make it through, and others not at all. The naturally produced enzyme in our guts monamine oxidase break down neurotransmitters in the stomach & intestines before they even reach the blood. That is why a doctor has never given you a pill filled with serotonin, and why Ayahuasca is a combination of at least two plants. Eating a plant filled with DMT does not make you "trip" because it is broken down in the gut.
A common combination involving the leaves of Psychotria Viridis (DMT containing) and the vines of Banisteriopsis Caapi (Monoamine Oxidase Inhibitor containing) - is an ingenious workaround to our gut defenses, which otherwise are incredibly important for our wellbeing. Interestingly, even certain foods containing tyramines can act as mild MAOI's. This shows the ancient wisdom of the dieta - the special diet that the wise follow before any psychedelic journeying. Some examples of tyramine rich foods are cured/smoked meats, aged cheeses, fermented foods, certain wines, and even coffee...
Normally these tyramine foods do not cause much of a noticeable problem on a normal day as they nowhere approach the MAOI effect of the vine of souls used in Ayahuasca mixtures or pharmaceutical MAOI's. But when eaten regularly or recently with a strong MAOI can make the effect so strong that it is actually quite dangerous. These ancient shamans knew little of the specifics of pharmacology, but they there were practically geniuses when it came to their knowledge of using psychedelic substances safely, and bypassing the gatekeeper of consciousness within the gut.
Respecting Sacred Plants & Potent Psychoactive Substances
This is all to say, take great care and make sure to either research deeply on your own, or even better work with someone trained in that knowledge - be they a shaman with a deep understanding of the tradition of their sacred plant, or any health practitioner that knows enough to warn you about safety concerns. Ideally do this before you take a trip to a foreign country - in the field of conventional medicine there are both experts and the uninformed practitioners. The same is true for shamanic practitioners and alternative health workers, there are both experts and the uninformed among them. Do your research in all ways - particularly with the most potent of all psychotropic substances - the psychedelic plants & psychedelic compounds. Fear is best dispelled with knowledge, and both the ancient and modern traditions have heaps of it.
A healthy amount of fear when undertaking a large leap into the unknown is indeed healthy - particularly when combining several types of psychedelic compounds, psychoactive medications or even certain foods which either have too much of a similar effect or block the breakdown (metabolism) of strong compounds. This is a general rule of thumb to be wary of, and something to research, ask questions from healthcare practitioners or shamanic practitioners that focus on such things, and be careful with.
Your body is a well guarded temple, so do not unlock the door haphazardly, or without reasonable consideration. Physiological medical emergencies are very rare with the previously mentioned examples, but psychological dangers are inherent to the practices - as they have both the healing wisdom of nature, as well as nature's terrifying force within them. In some sense when humans ingest plants containing alkaloids that closely resemble neurotransmitters, we are opening the doors of our brain to a mystery. Are we taking in something akin to the neurotransmitters of the plants - which serve as of yet undiscovered functions within the plant kingdom? Or are these compounds defense mechanisms of plants to prevent us from excessive ingestion of them?
The Dose Makes the Poison And the Medicine
This area is hotly debated in the ethnobotany and pharmacology fields - but in some sense it projects our own feelings towards nature onto plants, are they concerned with survival by any means, or is our perception of what a plant toxin is misguided from the start? I would suggest that regardless of the case, from a therapeutic sense it is secondary - as the legendary alchemist and physician Paracelsus discovered - "the dose makes the poison".
This points to an understanding of medicine that goes far back into history and is still true today, at some dosage everything is toxic to life, be it water or even salt. But it is in our understanding that what makes a toxic substance is often not the substance, but how it is used. At the right dosage, in the right circumstances, with good information supporting - all compounds have therapeutic potential, and all therapeutic potentials in compounds may become toxic to life if not used with wisdom.
This knowledge can be applied to any aspect of health: which foods are "good" and "bad", or what lifestyle factors lead to harm and which to health. Nature's wisdom is such that much of the compounds found in plants have either a rich complex of compounds which balance their effects - which allowed a kind of symbiotic partnership with the animal and plant kingdom, and ones which we have evolved over long periods of time to become immune to. Take theobromine in chocolate, a compound closely related to caffeine - to a human it is delicious and boasts of dozens of therapeutic benefits, but if your dog ate it it would be a serious cause for concern. What is safe and therapeutic to one, may be harmful to another.
As far as physiological harm most of the psychedelics would require nearly impossible amounts of ingestion to lead to bodily harm - psilocybin toxicity as a physical danger would require one to ingest hundreds of pounds in a single sitting, cannabis and other psychoactive plants alike. Yet some over the counter medicines like acetaminophen (Tylenol) cause more liver failure in the world, and around half of all liver failure in the United States - at doses that are not that from their therapeutic usage. Add alcohol or prior liver damage to the equation and even recommended doses can cause toxicity.
I was shocked to learn that in the United States overdose of acetaminophen is reported as the most common cause of liver transplantation. The opiate pain medication Percocet contains acetaminophen - raising many questions about overdoses on pain medications and the opiate crisis in medicine. The greatest irony is that the greatest danger in that particular formulation, may not be the opiate derivative but the medicine available over the counter, acetaminophen.
Again, it is the dose that makes the poison - and knowledge of medicines which makes for a therapeutic effect - the same thing that can harm can be used medicinally. One should always speak of dangers in their true form, relative to other dangers - particularly ones which are so common in use that their dangers have been disregarded. The disparity between the risks of many medications and plant alkaloids is however so unfathomably great, that opting for natural seems to be the winning bet in most cases.
Conclusions & Further Insights
I hope that this exploration raised more questions than it answered, for as the wise Socrates one said "wisdom begins in wonder". Let us tie together these ideas within natural medicine philosophy with some concluding remarks. Firstly, the Gut-Brain Axis has a lot to teach us about how best to approach our gut health, and reminds us to consider seemingly separate organ systems like the Gastrointestinal as ultimately part of our total experience of consciousness, how we feel, and the states of our mind. Holistic medicine is not always about choosing the natural in spite of the artificial - it speaks to an idea that can be applied to any study. This idea is that in studying the parts we must not forget the whole, and perhaps more importantly that the interrelation of the parts is the key consideration when we speak on a topic as general as health or wellness.
Health and wellness are phenomena that we experience when the parts of our being, and physical organ systems function like a well oiled natural machine. And that disease can teach us about health, for it is only when something is unharmonious that we become aware of our organs and mind. When the parts are integrated in a functional unity, they are as if weightless and unnoticed. It is in the contrast from unwellness that we experience wellness. In that sense dis-ease of any kind, is both a curse and a lesson that takes us to greater health - and allows us to enjoy the experience of health as contrasted from chronic un-wellness.
General Tips to Support Gut Health & Thereby Mental Wellness:
There is much that can be said about how to support the gut brain within ourselves so that it serves it roles as defender of the body, and source of our recovery and nutritive growth. I will save further explorations of the specifics of this for future articles, as my explorations are more expressed to those who would have interest. Let us suffice it to say that some of the key things to consider in gut health are the balance of the microbiome, and balance of our nervous system - and that our mental wellness is as tied to the gut as digestion is. There are books upon books, articles upon articles about supporting gut-brain-axis health. The key things to consider are of course starting from the foundations - the same lifestyle choices and diets which support health in general, often support the gut in specific.
Probiotics are one of the most promising supplements for gut health, as well as glutamine supplements (cabbage is a great source), naturally fermented foods (outside of the trip setting) and eating plenty of vegetables to intake that fiber which is so crucial to our digestive system doing it's job of clearing toxins. Another consideration is that our psychic health, and state of nervous system go hand in hand with our guts, and vice versa. Practices such as intermittent fasting have great benefit for some individuals, allowing time for our gut motility (movement in the gut) to activate and clear the waste from the nutrients. From my researches it is clear that oral antibiotics can have a disastrous effect on the gut microbiome - however when used correctly are wonder drugs and life saving.
It is common for naturopaths to work with patients that have been on long courses of antibiotics through the mindset of restoring a normal gut microflora. Prebiotics are also part of this equation, these are the foods that the health promoting bacteria love - examples are organic yogurts (which also naturally contain probiotics) and foods close to nature. My personal favorite from the slavic culture is a fermented yogurt drink called kefir. I recommend the natural sources first, and supplementation as a supplement. Nature has a wisdom that we will always strive to understand, in the meantime I feel it best to place our bets in the things which are natural in our environment, which have long traditions of use and co-evolution with. One also cannot overestimate the impact of moderate physical activity on gut health - it kicks starts that process of elimationa. This is no surprise for the body is like an organic clock which gains its power from movement.
The Light in the Darkness of Psychedelic Experience:
As far as the psychedelic experience, I have great optimism and experiential reasons to believe that they can be one of the most transformative revolutions in our views towards treating mental health - but in this article I hope I imparted a healthy realism about the potential dangers inherent within them. That decision, as all freedom, is for every individual to make for themselves and I firmly believe no-one should have the power to tell another how to live - particularly if they harm no one in the doing. There is risk in everything great in life, risk is something to prepare for and keep in mind - but at the end of the day the greatest risk in life is guaranteed.
That certainty is expressed by the philosophers as memento mori - that realization that all of us are mortal and that life's vitality is always counteracted by the natural processes of death. They are two sides of the same coin, to fear our end is to fear life itself. Let us keep in mind this fact whenever we are to make a big decision - that life is composed ultimately of things which simultaneously have no significance and the greatest possible significance. It is all in how we perceive it. Psychedelics seem to share many similarities with near death experiences, and the "ego dissolution" characteristic of higher dosages teaches us an important lesson.
The lesson of the transience of consciousness, the terror of mortality and at the same time shining a indescribable light into the nature of reality - from the spiritual down to the most mundane aspects of our lives. I have taken that risk on several occasions, and myself have always looked back at those experiences, regardless of their difficulty at the time - as some of the most transformative experiences in my life. Ones which years later I still look back on for wisdom, and aim to apply to my everyday life.
With Peace and Blessings,
Dr. Bogdan Makartchuk
Clinic & Blog:
Natural Health Podcast:
Academy of Natural Philosophy & Healing