Enteroimmunology & Endocrinology: How Dysbiotic Gut Inflammation Leads to Hormone Imbalances, and How Reversing Them is the Key to Resolving Chronic Illness

Dushyant Viswanathan, MD, ABIM, ABoIM, AACE

Chief Medical Officer, The Columbia Center for Integrative Medicine (CCIM)

Gut dysbiosis is associated with inducing a chronic inflammatory state that affects every organ and is implicated in the pathogenesis of multiple chronic conditions in the scope of internal medicine. Here we articulate relevance, diagnostic/therapeutic concerns of translational mucosal immunology (Enteroimmunology) and articulate the impact on measured cortisone secretion patterns as demonstrated by 24 hour salivary cortisol testing. Inflammatory cytokines stimulate cortisol secretion, and over time, an endocrinopathy develops: dysfunctional diurnal cortisol secretion, depletion of beneficial hormones such as testosterone, DHEA, progesterone, pregnenlone, thyroid hormone, and sometimes estrogens (although elevations of estrogens due to impaired excretion is more common) occur. These physiologic events are implicit in the process of aging. We will describe treatment approach and cases featuring gut microbiome repair and restitution of optimal hormone levels as essential to lessening physiologic/cellular aging and inflammation. We will review case studies including treatment of Crohns inducing remission, reversal of autoimmune inflammation, and reversal of prostate disease.