Curated Paper 1 Dickson

Intelligent Flow of Body and Brain: 

In my reading, I found a description of Ayurveda as, “intelligent flow between systems.” I thought this was a great way to characterize the way our bodies work. “Intelligent flow,” to me, might be the best way to describe the crazy, yet seamless, complexity of the pathways of our bodies. It all seems so effortless, because our bodies often work without us really thinking about it, but in truth so much goes on behind the scenes to keep everything running smoothly. This intelligent flow connects the whole body, so maintaining balance across different areas is vital to prevent downstream issues. Based on what we’ve studied in class and my outside research, it is clear that changes in one body system or compartment will affect the others. This applies not only to physical health issues, but also mental health issues. In some instances, this is hard to conceptualize, especially when we look for factors that are more difficult to quantify, such as how changes in microbiomes will have trickle-down effects all over the body and even up to the brain. 

I am intrigued by the idea that different body compartments have different microbe populations. Or, taking it one step further, how different areas in one body compartment will have different populations. For example, even the saliva and tongue in the oral cavity have their own distinct population of microbes from the hard palate. Track this through the throat, to the stomach, and down the intestines, and there’s too many microbe environments to count. One reason these distinct communities occur is because the conditions in each cavity (or section of a cavity) are different. With the oral cavity being exposed to the outside, and the stomach having low pH conditions, this will cultivate different types of microbes. Substances like bile also work as anti-microbial barriers between the mouth and gut. So, each environment is distinct in composition, yet connected through flow. All of these different microbe communities make it hard to track down the cause of dysfunction in the body. We have made steps to take inventory of human microbiomes, and draw connections to diseases, but I imagine that it will be very difficult to ever get a clear picture of each microbe’s role in the body’s balancing act. Nonetheless, in my reading I have found that we do have evidence that microbiome imbalances are related to different illnesses. For instance, oral cavity microbiome composition is related to diseases like Alzheimer’s, type 1 diabetes, various cancers, and atherosclerosis. People with these diseases have measurable differences in oral microbes compared to healthy controls. Alarmingly, some Alzheimer’s patients have been found to have oral microbes in their brain tissue. This is a frightening example of the flow within the oral-brain axis. This flow between mental systems and physical systems is especially fascinating to me. 

This curiosity made me interested in looking more into the association between diabetes and mental health after we covered it in class. In one example, depression tends to develop in diabetics (both type 1 and 2) at a 2-3X higher rate than in those without diabetes. One article I read described how diabetes could lead to decreased brain volume due to chronic inflammation, which would be a physiological contributor to depression. This study also indicated that those with depression increase risk of developing diabetes by 60%, and also are shown to have worse outcomes. One possible explanation for this is that antidepressants often interfere with blood sugar control, which exacerbates negative diabetes outcomes. This shows the two-way flow of body balance, where what happens in one area (metabolism) will inevitably begin to affect another (mental health). It has made me wonder whether diabetes and blood sugar regulation imbalances lead to depression, or whether depression leads to diabetes. I suspect that the answer is more complicated than a definitive one or the other. There is flow between the domains (body and mind), so when one is out of balance, there will begin to be dysfunction in both. In the case of diabetes and depression, it seems like the dysfunction compounds over time. 

To expand on this, anxiety is also common among diabetics. But, compared to depression (which is prevalent whether the patient is officially diagnosed with diabetes or not), anxiety is only significantly increased in patients who are officially diagnosed with diabetes. To me, this indicates that the anxiety might not be a physiological downstream effect caused by diabetes like how depression is, but rather stems from the stress of having a chronic illness in general. In this case, the cause might be mischaracterized as a metabolism issue, when really it is a stress issue. Something similar is seen in those with celiac disease, where the physical metabolism issues don't seem to contribute to the anxiety, but rather the stress that comes along with the condition. Again, this highlights to me that tracking down the roots of these diseases is incredibly complex. There is not one single cause or microbe to blame, but rather an array of factors that contribute to body dysfunction in different areas. 

Outside of mental illnesses like anxiety and depression, blood sugar levels have been linked to changes in personality, such as mood and impulse control. For example, there is an association between blood glucose levels and aggression. In one study, verbal aggression tended to be higher in people with diabetes, but there was no significant difference in physical aggression between groups. This shows how maintaining regular states of physiological factors is indeed important, because the effects of imbalance can go so far as to affect our moods and personality. Going the other way, issues like stress can create downstream effects on our physical status. One article I read brought up the negative effects of heightened cortisol resulting from excess stress on sleep, immunity, and blood sugar. Further downstream, if something like sleep is disturbed, a person may develop really serious issues like heart disease, stroke, and diabetes. These two examples highlight the “sugar-brain axis,” where flow moves both ways. Mental issues may lead to metabolic issues, and metabolic issues may lead to mental issues. Everything in the body is connected, and disturbances in the interplay between different domains and systems create potential for disaster. 

All in all, drawing connections between how mental health interferes with physical status (and vice versa) helps to showcase the intelligent flow of our bodies, as outlined in ayurveda. It also shows how hard it is to trace the root cause of a health issue, because there is so much give-and-take in the complex flow between systems. It has made me realize that health treatment could benefit from combining multiple angles. It is important not to only consider physical effects, but also mental effects, when treating a patient. They are so connected that it would be detrimental to ignore. One article I read described how treating depression in overweight youth drastically improved outcomes both in diabetes, and in other health issues like asthma. Like intelligent flow in our bodies, I think that developing intelligent flow between healthcare specialties (sometimes known as collaborative care) will be extremely beneficial to patient outcomes.