The intestinal barrier is more than just a digestive checkpoint - it's a key defender against non-beneficial microorganisms, toxins, and antigens while allowing the body to absorb vital nutrients. When this barrier is compromised, it can lead to a cascade of symptoms, including occasional bloating, abdominal discomfort, irregular bowel movements, and nutrient malabsorption.
An Integrative Approach to Modulating Self-Tissue Response in Joints
Presented by: Felice Gersh, MD+
Self-tissue response in joints affects 1 in 200 adults globally, predominantly women.1,2 This condition mainly targets joints, but can also impact other organs, which has the potential to impact quality of life. Early intervention can often make integrative methods the main approach for self-tissue response in joints.
While conventional therapies offer new management possibilities, they are most effective when combined with integrative modalities.
This presentation will cover key manifestations, clinical markers and drivers of self-tissue response, offering integrative strategies to manage the condition while improving quality of life and health span.
Join us to learn how to implement effective integrative approaches for self-tissue response in joints and improve patient outcomes.
Learning Objectives:
Recognize the key manifestations, contributing factors, and systemic impacts of self-tissue
response in joints.
Discuss conventional therapeutic management of self-tissue response in joints.
Review a comprehensive, integrative approach for managing self-tissue response in joints
to help improve patient outcomes.
About the Speaker
Felice L. Gersh, M.D.+, is an award-winning physician, board-certified in both OB/GYN and Integrative Medicine. She has special expertise in the use of female hormones, the impact of environmental toxicants on metabolic and reproductive functions and on all aspects of lifestyle medicine. She graduated from Princeton University and the University of Southern California School of Medicine. She completed her OB/GYN residency at Kaiser Hospital in Los Angeles and was fellowship-trained in integrative medicine at the University of Arizona School of Medicine. Dr. Gersh is the Medical Director of the Integrative Medical Group of Irvine and helped co-develop the PureWoman™ exclusive.
+Dr. Gersh is a retained advisor for Pure Encapsulations.
1Silman AJ, Pearson JE. Arthritis Res. 2002;4 (Suppl 3):S265-S272 2Shah B, American College of Rheumatology Committee on Communications and Marketing. Updated February 2023.
Autophagy vs. Inflammasome Assembly: A Key Leverage Point in Functional Medicine Cases
Presented by: Sam Yanuck, DC+
Autophagy is the process by which cells repair themselves. Bone marrow stem cells depend on it, as do all white blood cell types and brain cells. Many patients have altered autophagy, and for most of them, it’s a key reason they don’t improve. Inflammasome assembly generates cytokines that alter autophagy. In this webinar, functional immunology thought leader, Dr. Sam Yanuck, will teach you to recognize and address altered autophagy and its impact on metabolism, immunology, thyroid function, energy, cognition and a host of other clinical factors you see in practice every day.
You’ll come away with knowledge of the following key objectives:
Understand autophagy and its impact on mitochondrial and thyroid function, self-tissue response and other crucial determinants of health.
Understand the mechanisms by which autophagy becomes altered and how to identify factors in a case that contribute to those changes.
Understand the clinical approach to supporting autophagy and how that approach fits into the broader picture of case management.
About the Speaker
Samuel F. Yanuck, DC+, is the CEO and Director of Education for Cogence®, an online functional immunology course, serving nearly 10,000 clinician participants from more than 60 countries around the world. He is an adjunct assistant professor in the Program on Integrative Medicine at the University of North Carolina School of Medicine. Dr. Yanuck co-directs the Yanuck Center for Life and Health, a functional medicine clinic in Chapel Hill, North Carolina, where he’s been seeing patients from everywhere since 1992. Dr. Yanuck helped co-develop the PureResponse™.
+Dr. Yanuck is retained advisor to Pure Encapsulations.
The intestinal barrier is more than just a digestive checkpoint - it's a key defender against non-beneficial microorganisms, toxins, and antigens while allowing the body to absorb vital nutrients. When this barrier is compromised, it can lead to a cascade of symptoms, including occasional bloating, abdominal discomfort, irregular bowel movements, and nutrient malabsorption.
One common consequence of a weakened barrier includes intestinal concerns, often triggered by self-tissue response. According to the CDC, over 3.1 million Americans experience intestinal immune concerns,1 which can disrupt nutrient absorption and weaken overall immunity.
This article will explore the essential nutrients that support the mucosal immune system and strengthen the intestinal barrier, offering insights into how dietary interventions can help maintain gut integrity and overall health.
A Healthy Barrier and Its Functions
The intestinal barrier consists of a monolayer of specialized epithelial cells that line the gut lumen, forming a selectively permeable barrier. These epithelial cells are sealed together by tight junction proteins, including occludin, claudin-1, and zonula occludens-1 (ZO-1).2,3 Tight junctions function as "gatekeepers," determining what substances can pass through the intestinal lining into the bloodstream while preventing the entry of harmful microorganisms, toxins, and antigens.
The intestinal barrier also includes a mucus layer, which provides physical protection by preventing direct contact between microbes and the epithelial cells. It contains antimicrobial peptides and secretory immunoglobulin A (sIgA), which neutralize non-beneficial microorganisms and contribute to immune defense. This layer is rich in immune cells such as macrophages, dendritic cells, and T-cells, which play key roles in maintaining immune homeostasis.3
The primary functions of the gut barrier include:4
absorption of nutrients
regulation of immune responses
maintenance of intestinal homeostasis
prevention of the translocation of harmful substances
supporting bidirectional communication between the gut microbiota and the immune system
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A Compromised Barrier
When the integrity of the gut barrier is compromised, it can lead to increased intestinal permeability, commonly called "leaky gut." Increased permeability allows larger molecules, such as undigested food particles, toxins, and microbes, to enter the bloodstream, potentially triggering an unbalanced state and immune activation. This, in turn, can lead to persistent intestinal distress and self-tissue response in the intestines, further exacerbating symptoms and contributing to systemic changes.
Factors That Impact GI Integrity and Lead to a Self-Tissue Response
The integrity of the intestinal barrier and the development of a self-tissue response in the intestines is rarely a result of one factor. Instead, it is a multifactorial process influenced by numerous factors, including the health of the microbiome, immune and cytokine responses, and nutrition, lifestyle, and health components.
The Health of the Microbiome
The gut microbiome is a complex ecosystem of nearly 100 trillion microorganisms that maintain mucosal health.2 Beneficial microbes such as Bifidobacteria, Lactobacilli, enterococcus, and Clostridium produce short-chain fatty acids (SCFAs), which support tight junction integrity and signaling.2
Conversely, a microbial imbalance resulting from low microbial diversity or gastrointestinal infections can increase intestinal permeability and promote an increased immune response. Evidence suggests that individuals with a self-tissue response in the intestines have a reduction of beneficial bacterial species in the gastrointestinal tract.5
The Immune and Cytokine Responses in the Gut
The gut-associated lymphoid tissue (GALT) is an integral part of the immune system, responsible for responding to non-beneficial bacteria while maintaining tolerance to dietary antigens and commensal bacteria. Cytokines such as interleukin-10 (IL-10) promote immune tolerance, whereas excessive production of cytokines like IL-6 and TNF-α disrupt mucosal balance. Activation of these cytokines can perpetuate barrier and tissue changes, contributing to systemic immune activation.6,7
Nutrition, Lifestyle & Health Components
Nutrition: The Standard American Diet (Western Diet) contains a high intake of refined sugars, processed carbohydrates, red or processed meat, omega-6 fatty acids, and alcohol, exacerbating the body's cytokine balance processes. The way of eating is also partially responsible for decreased bacterial diversity in the gut and contributes to inadequate intake of essential vitamins and minerals. Poor nutrient absorption is a common presentation for people with a self-tissue response in the intestines.8,9
Conversely, a diet rich in fruits and vegetables, fiber, omega-3 fatty acids, fish, grains, and legumes protects and supports a healthy GI barrier. Studies have shown that eliminating some food groups, such as gluten and dairy or other known food allergies or intolerances, may help reduce GI symptoms and support a self-tissue response.9 Special attention should be given to replacing vitamins and minerals, such as B vitamins, vitamin D, electrolytes, and omega-3 fatty acids, as indicated.10
Lifestyle: Perceived stress that is uncontrolled or not well managed is considered a predictor of the exacerbation of GI symptoms and self-tissue response.11 Poor sleep quality is associated with elevated levels of IL-6, TNF-α, nuclear factor-kB (NF-kB), and CRP (C-reactive protein), known markers of the immune system.12
Health Components: General health components such as a history of intake of medications, exposure to environmental toxins and genetic predisposition also play a role in the susceptibility to a compromised intestinal barrier and immune response.
Nutrient Solutions to Build the Intestinal Barrier
Glutamine is the most abundant amino acid in the body. It is the primary energy source for enterocytes (the cells that line the small intestine and colon), utilizing about 30% of total glutamine.13,14 It also helps maintain healthy intestinal integrity by enhancing the intestine's protective mucosal lining and promotes tissue repair from metabolic stress.14‡
Studies have demonstrated that L-glutamine supplementation reduces intestinal permeability and supports outcomes in patients with compromised barrier integrity.13‡
Arabinogalactan, a fiber derived from larch trees, is a prebiotic that promotes the growth of beneficial gut bacteria. such as Bacteroidetes, Bifidobacterium, and Faecalibacterium praisnitzii, which are crucial for proper gut-associated lymphoid tissue (GALT) function and development.15 These bacteria produce SCFAs, including butyrate, which enhance epithelial integrity and modulate cytokine production.‡
Arabinogalactan also has immunomodulatory properties, supporting the production of natural killer (NK) cells and promoting mucosal immunity.16 It may also promote healthy production of cytokines, which mediate cell-to-cell communication between cells involved in the immune response. Its dual role as a prebiotic and immune supporter makes it a valuable addition to protocols to restore gut health.‡
Perilla (Perilla frutescens) is a traditional herb rich in polyphenols and rosmarinic acid. which promote cytokine balance and antioxidant effects. Its active compounds reduce the production of cytokines such as IL-6 and TNF-α, which are implicated in intestinal immune changes.17‡
In a randomized, controlled trial involving 50 individuals, 150 mg of Benegut®Perilla frutescens extract twice daily offered significant support for GI comfort.18 Perilla also stabilizes mast cells, reducing hypersensitivity reactions that can contribute to mucosal damage.19‡
Additionally, its antioxidant properties help neutralize reactive oxygen species (ROS), protecting the intestinal lining from oxidative stress.20
Astragalus (Astragalus membranaceus) is a well-known adaptogenic herb with a long history of use in Traditional Chinese Medicine (TCM). It promotes immunity by supporting B and T lymphocyte production, balancing Th1/Th2, and modulating cytokine response.21 It also protects the intestinal barrier by upregulating tight junction proteins and secretory IgA (sIgA) production. This key immune component coats the intestinal lining and prevents the adherence of non-beneficial microorganisms.22 Its adaptogenic properties further support resilience against stress, a contributing factor to a compromised intestinal barrier.23‡
Deglycyrrhizinated licorice (DGL) supports the healing of the GI barrier and other mucous membranes by increasing blood supply to mucosa, increasing the production of mucus, which acts as a protective barrier for the intestinal lining and improves the life span of intestinal cells.24‡
Created in BioRender.com
Pure Encapsulations® Nutrient Solutions
Pure Encapsulations offers expertly crafted supplements made with high-quality, pure ingredients and supported by verifiable scientific research. These products are designed to complement personalized care plans.‡
Epi-Integrity powder: is a carefully formulated blend of glutamine, prebiotic fiber, and herbal extracts that support the modulation of mucosal immune responses and promote gastrointestinal (G.I.) barrier integrity. It helps maintain a balanced microbiome, provides mucosal protection, and supports epithelial cell health for optimal gut function.‡
Suggested Use: 1 scoop, 1-2 times daily. Add 1 serving to 8 oz of water or juice. Shake or stir until dissolved.
Conclusion
Restoring intestinal barrier integrity and supporting mucosal immune responses are essential for addressing symptoms associated with self-tissue responses in the gut. Healthcare providers can leverage evidence-based nutritional strategies to address the underlying factors contributing to a compromised barrier. Nutrients such as L-glutamine, arabinogalactan, perilla, Astragalus, and DGL offer targeted support for mucosal repair, cytokine modulation and immune balance.‡
Resources
Gastrointestinal Self-Tissue Response Protocol: Designed by our scientific and medical advisors to help you deliver the most effective care and support for your patient's intestinal health.‡
Drug-Nutrient Interaction Checker: Provides valuable information on potential interactions between your patients' prescriptions, over-the-counter medications and nutritional supplements.
PureInsight™: Our streamlined platform easily collects patient data and provides valuable recommendations to help achieve their health goals.
Virtual Dispensary: Our Pure Patient Direct program provides account holders FREE access to our virtual dispensary to help simplify patient sales and reduce in-office inventory.
Self-Tissue Response: Managing the Case from Start to Success
Presented by: Sam Yanuck, DC+
Clinical success depends on your ability to recognize patterns in the case, address those patterns, observe results and repeat that cycle. Success also depends on your ability to partner with the patient and actively involve them in that process. In this webinar, functional immunology thought leader, Dr. Sam Yanuck, will walk you through a functional immunology case and provide real clinical examples that illustrate the order of operation of care for self-tissue response, how to manage key pivot points in the case, and how to communicate with the patient effectively at key moments.
You’ll come away with knowledge of the following key objectives:
How to identify key opportunities in the case and apply clinical leverage to maximize your chance of success.
How to move the patient through the stages of their case. Creating alliance, communicating proper expectations, and giving the patient the image of the flow of the case, so you are partners in the process.
How digestion and microbial balance in the GI tract drive self-tissue response, brain fog and fatigue.
About the Speaker
Samuel F. Yanuck, DC+, is the CEO and Director of Education for Cogence®, an online functional immunology course, serving nearly 10,000 clinician participants from more than 60 countries around the world. He is an adjunct assistant professor in the Program on Integrative Medicine at the University of North Carolina School of Medicine. Dr. Yanuck co-directs the Yanuck Center for Life and Health, a functional medicine clinic in Chapel Hill, North Carolina, where he’s been seeing patients from everywhere since 1992. Dr. Yanuck helped co-develop PureResponse™.
+Dr. Yanuck is retained advisor to Pure Encapsulations.
Clinical Strategies for Optimizing Thyroid Hormones
Presented by: Izabella Wentz, PharmD+
Thyroid health is foundational to numerous bodily functions, including energy levels, metabolism, digestion, mental health, fertility, stress resilience and more. In this webinar, Dr. Wentz, a nationally acclaimed thyroid specialist, will explain how essential vitamins, minerals and botanicals can be used to support optimal thyroid hormone metabolism, adrenal balance and thyroid-to-adrenal interaction. The discussion will address the role of nutrient insufficiencies, the impact of stress on thyroid function and factors involved in the T4 to T3 conversion process.‡
Learning Objectives:
Learn how to leverage essential nutrients (including vitamins A, D, zinc and selenium) to support thyroid cell metabolism and hormone function.‡
Discover how stress and adrenal function can influence thyroid hormone balance and review important methodologies for managing stress.
Understand the mechanisms of T4 to T3 conversion and how to support a healthy balance of these hormones in your patients.
About the Speaker
Izabella Wentz, PharmD, FASCP+, is a nationally acclaimed thyroid specialist and licensed pharmacist who has dedicated her career to helping practitioners and patients understand and properly address thyroid function, particularly in the >90% of cases involving an immunological component. Dr. Wentz is the author of several best-selling books, including New York Times best seller Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause and is dedicated to educating the public and healthcare professionals about functional medicine approaches to optimizing thyroid function and overall health.
+Izabella Wentz, PharmD is a retained advisor for Pure Encapsulations.
The adrenal glands are designed to keep basal rates of corticosteroids, mineralocorticoids and sex hormones and to robustly secrete stress hormones for resilient protection during a stressful moment. However, stress can overwhelm these glands leading to various stages of the adrenal response. In this webinar, Dr. Peter Bongiorno explains how most cases of stress and anxiety are a normal reaction to what we put our bodies and minds through. He will cover the workings of the HPA axis and reveal the true relevance of early, mid and late adrenal response. By learning from his 21 years of clinical experience managing these various stages, you can gain strategies for bringing your patients back to resilience.
Learning Objectives:
Recognize the impact of stress on adrenal function
Understand the workings of the Hypothalamic-Pituitary-Adrenal (HPA) axis
Identify the stages of adrenal response: early, mid and late, how they occur and the methods to test for them
Acquire practical strategies and clinical insights from Dr. Bongiorno to address various stages of adrenal response and enhance patient resilience
About the Speaker
Peter Bongiorno, ND, LAc+, is dedicated to bringing effective holistic healing to the practice of mental health. In 2004, he established two thriving practices NYC Integrative, in New York City and Long Island. Prior to earning his naturopathic doctorate from Bastyr University, he researched at the National Institutes of Mental Health and Yale University, studying stress and the HPA axis. He authored the first integrative medicine textbook for depression in 2008. He has written numerous publications since then including three more books on mental health, including How Come They're Happy and I'm Not?
+Dr. Bongiorno is a retained advisor for Pure Encapsulations.
