Oral and Gut Bacteria Influence on Heart Disease

Low vitamin D levels significantly increase dental disease and coronary artery disease

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Two Important Concepts Here:

1. Dental inflammation along with low vitamin D negatively impacts the heart.

2. Low vitamin D is a singular risk factor for significant tooth decay and gum inflammation.

Dental dysbiosis does not always present with overt dental issues. It can present as persistent autoimmune disease, chronic fatigue, atherosclerosis, continuously high small particle LDL cholesterol, and in some cases be a driving factor in cancer. The presentation is almost always a smoldering long-term issue that is only discovered when someone has a more detrimental health issue. And not all dentists, gastroenterologists and cardiologists will see the connection between the bacteria and the heart disease.

Not all dentists believe root canals are a problem or know what to look for. Not all are aware of the type of scans which need to be done to see a diseased root canal or even believe that a salivary microbiome test to measure oral pathogens is valid. Unless they’re practicing biologic dentistry or functional medicine.

As the years go by scientists become more aware of the incredible impact that bacteria have on our wellbeing. I actually think we don’t ‘have’ a microbiome. We are a walking talking microbiome. Which is why gut and oral dysbiosis is being revealed as a causative factor in all types of diseases from brain, heart, kidney and immune system. The more ‘bad’ bacteria there are in proportion to good commensal flora, the more bacterial endotoxins are shed, which stimulates inflammatory cytokine production. This over time causes immune system dysregulation, leading to illnesses.

The microbiome starts in the mouth

Dr. Stanley Hazen is a brilliant doctor who first suggested a link between gut microbes and heart disease.

In 2014, Dr. Hazen stated, “In the future, we may consider the gut flora to be the largest endocrine organ in the body. Gut flora, depending on the nutrients we consume, makes distinct biologically active substances that act somewhere in the body.”

According to periodontist Dr. Hatice Hasturk of Harvard, “Periodontal disease increases the body’s burden of inflammation, which involves an outpouring of immune cells that attack irritants and microbial invaders — fosters healing over the short term. But chronic inflammation is a key contributor to many health problems, especially atherosclerosis.”

“Daily tooth brushing and flossing can prevent and even reverse an early stage of gum disease, known as gingivitis. If your dentist says you have gingivitis, ask for a demonstration of brushing and flossing to make sure you’re doing both correctly.

Many people don’t spend enough time or care when brushing (the recommended duration is two minutes). Flossing sweeps away the sticky film between teeth, which leads to plaque buildup. Twice-yearly cleanings by a dentist or hygienist are also advisable.”

“Left untreated, gingivitis can turn into periodontal disease. The gums become loose around the root of the tooth, creating a gum pocket that gradually deepens. Eventually, the infection and inflammation can cause the tooth to loosen and possibly fall out.”

And now, you can add taking vitamin D to that list!

The Gut-Heart Axis:

In March 2020, I completed my master’s degree in Functional Medicine (woohoo!). I chose to do my thesis paper on the available research on the Gut Heart Axis.

What is the Gut-Heart Axis?

This is the way the microbes in our gut influence the health or disease of the heart. The studies involved in this research found probiotics could be used as therapy for the treatment of various heart diseases and cardiovascular risk factors (high blood pressure, high cholesterol, etc)

I painstakingly (ok, I enjoyed it lol) combed through every bit of literature and human study I could find, and there was NOT a large number of studies. In fact the majority of the literature I could find dated back to 2017 (only 3 years prior at the time).

I had stumbled upon a novel concept that was probably not being considered by Cardiologists or Gastroenterologists.

My research found people with various heart diseases have massive quantities of pathogenic gut bacteria. 

One study found that people with Small Intestinal Bacterial Overgrowth (SIBO) have a ‘sub-clinical’ atherosclerosis. Meaning, their arteries weren’t calcified enough to have a high calcium score. But, they were stiffer and had less pulse wave velocity (the velocity at which the blood pressure pulse propagates through the circulatory system, usually an artery).

Studies Showing A Relationship Between Pathogenic Gut Flora And The Severity Of Heart Disease.

Below are more fascinating studies finding relationships between pathogenic gut flora and the severity of heart disease.

•  A twofold increase in Atrial Fibrillation (AFib) during Irritable Bowel Disease flare-ups. Stroke risk was exclusive to the active IBD flare-ups (Kristensen et al., 2014).
•  Chronic Heart Failure (CHF) patients had massive quantities of Candida, Campylobacter, Salmonella, and Yersinia bacteria, and a 10x increase in markers of leaky gut vs. the control group. Overgrowth severity was interrelated with increased atrial pressure, inflammation, and venous blood congestion (Pasini et al., 2016).
• SIBO may be a very early indicator of Atherosclerosis, and people with SIBO may be at an increased risk for atherosclerosis (Ponziani et al., 2017).
• Vascular calcifications/High Calcium Score: the gut bacteria make vitamin K2/menaquinone-7 (vitamin K2/MK-7), which prevents calcium from depositing on the blood vessel walls. A subclinical Vitamin K2 deficiency can be determined by elevated undercarboxylated MGP (uc-MGP).  Elevated uc-MGP is associated with an increased incidence of arterial calcification for which vitamin K2, not K1 supplementation, can improve (Brandenburg et al., 2015)(Gast et al., 2009). MK-7 supplementation significantly decreases calcium from displacing into the arteries.

Probiotics as Therapy for CVD: 

This research highlights the importance of fusing the fields of Cardiology and Gastroenterology together because they are both interrelated.

Arterial Stiffness:

Multi-species probiotic supplementation can favorably modify vascular dysfunction and reduce arterial stiffness (Szulinksa et al., 2018).

Heart Failure:

Saccharomyces boulardii administered for 3 months significantly reduced cholesterol, improved left ventricle ejection fraction, reduced left atrial diameter, reduced uric acid, reduced inflammatory markers (Costanza et al., 2015).

Hypertension:

Those with hypertension have high amounts of klebsiella, clostridium, and strep bacteria. Those with hypertension also have low amounts of protective short-chain fatty acids.

The more hypertensive the subject is, the more potentially pathogenic bacteria there are (Yan et al., 2017).

Lactobacillus casei supplementation for 2 months showed significant improvements in hypertension and fasting blood glucose (Nakajim et al., 1995).

Probiotics can modulate Angiotensin-Converting Enzyme (ACE), this is a common drug that is given for hypertension, an ACE Inhibitor medication.

Watch a 10 minute summary of my findings on the Gut-Heart Axis click here

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