March 14, 2015

by Angela Pifer, Functional Medicine Nutritionist

Are you prone to sinus infections, get sick often, allergies… or a functional gut condition or disease? If so, knowing if you have low Secretory IgA, an antibody that plays a crucial role in your mucosal immunity, will help you target your treatment, and, if recovered, can improve your long term prognosis.

Mucosal membranes cover approximately 30 feet of your body and carry 15,000-36,000 species of flora. The number of prokaryotic cells that your body harbors outnumbers the human cells in your body.

In a healthy gut, matter simply moves too fast through the small intestine for the flora to build up to larger numbers. The endogenous flora that is present is literally hanging onto the small intestinal lining for survival.

Though it is beneficial to have a small amount of flora lining the tract, an overgrowth of bacteria or other organisms in this area will interfere with nutrient assimilation and absorption and it will cause bloating, pain and distention.

Your body defends against over-colonization of the small intestine by various host ‘defense mechanisms.’ It maintains a proper pH in the gut lumen. Forward moving digestion (keeps things moving from the top down) helps to prevent adhesion and colonization of ingested micro-organisms. Proteolytic digestive enzymes and bile help to digest ingested micro-organisms. The mucosal lining of the gut protects the cells that line your tract and the mucosal immune system plays a role in maintaining homeostasis in the gut.

Secretory IgA is an antibody that plays a critical role in mucosal immunity. If you again consider that mucosal membranes cover approximately 30 feet of your body and the constant environmental exposures of bacteria, pathogens, yeast… etc., that these mucosal cells come into contact with, it makes sense that Secretory IgA is the most abundantly produced antibody in your body. These secretions are found in tears, nasal mucus, saliva, vaginal secretions and bronchial mucus. Secretory IgA serves as your front line defense to protect your gut lining from infections, pathogens and toxins. It helps prevent the absorption of these allergens into the blood stream.

IgA secretions coat your endogenous flora and it helps them create biofilms, so they can group together and this improves their survival rate. They also attach to exogenous (from the outside) flora and can signal this to be cleared from your system without activating the immune system as a whole; without triggering inflammation (which is the usual immune system pathway trigger). Because of this, it is considered part of the innate immune system.

Low Secretory IgA (S IgA) is typically found in people suffering from chronic digestive conditions – inflammatory bowel diseases, Celiac, SIBO and IBS. A low S IgA means that you are immunocompromised at the mucosal level and that you will have a harder time defending yourself against pathogenic invaders. Your mucosal immune system cannot help keep the balance of endogenous flora and it can’t help tag invasive flora or pathogens for removal and this will make you more susceptible to infection, illness and allergies. Low Secretory IgA makes it more difficult to address candida and increases the likelihood of allergies and leaky gut.

SIBO Guru - How Does Low Secretory IgA Effect SIBO Treatment

How Does Low Secretory IgA Effect SIBO Treatment?

What does this mean with regards to SIBO? A low S IgA is a risk factor for getting SIBO. It is also makes SIBO more difficult to cure long term. Stress has a big influence on S IgA levels, and the stress of dealing with SIBO (or any other chronic digestive condition) can affect S IgA levels even more, by driving them lower.

How do you Test Secretory IgA

Secretory IgA can be tested through serum, saliva and a stool test. I am most interested in the stool test results.

If Secretory IgA levels are high, this indicates a chronic acute infection

If low, Secretory IgA levels can be recovered over time. Clinically I have seen this take 4-6 months and up to a year.

1. Test for pathogens/ parasites. I prefer a three day stool collection that includes both culture and microscopic evaluation of the stool to check for yeast and parasites. Parasites do not drop with each bowel movement so a one day stool collection may miss these. Yeast is very difficult to culture – it does not survive the trip into our bowel movement alive, so it cannot easily be cultured. Clinically, I often see ‘negative’ yeast culture, but ‘many’ yeast microscopically identified on each stool collection. This is ‘positive’ for yeast!

2. Stress reduction must be part of the protocol. I recommend walking, meditation, biofeedback and yoga.

3. Address food sensitivities (I never use a test for this; they are wildly inaccurate –we work through observation to remove known food sensitivities).

4. Support digestion, adrenals and detox pathways

5. Supplement support – target therapy with probiotic, beta glucans, digestive enzymes, bile, HCl, colostrum, choline, essential fatty acids, phosphatidylcholine, and amino complex may help.

6. Address low glutathione levels. Glutathione is the most abundant antioxidant produced in your body. You produce as much glutathione as you do cholesterol and blood sugar. GGT is a blood test that can help us determine glutathione levels. If high, this enzyme uses up glutathione, and we can then deduce that glutathione levels are low.

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Comments

from 13 people

Angela

Hi Beth,

Since methane is present, that is going to dictate the treatment. You will need to work with a practitioner to get the correct dosages, timing and to figure out how long you will need to be on these. This protocol might include Allimax and oregano. But again, I have had people come to me after taking a protocol with these included and this didn't 'fix' the issue. SIBO is a secondary condition. You need to figure out what set this up in the first place, address the underlying issues/ condition, get motility moving forward (if constipated), treat this long enough to get to a negative breath test and evaluate progress every step of the way. There really is no 'perfect' treatment for this. We need to treat the person as well and this takes a hands on approach with a health care provider. I do not find that the dual antibiotic protocol is the best plan out of the gate. I prefer to treat the body/ the system/ the underlying issues and use an herbal approach to treat this. I wish you the BEST of luck. Keep looking until you find a practitioner and approach that really speaks to you and work with them.

Warmly
Angela

Angela | August 21, 2016

What is best way to treat methane producing SIBO? Please desperate and need help
Beth

beth | August 3, 2016

Angela

Hi Margaret,
A stool test cannot diagnose SIBO. Only an aspirate culture (endoscopy) or a breath test can do this. I often see a +1 culture or 'rare' microscopic yeast treated, yet clinically I do not do this. I treat the person and not the labs. If a low level of yeast issues, then work on gut healing, rebalancing, etc. With low SIgA -I work on adrenals to support this. Focus on autoimmune (supporting the immune system, calming inflammation, stress management and adrenals). And working on leaky gut, but this would be a part of gut healing.

Best of luck to you!
Warmly
Angela

Angela | August 2, 2016

Got stool test results. Neg for SiBO. Positive for yeast but more important, very low Secretory IgA. Dealing with autoimmunity, adrenal fatigue , leaky gut and many food sensitivities. I have been on Dr. Meyers food plan and supplements but need additional support. Any suggestions?

Margaret Bonner | August 2, 2016

Angela

Hi Melissa,

If yeast was also identified on the stool test, then this might be why our S IgA level was elevated. Yeast is elevated because of dysbiosis and a breakdown of the protective barrier in the gut. Yes, yeast can be targeted with antifungal herbs and then it is important to work on gut healing and immune modulation too. You do not need to go on a NO sugar, NO fruit, etc, plan during this time. Fruit is not going to trigger further yeast issues. The yeast that the stool test is picking up is in your colon and fructose is digested and absorbed in your upper small intestine.

Angela

Angela | July 23, 2016

My Secretory IgA level was 320. I obtained this from a 1 time stool test. My functional med doctor said it means I have too much yeast. I am not sure how to treat this. I also have hashimotos.

Melissa | February 24, 2016

Angela

Hi Jason,
I hope that you have found some relief with your symptoms. I focus mainly on adrenal support to encourage the S IgA to recover. Lactobacillus is notoriously hard to culture. I see this all the time. On stool testing that also looks at PCR (genetic DNA probe to detect lactobacillus) I have never seen this truly at now growth/ not present. It has been as low as the 25% percentile of 'normal' range, but not below that. Bifido is a little easier to culture, but again, if NG, this may be a false negative.

I don't use biocidin by itself. I haven't found it to be effective enough. You can always try the colostrum that doesn't have lactose in it. I don't know your case perfectly, but I would first start to work on adrenals and blood sugar balancing and sleep. Calm symptoms with diet and a starting transition protocol (like biocidin) and then go deeper into treatment for a period of time - likely 2 months, then start to transition slowly to see if your symptoms come back. Then transition and/ or work on gut healing and immune modulation.

I hope that this helps!

Angela

Angela | July 23, 2016

Hi Angela-

I recently had a Doctors Data GI test and my sIGA was basically non existent and i had no growth of lactobacilli. In the past i had no growth of bifido but since starting a product called Biocidin my Bifido levels are back up to +4. I also had some overgrowth of enterobacter clocai. My symptoms have been severe bloating and difficulty passing stool ( at least the first part). I have been using Biocidin for 2 months now and have had some relief but its sporadic. I am starting to use L-glutamine now but i find it drys my mouth and makes me urinate a lot. I also use beta glucan and s.boulardi but i find they bloat me up. And i am not sure if i should be using regular probiotics or not. I would like to use colostrum however i am severely lactose. Would very much appreciate any insight since I am in the dark about what i should do. thanks for listening

Jason

Jason | October 11, 2015

Angela

Hi Bradley,

I hope that you found some relief from your symptoms. Your test is positive for SIBO and do recommend testing this. You also need to identify and fix what set this up in the first place. This is paramount to your long term success and making sure that SIBO doesn't recur.

Warmly

Angela

Angela | July 23, 2016

Hey Angela, I have had stomach problems for years and ready to do something about it. It's probably the usual that you hear, bloating, pressure, loose bowels, etc... I have had the stool test done in July (GPL) and the biggest things that stood out was a abnormally high Secretory IgA level (317, reference range is 51-204mg/dl) and pH levels are too acidic (5.9, normal 6-7.8). I also had a test done last year for SIBO and the 20 min timeline showed 43 over 20, 115% above the baseline, both 40 and 60 min tests showed normal. There are times that I can eat and the symptoms I mentioned will affect me very quickly, other times it takes a few hours depending on what I eat, what do you suggest?

Bradley | August 26, 2015

Angela

Hi Claire,

Here are a couple of thoughts: It is possible that the stool test didn't pick up the possible pathogen. Have you been assessed for celiac? I wouldn't expect heavy amounts of stress to increase SIgA all the time. I wonder though, if you are under a lot of stress and you have a food sensitivity... a few things adding up to create this heightened response in your gut. I like Biohealth 401 and Doctor's Data Stool Test x 3 day collection (plus parasitology) run concurrently sometimes, to really see the whole picture. If you have symptoms that are unexplained, digestive, immune, adrenal, then I would keep exploring this more. You might also embark on a 30-60 day gut healing protocol and then have this retested. You can test for SIgA alone through a fecal test.

Angela

Angela | November 7, 2015

My sIgA was 660 in my recent stool test. More than 3 times the upper limit. But no dysbiotic flora, parasites or yeasts found. There were some commensal flora found including low levels of klebsiella. Would this be enough to cause the high sIgA? I already had a 3 month natural treatment for the klebsiella 1 year ago. It has reduced since then.

claire | July 31, 2015


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