Excerpts from episode 29 of my podcast The Perfect Stool: Understanding and Healing the Gut Microbiome with Dr. Nasha Winters, ND
LP: Lindsey Parsons, NW: Nasha Winters
LP: Do you still consider yourself a cancer patient? Or do you feel fully recovered and not in danger?
NW: That’s a really good question. I personally don’t believe that there is a cure for cancer. I believe cancer is in all of us and the studies and research support that fact. I believe that we have the ability to turn the signaling and those pathways off, or to keep them quiet and dormant, or we have the ability to set them on fire and turn them on wildly. So, I feel where I am today, per Western medical standards, I am not cancer free. However, per my standards, especially since about mid 2010, I’ve stopped “cancer-ing,” if that makes sense. Everything is stabilized, and my body is completely in harmony and balance with all of this. And I know how to check under the hood: to test, assess, and address my process. That’s what I’ve learned for myself, what I’ve taught other patients and now what I’m teaching other physicians: is exactly how to manage this disease process and really understand where it’s come from, why it’s so individualized, and how to best support the person through the process. One of the coolest key foundations for getting better outcomes is based on the health and diversity of the microbiome.
LP: Well, that’s exactly where I was heading. So let’s talk more about that.
NW: First of all, one of the things I love—and you being the poo goddess, microbiome diva that you are, I’m probably not saying anything that you are not aware of—but I love how we consider the microbiome today the “Forgotten Organ.” Let me explain. We’ve known since Ayurvedic medicine, which is the sort of great grandmother of medicine that we know of today—so we’re talking anywhere from 3000 to 5000 years old information—saying that our health is based on the health of our gut. We didn’t quite know what that exactly meant, but we know today, when we started really looking at studies in 2005, and really started placing more emphasis on our GI tract, we certainly were validating thousands of year-old ideology and theory. So that’s the one thing that even as a naturopathic doctor, since my medical school training in the mid 90s, we were like, “the gut, the gut, the gut,” and everyone just basically said, “you’re crazy,” and “standard of care.” Yet today, we’re investing so many of our resources for research and treatment. Until they could monetize [research on the gut microbiome], it didn’t mean anything. But once they were able to really monetize it, now we’re paying attention. That’s unfortunately the way it happens a lot in our medical system. But I just think this is really a powerful thing to think about: the Forgotten Organ always been there, we’ve always known it played a role, and now we are paying for the research to really explain why. The other cool thing specific to cancer and the microbiome is that it is estimated at 20 percent of all tumors worldwide are microbially-driven. Let that sink in.
LP: And would that be bacteria, fungi, viruses…?
NW: Yes, yes, yes, yes, yes.
LP: …and parasites!
NW: Yes. You’re nailing them all! You hit them all. And there’s a great quote that showed up in a cancer journal back in January 2019. The article was titled “Gut Microbiome and Cancer Immunotherapy.” This simple quote says, “a healthy body is inseparable from an integrated gut epithelium with specific function and gut microbiome, immune cells and mucosal barriers together that maintain epithelial homeostasis.” In short, what that says is that what those crazy Ayurvedic doctors have been saying for 5000 years was spot on: our health comes down to the function and flora of our microbiome. I just think it’s very interesting that it took us until 2019, to really state that fact with much more certainty in the standard of care model.
LP: So let me dig a little bit more into what you were saying about 20 percent of cancers having a microbial origin, is the implication there that the microbe is somehow setting off the tumor process?
NW: Yes, basically what we have learned is that the micro ecology of our microbiome, the changes there, are where—if you’re going in the wrong direction, that’s where we will rapidly proliferate rogue bacteria, or viruses, or parasites, and then those little creatures will then interact with the lining of our gut: the epithelial cells, and these other cells, which hold the structure of our inner world into a sort of matrix or into sort of a scaffolding, known as the stromal cells. What happens when that ecology gets tweaked in any way [is that] the epithelium and stromal cells are altered in their function and their chemical responses. Even more specifically, what’s happening is that rapid shift in the microbiome, and those specific cells result in what’s known as toxic metabolites that trigger off what we call carcinogenesis: new cancer cells that can grow anywhere in the body, not just in the gut. Then that happens even further, causing a cascade of things like inflammation and immunosuppression. In my mind, the trifecta today of cancer is: gut dysbiosis with inflammation and poor immune function. This is the perfect combination for a cancer storm.
LP: Okay, so, now, when you said “toxic metabolites,” is that the same as the endotoxins? Or LPS?
NW: Yes, all of those pieces. So, endotoxins that the individual organism can shed, but also a perforation to the lining, that LPS, that lipopolysaccharide coating that goes across our whole tube—I always tell people, “we’re just a tube with the body wrapped around it”—and so that piece happens. But, then, also we trigger—because you and your listeners obviously know that, depending on who you talk to, about 70 to 80 percent of our immune cells and our immune function is happening at the GI tract level, the microbiome level—we trigger a cascade of cellular responses such as: natural killer cells, cytokines, which are inflammatory molecules. We can create a little cacophony, a little orchestra, of all types of things that are triggered, that not only impact what’s happening at the tube level, but send out all kinds of signals throughout the rest of the body.
LP: And so they’re sending those signals, and as a result a tumor forms? I’m having trouble taking the one part and making it connect to the other part.
NW: Well, so, here’s the thing: your discomfort around really grappling with this is because we have [in Western medicine], frankly, blown smoke up people’s asses for 70 years with regards to what cancer is. So, what I’m talking about blows people’s minds because we sort of think of cancers as exogenous invaders that somehow enter us, from outside of us, and we have to then kill it or fully eradicate it. We’ve given [cancer] unbelievable power, [in believing] that it’s driven by our genetics, that it is a genetic disease, and that we’re sort of powerless and dealing with it. However, what we have learned in the last–well, what we’ve re-learned, let’s put it that way, because we knew this back in the early 1900s, but we took a little different turn when Watson and Crick came along with their focus on genetics and DNA–but what we’ve since learned is that really cancer is a metabolic disease. It’s a disease on the energies that we take into the body. It’s a disease at the mitochondrial level: on the little powerhouse cellular structures that each of our cells carry, the turning on or off energy performance throughout our tissues, throughout our organs, throughout our whole body. But [because cancer is a disease at the mitochondrial level, it is also a disease on] the signaling pathways that tell things to grow. Mitochondria tell things to die, they tell things to stall, to hold off, they tell things to regenerate, they tell things to increase inflammation when you need it, or to decrease inflammation when you need it. So basically, all of these cell pathways start to communicate to each other for the rest of the body, and, then, over time, on average, somewhere between seven and ten years, enough cells start to congregate and clump up, and hang out, based on the inflammation we talked about at the level of those epithelial cells that not only line our gut, but line our vasculature, and line our cells, and line our organs, [and] so, too, at the level of our stromal cells that offer structure–think of them as the sort of jungle gym that cells walk around on, like travel around on to migrate throughout, building and metastasizing. So when you said, “Okay, I’m trying to understand where the bridge comes together–that suddenly you have a tumor from this,” [my response is] it’s a long standing, ongoing process that can take years to solidify to be big enough and loud enough and clumped together in such a way that we recognize it as a tumor, or a cancer diagnosis. What I’m trying to help your listeners understand is that we have the power to turn this around way before it’s big enough and loud enough to capture our attention by changing things down at that cellular level, and preventing things from getting on the move, and congregating and clumping up to make what we know today as a tumor.
LP: What do you recommend–short of a fecal transplant–to replace that diversity [in the microbiome] as a preventive measure?
NW: I mean, first of all, we eat very differently than we do from our ancestors. We ate so many more diverse foods, and plants for millennia. And as I said, we’ve really mono cropped. So, you, then, have to take it upon yourself to branch out your diet and bring in foods you don’t normally eat. I tell people: start playing with things like Jerusalem artichoke, leeks, plantains, things that you would probably normally eat a little bit of in your diet that bring in the prebiotics and the insulin and the types of fibers that are the food and fuel for your microbiome. Then, diversify your portfolio with your pre-digested soil rich foods. Don’t be too clean with your foods. Grow your own. Eat the dirt off your carrot… And then also, in the West, we’re not really keen on our ferments, but most cultures have some type of ferment: like borscht, like the kvass, you know, in some parts of the world and, and the kimchi in others, or the sauerkraut in others, or pickled vegetables in others. It’s now becoming kind of hipster and cool in the U.S.: thanks to things like Portlandia: “you can pickle that!” But ultimately it’s about encouraging people to eat a fermented food on a daily basis. If you have really terrible things like FODMAPs or Small Intestine Bowel Overgrowth issues, even those foods can backfire. So you have to work with a trained professional to help get the inner garden more ready to accept those foods. So that’s a big one. Another big one is sugar. We’re a bunch of sugar junkies and sugar is really a beast and feeding these little wrong directional microbes and organisms in our gut. They will vie for that fuel and basically starve us of our other nutrients. And then fiber. We tend to have a very low fiber dietary intake in the West. We just don’t do our veggies. You know, we want to be telling our patients to take their 9-15 servings of vegetables in a day, which is what I have my patients do: above the ground, leafy green, low-carbohydrate rich foods, but ultimately, most people can barely get three servings in a day.