Brushing, flossing, and visiting your dentist every six months are all essential components of keeping your smile happy and healthy. But did you know that your oral health can also affect your gut health? As a Tucson dentist with more than 20 years of experience, I’m here to shed light on the correlation between the two and what you can do to improve your dental health.
How Does Oral Health Impact Gut Health?
At first, it may not seem like there is much of a link between oral health and gut health. Upon closer inspection, however, the relationship between the two is evident. To start, your mouth and your gut are directly connected, so any bad bacteria in one can easily affect the other. Inflammation-causing bacteria, like P. gingivalis or Fusobacterium nucleatum, in your mouth can travel throughout your body via the bloodstream and saliva into your digestive system, weakening your stomach’s ability to fight off infection in the process. In response, your body sends infection-fighting cells to the area. In the long-term, this can damage the stomach and leave the rest of your body vulnerable to disease and inflammation. In short, if you neglect to care for your teeth and gums, you’re at a higher risk of other health issues, like IBD.
The link between oral health and gut health is a two-way street. Imbalances in your gut’s microbiome (a collective term for all of the microscopic organisms in a particular environment) can adversely affect oral health, contributing to things like tooth decay and gum disease. Other gut issues, like GERD, can also have bad consequences for the teeth (GERD can create make the mouth overly acidic, which can cause premature wear and tear to the tooth enamel).
5 Tips for Caring For Your Teeth and Gums at Home
The good news is that many dental health problems, from cavities to gum disease, are largely preventable with the right best practices in place. With this in mind, here are a few to implement:
Brush your teeth twice a day – Use a soft-bristled toothbrush and toothpaste with fluoride for two minutes at a time to remove food particles, bacteria, and debris.
Floss daily – Brushing alone only cleans about 60% of the surface of your teeth. That’s why flossing is so important!
Eat a vitamin-rich diet – A nutrient-dense diet will help keep your teeth strong from the inside-out. Plus, well-balanced meals will promote a healthier microbiome in your mouth and therefore your gut.
Drink plenty of water throughout the day – The list of water’s benefits is long, which is why you should be sure to have enough of it. Drinking water can rinse away food particles and bacteria and keep you hydrated. In addition, water neutralizes the acids bacteria create, lessening the impact on the mouth and gut.
Quit unhealthy dental habits – Smoking and chewing on ice are just a few unhealthy dental habits that can take a serious toll on the look and function of your smile. So, opt for alternatives, like chewing on sugar-free gum!
Why Your Biannual Checkups & Cleanings Are Crucial
Unfortunately, many patients have adopted the belief that six-month dental checkups and cleanings are optional. In reality, they are essential for both your oral health and overall well-being. During your dental checkup, your dentist in Tucson will check for dental problems, like gum disease, while simultaneously screening for non-dental issues, like oral cancer.
Since the symptoms of each can easily fly under the radar with an untrained eye, these visits have the potential to be lifesaving. The cleaning portion, on the other hand, is designed to remove stubborn plaque, eliminate surface stains, and clean the hard-to-reach areas of your mouth, which in the process helps promote a healthier gut.
So, if your next checkup and cleaning isn’t on your calendar yet, now is the time to schedule it!
If you’re struggling with your gut health, you’re welcome to set up a free, 30-minute breakthrough session with Lindsey. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
Niraj Naik left his service as a community pharmacist when he was diagnosed with a severe case of Ulcerative Colitis. Rejecting his choices of a colectomy or untested pharmaceutical drugs, he started his own route of healing using diet, breathwork practices and natural supplementation, including bovine colostrum powder*. It was not a quick journey, but after about 2 years, he was completely symptom free. He has since founded a school of breathwork practices called Soma Breath*. He also created a step-by-step treatment plan for fixing and even reversing leaky gut and other digestive issues.
Lindsey:
So tell us about your gut healing journey.
Niraj Naik:
Sure, I’ll try and put it as concisely as possible because there’s so many different twists and turns of the whole thing. Well, I actually started off as a community pharmacist years ago, in the UK, where I actually worked for seven years in this profession. And it’s actually where I really got an insight into the healthcare profession and how it is and how it operates. And it just wasn’t aligned to who I am, my values and I could feel it. I can freely feel that disturbance inside, that spiritual disturbance. And in the end, it actually took its toll on me. Because I tried very hard to get out of that career and into something more empowering.
I actually had a bit of burnout and went to a Tony Robbins event. And it was through that where I first discovered anyone talking about diet and nutrition and sleep and lifestyle things for health. And I was going to test this out in the pharmacy, right, because if this stuff works and they try it out, and the simple thing that I started to do was just to change people’s diets from a factory based diet, which most people are on, to a natural whole food diet. And I just got amazing results just doing that.
So I started to get actually even doctors calling me up and things like that, and telling me “this is amazing, keep going.” But then one thing led to another. I ended up actually getting promoted to the head office of one of the biggest corporations in the UK, where I was going to come up with this healthy shopping this service that would help a lot of people. In the end, for some reason, they decided to stop the idea and six months into it I was facing having to go back to this career as a pharmacist. It’s literally like working in a cubicle dishing out pills all day long. And it was so disheartening, disillusioned. I was so disillusioned, I’d lost my faith in spirit, everything and boom, that’s when I got a hit with an autoimmune disease myself.
I went from being the pharmacist to being the patient. And I ended up being housebound for almost a year. I was literally going to toilet 40 times a day, bleeding. I remember one time, the doctor said, “You’re going to have to wear a nappy”, because you get some social anxiety about soiling your pants when you’re out. And it’s horrible, horrible. And then I lost like a third of my body weight and it got so bad that the consultant and in the end, who actually initially told me that diet doesn’t make an impact, stress doesn’t make an impact, just basically said shut up and take the pills or have your colon removed. She then said you could be a guinea pig on a drug that hasn’t even been tested before, as a last resort. So she really was encouraging me to sign up for this and this is when I had my big kind of dark night of the soul moment.
And luckily, a dear friend of our family came to the rescue. And she basically said “Look, you’ve got a gift here. If you can change your perception of this and see it as a gift, you could actually really help a lot of people. And you know, first thing is to get better yourself without taking all this stuff.” So, I learned the basics of yoga, pranayama, which is the breathing system from India and then basically the Ayurvedic approach of fixing your health, and then finding the right diet based on you, really focusing on the mantra of know thyself, really understanding who you truly are, and then also understanding the kind of career that you should be going for as well.
And through that I realized that I’m the wrong personality for a profession that’s very left brained and analytical. I’m very creative. And I ended up going back into my passion for music. I decided to combine music with these ancient practices I was learning and started to get really, really compelling results using breathing techniques combined with this special brainwave music. And I started to compose again and that was really healing itself and cathartic.
But also through the Ayurvedic system, I discovered that most of disease begins in the gut. So you’ll get these symptoms. If you ignore them, that’s your gut instinct telling you there’s something wrong. You’ll get irritable bowel, you’ll get constipation, you’ll get bouts of constant diarrhea, usually when you’re in the wrong place, and you know it, but you’re not listening to it. And you know, when you suppress it, you shut off those symptoms, those feelings in different ways. Eventually it’s too late, boom, that’s when you get autoimmune disease. And it’s often emotions that are unresolved, where you’re not listening to your whole body intelligence that manifests as an illness, that kind of is like a cop out of the system that you’re in to tell you, “Wake up and do something else. Follow your soul instinct.”
Lindsey:
So let me let me stop you for just a sec. And just make it clear. So your diagnosis was ulcerative colitis, right?
Niraj Naik:
Yes, that’s what I had.
Lindsey:
And did you know right away when things started happening, that that was a likely scenario given your profession? Or did it take a while to get to the diagnosis?
Niraj Naik:
So be honest, first, the doctor said it’s hemorrhoids. Then I went three times, the doctor kept saying its pyles, so I just ignored it. I thought, “Okay, I’ve just been sitting around for too long.” In the end, it got really bad, the symptoms, I knew this was something else. And I started looking on the internet, and it is like, it’s cancer, it’s this, it’s that, you start freaking out. What could it be? Eventually, you have to wait a long time in the UK to get an appointment. And so eventually I got an appointment. This was after six months of suffering. They did an actual endoscopy and showed that I had ulcers in the colon. She said, “You’ve got ulcerative colitis”, and I had a moderate case of it, which then started to get more severe over time. And so that’s when it was confirmed. Before that I had no idea what it could be. It could be one of those things like colitis, it could be a bacterial infection or something. It could be cancer. That was worse, that was the thing playing on my mind the most was it could be actual cancer.
Lindsey:
Oh, yeah. No, I when get something, I go straight to cancer. And I work my way back.
Niraj Naik:
Yeah, exactly. And it usually isn’t that.
Lindsey:
Yeah.
Niraj Naik:
So yeah. So that was crazy. Because I if I knew about this, what it was early on, I knew how to fix it. I wouldn’t have gone anywhere near down the pain that I did you know, the anguish that I did, and you get suicidal when you’re going to the toilet that many times a day and you can’t go out. I remember going on a date once when I finally plucked up the courage, and I actually ended up soiling my pants during that. And I had to leave early. Luckily they understood. So you know, stuff like that you have to deal with this. Horrible, horrible.
So yeah, that was my big wake up call to get out of that career as well and follow my real heart. And I was lucky because I managed to combine my passion for music with healing. You know, when I was in the music industry, it’s a really brutal industry. It’s very, very challenging. It’s a bad culture. There’s a lot of sharks involved. And I knew that that wasn’t me either. But I kept trying to make something out of it. But it was when I actually finally woke up to the power of music for healing. That’s when I realized actually that there’s a whole new world out there where I could actually combine it and make it into a practice for wellness.
Lindsey:
You mentioned brainwave music. Tell me a little about that.
Niraj Naik:
So you see most people spend their day in a high alert state, a Beta brainwave state. And this Beta brainwave state is associated with active thought, but it can also be associated with stress. And if you don’t have enough of the lower brainwave states, like the Alpha, Theta and Delta, which is sleep, what will happen is that you will end up getting chronic stress because you need those lower brain muscles, which are associated with relaxation, to better heal and rejuvenate. Now, the reason why we say in these high alert brainwave states is because, it could be because we take a lot of stimulants, it could be that we’re doing a job that’s very stressful. It could be that our mind is constantly active, and we’re constantly mulling over thoughts over and over and over again. And when you switch that off, and you you calm down the monkey mind, the part of the brain that worries about the future, the past, it’s the ego part of the mind. It gets caught up in thinking thinking thinking. When you can calm that down and music is a very amazing way of doing that, especially brainwave music that has special frequencies that can help train your brain to those lower brainwave states. And also breath. When you breathe in a certain pattern. It also takes you out of this Beta awakened state into more relaxing healing states.
So I started to experiment with this music. I found it all on YouTube first and then started to compose my own and started to create my own guided meditations with it. And I then eventually created my own library of meditation, brainwave tracks myself, that I could compose. And I noticed as well that a lot of the music that was out there was kind of a bit dated, sounded like it had been made in the 70s with panpipes, you know. So I was like, right, let’s revamp all of this. And, and this would make it more accessible as well to more of a younger, more mainstream audience. So, that’s why I started to do and it really took off, I ended up making the soundtracks for like, people Anil Sapere(?), who’s a hypnotherapist. He’s quite well known, and then healing centers around the world. Now it’s used by like top spa brands, like Rituals. And actually, there’s a place called Six Senses where I’m facilitating tomorrow; they’re going to be using it. There’s all these different locations around the world which use this therapeutic music I developed, which is amazing.
But it started after my own view first, that was the inspiration and then combining breathing with it. So that’s actually what got me also connected to Wim Hof, who’s a famous guy. I produced all the soundtracks to the Wim Hof Method. He’s known for the breath work and ice baths techniques; he’s an amazing inspiration. So I did all that. That got me to really understand the power of the breathing and music combined even further. And then eventually, I developed a protocol of my own, which is to teach people for healing their own guts and optimizing their health.
And then I also developed techniques for getting into altered states where you can have this deeper spiritual experience like using higher yogic ritual practices, which are very powerful. When you do it with an instructor in a nice safe space, you can go really deep and have real powerful awakening experiences, really heightened states of inspiration. And this is where you activate the Gamma brainwave state, the Gamma is the frequency which is associated with heightened inspiration. And it’s like what meditators are trying to strive to achieve in long meditation sessions, but with the breath combined with music, with special music, you can activate these states actually pretty quickly. We’ve actually had studies done showing this and this has actually sparked the interest of Cambridge University, who are now doing a trial with our sessions. So these are really cool breakthroughs that are coming.
But when it comes to healing the gut, there’s a combination of that. And there’s a special breathing technique in pranayama, called kumbhaka, breath retention. When you hold your breath beyond a certain point, which you can create through fast breathing followed by fast rhythmic breathing, followed by breath retentions, you activate a state called intermittent hypoxia. Intermittent hypoxia lowers your oxygen levels for a short period in your blood. And this creates an adaptive change where your body adapts to a low oxygen environment, producing more red blood cells. You get better blood flow around the body, and you actually wake up blood flow to your heart, your brain. It’s like an awakening, a physiological awakening happens. And you actually strengthen your entire nervous system and physiology over time when you practice it as part of a protocol.
They actually do this with machines, called intimate hypoxic therapy, which simulates high altitude training, when people go up to mountains and go into low oxygen environments and they come back down. They get these benefits with their health and they’re trying to figure out why this is because they get the state of internet hypoxia, lower than normal oxygen, and your body adapts. And what it does is it naturally brings your breathing rate down, it slows it down. And it raises your ability to handle carbon dioxide. Higher amounts of carbon dioxide is what tells your brain to breathe again. And when you actually can increase your carbon dioxide tolerance and slow your breathing rate down, you actually will find you can hold your breath for longer periods of time and your breath rate slows down and there’s a strong correlation between breathing rates. The slower and calmer and more rhythmical your breathing is and the longer your breath retention times are, the better you are at getting oxygen to where it actually needs to go. Not being stuck to your red blood cells but getting them off the blood cells, the oxygen into your body tissue cells. That’s where healing happens.
Lindsey:
So I imagine then if you are getting an increase in red blood cells and oxygen going where it needs to go, you probably feel a lot more energy.
Niraj Naik:
More energy, you get better blood flow to the gut, remember your intestines as well are filled with blood vessels. But when you’re stressed, these blood vessels shrink. Oxygen as well, you overbreathe, right? When you over breathe, you get in too much oxygen, you take out too much carbon dioxide. You need the right balance of oxygen and carbon dioxide to get blood flow where the oxygen goes from your blood cells to the cells. And if you don’t have enough carbon dioxide, you have too much oxygen, your blood vessels narrow; it causes constriction and hypertension; it actually increase your blood pressure. What happens is when you’re stressed, and if you’re not listening to your gut, the blood flow to that area, it really diminishes. And you will then get disease happening in those areas, they cells start to, to degenerate basically.
And also what happens is you get tension in that area, you feel that pain in your gut. And if you get diminished blood flow, it messes up your gut flora as well, your microbiome goes out sink out of whack. So just by learning to slow your breathing down, to use techniques like kumbhaka, breath retention, you can actually dramatically improve blood flow back to the gut. And what happens as well, you actually wake up the natural intelligence of your gut, and you can actually start to resolve emotions. They get trapped there like anger, frustration, causes your gut to kind of get paralyzed, and you lose that energy like in the Ayurvedic system. Your gut is your driver, it’s your force, your lifeforce, it’s what drives you, produces energy. It makes sense, because that’s where you digest your food from, produce energy from digesting food.
So if you don’t listen to your gut instinct, eventually you’ll paralyze, and you will not move and you’ll become apathetic, you’ll become depressed, you would be able to get out of bed You’ll have no drive for life, your gut essentially stops you from doing things. But when you follow your gut instinct, you get courage, you become really able to take on the stresses of life without fear. So with me, because I’d stopped listening to my gut, and I had, I lost my courage to leave my job. And I became apathetic, turned into a robot, and I was just repeating the same cycles and patterns. When I started to tune back in, it’s my gut instinct. And when I went into the healing journey, I had this unstoppable energy and drive to succeed in doing what I really want to do. And through that came a real passion.
And our truth really is for everybody, I think, the true will, not the conditioned, the conditioned will is what society tells us to do, the true will is we want to be healthy, we want to be happy, when you surround ourselves with people who make us feel healthy and happy. We want that to rub off. And we want to be around community that we trust and makes us feel safe. And we want to give that back to others. And we want to create a world that’s harmonious. But society has made us polarized and split us apart from each other. And my job, what I’m trying to do is bring back the community.
One of the most amazing, actual things that happened to me when I was going through my healing journey, because Tony Robbins always says is study success, model success. And what I was doing at the time, which is really bad, was I was going on all the forums, and reading all the horror stories. And reading all the horror stories made me feel even more lonely and scared. And then everyone in my environment’s telling me you’re not going to get cured unless you take the pills. And I felt even more trapped. What I did was I actually started to look at people who had healed themselves. And then I started to find communities of people that are like mine through Facebook. Thank God for their community, that you can prey off Facebook. And then that in itself was part of the healing process, finding people to connect with and sharing my truth with people, and how I feel, and people listening and acknowledging. That was a huge part of it. So what I’ve done with Soma Breath* is we’ve created this amazing, thriving community of 1000 plus instructors now and the world is growing really fast, and everyone feels safe and everyone has a place to share and connect. And we have instructors who become like community leaders, bringing together people who are like-minded and building that cool sense of friendship and trust, which was what we were really desperately need.
Lindsey:
Right. So is that is that all online? Or is that in person as well?
Niraj Naik:
Well, that’s the cool thing, because we have instructors around the world who are real people in real life, they build their communities around them, wherever they are, you know, whether it’s in a yoga studio or a community center or fitness center or gym, wherever they can do sessions, they tend to bring together people. In Copenhagen there’s an amazing community there. And I’m now I’m in Ibiza. So yeah, it’s like in person and online. Online, we have a really thriving Facebook community as well.
Lindsey:
Okay, so backing up a little bit about your healing journey, did you try various diets and what ultimately helped you the most diet-wise?
Niraj Naik:
Okay, so what I said about in Ayurveda is know thyself, and with know thyself, what that means is really understanding who you are, and we’re all individual. So, in the Ayurveda system, we are all composed of different energy types. So Vata, Pitta, Kapha. Vata is air, Pitta’s fire, Kapha is Earth. For me, the Ayurveda system is the most powerful and wise system that has developed. And it focuses on this whole mantra of there’s no one size fits all. So what works for one person may not work for another and but you can get somewhat of a guide of a lifestyle to follow based on your energy type, which you can figure out through simple profiling of two questions that you ask about how you think, your likes, interests, and also down to your how you look, you appear, there’s a bunch of different questions you’re asked, and you find out your energy. So through that you can determine who you are.
Now, at the time, I was very sick, I had not really got into Ayurveda or known much about it. And I got caught up in this whole raw vegan diet movement thing. And I thought that was a cure to everything. So I went down this hole, even actually, believe it or not, I was on that kind of vegan raw diet prior to getting sick. And the last the first few months leading up to being sick, I was on that raw diet. And then I got sick. I don’t know, maybe it had something to do with that. But everything was just going through me; the food just goes through, boom, you’re going to toilet so many times. And then I tried a fruit only diet, tried all of that. That was even worse, the gas beyond belief; it was horrible. It was so painful, cramping, like it’s the worst thing ever, especially things like lettuce and salads were just a nightmare for me. And I thought all this time this was good. This is meant to be doing good.
Then when I read the Ayurveda system, I discovered that actually, the completely raw diet is terrible for Vata types. Vata-Pitta disorders is what causes ulcerative colitis. And I’m a Vata-Pitta mix. And it’s the worst thing to go on a raw, cold food diet. So what I had to do was actually go for grounding, nourishing warming foods. And also it says the meat is okay for people who have a Vata disturbance, which is what I had, I had a Vata imbalance. So I started to use bone broth, because the people who had healed themselves, they went on paleo diets, they went completely on paleo diets, or they went on to complete beef diets and things like that. And I was like, this goes totally against the whole Hindu culture and my parents would go crazy, you know, but I thought I have to do this for my own health. I had no no other choice.
And that’s when I also discovered colostrum* . Colostrum is the first milk that comes from a cow, it’s a bovine colostrum. We actually all consume colostrum. The first thing we consume as a baby, when we’re born, is the mother’s colostrum. And it gives you your immune system, it actually heals your gut, allows your gut to actually digest adult food. Without it babies, children suffer in childhood, they get allergies and all these health issues. And look, there’s a huge movement of mothers moving off natural breastfeeding onto powdered milks and all sorts of other nonsense. And kids are suffering as a result. It’s obvious, I’ve seen the link myself.
Lindsey:
I thought we were moving in the opposite direction, back to breastmilk.
Niraj Naik:
Yeah, we need to be moving back to that. So colostrum, super essential. And then what I realized was that actually, we don’t have to go and find pregnant mothers. Cows produce 1000 times more potent colostrum in humans, the same translation to humans. But also, thankfully to nature, and this is why cows are worshipped in India and considered holy, is they produce four times the amount of the colostrum the calf needs. So it’s actually the excess of the excess because they also use colostrum in the banks for calves where maybe the cow didn’t produce enough. So they’ll give excess to the calf to make sure the calf always has enough, but the excess of the excess is given to humans for human consumption, because of its powerful healing benefits.
So I discovered that and you get it in a powdered form, you have to get certain type, it has to be whole fat, full, whole colostrum, none of the fat removed. Otherwise, it loses a lot of its power. And so I started using that. And I literally went on a colostrum fast for like a week and just had some bone broth with it. And the healing benefits were just so fast – nine day fast. So that and a combination of the lifestyle changes and the breathing techniques and changing to a paleo diet is what got me back into full health within a few months. Then I started to teach other people that and I’ve now had hundreds and hundreds, if not thousands plus success stories over the years. People with things like ulcerative colitis, leaky gut issues, Crohn’s. Any autoimmune issue usually resides quite often from spiritual disturbance and also issues with digestion, which is often a result of spiritual disturbance in the first place, not listening to the gut instinct. So I help people rehabilitate that, get back onto the right path, follow their life passion. And we train instructors on delivering these techniques through our Soma Breath Community.
Lindsey:
Great. So tell me a little bit more about the colostrum because I have tended towards recommending something like MegaIgG (from Microbiome Labs* or buy from my Fullscript Dispensary*) , which is just the IgG. The immunoglobulins coming out of colostrum because of people being lactose intolerant. So I’m just curious, how do how do people react to a full colostrum who are lactose intolerant?
Niraj Naik:
So colostrum doesn’t really contain enough lactose in it to cause any of the symptoms. It’s not even the lactose in the form that you find in milk, it’s very different. Because children actually, before they consume colostrum, cannot really digest, babies can’t digest lactose. So the colostrum actually helps them. It seals, it helps the lining of the gut form properly, so that they can actually digest mother’s milk, right, which contains lactose in it. And same thing with a calf. The calf won’t be able to drink the full milk, they need the colostrum first, that helps the digestive process to be able to consume larger particles like lactose. Now, quite often, lactose intolerance is a result of the fact that maybe they didn’t get enough colostrum as a child or, or over the years they’ve done abuse to their bodies, to their guts through processed foods. And prescription meds is one of the big culprits, and stress in general is a culprit for rupturing that, and then we lose this lactose digestive ability. What I found is that when you seal the gut, and you fix it with colostrum, people are now able to digest things like gluten, and lactose again, although I still recommend, don’t have dairy milk because it can be contaminated with so much other stuff. They can start eating things like bread in small doses again, which is a lifesaver for a lot of people. They love bread, and can’t do without, but I always say, go on a colostrum fast, do our protocol and see how you go and then slowly, slowly, once you’re confident, bring in little bits of the things you really love. And you’ll be okay.
Lindsey:
Yeah, yeah, no, I find too that now that I’ve mostly healed my gut I can eat gluten every now and then. But it’s not going to be an everyday thing. Never.
Niraj Naik:
A staple. Yeah, an IgG, that, what you’re talking about, is one of the active ingredients. But what I love about colostrum is that it’s very broad spectrum. It has so many other things. That’s why I don’t like to meddle with nature too much because it has everything symbiotically working together in harmony. So you have the immunoglobulins, you have cofactors, you have all the vitamins and minerals that you need, you have all the whole fats that aids the absorption, so that’s why I really I just stick with Mother Nature. Mother Nature’s the most intelligent thing that is, that exists. So let’s trust in nature’s intelligence.
Lindsey:
Yeah. Transfer factors. Is that in there?
Niraj Naik:
Yeah, everything’s in colostrum, because all of these things come from, they actually use bovine colostrum medicinally actually, in drug development, where they’ll create immunoglobulins from concentration then from colostrum. And they can also make it targets. This is actually a new field. They’re using colostrum to create targets for specific diseases but the thing is, colostrum itself is quite potent, and maybe the drugs will help one day. And there are people who get very good benefits from being injected with these immunoglobulins. And lactoferrin is also a very, very important ingredient in colostrum, extremely important. So, that I don’t know if you get in other things, but it works in harmony with everything else. But people get a lot of benefits from these injections. But these injections are one injection and they have to have a month, costs the patient right on the NHS, it costs the NHS taxpayer 1000 pounds per shot.
Lindsey:
We’re talking about IV immunoglobulins, right?
Niraj Naik:
Yeah, which is insane.
Lindsey:
Yeah, no, I know. That’s, that’s one of the treatments I think they use for PANS and PANDAs in the traditional medical community. And I can imagine that’s pretty tough.
Niraj Naik:
Yeah, exactly. Yeah. Yeah.
Lindsey:
Yeah. Expensive and hard to deal with getting injections for a kid. Yeah, all of that. So tell me about any other supplements you use? Is it just the colostrum? Or what else do you recommend for people?
Niraj Naik:
Oh, yeah. So my protocol. So what happens in these sorts of issues, I suppose the gut microbiome gets messed up. So there is this amazing probiotic I discovered called Visbiome* . It also was VSL3, but somehow the company split into two, I don’t know. There’s some controversy over who actually invented and owns it. I think what they’ve done is each one’s claiming that the other one is your original origin. They’re still making the same thing. They’re trying to steal customers off each other or whatever.
Lindsey:
The one that was the VSL3 that all the studies were done on is now called Visbiome*, right?
Niraj Naik:
Yes, apparently. So I basically recommend that now. I think that’s that. I think they’re both probably still the same, but I recommend that because I took VSL3, and this megadose of probiotic is really high like, like hundreds of 1000s. Right?
Lindsey:
Billions. It’s like 450 billion or something a packet.
Niraj Naik:
It’s insane. Yeah. Yeah. So that combined with the colostrum and all that, so I recommend that on our protocol. It’s expensive. You don’t have to do it forever. It’s just a cost you take. So I actually put this all in my guidelines. So I recommend that as part of the course if you’re healing. But I don’t think that you need large doses of probiotics for long. Because colostrum in itself propagates, it acts like a prebiotic, it propagates a good microbiome, and natural flora.
Also, just listening to your gut, trusting your gut, finding your dharma, your life path, following your instincts, and doing breathing techniques where you’re switching off stress, aids the gut. Getting rid of sugar in your diet, getting rid of processed foods, getting rid of factory foods, and all that stuff. And eating a whole food diet will actually improve naturally your gut microbiome. So there’s other ways you’re doing it. There’s billions of bacteria around you all the time that we have. We’re literally wearing a suit of bacteria wherever we go. The bacteria is not the problem, it’s whether they want to reside in your gut. That’s the problem. And you know that there’s a lot of people who just take probiotics and don’t do anything else and think that that’s going to help them alone. But we need to think holistically. And you’re going to think that these are like entities that have a choice whether to live with you symbiotically or not. And if they’re not choosing to live somewhere, symbiotically, there must be some reason. It’s because you’re toxic. So you need to clear that out, you need to and it’s not just our physical body, it’s the mind. If the mind becomes toxic, we need to clear that too. So my whole system is all about helping heal the mind, heal the body, connect with the Spirit. And through that, the bacteria naturally comes to you and wants to live with you. This is the laws of nature.
Lindsey:
So I love the story of you being able to leave this profession that didn’t suit you and go do this other great thing. But I kind of feel like this is sort of like the privilege of the upper middle class to be able to just leave their job and go found a breathwork program. You know what I’m saying like, how does the average Joe who’s really sick and cannot afford to leave their job and branch out as an entrepreneur, how do they implement things in their life like this?
Niraj Naik:
Fantastic. I love, that’s a really, really good question. Let me just tell you about my story. I didn’t come from money. I actually was quite a lot in debt at the time. And my dad was completely depressed. And my mom as well, you know, they never had any money. I also had no job. And I had no financial support, actually at all. And I had no idea when the next income was going to come. I had sick pay for a bit, for about six months, but then that was stopped. But I literally had to do it. It was a do or die situation for me, I had to make this work.
Now what I had, I was smart enough to be able to study a course that taught me how to build an online business and do all that, and get off my ass and focus on that. And I had an ability to put it all together and make something successful out of it. But it really was a do or die situation. And I know, a lot of people may not have the means of access to a computer or, you know, be tech savvy, or even be able to understand what it takes to start a business and all that. I totally get that.
So there’s other ways of doing this, okay. And it all comes down to changing the perception of your situation. Okay. So, for a lot of people, let’s say the circumstance, and because I’ve helped a lot of everyday people as well, I believe that when you believe first and think small. Like first think in terms of just one goal. One goal that I’ve got to put into my mind is, I want to heal this illness. Don’t even think about oh, I need to get a new career or I need to quit my job. I know this job is stressing me out. We’re going to look at this healing journey as a game. And here is a system, if I follow this system, I do a little bit every day, the end result, the reward of that is I’m going to be healed, and I’m going to have more energy, I’m going to have a better sense of well-being and I’m going to then have more ability to do work, do the kind of work I need to pay the bills and all that. And through that, you can then start to ease the stress of it.
So what I give people is like a plan of action where first do this, alright, first do this, do this, you’ll get benefits from this. Get yourself here. That’s the first goal. And up. And you can actually do that with just the colostrum, the probiotics, and the breathing techniques. I really believe that. You may not completely be cured. But you can get close to it. And I hate using the word cure, because we don’t cure people, we transform people because a cure basically means bringing people back to who they were before they got sick. That’s not what we do. We take people, we change people at a spiritual level, right at that point of the ego. And from a cellular level, they become a totally different person. And they have a new set of habits, new lifestyles, new aspirations.
What happens is, you actually vibrate, without sounding too woowoo, at a higher level when you are feeling healthy and happy. Your vibe goes up so you start to attract things into your life. And when you trust that, what could happen is that you could turn a job that you don’t like into something that you start to enjoy. And what happens as well is because you’ve got the story now, you just healed yourself from chronic illness. And when you focus on that as your first thing, I want to tell a story, where I’m now healed and I can inspire other people. When you start inspiring people, you watch it becomes like a domino, like a butterfly effect, that one small change will start to impact other things in your life. And you will naturally start to attract things that will create more abundance in your life, more sense of well-being or you may naturally move from one career part of your career that you hate into a part of the career or company that you’re working for where you enjoy it more.
Right and through the Ayurvedic system, actually, you can find out what you’re really good at. Like actually so with me, I was doing a left brain job and I’m a right brain, very creative person. Totally the wrong type of job for me, and I find a lot of people who get autoimmune issues are in the wrong job that they’re spending eight, nine hours a day doing a kind of task, super repetitive, very robotic, that isn’t suited to them. And they may be more creative and more into doing roles where maybe it’s about talking to people, connecting with people. And when you start to know who you are, and you can communicate that to whoever your employer is. Actually, also, employers also want the best for their for their employees. Usually they want their company to thrive, they don’t want it to stifle. So quite often when you find the right person to speak to, they will start helping you transition to a better role.
Or you’ll get the courage inside to listen to your gut to apply for another job or company that you want. You’ll be surprised at how many amazing stories we’ve had people manifesting what they want, going through our 21 Day awakening journey, which lays this roadmap out for you, and is led by an instructor as well. The breakthroughs people have, you know, it’s amazing. Like the money thing, I understand, I get it. I didn’t have as many responsibilities. I didn’t have kids, didn’t have a mortgage, but I didn’t have any money. And I didn’t have a job. So I made it work. I had youth on my side and tenacity, things like that. But people can develop that. And it comes from getting one little result first, when you start to see some results, you start to trust yourself a bit more. And then it grows from there.
Lindsey:
Yeah, I listen to the One Thing podcast a lot. And, and their whole philosophy is, just keep breaking it down to what would make this step in my life easier or unnecessary. Until you get down to well, maybe just stopping and taking a deep breath when stressed out would be the one thing that I can do that would then get me to the next goal. And so it’s just really starting super small.
Niraj Naik:
Yeah, I think I’ve been on that podcast. Yeah, I was on that one.
Lindsey:
Okay, so we have maybe 12 more minutes. Do we have time to maybe hear about a healing story of somebody who’s gone through your program and then do a quick demo of the Soma Breath?
Niraj Naik:
Sure, sure. So for the demo, it may be better that I can play an audio because we’re very audio driven. And I could give you a session, which you could play to your listeners, what do you think?
Lindsey:
Sure.
Niraj Naik:
Yeah, so you can slice that in. And what I actually did recently was I interviewed a remarkable client that we had. She basically was one of these people you were talking about who has tried everything. She was struggling for money and all of this stuff. She had lost all hope. She’s got kids, got family. She was on 36 pills a day. She had fibromyalgia. She was so sick. She was puking up her own feces. That’s how bad it was. She was ruled out. She was written off by all the doctors. She basically found us, started on my free online meditations. And she started doing our protocol. And literally just did that every day, to a tee. And she wrote an amazing story in our group, about how she managed come off all the pills. She had regained a lot of body weight, but she was almost back to full, normal body weight. She had lost a third, like me, she had lost like a third or more of her body weight, and all of the diarrhea had stopped, she wasn’t getting all those symptoms anymore. And she hadn’t even at this point taken colostrum yet. She had just done the breathing techniques. Wow. So I was blown away by this. I was like, “This is amazing!” But just with breathing techniques.
That’s one recently, then there was another one who’s a stunt actress, who actually happens to be in the same studio at the moment where Alec Baldwin killed one of the directors or something of this movie. She’s like a stunt actress in Hollywood at the moment. She also suffered immensely from leaky gut issues, kind of autoimmune-like symptoms, really burnt out, really grueling schedule, trainings of a stunt woman, you can imagine, very busy. She even owned like part in the gym, very, very busy gym and all this. And she started doing the colostrum protocol. So she hadn’t done the breathing, actually just did the colostrum. And she has had remarkable benefits just from that, from the leaky gut protocol. So, you know, that’s two different stories, but then we have so many, you can go on our website and see, we’re getting new ones every week.
Lindsey:
Great, yeah, I’m sure people love that. And I’ll put a link in the in the show notes to the website. So I’ve got the affiliate link. So if people can follow that, they’ll be supporting the show.
Niraj Naik:
Fantastic. For sure. Okay. Beautiful.
Lindsey:
So anything final thing you’d like to say to my audience before we get off?
Niraj Naik:
So I love this mantra, which I got from an amazing doctor, if you want to get an inspiring doctor who really understands health, check out Dr. B.M. Hedge and head down and give him a shout out on YouTube. He is India’s top doctor. He’s won loads of awards and all this stuff. He’s a real Renegade. Basically, he says this one mantra, which is I is the first letter of ill, we is the first two letters of well. And the more I we become, the more I-centered and kind of selfish we become, you know, the more egotistic we become, that’s when we start to get ill. But the more we-focused we are, the more community driven we are, the more we actually realize that, actually, we’re part of the whole.
And the more we give back, selflessly, and this is Karma Yoga, Karma Yoga is healing, forgiving by just giving, giving, giving and through that, you reach a state of enlightenment or healing where you heal yourself of all past karma. And you look at disease, and it’s just a result of karmic things, actions you’ve taken, they’ve resulted in that illness. And what we like to do is, we like to go a layer deep to where the results in your life come from. And that comes from how you think, the quality of your thoughts, and if we can take charge of the thoughts at a cellular level, that’s the nervous system. Now, that’s where thinking comes from. We can actually improve the decisions we make, increase, improve the actions we make, and increase our results, the quality of our results, and heal ourselves and things and get back to our best. So with the breath, you have a tool where you can consciously actually gain control the entire consciousness of the entire body. Because every cell has a consciousness, has a brain, has a mind, it thinks, each one breathes. And when we bring that into harmony with just a few simple rhythmic breaths, which you can do every day, okay, we bring balance back to the body. And what that allows us to do is to start thinking less about just us, but the entire community of our entire planet and tap into them. The super consciousness of our planet. Imagine that there’s a whole mind, there’s a collective consciousness of everyone that exists on this planet. And when we start to become refocused, and we become harmonized within, in our inner world, we have a better connection with the outer world and that’s when abundance flows effortlessly and easily to each one of us. So there you go.
Lindsey:
Wonderful. That sounds like a good plan. Well, thank you so much for sharing about this with us. And I look forward to sharing the demo with my listeners. You take care.
Niraj Naik:
You too. Really great talking to you. Thank you so much.
If you’re struggling with ulcerative colitis or any type of gut health problem and are ready to get some professional help, you’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
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How old your son was when he was diagnosed with Crohn’s disease and what were his symptoms that led doctors to suspect a Crohn’s diagnosis versus just calling it something that was normal for growing kids? Like with my son [when he had stomach pains] they said, “it’s just normal, rather than getting headaches, some kids get stomach aches.”
Heather Hausenblaus:
He was 16 when he was finally diagnosed, and it really was a process. Looking back, we could see it almost years in the making. But it was in the fall of his junior year that he really became quite sick. We honestly just thought it was a virus. It wasn’t until he finally said, “Mom, Dad, I have diarrhea all day.” He was really trying to hide it and live in isolation about it, because it really is something you don’t tend to talk about. We don’t tend to talk about how many times we go to the bathroom. It was my husband and I pushing and pushing and pushing through health care, when we weren’t happy with answers that we were getting. That’s really how we came to finally getting his diagnosis. We were not accepting that he’s going to be okay in a few days, he was not okay, there was something really, really wrong. It was us being an advocate for him and not giving up and having many, many doctor’s appointments until we finally got the diagnosis.
Lindsey:
Was he having pain as well? Or was it just the diarrhea?
Heather Hausenblaus:
He was having pain. It really became around the last month that he was having excruciating pain. It was really, if you can believe it, in his throat. He was saying that he had never experienced throat pain like that. We honestly thought he probably had strep or something along those lines. It wasn’t until we finally got the diagnosis we had the realization that he had ulcers because of his Crohn’s disease.
Lindsey:
Now that’s interesting, I’ve never heard of that. Were there Crohn’s ulcers all the way that high up, or was it that it was pushing up acid?
Heather Hausenblaus:
It was pushing up acid and being in the constant pain that way that was causing those ulcers literally in the back of his throat.
Lindsey:
When did it start?
Heather Hausenblaus:
The problems got really, really bad in about middle of October, and he got his official diagnosis, the beginning of December. It got to the point where we knew something’s wrong. He began to eat dinner, and then not eat anything until about lunch the next day. He would skip breakfast in hopes to get through a period or two at school. And then it became almost clockwork where I get a call from him asking me to sign him out from school, he’d come home for a couple hours, literally lie on the couch, try to eat a little bit and then get back to school for the last period. We just thought he had some weird kind of virus and we couldn’t figure it out. This went on for a few weeks. And then it was finally us going to the doctors and not leaving until we got answers. We were actually beginning to get what we felt were tests that needed to be run; not your standard tests. We said we need more. There’s something wrong. We need a stool test. We need this, we need that. And it was finally at that point where we had his pediatrician finally really listen and say, “okay, there is something wrong.”
Lindsey:
Had this been going on since he was like five or was it just a relatively new problem at 16?
Heather Hausenblaus:
Looking back, we could see signs and symptoms when he was really really young, where he would have these emergency trips to the bathroom. I have vivid memories of us leaving a restaurant, getting in the car, pulling out of the parking lot, and him speaking up in the backseat saying he had to go to the bathroom. And my husband would say, “let’s just wait till we get home.” Well, he couldn’t wait till we got home. It got to the point when he was really young, that we would always say before we leave the house, “you have to go to the bathroom.” He’d go to the bathroom, and still, almost like clockwork, we were in the car for a couple minutes and he would have to go. It usually happened after he ate. It seemed like he would go from feeling great to all of a sudden having strep or having pneumonia or having bronchitis. It was this recurring pattern with him. It seemed that stress would often trigger it. Things like the start of a school year, we could almost guarantee that he would be sick for at least a couple of days at the beginning of every school year. Looking back I can see the signs and symptoms growing over time. This didn’t happen overnight.
Lindsey:
It sounds like you started out with his pediatrician, within the traditional medical care system. Did you eventually move to seeing a naturopath or a functional medicine doctor?
Heather Hausenblaus:
We did do the traditional route with health care. He had his pediatric gastroenterologist that we felt did help with getting the diagnosis and some medical tests that he needed, but it pretty much stopped there because they really the pushed for medicine. I felt it wasn’t working. I was able to, with my background, search the drug that he was on and realize that it really was not efficacious. So, it was me using my connections within the health and wellness and functional medicine area to seek out these experts and meet with them and talk with them and realize that there’s many ways to become healthy. What we did almost instantly after he was diagnosed was dramatically change his diet. We feel that in large part was what led him on the road to recovery quickly,
Lindsey:
Had you already done your PhD? Were you already in this field?
Heather Hausenblaus:
I got my PhD about 25 years ago. So, I have been in this field of health psychology and health behaviors for a long time, doing a lot of research. My research largely focused on the psychological effects of physical activity and moving, and honestly came from the training in the background that if you exercise, you’ll be healthy. Well, it really wasn’t until he was diagnosed and we changed his diet that I realized that diet is the most important thing with this disease and with many, many diseases or conditions. If you don’t change your diet, it’s going to be very difficult to be healthy or maintain health.
Lindsey:
It’s interesting you say that, just because I do see a lot of people, my husband, for example, has a perfectly good diet for somebody who doesn’t have any health issues. But there’s this idea that if I exercise a lot, it’s okay if I eat an entire bag of potato chips (not that he does that that often). Because I’m exercising and because my weight is stable, I should be able to eat what I want to eat, no matter how junky or crappy it is.
Heather Hausenblaus:
Exactly. It’s really interesting. I fell into that category, and this is what I researched. I really felt that exercising and moving was one of the most important things we can do for our health. If you exercise, then you’re fine. My son played varsity baseball, so he was extremely active and we ate healthy. But when you do a deep dive, you realize it’s shocking, honestly, how disturbing our food actually is.
Lindsey:
Yeah, so tell me about the diet changes that he had to make and that you made as a family.
Heather Hausenblaus:
The family was a challenge, because we have three boys and Tommy’s our oldest. I’m lucky to get one meal on the table, let alone making different meals for everybody. So that became a bit of a challenge and the running joke with his younger brothers became if Tommy could eat it, then they didn’t want to eat it because they felt that it was just too healthy. We’ve come a long way. What happened when Tommy was first diagnosed, I immediately reached out to a friend whose son also had Crohn’s disease. At this point, I didn’t even know what Crohn’s disease was. She met me the following day. I talked with her and she talked about diet. She put her son on the Specific Carbohydrate Diet. I’d never heard of this diet, but I went home and began to research it. I really needed to grasp onto something and that was something that I could grasp onto. I read up on it. There was minimal science on it, but there was enough for me to say, “I need to do this,” it intuitively made sense. We went bare bones with him and followed this Specific Carbohydrate Diet for several months. Now, you fast forward two and a half years later, and he eats what I would consider a very clean diet. We’re talking about organic, lots of fruits and vegetables, grassfed meats, eliminating pretty much all sugars, anything that’s processed. Basically, if you look at an ingredient label and you can’t pronounce it, we’re not buying it. Also, he’s eating as much as possible in the house as opposed to eating out.
Lindsey:
I know that one of the things that’s particularly bad for people with Crohn’s are these gums and emulsifiers. Is that something that you had to focus on a lot with him?
Heather Hausenblaus:
I did in the sense of just going bare bones with his diet, so cutting out all sugars, all types of additives and really taking a deep dive into ingredients and honestly spending hundreds of hours trying to find products out there that we trust and didn’t have all these basic added chemicals in them. That in and of itself took so much time, and I was lucky because I was able myself to take medical leave for work because of a sick family member. I was able to take a medical leave to get my son healthy and a lot of people don’t have that opportunity. It almost became my full time job, and it’s just not right for other people not to have these opportunities to be healthy. So, my goal is to try to create awareness and make it ally’sa little bit easier for people to regain their health or the health of somebody that they love if they become sick.
Lindsey:
I may be wrong on this, but I think under the changes to the Family Leave Act that came under Clinton, we all got the ability to leave for six weeks for a family illness. Maternity leave, for example, I was able to do six weeks of that and use my sick leave time. So I think if you have a workplace of above 50 people, that applies.
Heather Hausenblaus:
I believe that is the case also.
Lindsey:
So this Specific Carbohydrate Diet, people may not be familiar with what that entails. Can you just dig a little deeper on what kinds of things are included and excluded that diet?
Heather Hausenblaus:
Yes, it’s a restrictive diet. It’s based largely on eliminating your processed foods, clearly a focus on organic, but it went much more beyond that with focusing largely on fruits and vegetables and meats. There is a list for the legal and illegal foods, and I would almost use this as a Bible and continually go back to this list to determine what are legal foods. So, foods that somebody with IBD could eat on this Specific Carbohydrate Diet. Interestingly, what continually kept coming up on this SCD or Specific Carbohydrate Diet was yogurt. Not just any type of yogurt, but a homemade fermented yogurt. I learned to make this yogurt myself, and that was something that my son was eating multiple times a day because it was almost comforting on his gut and didn’t hurt him. He ate this continually for several months. Now, you fast forward to two and a half years later, and he can’t stand the yogurt. He ate so much at the beginning. This probiotic yogurt played a really, really big role. I began to make a lot of things from scratch. For example, almond milk. I bought almond milk, because I thought it was healthy, from the grocery store but then if I looked at the label, oftentimes it was made just with almond extract, there wasn’t even almonds in it. There were all these added preservatives. So I began to make almond milk from scratch, orange juice from scratch. If I could figure out how to make it from scratch, even coming down to salad dressings, I would do that. Knowing that I had control over the ingredients, and then what he would be eating, I almost felt like I was becoming the sneaky chef and trying to sneak healthy things into the food to try to make it taste a little bit better. With this diet, you cut out all types of sugar except for natural sugar from honey, so that was a sweetener that was used in his food.
Lindsey:
When I think about the Specific Carbohydrate Diet, and I was talking on one of my previous podcasts with Dr. Steven Sandberg Lewis about this, that it’s essentially some combination of low FODMAPs and Specific Carbohydrate, right? I think it was low in a certain type of fiber, soluble or insoluble? That points to the fact that at the root of Crohn’s and Colitis may be overgrowth of bacteria. That, in essence, you’re starving out some of those bacteria by pulling out some types of fiber.
Heather Hausenblaus:
You know, it is a good question. We really don’t know enough at this point, because unfortunately, when you take a look at the research, the medical research, meaning things typically with drugs and surgery, dwarfs research within diet and nutrition, but that is changing because there have been some pretty interesting studies that are recently coming up on these different types of diets, including the Specific Carbohydrate Diet, maybe the FODMAP diet, a gluten-free diet and testing to see if this actually is an efficacious treatment for individuals with IBD. In part, they’re showing that yes, diet does play a role. Does it need to be the Specific Carbohydrate Diet? Is that the only diet to follow? No, that was the one that we grabbed onto at the beginning. It’s a difficult diet to maintain in the long term. Once he began to feel better, we loosened up a little bit and increased the number of legal foods. Now that he’s at university, and he’s on his own a lot more, he has a little bit more freedom. He’s at a point where he tells me, “Mom, I try my best to eat as healthy as possible, but sometimes it’s a little bit of a challenge.” That’s where he is right now.
Lindsey:
Was he gluten-free as part of that?
Heather Hausenblaus:
We did start off with him being gluten-free for the first couple of months. He came to me saying, “I think I can eat gluten, I don’t think that’s the problem.” So we slowly began to introduce gluten into his diet, and when I say we introduced gluten back in, we were eating really healthy to begin with. It was oftentimes sourdough bread from the local bakery that I would get that he really, really liked. So even though I say he was eating gluten, he was eating really, really high quality food. And I think oftentimes, the whole gluten thing gets couched within a lot of unhealthy foods as well.
Lindsey:
We have a local baker here and I was talking to him about the bread and he told me they use this sourdough rising process. It’s a complete process that eliminates most of the gluten from the bread by the time you’re done with it. So, right at the end, the bread that you have is a lot healthier than maybe a quick-rise bread that didn’t ferment for 24 hours or 48 hours or however long.
Heather Hausenblaus:
I even began to make my own gluten free bread for a while as well at the house. Luckily I found a bakery that was making this type of sourdough bread that you’re talking about, which was excellent for him to eat. So it’s a process. I think the take home message is that everybody is different. No one diet is necessarily going to fit everybody. So it’s trial and error, and you need to figure out what’s going to work for you. What worked for was, I don’t want to say going bare bones but, really stripping out additives and then slowly beginning to reintroduce foods to see if he could eat them. Then staying completely away from sugar and fast foods and trying to eat at the house as much as possible, because that’s where you really have control over what you’re putting in your mouth.
Lindsey:
So you said you did eventually get some more complex testing? Was there anything they found on that testing like candida overgrowth or bacteria, like SIBO or anything like that?
Heather Hausenblaus:
It was eventually treated with the testing that we did, it was a diagnosis of Crohn’s disease, and then getting the inflammation out of his body and to a level where it was normal. The cause we’ll never know 100%. Looking back, I think that it was related to early antibiotic use. I really think that’s what the cause was, because as a very young child, I remember before the age of one, he had an ear infection, and he got an antibiotic. Many times when he was young, he was getting antibiotics for different illnesses that he had. And I think that threw him off and then it was becoming worse and worse until the point where he was diagnosed.
Lindsey:
Just looking at the one pager from your book, you mentioned some simple tips that people suffering with autoimmune disease can follow to find their way back to health. What are some of those tips?
Heather Hausenblaus:
You have to listen and trust your body. Go and take a close look at your diet and what you’re eating, what you’re putting in your mouth first and foremost. If we take a look at what makes us healthy, about 50% of our health is related to our health behaviors, with the top three being our diet. Whether you smoke or don’t smoke, how much you exercise, your environment counts for about another 20%, your access to health care only accounts for about 10% and then your genetics account for about 20%. So that encompasses what makes you healthy, but the bulk is our health behaviors, making up 50% of why we’re healthy.
I want people to know that they have a lot of power over their health, because we can control our health behaviors. You have control over what you eat, you have control over how much you exercise, whether you smoke or not. Also, your sleep, which is something that we tend to forget about, but sleep is vital and it is so important to make sure that you’re getting enough sleep and keeping your stress level down.
There’s many different simple health tips. You need to take a look at your diet, how much you move or exercise during a 24-hour period, how you’re sleeping, and your stress level, as well what is causing you stress or anxiety. We saw this with our son firsthand when he was experiencing stressful periods during the school year. We saw his symptoms increase, especially when he was first diagnosed. One example was, he was supposed to take the LSAT one night. He was in pain, he wasn’t feeling good, he was running to the bathroom. It was the stress caused by having to take the LSAT, so we ended up canceling it and he took it at a later date. He finally came to us and said that he was really worried that if he had to go to the bathroom during the LSAT, what was he going to do? We never even thought about this, but then we got paperwork done so that he could get a “stop the clock.” If he did have to go to the bathroom, they would stop the clock on his LSAT, so if he was in the bathroom for 10-15 minutes, he wouldn’t lose that time on his test. These were things that we began to do for him. Getting these types of accommodations done, not only when he was taking the LSAT, but also at his high school and university as well. If he does need it, it’s in place. That actually reduces his stress, knowing that there is that opportunity for him and that if he does get stressed, or if he has to go to the bathroom during an exam, that he’s not going to lose any time on his on his test.
Lindsey:
You know, I imagine there are a lot of people who don’t think like, “oh, I’ve got this gastrointestinal thing, that’s a disability.” They could go to the Disability Services office at their school or their counselor at their high school and get those accommodations.
Heather Hausenblaus:
You’re so right. You tend not to think that this is a disability, but there are things in place to help if you’re in pain, or you’re spending that much time in the bathroom. There’s even Ally’s Law, for example, that was passed where if you’re in a store, and they have a restroom, if you have the Ally’s Law card, then you’re able to use that restroom. A lot of people don’t realize that when some people say they have to go, they have to go. There’s no waiting till later. It is an emergency.
Lindsey:
I’m totally not familiar with this Ally’s Law. Where do you get the card?
Heather Hausenblaus:
You can apply online and you’ll get it in the mail. It’s an interesting story of a girl named Ally and she had Crohn’s disease. She was shopping with her mother in a retail store, she had to go to the bathroom and she had to go right away. There were no restrooms anywhere close outside the store, so they asked to use the employees’ restroom. They were denied access and she had an embarrassing accident in the middle of the store. Her mother advocated that this would never happen to anybody else. She went through the steps to get this passed as law; it’s passed as a law in many states. You can get this card, you keep it in your wallet, and when you’re out saying, “I need to use this washroom, it’s an emergency, you can’t deny me access,” and you show the card.
Lindsey:
So, one of the topics that you seem to be passionate about is journaling for health. Can you tell me a little bit more about that?
Heather Hausenblaus:
It was a process for me when our son was first diagnosed. I was experiencing a lot of stress and anxiety and having a difficult time sleeping at night because I’d wake up in the middle of the night trying to think about what I needed to do to keep him healthy and keep some level of normalcy. This began my routine of keeping a gratitude journal or a thankful journal. It would literally only take a couple minutes, not a lot of time. It was a simple process, but it actually set my day off on a more positive note and reframed how I thought about things.
What I also immediately started to do for my son is tracking his food. I kept a food sensitivity log, basically keeping track of everything that he was eating during the day, how many times he was going to the bathroom, if he was having any symptoms and how he was feeling so that I could try to pinpoint if there were certain foods that were triggering his symptoms. I feel that was so important, to be able to track and look back at his diet and see what potential symptoms were there. That really helped him on his road to recovery. I began then, of course, as I do with most things, to dig into the science. There is a great deal of science showing that keeping a gratitude journal is extremely powerful for people’s overall health, making them more productive, putting them in a better mood and just being kinder and overall healthier, and the same thing with a food sensitivity log as well. I’m a very strong advocate for these because they are really, really simple to do. They don’t take an extreme amount of time and they’re not expensive. You can create your own journal if you want, or you can go on Amazon and buy a journal for less than $10 that will last several months. I’m a really big fan of science-based health techniques that are easy for people to do and are not overwhelming. To me, journaling and health journaling is a very simple thing to do that can create a lot of positive health effects.
Lindsey:
You know, it’s interesting, because when I began my training as a health coach and launched my business, one of the questions that they suggested we asked new potential clients is, “what are five things you love about your life?” At first, it just felt fluffy to me at the end of the questionnaire, but I left it on there because I liked hearing the answers. I’ve noticed as time has gone on, that there are people who are really suffering, and yet can still find five things that they’re very thankful for and that they love about their life. Then there’s some people who are just so down in the dumps, that they can’t find a single thing to put there. You know, I think about what the prognosis is for someone who’s got not a single bit of hope to begin with, if that it’s almost the necessary precursor to healing.
Heather Hausenblaus:
I love that you said that. You said you felt like it was almost hokey to do it, it almost seems fluffy. The simplicity of it is so brilliant, and that it does work. I know for myself, especially at the beginning, when our son was really sick, I’d have to dig deep some mornings to find even a couple things that I was thankful for. As simple as my morning cup of coffee. Over time it grows and becomes bigger, and you realize that you do have so many things to be thankful for. By keeping this gratitude journal, it really reframes how you think about things, you begin to find the silver lining in a lot of things. We do know the power of the mind, and the power of positive thinking has an incredible effect on our health.
Lindsey:
After I went through sciatica, just feeling so thankful for having my body back, and being able to walk, I’m still constantly just amazed that I’m not in excruciating pain every day, and how thankful I am for that. How thankful I am to be able bodied and, it’s one of those things that sometimes you have to have lost to understand what it is to get it back.
Heather Hausenblaus:
It’s not until we’ve lost a piece of our health that we really appreciate it. We take things for granted. A gratitude journal reframes how you think so that you’re not taking these little things for granted. You’re not taking your health, your wellness, maybe it’s your walk with your dog, your morning cup of coffee, sitting quietly or peacefully, or watching your favorite TV show, whatever it may be, that you begin not to take those things for granted.
Lindsey:
Every night before I go to bed, I just thank God for each of the things that I’m grateful for. And some of it’s just the basics, that I’m in a safe house and that I have a warm bed. I think about refugees and people who have none of that. I try and keep my perspective to be thankful for even the very basics, and we tried to do this with our kids too, we tried to have a gratefulness circle going around the dinner table. For the life of me, I couldn’t get them to look at the simple things and just be thankful. Whatever they were currently unhappy about was what they wanted to complain about rather than find something to be thankful for.
Heather Hausenblaus:
We do tend to focus more on the negative, but you bring a great point about around meals around the dinner table. When you actually do finally slow down and sit down, it’s a great opportunity just to take a couple minutes, even just a minute, to express what everyone is thankful for the day. It just kind of sets the mood and sets the tone and makes everybody sit back and say, “okay, we do actually have a lot to be thankful for.” We get just so caught up in the stress of our day-to-day, thinking we need to do more and more and more. That’s not the case, we need to really slow down and reset.
Lindsey:
And the impact on your health, I mean, what is it? What does the science say about the impact of gratefulness on your health?
Heather Hausenblaus:
It’s really quite impressive. There are hundreds of studies now showing that individuals who express gratitude, whether it’s journaling every day, being thankful, has incredible health benefits for them. It’s so simple and easy to do. It’s something that I recommend people do, whether you want to create a journal yourself or buy one that’s out there. All you literally need is a pen and some paper and you start doing your journaling.
Lindsey:
Are there any other lifestyle practices that you found were helpful for your son?
Heather Hausenblaus:
The main one was this incredible change in his diet. Trying to eat at the house as much as possible, jumping onto a diet that we felt was going to work and going bare bones and then beginning to lessen up on it over time and include more of these legal foods. I recommend people get support, you need help. I was somebody that was able to reach out to individuals within the health and wellness community and to find other parents that were going through similar things that I could meet. I actually meet for lunch or talk on the phone or go for a walking meeting. To have that type of support is extremely important not just from your health team, but also from family members or friends or people that you can relate to that are going through something that’s really, really similar. There’s so often you feel really alone, and by having or creating this community, then that will lessen. I know there’s incredible support teams now out there on the internet as well, so there is that type of support as well. My husband and I, we joined the Crohn’s and Colitis Foundation and join their walks and try to create awareness and raise money for the organization as well so that we can help other peers who are going through this.
Lindsey:
Is that foundation functional minded? It’s not just traditional medical?
Heather Hausenblaus:
There is some functional-mindedness in it, there is a large medical focus as well. You do see a focus on the diet and importance of exercise. They really do have some great outlets for family members and even for young kids who are suffering.
Lindsey:
Did you have some mentors or authors around the topic of Crohn’s disease or autoimmunity in general that you’ve followed?
Heather Hausenblaus:
At the beginning, no. When he was first diagnosed, I’d heard of Crohn’s disease, I couldn’t have even told you exactly what it was. I was really starting almost at ground zero to try to learn the disease. It was connecting with individuals, connecting with organizations. I reached out to a medical doctor, David Susskind. He actually responded to my email, and I talked with him because I was really impressed with what he was doing. He’s a medical doctor who deals with pediatric issues, in particular IBD and IBS, and he was researching SCD. I was really impressed with the fact that he listened to his patients when they came in, and as patients’ parents were saying that diet does play a role, he began to hear them talking about the Specific Carbohydrate Diet. So, he began to research it. Now he’s a very strong advocate for it, because he knows that diet does play a really big role in the help of healing from this disease. He also realizes how difficult a strict diet is to follow. He’s doing some really cutting edge research on modifying the Specific Carbohydrate Diet, meaning, what happens if you include some illegal foods? Are you going to be okay? He actually has a clinical trial going on right now that hopefully will be published sometime in the near future that will bring even more light to this. I’m a big advocate of that. I began to read, honestly, everything I possibly could on Crohn’s Disease, buying a lot of books on IBD, IBS, reading people’s stories and listening podcasts. I was just trying to soak in as much information as I possibly could to try to understand what would be the best path for us.
Lindsey:
Besides David Susskind, were there books that you found particularly useful?
Heather Hausenblaus:
I think the books that I was drawn to the most were from these health, wellness, functional medicine, more naturalistic doctors’ books that were out there. In particular, I became a very big fan of Dr. Mark Hyman, he’s a functional medicine doctor.
Lindsey:
Cleveland Clinic.
Heather Hausenblaus:
Yes, I love what he has done. The books that he has written, his podcast are phenomenal. Dr. Josh Axe was another individual. I went to his website, knowing that things were going to be science based. His books are phenomenal. An individual who’s a big leader in the health/wellness industry named Naomi Whittle, as well, who’s done a lot and written some New York Times bestsellers on specific diets and how they help with overall health.
Lindsey:
Yeah, those are great resources. I hadn’t heard of Naomi, I will have to check her out. Tell me about the research that you’re doing now.
Heather Hausenblaus:
My research most recently is focusing on sleep and how sleep affects our overall health. Focusing on whether there’s a supplement, potentially a type of music, that can help us sleep better. Most recently, I’ve actually begun to take a look at some of the health effects of journaling, and how keeping a gratitude journal or keeping, for example, a movement journal, how that will help people overall on their health path, whether it will help them move more, to sleep better, to be more thankful, to be more productive or to lower their stress.
Lindsey:
On the topic of sleep, what do you find are some of the biggest obstacles to people getting good sleep and what are some of the solutions related to these obstacles?
Heather Hausenblaus:
I would say one of the biggest obstacles right now is how much we’re plugged in during the day with our life. Sleep is a behavior that we do every single day, so you would think that we’d be experts at it. Most of us are not very good sleepers. A few simple tips to help with sleep, get your electronics out of your room and do something quiet before you go to bed, read for a couple minutes. You want to create a sleep environment where you’re sleeping in a very quiet dark room and begin to have this consistent bedtime and this consistent wake time. Try to go to bed at about the same time every night and also try to wake up at about the same time every morning because we have our circadian rhythm, a circadian clock that resets every day. We’re creatures of habit. I know myself, I used to fight this for years, because I’m really more of a morning person, I love to get up around five in the morning. On the weekends, I would feel this pressure to stay up till midnight or beyond. I just stopped doing that. It didn’t work for me and would really throw off my health. For people to say, “my sleep is important and I need to make it a priority during my day.”
Also, know that what you do during the day is going to affect your sleep at night. If you don’t move enough during the day, you’re probably not going to sleep as well at night. You should try to exercise every day. You should be getting outside every day and getting that natural light, which is so important. You do need to watch what you eat as well, because certain foods can throw off your sleep, especially eating a large meal right before bedtime. These are things that people have control over. People think about sleep as a really, really important health behavior, and if they don’t get a good quality of sleep, it’s going to affect everything that they do the next day.
Lindsey:
I’ve talked to clients who are completely exhausted and they have brain fog, and they’re only getting five hours of sleep at night. That seems like it’s probably the first thing you need to address because it may not be because of the gut issue that you’ve got brain fog. It may be that the five hours of sleep are a bigger culprit.
Heather Hausenblaus:
It’s all related, your body’s going to have a hard time healing properly if you’re not getting adequate sleep. It is really, really critical. It’s important for people to say, “I’ve got to take my sleep time and know that it is so important for my health. If I’m not going to sleep well at night, it’s going to affect everything. The next day, I’m not going to be as productive. I’m going to be grumpy, or I’m probably not going to eat as healthy.” Have you ever noticed what type of foods you begin to crave when you’re tired?
Lindsey:
Oh, yeah. An instand pick me up with the carbs.
Heather Hausenblaus:
Exactly. People need to realize that sleep is important. There’s many things that I can do to sleep better that are in my control that I do have control over.
Lindsey:
One thing that I hear a lot from clients is, “I don’t have any trouble getting to sleep, but I’m waking up at three in the morning.” Is there a solution for that one?
Heather Hausenblaus:
Oh, gosh, I wish there was a simple solution to that. It’s really common that people say, “my problem is I wake up in the middle of night, have to go to the bathroom, or I just wake up and then my mind goes into overdrive, I begin to think about everything that I have to do. And it will take me an hour or two to fall back asleep. And by the time I fall back asleep, it’s time for me to get up.” Once again, take a look at your entire sleep environment. If you do wake up and you begin to get a little bit anxious, you’re having a difficult time falling asleep, don’t just lie there for an hour or two. Get up out of your bed, go somewhere quiet, pick up a book begin to read or listen to some really relaxing music. You’ve got to do something just a little bit different until you begin to get groggy again, and then go back to bed. I find for myself, that’s what works.
Lindsey:
You need to associate your bed with sleep not with agonizing over the details of your life.
Heather Hausenblaus:
Exactly. You don’t want your bed and your bedroom to be this stressful environment that provokes you. There’s many individuals who almost dread going to sleep because they fear that they are going to wake up in the middle of the night, it’s going to be the same routine and they won’t be able to fall back asleep. You have to ask, “what can I do about it?” Maybe it’s as simple as picking up a journal and writing in it for a few minutes; that may make you tired. Again, don’t turn on the TV. You certainly don’t want to do that. Do something quiet, and what’s often recommended is reading or listening to soothing types of music. We do know that listening for example to relaxing types of music, like classical music or like something like wholetones, does actually promote sleep.
Lindsey:
I had a yoga nidra CD I scanned in ages ago and I will put that in my earphones if someone else is in the room or just out loud if not, and that will be my go back to sleep or at least if not go back to sleep do something relaxing that is supposed to be somewhat equivalent to sleep.
Heather Hausenblaus:
That’s so important to do and I know this might sound a little kooky, but I now typically sleep with a sleep mask on so that everything is dark in my room. Sometimes I’ll even put in earplugs, because I can hear the noises, my kids may still be up or whatever, because I do tend to go to bed a little bit on the earlier side.
Lindsey:
Speaking of circadian rhythm and going to bed early, I think that’s a battle that many people struggle with, which is, waking up at 5 in the morning, well, then you’re going to have to go to bed at like 8 at night, right? There’s only so many ways to add up to 8 or 9. And it’s not going to be going to bed at 11 and waking up at 5.
Heather Hausenblaus:
That’s a good point that you bring up because not everybody needs the eight hours of sleep, some people can actually operate on less sleep, some people may need a little bit more. But that’s on average, the average person needs between seven, eight hours of sleep. What I recommend people do is, if you wake up without your alarm clock, that means that you’ve had enough sleep. If your body wakes up naturally, then that’s telling you’ve had enough sleep. If you’re waking up with an alarm clock, then you didn’t have enough sleep that night. I know, we can’t do this every day, but potentially on the weekends, try to see when is that time or when is that point that you wake up naturally, and then count back and say, “this is how many hours I seem to need on a regular and consistent basis to get an adequate amount of sleep.” We’ll say it’s seven hours of sleep. Then take a look at that and say, “if I need to get up at five in the morning, then this is the time that I should be going to bed so that I get those seven hours of sleep.
Lindsey:
You have to keep in mind too, that you’re not falling asleep instantly, and that you may be lying in bed for a few minutes after you wake up. So you have to add in a little fat, you can’t just go to bed seven hours exactly before you’re going to wake up.
Heather Hausenblaus:
Factor in that buffer period. Typically, it doesn’t take us too long to fall asleep, it shouldn’t be taking more than five to 10 minutes. When your head hits the pillow you should be out and then when you wake up in the morning, you should pretty much be ready to go if you’re waking up without an alarm clock.
Lindsey:
For me, if I don’t take melatonin, then I can’t fall asleep within five or 10 minutes. It’ll take me 15 to 30 minutes.
Heather Hausenblaus:
Everybody is so individual. Maybe it’s, you know, a hot cup of chamomile tea. One of the tricks that I have that I learned from Dr. Michael Bruce, who’s a sleep expert and has written some wonderful books on the science of sleep, recommends hot water and you put a banana in in the hot water and just let it seep for a couple minutes. The banana still has its peel on, you just cut the ends off of the banana, put it in a cup of hot water and just let it seep for a couple of minutes. And then you take the banana out, you drink this hot water that has a hint of banana. It’s actually enjoyable to drink, but it’s the potassium that’s in it that actually helps with sleep. And that’s a really simple easy thing to do.
Lindsey:
Organic banana, unless you want a glass of pesticides.
Heather Hausenblaus:
Yes, exactly. Good point.
Lindsey:
I appreciate you sharing your story about your son with us. I know there’s probably a lot of parents out there struggling to help their kids get back to health. Crohn’s is a very serious diagnosis, I know someone whose child died of this, so I’m glad to hear about your story and that it turned out so much better and that you’ve written a book to help other people. Where can people find you and your book?
If anything, I want to tell people that they have the power to be healthy and to really take control of what they’re doing and to critically take a look at their diet and how much they’re moving and sleeping at night and really take a look at journaling as a positive health thing that they can do.
Lindsey:
Great. Well, thank you so much for talking with us today.
Heather Hausenblaus:
Thank you so much for having me and thank you for everything that you do.
If you’re struggling with Crohn’s Disease or any type of gut health problem and are ready to get some professional help, you’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
What are diverticulitis, diverticulosis and diverticular disease?
Today we are going to be doing somewhat of a deep dive into the world of diverticulitis, diverticulosis and diverticular disease. While people tend to use all of these terms interchangeably, there are distinctions between them. Diverticulosis simply means that there are pouches that are present in the large intestine (see image further down this page). The presence of pouches alone isn’t necessarily a problem. When these pouches become inflamed or infected, it is referred to as diverticulitis. Diverticular disease is a broad name of all of the symptoms that can be experienced due to these pouches forming. And this is, in fact, a super common condition as we age, with over 50% of people over the age of 60 and 60% of people over the age of 80 having colonic diverticula.
But let’s back up a little bit and talk about what exactly diverticular disease is, in case you haven’t heard of it. If you are diagnosed with diverticular disease it means that there are pouches, known as diverticula, in your colon or large intestine. They’re kind of like bubbles or bulges in the weaker areas of the wall of the colon. Just having them is called diverticulosis. Most people with diverticulosis are asymptomatic, so that alone isn’t cause for concern. However, when the diverticula become inflamed or infected by bacteria, this is called diverticulitis, which used to be estimated to happen in about 10 to 25% of people, although more recent estimates are around 5% of people with diverticulosis. Diverticulitis can be accompanied by fever, chills, tenderness over the affected area, nausea or vomiting, leukocytosis, or an increase in the number of your white blood cells, cramps, rectal bleeding and pretty severe discomfort in the lower left part of the abdomen. The pain will often be bad enough to necessitate significant lifestyle changes, or even a trip to the hospital.
About 25% of those suffering from this illness will see complications such as perforations, peritonitis or inflammation of the peritoneum or lining of the abdominal cavity, abscesses or collections of pus from bacterial infections, colonic fistula (which is when a diverticular abscess extends or ruptures into an adjacent organ such as the bladder, vagina or small intestine), or an intestinal obstruction. So if you have consistent pain on the lower left side of your abdomen, which may get worse over the course of several days, you should definitely see a doctor and determine if diverticular disease is at play. But I should also mention that there are some case studies of attacks of diverticulitis that mimic the symptoms of appendicitis, if the infected diverticula are on the right side in the cecum.
Something that makes this disease complex is that it is difficult to know when to seek medical help, and it is even somewhat difficult for doctors to diagnose. A diagnosis usually comes when a person has an acute attack, which requires a CT scan. Short of that, a blood test to reveal a high white blood cell count, a stool sample to check for abnormal bacteria, or a digital rectal exam may be done. Other possible tests that may be warranted include a barium enema with x-rays, a sigmoidoscopy (like a colonoscopy but of your sigmoid colon where most diverticula form) or a full colonoscopy.
One thing I learned while researching this is that diverticular disease is frequently accompanied by Irritable Bowel Syndrome, which may be coincidental, but there also is evidence to support diverticular disease leading to the development of IBS. In one study of acute uncomplicated diverticulitis, one year after the attack of diverticulitis, 45% of participants reported abdominal pain and 30% had altered bowel habits. Another study found an almost 5-fold increased risk of a diagnosis of IBS following an attack of acute diverticulitis. Of course what they may be seeing is an infection with pathogenic bacteria, which causes both the attack of diverticulitis as well as the subsequent symptoms of IBS, or perhaps the result of antibiotics often taken for diverticulitis attacks.
Some of most agreed-upon risk factors include aging, obesity, smoking, use of NSAIDs or non-steroidal anti-inflammatory drugs or aspirin, opioids, and a sedentary lifestyle.
The more disputed claims are that a diet that is very high in red meat but very low in fiber is to blame. The two cross-sectional studies I mentioned above did not support that claim, as there was no correlation between those factors and diverticulosis, as confirmed with colonoscopies. The author of those studies criticized the methodology of studies that did support it, but I’m still a bit on the fence after reviewing it all. The author also found that those with hard stools had reduced odds of diverticulosis.
Another theory is that the seated position of defection in western societies, on a toilet, leads to a lack of support of the colon, incomplete evacuation and backup in the sigmoid colon, where most diverticuli occur, due to ongoing pressure on this part of the colon. Squatting while defecating, like other primates do, might alleviate this problem.
Another popular theory that emerged was that diverticular disease could be a result of eating nuts, corn, popcorn and seeds. However, there have been studies that nullify this theory completely.
How do you treat diverticulitis?
In the allopathic medical world, the common treatment for an attack of diverticulitis is antibiotics. In severe or recurrent cases, laparoscopic lavage to wash out the diverticula or surgeries like bowel resections and colostomies may be necessary. Of course this depends on the type and severity of your symptoms. Someone dealing with a mild case would most commonly be prescribed antibiotics, including Rifaximin, an antibiotic commonly used for SIBO (Small Intestine Bacterial Overgrowth).
How do you prevent or reverse diverticular disease?
While there is some controversy around this recommendation, it certainly wouldn’t hurt to start by trying to gradually add more fiber from fruit and vegetables to your diet, as this is helpful for health overall and gut health in particular. A study of almost 48,000 men found that those who ate the most fiber (>32 grams/day) had a 42% lower risk of developing diverticulitis than those who ate the lowest amount of fiber. The risk was also higher in men who had a higher intake of fat and red meat along with low fiber. But I want you to take that in context. Knowing what we do about how ketogenic diets produce butyrate naturally in the colon and often help people resolve bowel issues, I wouldn’t want you to lump a ketogenic diet into this category. I’m assuming that the people in the study consuming this low fiber, high fat, high red meat diet were on more of a Standard American Diet, where the fat was coming from processed seed oils used for deep frying the fries that went along with the burgers and their buns, not from grassfed, high quality red meat, prepared at home and accompanied by healthy oils coming from avocados, as well as avocado oil and extra virgin olive oil, ideally atop a nice big salad with a healthy carb like sweet potato or winter squash accompanying it.
All of this makes sense to me because in the end, to have an infection in the diverticula, you may need an overgrowth of pathogenic bacteria, and pathogenic bacteria are kept in check by commensal bacteria, which feed on healthy foods that are high in fiber.
Historically, as I mentioned before, a common recommendation for people with diverticulitis was to avoid nuts, seeds, popcorn and corn. This was debunked, at least for corn, popcorn and nuts, in the Health Professionals Follow Up study I mentioned before with the 48,000 men. In fact, popcorn and nuts were actually found to be beneficial.
As always though, you should take your time when you eat and chew your food well, especially if you are eating nuts and seeds.
Dietary approaches you can take include eating more probiotic foods, again to continue providing beneficial bacteria to your system, drinking bone broth, which provides healing nutrients to your intestines and eating an anti-inflammatory diet (which for my personal bias tends more towards a paleo diet).
Reducing alcohol consumption is also a solid recommendation not just for your general health, but also because one study showed a 2.2 times great risk of developing diverticulosis in drinkers versus non-drinkers.
Supplements that may be helpful in soothing the gut lining include slippery elm, aloe vera, marshmallow root extract and DGL or Deglycyrrhizinated Licorice Root Extract. There’s a supplement with those four combined I often recommend to folks with H Pylori called DGL plus made by Pure Encapsulations. You can find that in my Fullscript* or Wellevate* Dispensaries.
And I checked and my new favorite supplement, butyrate, also has evidence supporting its use for diverticulitis, which makes sense because it helps feed and heal the your gut colonocytes, or the cells lining your large intestine, especially when you’re using forms of it like Tributyrin* that definitely get down to the large intestine, which we talked about in my last podcast. In one study of 52 patients with diverticulosis, patients in the experimental group who received 300 mg of sodium butyrate a day, which is a pretty low dose in my experience, had significantly fewer episodes of diverticulitis than those in the control group. While I don’t personally have diverticulosis, to my knowledge, I take butyrate for other reasons, including great stool quality, and currently take 2-3 500 mg pills a day of Tributyrin-X*. Now if you’re constipated, you should only start with one pill every 3 days – just a warning. Check out my last podcast or the blog/transcript version for more details on that. Those links will all be in the show notes.
So I hope that was helpful for those of you suffering from diverticular disease. As always, if you’re struggling with any type of gut health problem and are ready to get some professional help, you’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
*Product links are affiliate links for which I’ll receive a commission. Thanks for your support of my podcast and blog by using these links.
So you want to start by just telling us all a bit about your gut health journey and what brought you to found healthygut.com?
Steven Wright:
Yeah, love to. First, I just want to say that I love the name of your podcast and what you’re doing here. I think we need a lot more levity. We need to bring levity and seriousness to this work. So thank you for doing what you’re doing here. And I love the name of your podcast. So, I feel like some people identify with me, which is I’m a “from birther”, or I had a birth defect that caused intestinal issues, right from the start. And other people are what I would call trigger people. They, they have some sort of life event, they go to Mexico or something, and then everything changes. So, I’m a from birther. And then of course, things just compounded with dermatologists prescribing four years of antibiotics, animal house college experience, and then a high stress consulting job at a big four accounting firm. I sort of realized along the way that I wasn’t normal. When I talked to other people, I wasn’t normal. But at that job, I actually got called to my boss’s office and told that I was stinking up the place and that I was probably going to lose my job if I didn’t fix my gut. And, of course, I knew this. Every meal that I ate, I would bloat up so bad that I would cry softly in my cubicle. I tried chicken breast and salad and I tried beer and burgers, nothing really worked. I saw a bunch of Western medical doctors in Chicago. And basically, they told me that I have a family history of IBS. And that I should suck it up, essentially.
Lindsey:
Can I ask what the birth defect was that that gave you gut issues?
Steven Wright:
So I was born with a hydrocele hernia, which is where the ball sack doesn’t necessarily close. And you can get a bunch of the abdominal cavity kind of stuck in the layers there. They didn’t catch it. And so I was in pain from zero weeks to 12 weeks, and my mom kept asking for someone to take a look at me. And they just kept telling her that she’s a new mommy, she doesn’t know what she’s doing. And then at 12 weeks, I had only gained one pound. So, I was now in the failure to thrive category. Luckily, finally, someone gave me a manual exam, they found the hydrocele, and they gave me an antiemetic drug to help me basically keep food down because I was literally spitting up everything.
So yeah, it’s been a long journey that, you know, I don’t wish it on anyone. And I do know that people have had it much worse than me. When Western medicine said, “there’s not much we can do for you, if you’re not eating your whole grains, we can’t help you,” That’s when I just got really mad. I thought, well, I earned a degree in problem solving. Electrical engineering, this is my college degree. You can’t touch electricity, you can’t really see it. It’s this thing that’s in a box, and you just have to monitor inputs and outputs.
And I was just really angry, up all night having diarrhea, and I was like, “the body’s no different.” I can figure this out. I just have to find mentors and people who have helped problems that I have, and then I’m going to reverse engineer this. That kind of launched me on this different trajectory of my life in which I changed my diet and immediately started seeing improvements and gaining confidence. And then, writing about it because I was so angry that I wasn’t given any other options. You know, this was 2009. The internet was nothing like it is today; we don’t have amazing podcasts like this one. So yeah, that kind of kicked off Healthy Gut and then as I fixed one thing or got partial benefit, it just kept driving me down the rabbit hole deeper to be like, well, why does my skin still react? Why do I have mental health struggles? Why am I still overweight? And that’s how you spend $400,000 in like 12 years
Lindsey:
I see that you trained under Daniel Kalish. He’s one of my mentors as well, so I’m curious how you thought that training was.
Steven Wright:
I thought it was amazing. I really appreciate Dan’s work and models. I think he produces some of the best clinicians out there versus IFM and some of the other functional medicine schools. I think it’s mostly because he’s really good at some simple things that a lot of other schools make really complex. I’m not saying that the Kalish Institute is the place if you have super complex issues or gene-related things, but for basic and some really solid protocols that work on 90% of people? I think he knocked it out of the park. He’s got the, you know, 20-40 years of experience to back that up.
Lindsey:
Yeah, I just finished his amino acids and B vitamins course, and we even had a webinar with Richard Lord.
Steven Wright:
Oh, man, he is so smart.
Lindsey:
Yeah! I’m still trying to work my way through the text materials from Laboratory Guides to Health for the relevant chapters. And it is definitely more of a reference guide than a novel.
Steven Wright:
I bet that guy’s IQ is off the charts.
Lindsey:
Anyway, at least when I tell people, “this is the recommendation that Richard Lord, who invented the test and wrote the textbook for it, says,” I feel pretty confident that I’m making a good recommendation.
Steven Wright:
Totally!
Lindsey:
Okay, wow, that must have been a super awkward conversation when your boss had to complain about your gas. Was that a long time coming? Until like the entire office was about to mutiny.
Steven Wright:
Yeah, I mean, I guess so. It was super uncomfortable and embarrassing for me. I have plenty of other embarrassing stories about commuter buses and being locked in certain places where I’ve had issues. I think what’s true is that the majority of us who have a chronic health issue who break out of the pharmaceutical model, we have an emotional breaking point. Where the pain gets so strong there’s an opportunity for a new paradigm to come through, and that was one of the biggest ones in my life. I’ve had multiple, but that was a big one. I don’t think he enjoyed it. I didn’t enjoy being the stinky guy. That’s not what I want to be.
Lindsey:
So looking back on it, do you think it was hydrogen sulfide SIBO? Or what do you say you had?
Steven Wright:
Well, I have positive stool tests from within a year of that. A positive stool test for Candida, and I immediately responded to the specific carbohydrate diet. Obviously, I was not absorbing or malbsorbing all the carbohydrate groups or FODMAP groups, or both of them. I had low stomach acid, because betaine HCl supplementation just almost immediately changed my life.
Lindsey:
You just had a whole messed up gut.
Steven Wright:
Yeah, heah, I had all kinds of things. I had a history of head injuries. I had leaky gut, couldn’t eat any dairy. Taking dairy out allowed me to smell again. I just thought you walk through life congested, I didn’t know any different. I was in a bad place with a host of things. I didn’t see a functional medicine provider until years later. Had I seen someone that graduated from the Kailash Institute and they did an Organic Acids panel, a GI test and, some basic blood chemistry; it would have been two hours’ worth of material there.
Lindsey:
I’m curious, did you settle then on digestive enzymes, betaine HCl and butyrate as the three products to heal the gut.
Steven Wright:
I don’t know that those are the only three, I just want to start with that. But I think they’re really core to gut healing. It started from my experiences. On one hand, I think I have this brilliance, but this brilliance comes with a downside. I believe every claim, I believe every miracle. You tell me about açaí juice, I’m going to buy some açaí juice. You tell me about some jungle herbs, I’m going to try it. That’s me. It started when I was buying MLMs with my first $20 when I was 13 years old. I just believe everything, therefore I fall for everything. But I’ve done it hundreds and hundreds and probably thousands of times now. I take recommendations very seriously, because of how much I’ve been burned. I’ve tried all the latest stuff on myself. One of the things I ended up realizing is that this idea that it’s just prebiotics, or probiotics or things like that, it’s not working! You have a certain class of people who react to them, and right off the bat they can’t even process them. So that drove me back to my engineering principles. What are the first principles? Well, the first principles is, if you eat it and you cannot absorb it or break it down, it is toxic to you. It doesn’t matter how “good” it is. It just kept driving me nuts. Why are there so many SIBO recurrences? Why are there so many lifelong gut people? It drove me back to the naturopathic principles of terrain. I guess, with this new engineering model of building an ecosystem that is super uninhabitable for the things that we don’t want, we have to determine what the prerequisites to that ecosystem are. One of the prerequisites is great stomach acid. Another prerequisite is proper enzymes at all three levels; at the pancreatic, brush border and microbiome. Another prerequisite is short chain fatty acid production, especially butyrate. It seemed like as I looked at the marketplace over the last 10 years that no one was focused on these boring things that have been around for 30-40 years. They’re really focused on the new exciting probiotics, which I also am excited about. So I decided if no one’s innovating, I’m going to go innovate on this. To build the best products for creating the great ecosystem, you need to have a great gut.
Lindsey:
You mentioned that you don’t think those are the only things. Do you think that most people would maybe need a round of antimicrobials or two, if they have SIBO or Candida prior to using the products that you have?
Steven Wright:
Definitely need them, not prior to but in combination with. In my opinion, we want the body’s defense mechanisms up and working when we use antimicrobials of any type, whether it’s antibiotics or herbal. I think that’s one of Kalish’s principles that he drove home for me in my class. If you just keep throwing antimicrobials at the body, but the body’s defense mechanisms never support you in that process, why would you be surprised if the infection comes back? It’s going to come back. And so I think they’re in conjunction with a program that needs to happen for that person.
Okay, so I tend to think of butyrate as a stool hardener. I’m assuming that it’s related to making the gut more hypoxic or less hospitable to facultative anaerobes, like proteobacteria, and increasing the anaerobic bacteria, as a consequence of it becoming more oxygen free. Those anaerobic bacteria tend to be butyrate producers. So in theory, I think that it should turn things around to take butyrate for a while. And then ultimately, you have more of this anaerobic bacteria that sort of supports itself. Because of that, I feel like I should be able to get off butyrate. But each time I go off it, I regret it. And I have to go back on it to keep up with my podcast namesake of the perfect stool. I do have a reputation to keep up. Do you find that after being on butyrate for some time that people can wean off it and stay in good health? Or is it something you’re finding that people need to stay on for life at some dose?
Steven Wright:
Number one, I think the oxygen hypothesis is so fascinating. There’s one study now on mice involving butyrate and antibiotics and how, basically all the probiotic studies taking probiotics with antibiotics to recover from microbiome have failed. The one butyrate study has so far been a success. So I hope they do more of that, because I think the oxygen hypothesis-
Lindsey:
Oh, I’m not familiar with that one.
Steven Wright:
It’s really cool. I think the oxygen hypothesis that you and Lucy talked about is really, really fascinating. And I cannot wait for more work on that. I do think it’s going to end up holding out because again, it’s setting up the conditions for a healthy microbiome. That’s what we want. Now personally, I don’t know if these are “lifelong supplements,” I highly doubt it. I’m going to be working over the next five to ten years to make sure that we have a roadmap for someone like yourself who wants to bridge off of a butyrate product or tributyrin product on to maybe prebiotic, probiotics, fruits and vegetables, whatever your belief is or what you need for the perfect stool.
There’s a few things that could be holding people on a butyrate supplement. One, is the microbiome actually recovering? For instance, when you’re on the supportive crutch of a butyrate supplement, can you introduce higher and higher loads of specialty prebiotics that are known to increase butyrate producers? And then maybe after three months of that, could you bridge off of it slowly? With that higher prebiotic load that would be one possibility and also coupling that with probiotics. That’s the hypothesis I have on how to get people from a tributyrin or butyrate product bridged off onto something else. I think the other thing that’s fascinating that kind of works counterintuitive to that, or maybe not counterintuitive, but butyrate is a lot like magnesium in that. Basically wherever researchers look, they find butyrate acting systemically. And so if we’ve been depleted for long time due to dysbiosis. For myself, my whole life I’ve had messed up short chain fatty acid production. There might be a nutrient deficiency that has to be filled systemically before it’s time to get off. And again, total hypothesis, but these are the things that I think about, late at night when I can’t sleep.
Lindsey:
Do you know of special prebiotics for butyrate producers?
Steven Wright:
There’s several studies out there. Research is kind of new, but they’re typically really, really brightly colored fruit. So certain types of grapes, pomegranate, cranberries, green kiwi fruit. I’m missing another one or two, but in general, really brightly colored fruits seem to be preferential. Also, lacto rhamnosus GG, LGG, is one of the most popular longest standing probiotics. There is one or two studies on that increasing the butyrate producers.
Lindsey:
I’m always on so many different things, because people are sending me free products to try and I’ve got new theories I want to try out myself. And I have that on my list of things to try next when I’m done with the current thing, because you can only take so many pills in a day, you know. That’s good to know, though. I mean, at least I can certainly think about including more of those foods in my diet. On another podcast, I heard you talking about butyrate for constipated people, not just people with soft stools, or diarrhea. And I found that surprising! As I was saying, when I tend to ramp up the butyrate, I’ll get to the point where I start getting rabbit pellets, and then I’ll back off. That usually does the trick of getting back to more of a perfect stool. I’m curious about using it and the dosing and the mechanism of action that you’re using when somebody is constipated.
Steven Wright:
This is also something that is going to take me another six to twelve months to really wrap my head around. At this point in time, there’s been a few human studies showing that in constipated people, you have low butyrate production. And there’s been one intervention trial, I believe, with sodium butyrate 300 milligrams once or twice per day, I can’t remember off the top of my head, but I believe it, I would assume it’s once per day. In that trial, only a certain percentage of those people got help. But in general, their pain and bloating went down. What I’ve seen in practice with our Tributyrin *, which is a totally different compound, and we can get into the specifics of that later, is that I believe there’s something around constipated people in this sort of oxygen microbiome hypothesis. And I don’t know what exactly would be happening over eight to twelve weeks. But what we’ve been seeing is that people who have been extremely dependent on laxatives of all types, if we can get them to take the Tributyrin-X* once every three days for about a month, and then they go to every other day, somewhere between eight and twelve weeks, a seismic shift tends to happen inside of their GI environment such that they are tolerating new foods, they’re going every day. It’s really weird. There’s an unlocking that happens. And I’m assuming or hypothesizing that it’s creating a shift in the GI tract, probably in the microbiome, such that it maybe gets that oxygen balance right, finally. But you have to go so slow, like you said, because the number one side effect or really the only side effect of butyrate supplementation is you can slow the motility down too much.
Lindsey:
I think of butyrate as an intervention for the large intestine because it feeds the cells lining the large intestine. I’m curious about why you don’t have a product with l-glutamine to feed and heal the small intestine?
Steven Wright:
I’m not against l-glutamine at all. In fact, I wrote a really long blog post on it many years ago; it’s been helpful for myself and for many others. I think, unfortunately, too many people out there are under dosing it, you know, most of the studies suggest 30 to 80 grams is what you really need to be at to see some benefit.
Lindsey:
30 to 80 grams a day?
Steven Wright:
Yes.
Lindsey:
Wow. That’s pretty hefty.
Steven Wright:
It is from the functional medicine perspective, but not if you look at it from a bodybuilding or a burn unit perspective. So if you want to be on l-glutamine for the rest of your life, then you can take it at three grams a day or two grams a day. But if you want to have a quick intervention for someone who has small intestine issues, or leaky gut issues, and they don’t convert it… the other thing with glutamine is that some percentage of people, I don’t know if it’s 10%, or 20%, seems like it’s going to follow the 80/20 principle. That’s my observation. But some people preferentially convert it right to glutamate, and it causes all kinds of neurological issues. I don’t know how to screen for those people based on a test or symptoms at this point in time, maybe you do. But because of that, I don’t like it when you get people in that state of mind where they’re ready to invest as much money as it takes and emotionally change their life. And then you give them something; they have a big adverse reaction from just one scoop. So, I’m not against l-glutamine in any capacity. It’s just that butyrate to me seems better tolerated and has just as profound impact. Used in combo, they could be amazing. I haven’t even done it yet.
Lindsey:
Okay, so why do you think that so many people need supplemental stomach acid? Shouldn’t we as a species have what we need to digest our food if we’re in good health, and we’re eating a healthy diet?
Steven Wright:
That’s if we don’t take into effect aging. The thing that people are often overlooking is that, for instance, ovaries and testes are literally going into organ failure. Potentially the stomach is too. So there’s been a really cool paper that came out showing that in 90% of people over the age of 60, they don’t necessarily lose their ability to produce stomach acid when they test it without any food or in a fasted state. But they seem to really lose their ability to regulate and produce stomach acid after the introduction of food or some sort of nutrient. That ability to acidify and then re-acidify the stomach tends to really drop as we age. I don’t know if you’re stressed but I’m very stressed. I struggle to make sense of the world today; there’s a lot going on. And when we’re in a sympathetic state, we can’t make as much stomach acid because we need to be in the parasympathetic state to actually produce that stomach acid. So I think between the increased use of technology and stress, and then just general aging, I think we’re often overlooking those two really important principles.
Lindsey:
And so with your betaine HCl product, I noticed that it had an intrinsic factor in it, which is what we need to digest vitamin B12. I was intrigued because I had, at one point, gotten the diagnosis of pernicious anemia, which means I had some autoimmunity against the cells in the stomach that produce intrinsic factor, although my latest test was actually negative. But at the time, I couldn’t digest B12. And I had to either get injections or take sublingual pills. When I saw the intrinsic factor in there, I thought, that’s genius. Because by doing that, you’re basically saving someone one more pill to take, or at least covering your bases for the digestion of B12 just in case somebody has undiagnosed antibodies. So I’m curious how you came to decide to put that in there, and what kind of customer feedback you’ve gotten.
Steven Wright:
Well, it basically just came from exactly what you said, honestly. I didn’t really want to start a supplement company. I mean, I love supplements, I told you earlier I buy every miracle pill out there. But I thought the world needed something different from me. There’s already 1000s of supplement companies out there, but I had been wanting an intrinsic factor HCl product for six or seven years now and none of the big name practitioner-grade supplement companies would build it. I would tell them at conferences, “hey, what do you think about adding intrinsic factor,” but I guess it’s just not a product that people wanted to innovate on. So that’s part of what I want Healthy Gut to do; take some things that just biologically make sense. We know that the intrinsic factor may be low if we have to replace stomach acid, kind of like including pepsin in there. That was just what I thought is supposed to happen biologically, and then there appears to be a difference. I would say that the number one thing that practitioners report to me about HCl Guard*, is that it’s working better than anything they’ve ever tried. They’re not sure exactly why but in general, people report using two to three less capsules than whatever other brand they’re using. And they actually get the results, such as regulated motility, less burping, less gas, less heartburn and different symptoms that would suggest that your stomach acid is regulated.
Lindsey:
And do you recommend people take it in the same way that a typical HCl challenge would go?
Steven Wright:
Same way, same ramp up dosage, starting with one pill. One other big misconception is that everyone’s always trying to find burning or some sort of uncomfortableness and I’ve observed that 20 to 30% of people never really feel that. What they do feel is loose stools or some sort of speed up in their symptoms. I would encourage people to try to find their dose, whether they use a different product or our product. You do need to find that ideal dosage because one pill too much or one pill too little from any brand, and you’re really not getting the perfect change in your ecosystem that you’re hoping to.
Lindsey:
Okay, what’s the dosage of one pill of your Betaine HCl?
Steven Wright:
We have 550 milligrams of Betaine HCL in our pills, 30 milligrams I believe of pepsin, 15 milligrams of intrinsic factor, we have the organic ginger at 100 milligrams and DGL at 50 milligrams.
Lindsey:
Why the ginger?
Steven Wright:
Well, the other thing that kind of annoyed me is that one of the biggest drivers of peristalsis is your stomach acid, the pH of the food as it moves through the body, that’s a huge signal. It seems like in today’s world, that prokinetic usage and prokinetic support has just gone through the roof. I was trying to think about that, and I think it’s related to the stomach acid issue. But I also bet that the cells are getting a little weaker in there, and maybe even forgetting how hard to contract. There could be so many factors, I mean, who knows, it could just be low thyroid; there’s a lot of variables that could be at play there. But with the up-regulation of prokinetic use, it just seemed natural to me to use a strong prokinetic like organic ginger in the formulation to help people get their GI tract regulated. Also, ginger has a long history of use for anti-inflammatory possibilities, healing the gut lining and all those types of things. So to me, it was just a natural herb to add in there. There was a study done with ginger extract for producing a peristaltic wave, so it is backed up by studies in humans, which is the other thing that I really try to do.
Lindsey:
Speaking of prokinetics, that’s my current fascination since I have now had a positive IBSsmart test* for the anti-vinculin antibodies. I’m on a mission to discover the best prokinetics, do you have any experience with this?
Steven Wright:
I’ve never tried any other prescription prokinetics. I’ve tried many of the supplemental forms; you’ll probably be more up on it than me. 5-HTP, and the amino acids can be really, really helpful for brain related things and mood related things. But I’ve never really seen them do much for prokinetic related issues. I’d be curious to hear from you what you’re excited about?
Lindsey:
Well, I’m trying Iberogast right now. It’s hard to say if it’s going well, it’s one of these things where you have these issues and they come and go. I think those of us who have these kinds of either inborn errors or acquired problems, in my case, food poisoning, that we may likely always be off and it’s always going to be sort of an ongoing battle. I haven’t tried any prescription ones. I’m working to try and find a gastroenterologist who will actually listen to me and not blow me off and try and get me to a colonoscopy like my last one. Anyway, the digestive enzymes that you produce, is the theory behind that, that if you’re digesting more while everything’s in the stomach and small intestine with the help of those enzymes, even if they aren’t deficient, that the less you’ll send on to bacteria that will then overgrow in your gut and ferment the food?
Steven Wright:
Yeah, that’s one of the big issues. If you want to have a healthy microbiome, we have to send it the right types of food particles and the right sizes for it to ferment. Then the other thing is, we don’t want the wrong size food particles or food in general sitting around in the small intestine, which I think is driving a lot of the SIBO, Candida, SIFO, all these different sorts of overgrowth in the small intestine. I think one of them is just mal-absorbing food due to poor enzyme production, release or activation. So Holozymes*is my answer to all of these carbohydrate malabsorption issues with FODMAPS, as well as just the generalized issue that people have with stomach acid. I think, potentially, if you have any inflammation from the SIBO/SIFO/etc., you’re in this loop where you have inflammation probably shutting off your brush border enzyme release at some level, or inhibiting it at some level. How do you dig yourself out of that spiral where it just gets worse and worse? I think Holozymes can be a solid intervention for that type of situation.
Lindsey:
Can you just elaborate a little bit on the different types of enzymes, I think that might be helpful to people?
Steven Wright:
Going from top to bottom is the best way to visualize it. But there’s a little amylase in your saliva. There’s pepsin in your stomach, a super important proteolytic enzyme. The three most important enzymes for digestion, in my opinion, are the pancreatic enzymes, which are protease, lipase and amylase. Protease is protein. Lipase is fat. Amylase is carbohydrates. That’s coming in at the top of your small intestine from your pancreas. Then you have at the brush border, the villi In the crypts area. They’re releasing brush border enzymes. These are typically things like lactase for lactose absorption. A lot of people “lose” their lactase over time. Who knows if it’s inflammation at the brush border, or if it’s actually happening; you have other ones there like sucrase and maltase. These break down the last bonds of disaccharides, down to monosaccharides. And then in the microbiome, you have all these crazy cool enzymes. And I bet we’ll learn about hundreds more in the next decade. Specific ones that people have probably heard about are things like cellulase, which breaks down the cell wall components of your vegetable and fruit matter. Alphagalactosidase, which break down raffinose, it’s an oligosaccharide part of the FODMAP fructan group that often is found in cruciferous vegetables, beans and lentils. Those traditional “gassy foods,” if you will. If we start going back up the chain, if you have dysbiosis, you might not have the right bacteria classes, or the right enzyme production from those bacteria to break down the last part of your food. This would be the vegetable matter, the fibrous stuff and the prebiotics. In the small intestine if you don’t have your brush border, that’s where you’re going to be really feeding SIBO/SIFO. You’re not going to be able to break down, for instance, sucrose, which is two molecules of monosaccharides combined. You won’t be able to break that down, and that’s going to cause an easy meal for some bacteria. The pancreatic enzymes are the heavy lifters at the top, so they really need to be happening to begin the unfolding of the big complex molecules that we eat.
Lindsey:
Is there any situation in which digestive enzymes might be contraindicated? If you keep on taking them past the point when you really need to, are you in danger of eating up your own stomach wall?
Steven Wright:
If you have active gastritis or if you have active ulcers and you take any enzyme product, ours or anyone’s, and you have pain, then that is contraindicated. Work with your provider to do something to heal your mucous lining and whatever is happening with your gastritis. Beyond that, I don’t believe so. I’ve looked for this; I bought almost every book that’s ever been made, ones that are out of print. I’ve tried, I found every paper I can on this, and I have yet to find anybody with a theory even on what a negative feedback loop would be basically that would turn off our internal production of enzymes, if you take them exogenously. Everyone’s pretty familiar that if, for instance, males take testosterone replacement, it shuts off any internal production of testosterone in a ratio based on how much they’re taking. That sort of feedback loop I have not yet found, and I haven’t found anybody even with a theory on it.
Lindsey:
How about for HCl?
Steven Wright:
I haven’t found that either.
Lindsey:
It’s the opposite, isn’t it? You take it for a bit and eventually your production comes back on?
Steven Wright:
Right, right, that’s what I was going to say. In fact, I’ve experienced that personally. I’ve seen that in our community quite a bit. And people like Dr. Jonathan Wright and Dr. Steven Sandberg-Lewis say that you can typically bridge off of your HCl usage, at some point.
Lindsey:
Yeah, that’s what happened for me. At first when I started taking it, I seemed to need it. And then after a while, I started getting that burning sensation. Now at this point, if I try even one, I get that sensation. I kept thinking I needed it, until I got my negative intrinsic factor and parietal cell antibody test, and now I know I don’t.
Steven Wright:
Well, that’s great. That’s awesome healing.
Lindsey:
Yeah! And what might people see that indicates that they’re not digesting their food well, that they might need digestive enzymes?
Steven Wright:
I do want to touch on my last point on enzyme usage. I, coming from the functional medicine world, thought that I should probably only take two or three or four, and that seemed like a lot to me. Then my fiancée was diagnosed with breast cancer. So we’ve been on a journey for a couple of years. She has no evidence of disease at the moment. She’s recovering very well, but the fight is not over. In our journey through the cancer underworld of medicine, there’s a whole class of cancer doctors who have successfully used high dose systemic enzyme therapy for this and they take like 130 to 160 capsules a day. When I realized that people were dosing enzymes systemically, at 100 times more what functional medicine people were doing, I realized we’ve fallen for a few myths here. I really started to experiment with that and check in with other doctors and practitioners. It does seem like, as the integrative and functional medicine community has been trained, that we might be under dosing. It doesn’t matter what brand you’re using. And if people are not responding, they’ll still continue to have symptoms like undigested food in your toilet or in the stool, oily toilet or experiencing food sensitivities to certain classes of foods. All of these things suggest a lack of ability to break down the food. Gas and bloating are the top symptoms, other than the pieces of food and food sensitivity. That’s kind of the main driver of your inability to break down your food. It is real and it’s live and it’s happening. Now, of course you can run tests like fecal elastase, but as far as I know, there’s no real test for microbiome enzymes, or brush border enzymes. That makes it more, I think, symptom driven, at least at this point in our understanding of testing and the body. And so if people are having those issues, I don’t care what brand you have, double or triple the dose. The safety profile of enzymes in humans seem to be extremely robust.
Lindsey:
Speaking of that, using enzymes on an empty stomach systemically, I’ve done that with the proteolytic enzymes for Hashimoto’s because there was a study around that.
Steven Wright:
Did it help?
Lindsey:
I assume so because my Hashimoto’s is completely reversed. My antibodies are completely negative, or normal.
Steven Wright:
That’s amazing!
Lindsey:
Yeah, it all works!
Steven Wright:
With the Holozymes, there’s been six pilot trials on our product, and the patent behind it, and they were looking at both systemic and digestive use. The dosage was two per meal, and then two before bed, and we routinely get comments around improvements after exercise. Some people can only exercise once a week or twice a week, and they get really, really fatigued, right? Because they’re trying to come back from all these issues. Immediately, their exercise tolerance doubles, or triples, and they can work out every other day. We have people who have joint stiffness and aching, which could be related to things like arthritis or getting old, and they’re moving. They’re walking four or five miles again. Also, things related to gout, pain, and high uric acid pain. Lots of anecdotes, again, this is not treating any of these diseases. This is just anecdotally, when you use the whole enzyme systemically and adjustably. I’m just a huge fan, whether you’re using ours or somebody else’s for systemic enzyme use.
Lindsey:
That’s interesting about the gout because my husband has gout and refuses to take anything or do anything. When he has a flare, he takes the prescription stuff you’re supposed to take, but I should try to get him on that.
Steven Wright:
Yeah, and this is just anecdotal usage. This is not indicative. Our product does not treat gout or any of these things. But I developed high uric acid at 32 after about six or seven years on a paleo, gluten-free style diet. That was five years ago. And I was just mortified, right? Like I’m supposed to be this healthy guy. And I’m trying to set the bar, and here I am hobbling around the house. I tried to suck it up. I tried all kinds of cherry this cherry that, and other stone breaker thingies, anything related to uric acid I could find out there. I got nothing and nowhere and I almost had to give up working out and being out in the mountains, because it would hurt so bad when it was flaring. Then I met the PhD behind whole designs that I partnered with on this formula. He was telling me, “oh, we did these six pilot trials.” Well, two of the pilot trials were on high uric acid and gout patients. And I was like, “okay, give me your miracle pills, buddy.” Basically about 14 days of higher dosing, I did a loading dose, and I have not suffered the big toe issues that I did since. It’s been over three years now.
Lindsey:
Are you talking about taking them on an empty stomach or both with meals and then on an empty stomach?
Steven Wright:
With meals and on an empty stomach. That’s how I use them. So I did a loading dose of six per meal and six before bed for two weeks, and then I cut back. On average now I use three to four per meal, depending on the meal. And I use three to four, depending on the day, before bed.
Lindsey:
Do you find now that you have these few products that are helpful that you can limit yourself to those?
Steven Wright:
Yes and no. I still believe that one of the most important things for aging and for our longevity and for our immune system health is microbiome health. And so I am regularly testing probiotic brands, probiotic strains, I take probiotics on a regular basis and I cycle through all different kinds. I don’t just limit it; every once in a while I throw some immunoglobulins in there, because especially in today’s world we don’t want to catch anything. So I’m hyper vigilant on taking my products and testing out new things. The product lineup at Healthy Gut right now, which is just the HCl Guard, Holozymes and the Tributyrin-X, are the basics. Those are mechanically what a gut needs to do its job and then everything else beyond that is the really fun, fancy stuff. Very exciting stuff. I want both worlds, basically,
Lindsey:
I really liked the Tributyrin-X* because it’s a small, easily swallowable pill. And with three of them, you’re getting 1500 mg. I like Probutyrate too, but it’s only I think 300 per pill. So if you take four, you’re getting 1200. That’s one reason I really like yours and chose to get those, just to take fewer pills at the end of the day and get a higher dose.
Steven Wright:
I’m glad that you’re testing it. Are you noticing a difference at all between the two?
Lindsey:
The impact is roughly the same, but the difference is that I can take one fewer pill. I think that the goal for people who’ve been through these high supplement regimes, as many of my clients have, is to get off of as many pills as possible and get back to just eating food and being able to digest it and live a normal life. I think for some of us, it’s going to be a lifelong battle where you have to take something to help out. If that something is digestive enzymes, that makes sense, because if you’re not fully digesting your food, because you have a tendency to have SIBO and overgrown bacteria that are going to steal some of your nutrients, then it makes sense that perhaps digestive enzymes is the thing that helps you to not have to take the other things.
Steven Wright:
100%. That’s my only thing that I try to tell people. I see people spending thousands of dollars and many, many hours trying to source organic grassfed beef or wild caught salmon or organic vegetables from a local farm. And then they can’t utilize the nutrients from that food. It’s just sad to me, it’s really heartbreaking at some level, because I’ve been trying to optimize every single variable in my diet, only to mal-absorb it. I think enzymes, especially as we age, have this sort of pancreatic theory of aging. I can’t remember the exact term on it. It’s basically that you only have so much pancreatic enzymes, just like you only have so many stem cells. As you age, they’re running out. So I think enzymes as you age should be thought of like magnesium or vitamin D. It’s what you need to be healthy in today’s world. We have products like butyrates and tributyrins. Again, if that is a lifelong thing, it’s better than losing a colon or ending up with a worse diagnosis, in my opinion.
Lindsey:
I mean, at the end of the day, if all you have to do is take some digestive enzymes while you eat… I find that three butyrates once a day pretty much does the job for me.
Steven Wright:
That’s awesome. At healthy gut, I really want to support people and their dosing because I know that a lot of people have dosing challenges and most supplement companies really don’t want to talk about that. Whatever the back of the bottle says, may not be true for you. We do know that based on studies and talking with clinicians that around 1000 to 2000 milligrams a day of tributyrin should be where 80% of everybody falls. I personally only need one per day, but when I started I needed three per day. I wouldn’t be surprised if over time, Lindsey, you reduce down and need less. We have some people who haven’t had a formed stool their entire life. They’ve tried almost everything, and they use you know, four butyrates three times per day. And they’re finally having regulated, perfect stools. It’s very dependent upon the person, genetics, epigenetics and the environment.
Lindsey:
Are you seeing butyrate useful with people with ulcerative colitis?
Steven Wright:
We have some amazing testimonials from people with ulcerative colitis. I think one of our most famous was a father who during the pandemic, his wife got pregnant. You got a pandemic happening and your wife gets unexpectedly pregnant. That’s very surprising and awesome, but also very stressful. He already had IBD and was just on the verge of being out of a UC flare. He was super super concerned. He bought the product and sent us an amazing review. He told us that his prayers had been answered, he’s able to take care of his wife and child and he’s not flaring. That was unheard of for him. I think it’s super exciting for the IBD crowd. Butyrates in general, whether it’s our product or anybody else’s
Lindsey:
Any thoughts about dosing that people should know? I too think the dilemma is that people think, “I get this bottle and in theory it should last me at least a month,” but the reality is it may not. Especially at the beginning, right?
Steven Wright:
Some people are going through a bottle a week and other people are going through a bottle every 90 days. I think the one thing that’s not being talked about in integrative medicine and functional medicine is that you cannot escape statistics. I don’t care how quantum you want to talk, statistically speaking, 34% of the people you see will fall on the long tail of a bell curve. That means they’re either going to need a lot more or less of whatever product. I mean there are studies showing that some people do not respond to vitamin D3 supplementation until you crank it up to like hundreds of thousands of units, which for other people would be potentially a fatal dose if they took it for six months or a year. We actually do a very similar thing for our product as the HCL challenge, which is start low, start slow, especially if you consider yourself a sensitive person. Then, ramp up until you notice things like really good Bristol stool chart poops, your bloating is going down or your reactions change. The number one thing that we see is histamine, mast cells and food sensitivities are the biggest thing beyond stool regulation. So whenever they stop reacting to perfumes, environmental toxins, dogs, foods, all those types of things. I tell them, “you’re really close to your dosage so stay around that dosage, because obviously something important is happening.”
Lindsey:
That’s really good to know because that is an area where I have felt I needed assistance. I just use over the counter allergy pills for this type of histamine reaction, and of course, diet changes, but that’s good to know butyrate is useful in that case, too.
Steven Wright:
Well, it’s got to be an tributyrin product. Sodium butyrate is absorbed extremely fast. Calcium and magnesium butyrates are absorbed extremely fast in the upper GI tract. So you want to get a tributyrin, which is more of a delayed release just because of the compound, it needs lipase to begin to break down. Any tributyrin product from any company, you want to spread it out. The reason why is that you want to spread it out across the mast cells all the way through the GI tract as far as you could go. So if you slowly coat the GI tract from the top of the small intestine down, the farther you can get it, the deeper into the small intestine and potentially even into the large intestine. That’s your ideal delivery zone. But you want these slow release ones so that wherever you have mass cells that are over activated, you’re sort of like putting a nice weighted blanket on them or something to kind of see, you know, calm them down a little bit and regulate them.
Lindsey:
Are you the only tributyrin product or are there others?
Steven Wright:
There’s others! I think the second best product on the market is SunButyrate* by Pure Encapsulations. It’s a liquid. It’s like a blueberry-lemon flavored tributyrin liquid and it’s packaged in a liposomal. All butyrates smell terrible, whether it’s tributyrin or sodium butyrate, but also you have got to protect the tributyrin from the stomach acid. Sun went with a liposomal package that gets about 90% of it through the stomach acid. I think that is what their practitioner handouts say but it might be 92%. What we did is we found an amazing enteric release capsule that’s patent pending right now. Our capsule failure tests are showing zero. Of course if you left them in acid all day they would fail at some point. So it’s not that it’s perfect. We just put a gel cap that is enteric coated rather than gastric resistant. There’s a lot of other capsules out there that are not enteric capsules, they’re gastric resistant. That’s kind of the difference between an iPhone 6 and an iPhone 11. You drop an iPhone 6 in the water and you have a few seconds to get that thing out, but you can drop an iPhone 11 in the water and it’s totally chill, it’s not a big deal.
Lindsey:
I’m surprised there’s a liquid. I wasn’t aware of the liquid tributyrin product, that’s interesting. So you could give that to a child.
Steven Wright:
It’s a great option. There are powdered tributyrin products as well. Now the unfortunate thing is that to powder something, you always have to dry it with something. As far as I know, all the powdered tributyrins are roughly 30% standardization by weight. If you think about that dosing of getting to 1,000 to 2,000 milligrams a day, now you’re talking at like 5000 milligrams to get roughly into that payload range of actual tributyrin delivered. I’m not a huge fan of powdered tributyrins at this point in time in their technology.
Lindsey:
Any further thoughts about the products before we talk about some offers that my listeners can get for buying them?
Steven Wright:
People should be skeptical of everyone that’s coming on and talking about supplements. Be skeptical. That’s why we have a 60-day money back guarantee. That’s why we’re growing slow, because people are skeptical. Could you really make digestive enzymes better? Could you really make HCl products better? Is Tributyrin-X really that much better than a sodium butyrate that’s been studied in 15 plus human studies? The answer is yes, actually, and the benefits are meaningful. We have doctors signing up left and right to be wholesalers. That being said, I know without a doubt from being the sick person who’s tried a lot of things, and with working with a lot of people one on one, that not everything is right for everybody. If you don’t get that dose right, it’s definitely not good for you. We offer that money back guarantee and we offer free health coaching. If you have a dosing issue, you can hop on the phone with one of our health coaches and try to work through it. We still refund around three to five percent of purchases, because at the end of the day, you might just not need it. You might not have low stomach acid, you might not have an enzyme issue or maybe a different brand is better for you. I want to respect people’s time and money. They gave us a shot, and I don’t want to slow them down from healing. You can read more about our products online, and about how we’re different and how we’ve innovated on things. But I think you feel the difference; that’s why people stay with us.
Lindsey:
So they can find you and the things that you sell at healthygut.com?
Steven Wright:
Yeah, but they should go to healthygut.com/perfectstool if they want to support your show and also save $15 and get free U.S. shipping. That’s our main site, but we want to make a perfect stool community offer. Save some money and reduce the risk, and also get free U.S. shipping.
Lindsey:
My understanding is you’ve got a code “perfectstool15” for $15 off. I’ll put those all in the show notes so people can find them easily enough.
Steven Wright:
Again, I tried to do a lot of different things in my brief time on the planet here, but for some reason I just keep getting directed back to supplements. I bought my first supplements off the internet at 13 and my mom was like, “you just got our credit card hacked, and you’re going to die of cancer from that.”
Lindsey:
I think we have the same mom.
Steven Wright:
So I mean, I’ve been using products from all over, all the weird stuff, my entire life. I enjoy it. If I can be the guinea pig, and then back it up with research and trials and good formulations with the smartest PhDs I can find, and then offer the dosing and guarantees that I think a reputable company should offer, I guess that’s what Healthy Gut is. And I’m very excited about the results. I’m most proud about the stories of our users. That’s what gets me excited and keeps me going.
Lindsey:
Thanks so much for sharing all this information with us. I think it’s really useful to think about some of the basics of gut health. I focus a lot on the more complex interventions and these are just your basic digestive function interventions. And that’s what’s important for a lot of people.
Steven Wright:
Yeah, yeah, I hope I can make that sexy again.
Lindsey:
Great. Well, thanks so much for being with us.
If you’re struggling with any type of gut health problem and are ready to get some professional help, you’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
*Product links are affiliate links for which I’ll receive a commission. Thanks for your support of my podcast and blog by using these links.
So your approach to gut health is a little bit different than my approach, and I know it’s very diet focused. Which is not to say that I don’t address diet with my clients, but it sounds like you use it as a primary vehicle for change. Can you tell me more about that?
Laura Martin:
Not so much, I focus more on the gut-brain connection. There’s two different ways that I do that. A lot of people get wrapped up in food sensitivities and elimination diets and things of that nature, when really, when it comes to IBS, it has to do more with the nervous system. So the foundation of Healing To Happy, is, okay, what’s the mindset first? If you think of a triangle, the foundation is mindset. So what are the daily habits? What are things that are impacting that? Where did that start? And then the things that come together are lifestyle and nutrition, because you can’t have those two built on an unsteady foundation. Really what we focus on is the gut-brain connection to get balance back in. And then also we focus on restoring the metabolic function. That looks like, what are your core body temperatures, what organs aren’t functioning properly? Instead of focusing on what foods to take away, we’re focusing more on what nutrients need to be added back in so that we can really optimize the body to start taking in food normally again.
Lindsey:
So it’s interesting that you mentioned core body temperature, because I know that’s a factor in fungal overgrowth. And I know personally, I have a low core body temperature. And I’m curious what foods help bring that up.
Laura Martin:
When it comes to core body temperature, we look at more of the lifestyle practices; just a simple bubble bath will help bring that up. So it’s getting more into, how do we balance the circadian rhythm? Because people that struggle with anxiety or struggle with food sensitivities or depression, their entire body’s core temperature is all thrown out of whack. So we focus more on what it is throughout the day that’s throwing that off. Yes, we need some root vegetables. We need some heartier foods. Oftentimes, when we think of, “healthy,” we’re thinking of salads and smoothies and things that are very light. When our body is telling us it’s not functioning optimally, and things like our body temperatures, or our pulses are not really being optimized in the way that the body needs to be using it, we’ve got to work our way backwards. So we need heartier foods. Think of more of the fall kind of foods; stews, eggs and potatoes; things that have more sustenance to them. We often shy away from them because of a weight thing or we don’t like to feel full, which over time actually decreases our body temperature. And when we’re talking about metabolism, a lot of people will refer to that as skinny-ish people. But really what I’m talking about is core body temperature. What is the temperature of your body? And how is that impacting the rest of your health?
Lindsey:
So when you say hearty foods, are we talking like meat?
Laura Martin:
In my practice I’m doing organ meats, because we’re not really eating those as much anymore. We’re talking about fish, seafood, fatty fish, more of the salmon, the fatty tuna, sardines, mackerel, oysters, depending on where we are in our hormone cycles. Things of that nature, and just kind of playing around from there.
Lindsey:
So organ meats are a tough sell. I can tell you I tried my darndest to make some edible pâté out of chicken livers. And I could not do it. Although my friend who was a chef did make chicken liver pâté that I loved, I wasn’t able to pull it off and have multiple jars of pâté sitting unused in my freezer.
Laura Martin:
100%. It’s one of those things where I can’t even stomach it. So that’s actually one that I do supplement from a certain company. When I was living in Thailand, I was like, “well, this is easier.” It’s in everything. You don’t have to think about it, it’s just in curries, but here, we don’t use it. We don’t use all of the animal anymore. I was doing a panel the other day and someone mentioned that you can get ground organ meats inside of ground beef, but again, that’s not a common thing people are out there looking for. It’s definitely an acquired taste. So I personally just take a supplement form of it.
Lindsey:
Yeah. So is that a beef liver supplement?
Laura Martin:
Yes! It’s this company called Ancestral Supplements* (use code TRIBE10 for 10% off), not sponsored or anything, I just genuinely like them. It’s pasture raised, locally grown, it’s sustainable, all that stuff that we’re all into nowadays. I have not had any side effects and my clients have not had any side effects from it. And so I just kind of go that route as opposed to being like, “well, here’s some iron here’s some vitamin K.” Just eat the organ you’re trying to support at the end of the day.
Lindsey:
I’ve sent people to look for various and sundry organ meats, especially people who are dealing with autoimmunity and those types of things. Sometimes they’re out of stock though, I think they get into hot demand when people catch on to that being a good one. I buy from a local farm, and I wrote to them and suggested they do that, try to mix in some organ meats [into their ground beef], and they took that into consideration but I have not yet seen a product. So we’ll see. I’ve also heard of people cutting up pieces of liver out of the freezer and swallowing them whole.
Laura Martin:
Yeah, I saw people do that, but I like to enjoy my food.
Lindsey:
Yeah, that’s challenging. So how many beef liver supplements you have to take in a day to make it worthwhile.
Laura Martin:
So it says six, I take three. Because it’s one of those things that after you do it for a while, your body starts to catch up and you don’t need that stuff as much anymore. As time goes on, I don’t really need that many B vitamins in my body. I’m pretty wired when that happens.
Lindsey:
So back to core body temperature, what should we be shooting for? And are we talking about basal body temperature, when you take your temperature right after you’ve woken up and not done anything?
Laura Martin:
Correct. For any of my ladies that are trying to get pregnant, test your temperature right when you wake up just to see if you’re fertile or not. You want it to be around 96.8 when you wake up. By the time you go to sleep, you want it to be around 98.8, because it’s supposed to get hotter as you go throughout the day. And then you take it again 30 minutes after you eat to make sure that you are increasing the temperature of your body, because that shows that your body is actually using the food. For a long time that was not my case, that did not happen. I do see that quite frequently in a lot of people with IBS and anxiety. It’s just our body temperature’s all over the board, and really, it actually goes down. This is when you’ll see cold toes and fingers all the time, your hair’s falling out, you’re getting hangry. We normalize these things, but they’re really not normal. You really want to aim for getting this back up. Oftentimes that means getting more nutrient-dense foods into our body while also working on lifestyle practices that downregulate the nervous system.
Lindsey:
My niece was doing some type of thing, I think the person she was following was named Ray Peat. It involved carrot salads. Are you familiar with that?
Laura Martin:
Yeah, the raw carrot salad binds to estrogen dominance. That’s a big thing for migraines, or PCOS. I suggest that in one of my programs, but it’s interesting because it doesn’t work if it’s a cooked carrot. It’s only a raw carrot that binds this excess estrogen fiber to get it out of the body and helps really balance it out. The study was started based off of migraines, and then it caught onto the metabolism world and restoration and kind of ran wild there.
Lindsey:
So 96.8°, that would be pre-ovulation, right? Post ovulation, you’d have a higher temperature, correct?
Laura Martin:
Correct. Right.
Lindsey:
So that would be more in the 98 range.
Laura Martin:
That’s what we’re looking for.
Lindsey:
And for men, what should they expect?
Laura Martin:
I don’t study them as much, so I can’t give a full answer on that. I really do dedicate my time to women.
Lindsey:
Fair enough. You were saying a bubble bath would bring up body temperature, are there any other lifestyle practices that tend to bring it up? And by that, I don’t mean at that given moment, but bring it up over time?
Laura Martin:
Yeah, it’s just slowing the body down. How do we get the circadian rhythm of our body back into balance? That’s essentially what it is. It’s just thrown off all the time. We’re not in balance. It starts with how you start your day. Are you up? Are you jumping? Are you snoozing? Slamming a cup of coffee and booking it out the door? Or, are you slow to rise? Letting your body really adjust to getting out of those brain waves at that moment? Or is it this fight or flight response right away? And then out of the day, are you moving? Not going to cross fit. Are you going on a walk? Are you moving your body? Are you downregulating? Are you getting in nature? Are you seeing the sun? Are you breathing air? Now we’re working from home and we don’t go outside that much. It’s not a common thing. You have to actively add it into your routine. And then, do you keep all the fake lights on throughout the day? Are you turning them off, getting by candlelight? Or, are you rising and falling with the sun and really adjusting with that so that your body can get into that rhythm as well?
Lindsey:
So what mindset obstacles or issues do you find tend to be related to IBS?
Laura Martin:
Oh my goodness, that low FODMAP is the only solution, and elimination diets and restriction! You know, of course it feels better at first, but then people cling to it, not realizing that the longer they cling to it, the more damage they’re actually doing. I will get on calls with people and they’re like, “I have been doing [low FODMAP] for like 25 years.” I’m like “what? It was supposed to be six weeks!” It’s definitely not supposed to be that way. I sit down with doctors, cardiologists or endocrinologists, and they’ve even said low FODMAP was just a way to distract the clients. “As long as you just tell them that, then they’ll be hooked on food.” And that just breaks my heart. That’s what they’re taught. This is just a distraction. So a really big roadblock is then getting off of that, because this is the only thing that makes them feel safe. This is the only thing that makes them feel like they have any type of control. Restrict what you want for the time being, but do the work on restoring why your body isn’t digesting those foods to begin with.
Lindsey:
So when you have somebody who has restricted their diet severely down to the point where they have very few things that they can eat, how do you work with them to expand what they eat?
Laura Martin:
That was my own personal experience. So I focus more on, do you have the right resources where you’re also repairing your relationship to food? It doesn’t matter what diet I give you, we’ve got to do that psychological work around food. I think it’s called food re-intake disorder, which often we see a lot with children where they don’t eat something because it’s a color or a texture, but then they generally grow out of it. People with IBS, oftentimes it’s gluten or dairy, or whatever showed up on the food sensitivity test, that they’re now afraid to consume. That fear is actually what’s spiking up their relationship with food. I have multiple different master classes and programs because I personally went through that as well. But at the same time, if it’s so deep, we need to do psychological work and we need to get you help around that arena. And then we can start addressing nutrition. But if we don’t heal the relationship with food, it really just isn’t healthy to throw anything else on top of it. They’re just going to become obsessed with it and go the whole orthorexic route.
Lindsey:
And how do you heal your relationship with food?
Laura Martin:
A lot of work, and everyone is different. Oftentimes, it started when we were younger. I have been on a diet since I was 13. I had to realize that my relationship to food was my sense of belonging, and then, really challenging what I knew. A lot of times we think we’re doing our best and we don’t realize how disordered it actually is and how it’s stressing the people out around us. When we take radical responsibility over that, we have to be able to be honest with ourselves. It’s not like it just goes away, it’s not ideal, but it stays with us for a lifetime. I know how many calories are in a banana, I know how many calories are in a tomato, that doesn’t leave my brain. I know what’s made up of these different foods. Going out to eat, I know what oils they cook with. That’s in your brain. It doesn’t just go away. But the way you let it impact you changes. You’re able to sit there and be like, “I’m gonna be okay.” Even if they’re using polyunsaturated fats, it’s fine. I do the majority of the work 87% of the time, and I’m good. If something bad happens somewhere along the line, my body’s okay to clean up that mess. It really is learning how to radically trust that your body, given the right tools; doing the work of restoring your metabolism, healing the mindset, doing the lifestyle stuff, trusting that you got you; can really carry yourself through that. Even if there is gluten or dairy or something in the food, your body is going to be smart enough to taper that off because you’ve done the work over this time period.
Lindsey:
And so are you finding that people are able to eat things like gluten and dairy after they’ve worked with you?
Laura Martin:
Oh my goodness, yes! That’s the coolest thing! Of course it’s not an everyday thing, but they’re able to go out to dinner again, they’re able to go on dates, to family parties. That is what the whole purpose of this work. People sit there and they’re like, “yeah, I’m a little bit bloated but I’m not running to the bathroom like ripping off my pants on the way. This is a lot better.” We’re making that progression.
Lindsey:
Yeah, I got to the point where I can now have gluten or dairy, probably a little more often than I do, maybe every four to six weeks. It doesn’t feel good, I get a sore throat from the dairy, and a little acid reflux. I get bloated if I overeat, because, invariably I overeat because it’s good and I don’t get to have them very often so I’m just like, “forget about it, I’m just having as much as I can because this is it for the next six weeks!” But yeah, it’s not the end of my world. It’s not like my entire health is destroyed or my Hashimoto’s came back, that doesn’t happen.
Laura Martin:
Exactly. Your body is going to be like, “well you don’t normally eat this.” It’s like going to the gym and thinking that you’re going to pick up 100 pound weight and it’s going to be perfectly fine. That’s not how that works. If you don’t have the digestive enzymes, it’s going to give you a little bit… Like for me, I probably eat dairy every day. Whether it’s Greek yogurt or it has some cheese, my favorite meal is charcuterie board. I know that’s not what you were expecting. With gluten, I know that does affect a little bit of my cognitive function because I am more prone towards depression. So that will slow the synapses in my brain a little bit but I still have it probably once a week. I’m dating a New Yorker. He loves his pizza. I’m not going to always be like, “no, we’ll opt for cauliflower and opt for gluten free.” Sometimes he wants a regular pizza. I can’t win all the battles. It’s one of those things where, my body’s fine, I just wear a looser pair of pants that day.
Lindsey:
That’s practical. So I understand you deal with the issue of hypothyroidism. And I’m curious what diet changes, if any, or what lifestyle changes that you’ve found particularly effective in reversing hypothyroidism, both in the context of Hashimoto’s, and autoimmunity, as well as non-autoimmune hypothyroidism.
Laura Martin:
It would be the same thing as restoring the metabolism, because the whole reason we have autoimmunity responses is, yes, we have the gene in our system, right. But for some reason, somewhere, that light switch got turned off and on. And so we have to work our way backwards. And that’s often because of those temperatures. That’s also because of our metabolic function. The gut isn’t absorbing the right kind of food, so that starts to set off an alarm response to the rest of our organs. And they aren’t replenishing where they need to replenish. So we’re working our way backwards from there. When it comes to hypothyroidism. It really is, what is that iodine? What is the copper? What’s the vitamin K? How is that really working? It really is just kind of supporting the thyroid, the adrenals, different areas like that, so that it can start to function out of this fight or flight response, and really start to actually absorb the nutrients again.
Lindsey:
So are there particular foods that are nourishing to the thyroid?
Laura Martin:
Same thing, it’s those organ meats. I’m so repetitive of it, because a lot of people are like, “okay, so what’s the supplement? What’s this raw carrot salad thing?” Where it’s like, no, not really, it’s the organ you want to support, which I can list off the vitamins and things, but then you’re going to be a walking pharmacy. Or you can go and choose the organ you’re trying to replenish. Or there’s things like making sure you’re getting your weekly dose of oysters, because that’s the zinc, the selenium, the magnesium. It’s your multivitamin, and you just get it that way. So it’s just using whole foods in that direction. If you have to supplement and do things like that, you run that by your doctor and you have to run those things. But from there, you want to continue to restore the metabolism so that the organs start to function in a steady calm state.
Lindsey:
And what if you don’t like oysters?
Laura Martin:
People keep asking me that! But I’m like, “put extra hot sauce on it!” I don’t know, I do believe we can train our taste buds, but you can do things like sardines, which again, I know, aren’t the hot topic. But they really are just so nutrient dense. I don’t want to give any alternative because it’s just so good.
Lindsey:
Yeah, no, that’s a tough one. I am not a fan of fishy fish and not a fan of slimy things. But who knows, who knows. I have trained myself to like a number of things as an adult and it’s not impossible. I can train myself to like oysters but in the meantime, I’ll just take my zinc supplements.
Laura Martin:
Exactly.
Lindsey:
So I remember hearing a really interesting podcast where they were talking about how corn, well I think all the phytates, deplete zinc. Oysters have like a ridiculous amount of zinc in them, I can’t remember if it’s like 800 milligrams (Note: It’s actually 74 mg in a 3 oz. serving) or something like that. But if you eat that with corn chips, basically that’s all gone. That corn will take away all the zinc you just ate.
Laura Martin:
Really?
Lindsey:
Yeah.
Laura Martin:
I did not know that. I don’t know why I would eat corn chips with oysters.
Lindsey:
Maybe it’s like an oyster ceviche, or something? I don’t know.
Laura Martin:
But yeah, that’s interesting. You do see a lot of people, in the PCOS world specifically, downing oysters like it’s no one’s business. They’re like, “just put it on a chip and eat it if you don’t like it.” Maybe that’s why that study came out, because it stemmed from a lot of people being like, “I can’t stomach it, let me put it on a chip.”
Lindsey:
So in terms of supporting the organ with the organ meats with the thyroid, I mean, I know they sell desiccated thyroid. Do you recommend that ever?
Laura Martin:
Yeah, I mean, you could. But really, it’s a plethora of things. It comes from the liver, if our body isn’t processing, or detoxing what is ever being overloaded that’s causing the inflammation, that’s usually because of our liver. It comes from wherever the alarm bells are going off, but really the main focus is our liver because it’s our main organ of detoxification. So I always aim for that one and work from there because it’s how we get the nutrients back in our body. At the same time, yes, we’re focusing on the liver, as well as the nutrient dense foods, the things that are just darker in color, the things that are a little bit harder, the root vegetables, the things that look hearty. We want to add that back into our nutrition routines.
Lindsey:
So tell me about the root vegetables you really like and how you prepare them. Because I’ve struggled to get into root vegetables to some extent, because I just love grains so much.
Laura Martin:
I love potatoes, every single form, whether I make homemade French fries, or I do an air fry, mashed potatoes, I love them. They’re easier to digest than a sweet potato. I know sweet potatoes are super fun for everyone, but potatoes are where it’s at. Especially when you have gut issues, it’s just easier. And then beets, carrots, turnips, different kinds of things. I honestly just roast them, I just put a whole bunch in the oven. And then the whole name of the game is, what sauce are you putting on them today? Just sprinkle on the salt and pepper. So then the rest of the week, it’s not the same vegetable. They’re the same vegetable, but they don’t taste the same. You just make some fun sauces to dip them in or pour on top of them.
Lindsey:
Yeah, roasting makes everything delicious.
Laura Martin:
Oh, 100%.
Lindsey:
I understand that you use the normal blood test people get from their doctors rather than stool tests to guide people. Can you tell me a little bit more about what you can discern about a person’s gut health from their blood tests?
Laura Martin:
Yeah, again, I look at inflammation. Because at the core, I think when we’re getting those stool tests, yes, we want to know if you have SIBO. Yes, we want to know, if you have some type of Candida or parasite. That’s why you should go run those and make sure your doctor is checking that before you do anything. Otherwise you’re just wasting your time, because you’re going to keep getting trapped in that cycle. When it comes to matters of guts, you want to test, not guess. But then we’re looking at, where’s this inflammation? How much inflammation? Where’s that stem from? And usually, that’s back to the thyroid and how it’s functioning optimally and making sure we’re getting a full thyroid panel. How is that re-uptake? You know, beyond just, “are things normal?” No. Get a full panel, look at it. Is it optimal? Not normal? Where is our C reactive protein? How high? How low? What’s that going on there? And just diving into what their hormones are doing and why they aren’t functioning in the way that they are. Because, again, when it comes to IBS, it’s not a food thing, you know? Yes, if it’s SIBO, yes, if it’s a parasite, yes, if it’s Crohn’s, or things of that nature, that matters. But when it’s IBS, they push you off to the side and get you obsessed with the food thing. Let’s bring it back. Let’s look at what is happening with our body. How inflamed is it? And where do we start to have to replenish from there. Which, again, at the root, it’s just metabolism in the gut brain connection to downregulate the nervous system.
Lindsey:
So let’s talk a little bit about the thyroid, and the normal reference ranges versus the optimal reference ranges.
Laura Martin:
Yeah, I mean, when we’re looking at it, I mean, it’ll say on there, right? Like, if it’s low, and they’ll tell you and that’s when you have to ask your doctor, just like, what is the optimal range? The thing is, I’m not qualified to be reading things as I go over them with people. And I look and I go, and I go, okay, so it says “low”, what did your doctor say about that? And we start to build from there because I’m not a doctor, you know, that’s not my zone to be in. It’s, what did the doctor tell you in there like that, really, but it’s low. Okay? So go back, ask them these questions, tell them like you want to know what the optimal numbers are. Because some of them are way different spans than is printed and talk to them about them and see what that diagnosis is, what they have to say. And then we come back and we build out a plan from there.
Lindsey:
Right? So I’ve gone through Hashimoto’s, so I’m pretty familiar with all this. Basically, my understanding is that the standard reference ranges for a TSH can go up until 4, sometimes even 6 for some labs. But the optimal reference range is really between 0.5 and 2. So above that, you should start to think about, well, I should probably get my antibodies tested and see if this is not Hashimoto’s rather than just plain old hypothyroid. But my understanding is about 80% of hypothyroid is from Hashimoto’s thyroiditis.
Laura Martin:
Hmm. Yeah, exactly.
Lindsey:
I understand that you do group coaching programs around sensitive issues like gut health and anxiety. So I’m wondering how that works in terms of confidentiality and people’s comfort and speaking up in a group setting?
Laura Martin:
Yeah, so when it comes to the anxiety courses, I realize a lot more people are willing to talk about that. But when it comes to poop, people don’t really talk about that too much.
Lindsey:
Go figure! I love to talk about it, I’m not sure why other people don’t!
Laura Martin:
I mean, I facilitate them. They show up every time but, okay, whatever it is. I feel like when we’re talking about anxiety, there’s more of a, “oh, you feel that way too.” Like a calming, especially with women, we love to nurture. When it comes to matters of the bowels, people want to learn, but they’re not so vocal in being like, “I don’t poop or I can’t stop pooping.” And all the time people say, “sorry, if this is TMI.” This is literally my job, it’s never TMI! This is the point! It’s totally fine. In group settings, the reason I like my containers is because it is confidential, it’s what I missed when I was going on this journey. I thought I was alone, I thought it was this foreign thing. Any of my personal friends, if I did bring it up to them, they would say, “no, that doesn’t happen to me,” and then I felt even more isolated and misunderstood. When I started to realize there are so many women that struggle with gut issues, and so many people that struggle with anxiety, I realized we just need to facilitate a conversation around it that doesn’t feel so crunchy. That really is open and communicated. And so it’s growing in that conversation, people will see it. But most often, on the back end, people will message me and then I will answer that in a group setting because if one person has a question someone else has that question somewhere. So we facilitate it that way. Also, the sisterhood in it. I think it’s just a missing thing inside of the healing world. Things beyond just, “what am I eating?” And, “what am I doing?” But like, “how am I feeling about this?” And, “how is this affecting my relationship?” Being able to facilitate and hold conversations around it. That is really important. That’s why I’m currently studying to become trauma certified, to learn how to hold space for things like that. A lot of times it is a trauma response, when our bodies are fighting against us, it’s a scary thing. And we don’t have the words to express it a lot of the time, we don’t have the people around us. And so how can I, myself as a facilitator, hold space and ask the right questions and create an environment where people feel safe enough to really explore the continuation of starting these conversations and truly healing?
Lindsey:
It’s true that you really feel in your body, if you’re willing to stop and take the time to do it, your body speaks up for you in a way that sometimes your mind doesn’t. And, if you’re a person who is like me and is totally in your head, on the Myers Briggs you’re much more of a T than an F. So if you’re very in your head, you may not take notice. But your body will tell you something’s not right here. You are nervous, you’re tense, you’re something, because something’s not right. Something that’s happened is not sitting right with you, and your body will tell you. It’s just a matter of giving it a chance to listen.
Laura Martin:
Exactly. And that’s why we get so scared of doing that, that’s why I said it goes back to childhood. When did we start disassociating from our body and start going cerebral? As opposed to being like, “my heart is beating really fast right now,” or, “my shoulders are super tense, I’m clenching my jaw, my back is hurting in this way, I’m feeling like I’m sucking in my belly, and I’m tensing my gut.” It’s in these ways that our body tries to subtly tell us something is wrong, but because we’re so cerebrally thinking, we don’t feel any of that.
Lindsey:
Yeah, you really do have to stop and give a second to notice. But you do notice when it comes out the other end. That is sort of unmistakable. So when do you send people out for additional help versus dealing with what they are dealing with in a group or individual coaching context?
Laura Martin:
Usually they come to me after they’ve been to so many people, and then it’s more of the mental coaching side of stuff. But when I start to see people respond to things, or the way they’re not responding to things, that’s when I’ll be like, “okay, so talk to your doctor about getting additional blood work here.” They’ll get PDFs of how to talk to their doctor, because I realized a lot of people don’t know how to and don’t like having a voice with their doctor. I realized that was a big thing for me. I can’t tell you how many doctors told me I was frustrating, and I told them, “thank you, do your job and figure out what’s wrong with me.” I’m not making this easy. But a lot of my clients don’t feel they can vocalize in that way. So I coach them on how to talk to their doctor. If there needs to be further testing, if there’s a parasite or there’s SIBO, if they need to go get more testing there, or if there’s things that they just need to continue the conversation about. It’s really just giving them confidence, that is how they talk. This is what we need to ask.
Lindsey:
That is a totally challenging issue. I mean, I’m obviously somebody who’s well informed about gut health. I saw a gastroenterologist, and I was determined to go in there and say, “listen I’m somebody who knows a lot about this stuff, I know I’ve got this, this is what I want.” And I mean, I got three sentences out. And then I got a 12 minute lecture about how I knew nothing, how I should be getting a colonoscopy, I could have inflammatory bowel disease! Okay, there are blood and stool markers that will tell me whether I have inflammatory bowel disease, I do not need to get a colonoscopy to discern that. Now it’s possible I could have colon cancer, totally within the realm of the possible, although my Cologuard garden was negative. Obviously, there are false negatives. But that being said, I hardly needed to get a colonoscopy to deal with the symptoms I was having. And it was so frustrating. She was so condescending. I left there, so completely furious. And I thought, “well, maybe I will get a colonoscopy to make sure I don’t have colon cancer, but I sure as hell won’t be getting it with you! I wouldn’t trust you in a million years to put a scope up my butt, thank you!”
Laura Martin:
Exactly, because you know it, you can come in and say things. More often than not, people don’t know the words. So they just sit there and then they’re scared out of daylights about their health and their body and their medical bills are through the roof. And it’s like, all this showed was you have a little bit of inflammation. That’s it. It breaks my heart to see the discouragement that comes and then oftentimes, the blame is shifted to them! They need to be more strict when they already have such a disordered relationship with food that they’re hardly eating anything. What do you want them to be more strict about? That’s not actually the problem. They just don’t have enough diversity and explanation of what’s going on. And now you’re blaming them, which is going to let that eating disorder brain or disordered eating brain come into play, because you’re just using fear. That is not the way we need to be talking to anyone, we’ve really got to break it down. Explain it, give people directions on how to really have conversations. Now, keep doing the digging, because believe that no matter what someone else is trying to tell you, follow through with that and make sure you feel healed and whole, until you get to your answers.
Lindsey:
It can be very frustrating. Obviously, you have doctors that have a lot of expertise. You have doctors who are compassionate. And sometimes they do not cross paths, especially when it comes to gut health, right? So there are doctors who truly understand and of course, functional integrative doctors, naturopaths, etc. know typically a lot more about that health. But if you’re trying to stick to insurance, and you’re trying to see somebody who’s covered, then finding somebody who’s both knowledgeable and compassionate, and will listen to you and take you seriously, that combo is pretty rare. I feel for people out there who are in that situation, because I mean, I have the luxury of sort of self-treating, and I have the luxury of taking my time. I can wait another three months for the next referral and see somebody else and see if I like that person better. In the meantime, there’s plenty of things I can do. But not everybody has that option. So I’m curious how you help people to speak up and train them to do that in a way that actually results in some other outcome.
Laura Martin:
I think when we start to be around people that get it, we stop feeling so desperate when we go to the doctor. Once you have someone that’s there being like, “we’ll get PDFs, we’ll print things out, we’ll go get these tests done, ask them more about what this is so that you can understand it a bit more.” When I’m coaching people I ask, “what do you want the outcome to be? How do you want to feel at the end of your doctor’s appointment? What’s usually come up that made you not succeed in that feeling? Okay, so what can we do now?” Questions we need to ask so that by the next time you feel supported, I mean, that’s what the coaching that I do is in between those three months. Over time, we start to learn how our body works, we stop fearing it so much. We can easily be those people that walk in and say, “this is what I need to know, this is what I need to ask.” It’s through our radical responsibility of educating ourselves, right? Like that doctor isn’t there to fix you entirely or learn about your family history, learn about your lineage, learn about your response to food, learn about all these different things. You get 12 minutes with them, right?
Lindsey:
12 would have been great. I would take 12 minutes in a million years. That’s amazing. I got like three minutes. Six minutes, maybe for an annual physical. That’s what I got.
Laura Martin:
That’s it right? They can’t give you that. So we have to do the work outside of the doctor’s offices to then be able to optimize those six minutes.
Lindsey:
Exactly. My goal now with allopathic doctors, as I walk in I’m like, “these are the tests, I would like you to order.” And I’ve moved to writing them on a page, because sometimes it gets awkward as you’re like, “and then this one, and then this one, and then this one.” So I just hand them the page so they can just go down the list and go, I can order this one and this one, but this one you’re going to need to go to a specialist.” Okay, fine. But at least we got them done, eventually.
Laura Martin:
Exactly.
Lindsey:
Our Medical system. My favorite thing to gripe about. . .
Laura Martin:
I was reading something that talked about how the healthcare system is about sustaining, or “managing,” a disease until it becomes unmanageable. Then we need it even more. So that’s when they give different kinds of medications. Because it’s just a management tool. It’s not a healing modality, and that’s at the root of the problem. And it’s not their fault, right? I’m not bashing doctors here. It’s just that’s not what they’re trained for, so they stick to one lane. So even if they’re busy professionals, they don’t really have the time to also sit down and do this other kind of stuff. They’re working 18 hours a day.
Lindsey:
Oh, yeah, no, they’re working way harder than I am. Let me tell you.
Laura Martin:
They don’t have the mental capacity to sit and read the journals and the studies and do an extra education system unless they truly, truly seek it. We all have our different arenas; that’s why you can’t go to one person for everything. You can even compare it to our relationships. We can’t just have our partner be our only friend and only best friend and lover. We can’t do that either. In our life spectrum, we have different friends for certain things, we have our partner to do certain things. We have different doctors for certain things. We have different coaches for certain things, we have different specialists. Not everything is going to be that one thing, we have to look at all spectrums and be okay with that. And yes, it might require a little bit more balancing of the organization system on our calendar, but it gives you the actual answers and fulfillment that we’re desiring, right?
Lindsey:
Yeah, no, I rag on doctors, but I shouldn’t as much because they are part of a broken system. And that broken system requires them to spend very little time with their patients, because of the insurance reimbursement and everything. So I understand that they’re part of a system and I see this sort of helplessness and frustration in my own doctor who wants to be compassionate, who wants to be a good doctor, and simply does not have the expertise or the time to address the kinds of things that I’m bringing up because I’m getting deep into it. She’s a primary doctor.
So, I know you’re about to launch a group coaching program. Can you tell us a bit about the length and the format? And how do people find out more and sign up?
Laura Martin:
I run two programs. One is the Gut Recharge program, and one is the Labyrinth, so it depends on what you are looking for. So this is where we are focusing on what is going on. Why do we have food sensitivities for daily practices? What are the new nutrition routines we have to implement? We talk about supplements, we talk about things like that. And it really gives you the foundations so that you can go talk to your doctors with confidence. That’s a four week program. The modules are automated, but we have our live coaching because I do think live coaching is so valuable. On Fridays, we have a live Q&A. And then, for anyone that’s struggling with anxiety, I have the Labyrinth which is focusing on the gut brain connection, and really optimizing our mental health and healing our relationship with food in our bodies in our life so that we can gain back control.
Lindsey:
You described two different programs there?
Laura Martin:
Yes I did, Gut Recharge is the metabolism program.
Lindsey:
Okay. Then the Labyrinth was the anxiety.
Laura Martin:
Correct.
Lindsey:
Is one of them starting soon? Or are they both starting soon?
Laura Martin:
Yeah, we just started the Gut Recharge program. We are on week one, we just finished. So we’re coming into week two right now. And then the Labyrinth starts at the end of October.
Lindsey:
And that was also four weeks?
Laura Martin:
That one is five weeks.
Lindsey:
Five weeks, okay. And you have weekly group coaching calls?
Laura Martin:
So the Labyrinth is all live. So it’s kind of just like you’re facetiming me inside of a Facebook group. And you get to ask your questions live.
Lindsey:
I do occasionally hear people say, “I’m not on Facebook. How do I do this?”
Laura Martin:
You can make a pop up Facebook group. You don’t have to use it for social media purposes. But that is where I host that program.
Lindsey:
And what time of day do you do your group calls? What day of the week?
Laura Martin:
Our Gut Recharge Q&A’s are on Fridays at 1pm Eastern Standard time. The labyrinth, that’s not until October, but that’ll be 2pm Eastern Standard Time on Tuesdays, I believe.
Lindsey:
So it’s a once a week call?
Laura Martin:
Correct!
Lindsey:
So the link to sign up for The Gut Recharge Program is https://www.healingtohappy.com/highdeserthealth*, and the link for the Labyrinth is http://www.healingtohappy.com/labyrinth(enter “High Desert Health” in promo code spot so Lindsey gets credit for sending you)*. Do they receive any sort of one-on-one in the context of the group programs, or how does that work?
Laura Martin:
No, that’s my Gut Accelerator program. My one-on-one three month mentorship.
Lindsey:
Can they email you?
Laura Martin:
Yeah! They drop questions either through email or through the group, and then I answer them live.
Lindsey:
Okay, so there is some chance to ask questions.
Laura Martin:
Oh, definitely. That’s why the live aspect is so important.
Lindsey:
Right, right. Anything else you would like to share with my readers?
Laura Martin:
Just wherever you are, know that the harder we fight our bodies and the more we fear it, the longer the healing journey is going to be. We need to ask our bodies, “what are you trying to communicate with me, how can I honor that and where can I go?” To change the trajectory of the story of being, not stuck in this, but the journey. It’s a journey of a lifetime to learn how your body works, and what it’s trying to tell you. And we can’t be at war with it when that happens.
If you’re struggling with any type of gut health problem and are ready to get some professional help, you’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
*Product links are affiliate links for which I’ll receive a commission. Thanks for your support of my podcast and blog by using these links.
Today I wanted to revisit something I haven’t done since the end of 2019 and give you an update on my gut health and health journey, as I think it may have pieces that will speak to a lot of you and also because I’ve referenced it in various podcasts at this point, so I wanted to make sure you had it all in one cohesive whole. Also, I kind of wanted to put it all together for myself as well so I could make better sense of how things went downhill.
So I just want to start by saying that this story may not be the same one you may have read elsewhere on my web site, or the same one you have heard me mention in podcasts, because I got some information recently that has changed my perception of how everything came to pass. So this is my re-interpretation of events in light of that information. So that new information was that I have autoimmune IBS, which is something I found out from taking something called the ibssmart test about a month and a half ago (thank you ibssmart people for the free test). They call it post-infectious IBS because it follows on a bout of food poisoning, of which I’ve had three pretty memorable in my life.
But at the end of the day, it is autoimmune in nature. The ibssmart test tests two types of antibodies – anti-vinculin and anti-Cytolethal Distending Toxin B or anti-CdtB for short. So the most common bacteria that cause food poisoning, including Shigella, Campylobacter, C. difficile, Salmonella and E. coli, release CdtB toxin into your body, which your body fights as it would any other invader, by creating an antibody. So if you’ve had a recent infection of that type, you’ll see the anti-CdtB antibody elevated on the ibssmart test. My anti-CdtB antibodies were not elevated, but then again, my food poisoning was a long time ago.
Now vinculin is a protein in the gut that helps nerves migrate and interconnect. And as is common with most other types of autoimmunity, when you have a reaction in the body to some type of invader, you often have some other protein in the body that looks like that invader. Well vinculin, unfortunately, looks like CdtB, which means that your body can create antibodies against vinculin as well, and start attacking that. And so my anti-vinculin antibodies were elevated. The result is damage to the nerves lining your gut and/or motility issues, or more specifically, improper functioning of the Interstitial Cells of Cajal and the Migrating Motor Complex.
The Interstitial Cells of Cajal are involved in the communication between the autonomic nervous system and smooth muscles and injury to them can create dysrhythmias, or an abnormality in a the rhythm and movement of the GI tract, a slow intestinal transit time or gastroparesis, which means problems with the stomach emptying itself of food in a normal fashion, which can cause heartburn, nausea, vomiting, and feeling full quickly when eating.
Now the Migrating Motor Complex is what clears food out of your small intestine, which normally happens every 1.5-2 hours for about 30 minutes. During that time, you may hear your stomach gurgling – this is a good thing. It means you’re having peristaltic contractions starting in the stomach and moving food through the small intestine, clearing the food out so it doesn’t stagnate.
Now if you’ve ever seen a stream drying up or a stagnant pond, you know what happens – it gets covered with algae. Well the same sort of thing happens in your gut when it gets stagnant, except it’s bacteria that overgrow. The result is bloating from those bacteria fermenting the food you eat, a premature feeling of fullness, and then typically soft stool, diarrhea or a mix between constipation and diarrhea.
Now don’t assume that because you have problems with small intestine motility that this means you will be constipated. Not necessarily. What happens with the stagnation is the overgrowth of bacteria in the small intestine, aka SIBO or Small Intestine Bacterial Overgrowth, or also possibly SIFO, or small intestine fungal overgrowth, in the form of candida overgrowth. And those two typically will leave you with diarrhea, soft, messy stool, or a mix between constipation and diarrhea. Constipation alone is also possible, but that tends to be more from an overgrowth somewhere in your intestinal tract of methanogens, or methane-producing bacteria.
So anyway, back to my story, I had two incidents of food poisoning before I started having any diagnosed health issues that I think are important in how things went south for me. The first was during a study abroad program in Costa Rica in the summer of 1993. I don’t know what I got in particular, but it involved me having no appetite and stomach pains and ultimately it required special antibiotics. I remember this distinctly because I had traveler’s insurance and the antibiotic cost like $70 American but they misconverted the currency and sent me $700, which was of course absurd, that any antibiotic would cost $700 in a country like Costa Rica, but would have been completely believable in the US context. But I was a good citizen and returned the money. So that may have been a parasite; I’m not really sure.
The next and most memorable food poisoning incident was when my future husband and I were living in Costa Rica about a year and a half later and we went on a weekend trip and decided to defrost our very much not frost-free refrigerator. We had a weird washing machine that had a separate compartment for washing and spinning clothes, and the spinner part was the closest thing we had to a cooler, so we put all the food in there with ice and left it for 2+ days. By the time we came home, the food was completely warm. Now if my mother hadn’t gifted me with an almost pathological aversion to wasting food, I may have just thrown that mayonnaise out. But no, instead, that very evening, I used it to make tuna salad. Within 90 minutes my husband, whose system is on a hair trigger, was throwing it up. I was up all night with the runs. So that may have been when it all started.
The other possibility is an incident on our honeymoon to Italy. I probably ate some bad food or drank some bad water there as I spent about a week of the trip not really being able to enjoy food and having stomach pains, not unlike the first incident in Costa Rica, although I never took anything for it that I recall.
But what I do remember is that after that, while working at the University of Georgia as A Study Abroad Advisor, which incidentally was my previous career, I remember distinctly that my stool quality changed for the worse, as I ended up having to use those “flushable” wipes that eventually ended up clogging up our pipes as they weren’t really flushable. I remember at that time I couldn’t leave home without a pack of them.
So just a brief interlude to tell you that if this is you, this is not normal stool. Your gastroenterologist may not call in the cavalry when you tell him you have soft stool, but I will, because normal stool is solid and continuous, a 3 or a 4 on a Bristol Stool Chart, and comes out cleanly, such that when you wipe, there’s nothing on the toilet paper most of the time. But honestly, I never thought to talk to a doctor about this. And I had had bloating every time I ate out for most of my life, so when it became more common, I don’t think I noticed it that much or thought it was something to tell a doctor about.
Now I just want to stop to say that the diagnosis of IBS was never given to me at any time by a doctor, and I feel a little uncomfortable owning it, because I never had diarrhea six times a day, or accidents because I couldn’t get to a toilet. But I’ll tell you this, when I had to go, I had to go. And that was different from my husband who could put it off. But I thought that was just me and how my body worked. And now I know the difference. When I’m having a bout of SIBO, I will have urgency that gives me about 5 minutes warning and sometimes I’ll have full on diarrhea several days in a row. But when it’s under control, I can hold it for a good 30 minutes if necessary. It’s not fun, but I can do it.
So anyway, to continue my story, I was in Georgia for about six years, and I don’t think I saw a doctor about GI issues at all. I was too busy trying to get pregnant in those latter years and experiencing infertility. Which was likely related to the dysbiosis in my gut, as I believe in retrospect that I was estrogen dominant. And I was ultimately diagnosed with endometriosis, but that was long after I had succeeded in getting pregnant and had my older son.
So after Georgia, my husband and I moved to Australia, and again, I never saw anyone about my gut, but soldiered on with bloating, premature feelings of fullness and soft stool. I did my Doctorate in Education there at Griffith University in Brisbane, by the way, which was awesome. While I was there I did go through infertility again and was diagnosed with endometriosis. I had an operation to remove it in order to try to get pregnant. And then I did get pregnant but unfortunately lost my baby at 10.5 weeks, which is why I ended up adopting my second son from Thailand.
So after about 3¼ years, we came back to the US and ultimately moved to Tallahassee, Florida, where we lived for 5 years. Again, never saw anyone about all this. I ate everything, never really changed my diet. I just took lactose digestant tablets when I ate dairy since about age 22 or so as I realized I was lactose intolerant, and I racked up my symptoms to that. I did have GERD or gastroesophageal reflux disease, and I took Omeprazole for about 10 years, which may have been a contributing factor to things going downhill, but I can’t be sure of that.
So after being in Tallahassee for 5 years, we moved to Washington DC. Soon after arriving, the doctor noted that I had what felt like an enlarged thyroid and low levels of platelets on a blood test, maybe just below normal, and perhaps I was also having symptoms of B12 deficiency, namely tingling in my extremities. So she sent me to an endocrinologist and a hematologist. The endocrinologist did an ultrasound and diagnosed me with Hashimoto’s thyroiditis, which is autoimmune thyroid disease, from the damage she could see on the ultrasound, although at that point I wasn’t hypothyroid; my TSH levels were normal. But my thyroglobulin antibodies were elevated. By the way, if you have had only your thyroid peroxidase antibodies tested but you suspect Hashimoto’s, make sure you get your thyroglobulin antibodies tested too, as my thyroid peroxidase were never elevated, although I’ve heard those tend to elevate first.
And then the hematologist diagnosed me with ITP (an autoimmune condition where your body attacks its platelets) because of antibodies and low platelet levels. And he also diagnosed me with pernicious anemia, which is an autoimmune attack on the cells lining the stomach that help absorb B12, called parietal cells, which produce the protein intrinsic factor, which helps you absorb B12, because of my low levels of B12 and originally positive parietal cell and intrinsic factor antibodies. But in my most recent visit to a hematologist, I have found out that my platelet levels weren’t really that low and that the antibodies they thought related to ITP no longer are considered accurate for that, so that doctor has told me he thinks I never had ITP. So who knows if I ever had it or not?
But for sure at one point I had elevated parietal cell antibodies and intrinsic factor antibodies, which meant that I couldn’t absorb B12 in my stomach and had to either get B12 shots or use sublingual B12 tablets. Now in theory, this is not a reversible condition, other than through getting B12 injections. I only ever had one injection and have used sublingual B12 and progressively healed my gut, and I just had both the parietal cell antibodies and intrinsic factor antibodies tested, and both were negative! So there medical establishment!
And my Hashimoto’s antibodies have been normal in my last two blood tests. So three autoimmune diseases down, one to go!
So now that I know that the SIBO was autoimmune in nature, I might rethink the role of antibiotics in my disease process. While I do think it’s best to avoid them whenever possible, I had a couple of rounds of Cipro one year before my diagnoses, but honestly, each time I took it, my stool got solid and I felt better gut-wise. And of course I did because it was killing the overgrown bacteria. But I didn’t make the connection and neither did the doctor I eventually saw and talked to about it. I didn’t feel worse on the antibiotics. Now it’s possible they were bringing up my candida levels, because when I did ultimately take an Organic Acids Test, I did have two elevated fungal markers, but I don’t see them as a primary causative factor for me. And I should mention that at some point in DC, I did see a gastroenterologist about the bloating and soft stool and he did an upper endoscopy, which was normal, and then just gave me some hycosamine, which is an IBS medication that stops stomach cramping, which I used very sparingly. In fact, I’d only take one about every 4-6 months when I’d go out to eat and gorge on gluten and dairy and feel terrible. That would take away the pain. They were like magic pills. But I only finished one month’s prescription like 2 months ago and it was easily 5 years old. I was very sparing in my use of prescription meds, other than the acid reflux meds, which I eventually went off after I stopped eating dairy, which got rid of the main symptom of my acid reflux, a chronic cough.
And the other thing I’m rethinking is how the Hashimoto’s came to pass. I’m thinking that it was most likely the SIBO causing leaky gut, as gut infections do, that led to the Hashimoto’s. Hashimoto’s is often attributed to molecular mimicry involving the body attacking your thyroid because it looks like gliadin, one of the proteins in gluten. And there is also a strong correlation between Hashimoto’s and pernicious anemia, with Hashimoto’s often preceding pernicious anemia. So I’m thinking that the food poisoning may be at the root of all of this.
So onto how I got better.
First of all, I started with an elimination diet and felt a whole lot better on it. I started with gluten, dairy, seed oils, corn, alcohol, sugar, caffeine and processed food. I stayed off of gluten for a time and dairy I think more solidly after that. That’s always the first step in my opinion on these gut and autoimmune issues, because even if the food isn’t the cause of the problem, it’s contributing to you not getting better by slipping out of your leaking gut into your body and then your body is starting to attack your own cells when it sees proteins that resemble them floating around where they don’t belong. And side note, if you have SIBO, your gut is most likely leaky. I also started taking fiber, psyllium husk in particular, in my smoothies, 1 tbsp./day, to help solidify my stool. That was also helpful but not a complete solution.
Then I saw a functional medicine doctor (who was an MD with functional medicine training) in DC who gave me a SIBO breath test, which was pretty marginally positive for Hydrogen but given my symptoms, he put me on antimicrobial herbs for 6 weeks along with a low FODMAPs diet and Betaine HCl to bring up my stomach acid. Then when the bloating wasn’t gone yet, I requested Rifaximin, the prescription antibiotic that only impacts your digestive tract. If you can get it covered by insurance, it’s very expensive but, it’s a lot quicker route to the same endpoint (except that it doesn’t kill fungi too like antimicrobial herbs). Rifaximin only takes two weeks. At the end of that I felt much better, my stool was starting to get back to normal and the bloating was gone. They also put me on Monolaurin for candida in case that was an issue. But they didn’t really know what to do about the Hashimoto’s, so I had to figure that out on my own with research.
What I ultimately did for that was another elimination diet like my previous one for a bit longer and a bit more strictly, a series of detoxifying supplements, and then I just stuck to being gluten, dairy and soy free for about a year, before retesting myself. My antibodies kept going down, and I ultimately ended up reintroducing soy since I never felt any concrete problems with it, but that was many years later, because after one attempted reintroduction, my antibodies rose, which was how I tested things since I didn’t have big, obvious symptoms.
So all the while I was learning more and more about gut health and ultimately, began my training as a health coach and got more and more advanced training on gut health. Once I gained some of the knowledge I have now, especially regarding many of the neutraceutical products out there to treat these conditions, I knew how to deal with my issues myself.
So since that time, I have gone through three rounds of antimicrobials herbs to deal with both the bacteria and fungi, and have done low FODMAPs once more and a keto diet for one month while treating for candida after doing my Organic Acids Test. Each time I start to get bloated again or have ongoing diarrhea or soft stool, I do it again. But now, armed with the knowledge that what I have is autoimmune in nature, I know that I have to help my migrating motor complex with something called a prokinetic, which is like a motility activator for the small intestine so things don’t stagnate and I don’t get SIBO again. I’m currently using Iberogast*, which is an herbal supplement that you take before bed and has some good research to back it up. I’m also using butyrate, because I have done stool tests showing an elevated level of proteobacteria and because it works beautifully to firm up the stool by slowing motility in the large intestine and promoting a hypoxic or oxygen-free environment in the colon and helping make that mucus layer healthy, which will favor the anaerobic bacteria that produce butyrate, rather than the facultative anaerobic bacteria like the proinflammatory proteobacteria. I like Tributyrin-X* (coupon code highdeserthealth15 will get you $15 off and free shipping) as the pills are higher dose and smaller to swallow. I went up to 3 pills twice a day for a while, and when my stool started to turn into rabbit pellets, I backed down to 3 pills once a day and now 2 pills once a day and just keep adjusting based on stool quality. Another good butyrate option is Probutyrate which you can find in my Fullscript Dispensary* and is less expensive but lower dose per capsule, so you may have to take more, like 3-4 pills per dose once or twice a day. The same company also makes something called AuRx, which is a powdered butyrate supplement, which could be mixed in applesauce for kids, for example. That’s also available in my Fullscript Dispensary. Note that these forms of butyrate are different from less expensive sodium butyrate supplements, which may not make it to the large intestine and have the same effect on stool quality and gut hypoxia.
I’ve also been taking digestive enzymes partly because someone sent me them for free and partly, after talking to the guest who sent them to me and will be on my podcast in episode 58, I realized that the more I can quickly digest and absorb my food, the less there is for the bacteria to ferment.
So with all of that, I have been consistently enjoying Perfect Stool, which makes me very happy. Funny how something like that matters so much, but for me it just reflects what’s working in my body and is like another vital sign, so it is important.
Anyway, I hope sharing my health journey will help some of you. And if you’ve been hacking at your problem and haven’t been able to get to a place of wellness, or all of this seems a bit too much to you and you need some professional guidance, I’m happy to offer a free, 30 minute breakthrough session to any of you kind readers. I can hear what you’ve been going through and let you know if I think I can help you. I have a 5 appointment gut healing program that may be right for you. I also offer single appointments.
*Product links are affiliate links for which I’ll receive a commission. Thanks for your support of my podcast and blog by using these links.
So my first question is just since you are a DO or a doctor of osteopathy, and not a naturopath like many of my guests, I’m curious what it’s like to be amongst your DO and MD colleagues, but focusing on functional medicine; do you encounter a lot of skepticism?
Dr. Rose:
Interesting, it’s a good question. My colleagues, yes, I will encounter skepticism. However, from the people in the surrounding area where I’m starting to practice, they really are searching for this type of medicine. You know, I look at it as more of precision healthcare, precision medicine. It’s still driven by science. And it’s very data driven. And you know, there’s a lot of scientific basis behind it. So it’s just as good if not better than conventional medicine. And that’s what I have to say to my colleagues that don’t believe.
Lindsey:
So today, we were going to focus on this Biome FX test, that’s Microbiome Labs’ gut health test. And I was just wondering why you like this, as opposed to the more traditional diagnostic tests in the functional medicine realm, like the GI Map or the GI Effects?
Dr. Rose:
Yeah, I like that there’s actually whole genome sequencing of the gut microbiome; I think that they do a little bit of a deeper dive. It’s a metagenomic test. And I just like that Microbiome Labs is so driven by R&D; there’s just so much research and development, and they put so much money into it. And a lot of their tests and their products are all backed by peer reviewed studies.
Lindsey:
And do they give you the raw data? Or do you just know that they’re sequencing the whole microbiome?
Dr. Rose:
Yeah, I know who they use. I know the company that they’re using. And they’re really the only one that can do it. We’re not given the raw data, but I trust that it’s the real deal.
Lindsey:
That you’re given the relevant data, right? Yeah, because I’ve seen Onegevity or what’s now the Thorne GutBio test. And that was really just a straight up Excel chart of everything in the gut. And now apparently, they’re not giving that anymore.
Dr. Rose:
Well, they’re not supposed to. But same with MBL. They’re not really supposed to give the raw data.
Lindsey:
Why not?
Dr. Rose:
I don’t know.
Lindsey:
Like, if people have information, they might do something with it.
Dr. Rose:
Well the contract that they have with the lab that they use. Actually, it’s the same, you know, Onegevity has the same issue. Right. And so it’s not something that I have – it’s proprietary information. I wouldn’t, I don’t know the legalese around it. But I don’t think that they should be sharing it based on that.
Lindsey:
Do you know what the retail cost is to the consumers for this test?
Dr. Rose:
I pass the charge on to my patient. So we pay $299. And that’s what my patient pays. I don’t know if some doctors, you know, they might retail it differently. But that’s what the cost is. And that’s what I charge.
Lindsey:
That’s pretty reasonable; that’s comparable, or less than some of the other gut tests. Okay. So I have a Biome FX report. And it’s going to be on my website for people to pull up. So let’s start looking at this test. And I’ll just ask you some questions about it.. So it starts with this summary and gut microbiome index, kind of amorphous. What does that mean?
Dr. Rose:
So the microbiome index score takes into account three factors. And that’s your alpha diversity, your beta diversity and your resistance. So let me explain that. So your alpha diversity is what your species richness is, so when you talk about your gut microbiome, and you’re looking at microbial diversity, right? So we have trillions of bacteria, friendly and unfriendly. And then we have about 250 to 300 different species, right. So how many species do you have occupying your microbiome? Okay, so that’s your alpha diversity. So what is your your individual species richness, then we look at beta diversity. And beta diversity is basically okay. So based on that richness, how do you compare? How does that compare to the US adult healthy population or people that are living in your geographic area? And so whatever is there, maybe your alpha diversity, isn’t that great? Or maybe it is fantastic, but whatever is there, how does that compare to the other people living around you?
Lindsey:
And so wait, the alpha diversity is compared to what?
Dr. Rose:
It’s the norm, it’s norm of other people, right? Like, what their richness looks like.
Lindsey:
Like worldwide, then?
Dr. Rose:
No, it in the US or North America. I’m not really sure. You know, I always mean to ask them that question. I think it’s North America, I think it includes Canada as well. So for example, if I took you, and I put you into the Amazon rain forest, okay, you would likely still have good alpha diversity, but your beta diversity would likely be close to zero, because you haven’t been living there for long enough to accumulate that same type of microbial diversity that the Amazonians have. So does that make sense? So that’s how I explain it to my patients. Okay. And then, based on your alpha diversity and your beta diversity, so based on your species richness and your stability and the stability of your gut microbiome, how prone are you to perturbation? So if you get sick, you know, whether it’s the flu or you have a stomach bug, or a gastrointestinal virus, or you eat something that doesn’t agree with you, you know, how well does your gut handle it? How resilient is it? Right? How well does it handle those things? And so this person’s resistance is really terrible. They’re 1.71. Normally, they’re actually changing the test, it really should be out of five. Nobody I’ve never even seen, no patient was above 3.8. So this person, you know, they’re struggling. I see most people cluster in the threes, maybe I’ll see some people under two, barely ever under one. And so that’s what makes up that index score. So that person’s index score is 23.64. Right? At a 40 again, it’s a little skewed. I’ve never seen anybody’s over 28. I would say most people cluster between in the mid 20s, like this score. And then some people I will see under 20, as well. But most people cluster in the mid 20s.
Lindsey:
And would it be safe to say that the people you’re seeing have gut issues?
Dr. Rose:
Well, I mean, here’s the thing, Lindsey, we see everybody, okay, and this is a really good point that you’re making. So I would say that the majority of people probably have some sort of gut complaint, okay. But there are a lot of my patients that have no complaints, but they have autoimmune disease, or they have a history of anxiety or depression or migraines or a skin disorder. And so we know that the gut is the guardian to your health and the gateway to disease and there’s so many connections that fan out from the gut, the gut-skin, the gut-brain, gut-hormone, gut-thyroid, like I could go on and on and on. Right? So everybody I feel, unless they live in a bubble and eat plants all day, I think that they have an element of leaky gut and dysbiosis. And I think that’s why the vast majority of people have some sort of struggles, I will see them struggling somewhere, or if not in many places on this test, because of the way we live our lives. I mean, whether it’s the standard American diet, obviously, which most of us eat, which is horrible, and that doesn’t feed our gut microbiome. And what destroys it from alcohol that we drink on a daily if not weekly basis to the tap water we consume to the non-steroidal anti-inflammatories we take on a regular basis, the antibiotics we’re prescribed, the air pollution that we breathe in, I mean, I can go on and on and on. And all of that is going to affect and chip away at the health of your gut microbiome. Right?
Lindsey:
Right. So it may be that the sample you’re working with is a less healthy sample and that their test is based on a group of healthy people?
Dr. Rose:
Right.
Lindsey:
Or some mixture?
Dr. Rose:
There’s a range; nobody’s test is the same. Every person is different; that’s the whole idea. Right? We’re all uniquely different, right? We all have our own unique biochemical individuality. And this is just another piece to that puzzle when we’re trying to figure that out so that we can really create bespoke health care plans for people and really treat them for their unique needs.
Lindsey:
Yeah. Okay. Well, let’s go down to the next part of that same page, which is page two, and look at the pathogens. So the Clostridia difficile is high. So I’m just throwing this out, because you know the patient of yours, what actually was going on, but say this person was not suffering from explosive diarrhea seven times a day. Would you go ahead and treat C difficile?
Dr. Rose:
Yeah, so the vast majority of people are overgrowing it, they’re not pathogenically colonized with it. And so and I see a lot of people that have high C diff. I do not treat them with antibiotics. What I do is, is I restore, I repopulate and restore balance to the gut so that that C diff gets crowded out.
Lindsey:
So you’re more using probiotics and foods and such.
Dr. Rose:
Yeah, the idea is, is that we’re all, and this is a summary page. So when you go down, you’ll see each one of these things is going to be teased out. But basically, that what we’re doing, like these pathogens, this pathobiome that you’re seeing in this patient, the C diff, the E. coli and the Bilophila, you will pick this up in many people. And even if you don’t pick it up, they’ll have very small amounts of this in their gut. It’s just when it becomes problematic is when it starts to overgrow, and it’s outside the reference range and it’s too high. That’s when you want to deal with it.
Lindsey:
Okay. And just by chance, I happened to be thinking about this Bilophila Wadsworthia. And that’s one that tends to promote constipation, isn’t it?
Dr. Rose:
It’s actually consistent with SIBO because it’s a small intestine colonizer. And so that’s where we want to see Bilophila living, so when we start to see high amounts of it in the colon, that means it’s overgrowing. The small intestine spilling over into the colon. There’s two main characters that Bilophila, it increases secondary bile acids, which are very toxic to the gut lining. And they’re also hydrogen sulfide reducers. So anything that you eat with sulfur in it gets reduced to hydrogen sulfide. That’s what it wants to eat up and then, when it reduces hydrogen sulfide, hydrogen sulfide is extremely toxic to the gut lining as well.
Lindsey:
So this is like a hydrogen sulfide SIBO bacteria? Okay, that may have been what was sticking in my head.
Dr. Rose:
Yeah, it’s really affecting your gut barrier dysfunction when you have Bilophila. So we want to definitely deal with that. And a lot of patients will say, yes, I have flatulence that is consistent with a rotten egg smell. They may get bloated a lot more. And although we love our cruciferous vegetables, and they’re very important for feeding our gut microbiome, while we try to treat and rebalance this person’s gut, we might have those people maybe eat those in much lesser quantities and maybe eat the other colors of the rainbow instead, while we’re trying to heal them.
Lindsey:
Okay, so let’s scooch down since this stuff goes into more detail below and let’s look at page four and the Bilophila.
Dr. Rose:
Okay, so this is the analogy I make with my patients. You have basically four major phyla in the bacterial kingdom, okay, sort of like if you think of the animal kingdom. I don’t know if I can come up with four but you know, your amphibians, you have your mammals, your reptiles, right? So it’s the same thing in the bacteria, like four main players. And you have your Bacteroides and your Firmicutes and they are supposed to balance each other out. And then you have your Proteobacteria and your Actinobacteria and they are supposed to balance each other out. Okay. And so if you look at the adult US healthy population, you should have about 64% Bacteroides, 27.8% Firmicutes, and then you should have about 2.86%, proteobacteria and 4.21% Actinobacteria.
Oh, so now let’s look at this person. Okay. First of all, there’s so dysbiotic in the fact that they’ve flipped that Firmicutes and Bacteroides. They have like almost half of what they should in in the Bacteroides, which is not good. They have a little bit more than what they should in the Firmicutes and they have so much Proteobacteria and Proteobacteria tend to be much more inflammatory also. Then if you scroll down a little more, you can see the percentage of Actinobacteria that they have. It’s on the chart below, it doesn’t come up on the pie chart, but if you scroll down a little bit I can show you right here. Yeah, so they have about only 1.82% Actinobacteria. So that’s not great.
And then if you scroll right back up, again, Lindsey, I can show you one other thing on this chart, right here, this chart on this bar graph on the right, so as you can see, it has the four main phlya there, the Bacteroides, Firmicutes, Actinobacteria and it’s showing you the percentages. And then, what also is populating here, these are other phyla, but they’re just much more rare.
And we will pick them up in in people and so like for example, the Euryarchaeotas you know, underneath where it says bacteria_u_p, they’re methane producing organisms. The synergists are basically bacteria that are normally found populating the oral mucosa. And so if they are populating the colon that means that there’s likely an issue with low HDL or stomach acid or things being broken down above because it’s escaping. And it’s getting into the colon and colonizing there. The Ascomycota are associated with fungus and Candida and the Eukaryotas are like protozoa and parasites and fungi. Okay, so those are the main things; you’ll see people growing those out. I’ve never really seen anyone grow out the Fusobacteria or the Chloroflexi, so not really.
Lindsey:
So one thing I’m noticing on here is that they do not have unknown listed. And I have seen in the metagenetic raw data that there’s a whole huge section, something like half of the bacteria
Dr. Rose:
I think that that’s what the bacteria_u_p is. It’s bacteria of unknown . . . I forgot. Yeah.
Lindsey:
Okay. Got it. So, what’s the highest you’ve seen of Proteobacteria on someone’s report from these?
Dr. Rose:
This.
Lindsey:
This is it? Hmm. Okay. Have you ever used Biohm? Their test?
Dr. Rose:
No. No.
Lindsey:
Okay, because I did one of theirs. And mine was 50% Proteobacteria. You know Lucy Mailing? She questioned their test, because she said, I don’t think that that’s even physiologically possible to have that much Proteobacteria.
Dr. Rose:
That’s a lot of Proteo, yeah, that’s a lot. Biohm? What’s the full name of the company?
Lindsey:
Biohm Health?
Dr. Rose:
The one that you don’t need a practitioner, you just order it and send it?
Lindsey:
Yeah.
Dr. Rose:
Yeah, I’m very familiar with that company. I’ve never used the test though.
Lindsey:
Anyway, I kind of wonder whether there isn’t like some grouping of the unknowns. I couldn’t tell you if it’s if it’s real or not. But that’s a lot of proteobacteria. And I waited until I felt like I was doing really well, like I was having a great gut health week. And I thought, now I’m going to nail it. I got rid of those proteobacteria. Nothing! So what do you do when someone has this many proteobacteria?
Dr. Rose:
I mean, I would retest, I would retest them six months down the road after we’ve really cleaned up the terrain, rebuilt the foundation and planted some seeds, sprinkled some fertilizer, you know, and did all those things to really get that person into a much better place. And then I would retest.
Lindsey:
Yeah, I had done all that stuff.
Dr. Rose:
So we maybe I can get you a test – when you’re done with this recording, what I’ll do is I’ll send it over, I know the owner of the company very well. And I’ll give them this. I’m sure they’ll send you a complimentary test.
Lindsey:
That would be lovely.
Dr. Rose:
I’m sure they will, and then you do the test and Lindsey, I’ll look at it for you. And we’ll go from there.
Dr. Rose:
(p. 5 of Biome FX) Now see this, I don’t pay too much attention to this, families, because it’s really just the breakdown of what we just saw. So it’s showing you the different families and then it will be broken down into further genus, of what those four main phyla were and so the percentages are going to basically stack up, be analogous to the percentages, we saw the other four, you know, so I don’t get too crazy about this page. I’m like, “uh, you know”, unless there’s something crazy jumping out at me, which there’s not so.
Lindsey:
Okay. So, now we are now on page 6.
Dr. Rose:
Yeah. So now these are rare bacteria that grow out. Okay. And I just had two I did though in the past few days, and they had eight rare species growing out and someone had six rare species. I would say the average I see on most people’s is anywhere from two to four, maybe every once in a while someone will have one, but I usually see a couple. And again, that’s based on dysbiosis, your gut microbiome balance and what’s going on. And then, you know, maybe some of these rare characters are just sort of rearing their ugly head. Not that it’s that ugly, but you know, just because they got space to because a lot of the commensal and keystone organisms aren’t in there, right? So Desulfovibrionaceae, this guy is also a sulfur-reducing organism, right, so this person is going to have issues with gas bloating, probably rotten egg smelling flatulence at times, depending on what they eat. And the Eggerthellaceae species, they have some good properties and bad properties, you know, it’s like neither here nor there. That’s why they’re not really classified as pathogens, right. They’re just these rare organisms that we’re learning more about, and that we’re seeing and, you know, we’re seeing it more of an abundance in some people and more so in some samples than others.
Lindsey:
Yeah you know, back in the day, when I was getting my first gut test, and you will get one of these – your sample is particularly enriched for some random bacteria, you know, and curiously search it in all the scientific databases. And at the end of the day, I’d be like, there’s really nothing I can do about this. I don’t know if it’s good or bad. I don’t know how to kill it or help it either way.
Dr. Rose:
Right? So it’s all about when we’re restoring gut health and restoring balance, like after we are done with what we’re really doing with this person in particular, these species should really go away, or we really shouldn’t see them as much, right. That’s the whole point. That’s why you’re seeing it because there’s imbalance right now. Okay, that’s how I look at it.
Lindsey:
So let’s go down to the dysbiosis, which shows on page 7.
Dr. Rose:
So yeah, first of all, this ratio the Firmicutes:Bacteroides, no surprise is within norm, this is falling within range, because even though they had a lot less Bacteroides, they had some more Firmicutes, but they didn’t flip it. It wasn’t like they tripled or doubled their Firmicutes and did the same with their Bacteroides in the opposite direction. So they sort of still were balancing each other out. So because again, it’s all about balance, right. So this one’s okay, but look at the next one.
Lindsey:
Okay, before we do that, let me just ask, is there a type of diet that tends to bring Firmicutes into dominance?
Dr. Rose:
I would say probably when you’re eating less plants, and having more of an inflammatory type diet, that’s what I would say.
Lindsey:
Okay. So next one is the Proteobacteria:Actinobacteria Ratio. And speaking of which, I have zero actinobacteria from my previous samples.
Dr. Rose:
There’s like four of them. So this one’s out of control. Let me tell you something. When I do these, I want to see everyone’s ratio less than one because that’s associated with a really good, healthy metabolism. Good cell turnover, stuff like that. So when you see it like this, even when I see 1.5, I’m like yeah, that’s not good, your dysbiosis; this person is at 14.75, so not good. Okay, we got to fix that.
Lindsey:
Yeah. But I mean, is it possible, so just based on my previous samples, I literally think I had zero. Is it possible I’ve just killed them all off and there’s no getting them back?
Dr. Rose:
No, you can get them back. You’ve got it.
Lindsey:
I’ve got small quantities hiding in my appendix?
Dr. Rose:
Right. Yeah,you’ll get them back. So then and this one (Prevotella:Bacteroides Ratio) I don’t pay so much to. Everyone is always around zero. Every once in a while, there’ll be somebody that has really high Prevotella, and that’s when the ratio gets a little wonky and high amounts of some of the Prevotella species have been implicated in autoimmunity and things like that. But for the most part, I would say most people fall, even the vast majority are zero.
Lindsey:
In the US . . .
Dr. Rose:
Yeah.
Lindsey:
Okay, so scooting down to page eight.
Dr. Rose:
There’s their pathogens that we were talking about. Okay. Yeah, these are really high. So I mean the E. coli is six. The highest, actually, the other day someone had 7.2. Again, unless the person is really, really symptomatic and had some crazy thing like bloody diarrhea, you know, this isn’t giving me like, oh, this is E coli 0157 or something, right. But there’s clearly something going on where they have an overabundance of E coli. And again, I’m going to go after the C diff and the Bilophila anyway. And as I do that, I’m assuming that the E coli is going to get crowded out as I get some of those good commensal, keystone organisms repopulating the gut.
Lindsey:
And yeah, will they tell you if there’s E coli 0157?
Dr. Rose:
If you scroll down a little bit, it gives you all of the pathogens here, just go down to the next page. And, I don’t know. No, it just gives you E coli. You know, it gives you that type of salmonella. That’s what it’s giving you, those exact species and genus.
Lindsey:
There’s E coli Nissle and there’s E coli 0157.
Dr. Rose:
And you’re assuming unless the person is like, definitely, you know, they’re really ill and extremely chaotic, then it’s just again, this overcrowding this dysbiosis, imbalance, right? The pathogens are really winning over the commensals.
Lindsey:
Yeah, it just it sort of bugs me that when they don’t give you the strain, and they don’t give you the raw data, it’s like, help me out here.
Dr. Rose:
It’s hard to do that, though, I think, because I mean, not everyone’s a physician looking at this. And then unless it’s a pathologic issue, then at that point, if you think it’s really pathological, then you should just do a conventional stool test and see what you’re growing out.
Lindsey:
It’s just hard to know with these numbers . . . what number would it have to say? Or would it be more be symptomatic?
Dr. Rose:
I want to say that I did have a case where the C diff was really high. And I feel like they said, if it was greater than five or something with the C diff, which I’ve never seen, you had to choose antibiotics. Okay, but again, I would maybe then do a standard stool test. And check it out. Yeah, you should go to the last page. Because the way I look at this, I would go to the last page first and I’ll tell you why. I like to look first who’s taking up real estate before I get to structure and function. I want to say who’s there, who’s taking up real estate, what good guys are there and what bad guys are there? Because I feel like it sets up the story much better.
Lindsey:
This page here? Page 20?
Dr. Rose:
Yeah, I told them to move this up. I think it should be up above. So yeah, this is pretty bad. So this person really lacks a lot of good stuff. So Akkermansia is like one of your big, big keystone species. Huge for short chain fatty acid production and metabolism. They have none.
Lindsey:
Yeah, that would be me.
Dr. Rose:
Faecalibacterium prausnitzii again, like none, you want to have a good amount. That’s protective against colon cancer. Ruminococcus bromii, Ruminococcus flavefaciens these are both cellulose degraders. So anything that’s like coming down through the upper part of the GI tract, middle part of the GI tract that’s not really broken down very well especially like fibrous foods. These guys are there to really get them to a place where the bacteria can utilize their energy, use them as energy resources and that’s not happening. So you you’re going to need some help above, so this person I would definitely put on enzymes for sure. Roseburia, another one not detected. Let’s see what else we got here. No Eubacterium no, Bifidobacterium, no Lactobacillus. They have like nothing basically. What else? And very little Butyricicoccus. So what do they have? Do they have anything? Hold on, go back up? Tell me that. Anything? Yeah, they’re lacking like pretty much in all of their commensals. So the issue here is that’s why there’s probably so much Proteobacteria because they just are so crowded out and there’s no good keystone commensal organisms.
Lindsey:
So looking at this, you might think, Oh, this is a person who must have a terrible standard American diet and who knows what else? But I had a report that probably wasn’t a heck of a lot different except I had tons of Faecalibacterium Prasnitzii.
Dr. Rose:
And you feel like you meet pretty good?
Lindsey:
Yes. I mean, gluten-, dairy-free, healthy, you know really high in fruits and vegetables. I mean, I eat meat and stuff, but not excessive quantities. So, you know, once you’ve sort of gotten into this situation and diet doesn’t seem to be turning it around, and you’ve killed everything off and you’ve replaced it, you kill everything off and you’ve replaced it like. . . Well, I know the answer my own case, because I’ve got sort of recurrent SIBO. But what do you do?
Dr. Rose:
Well first, I always ask these patients, especially if they’re like, well, I’ve been eating really good. And I’m like, Alright, so what what’s happened, though, in the last few years, right? Like, have you had extensive antibiotic use for something? Were you in the hospital? Did you have surgery? I’ll ask them all these questions that could really have really affected the health of their microbiome significantly. I want to know what has happened, right? Because it’s so important, we always want to understand where the person has been, where they are, and then where they’re going with their health in the context of their life, so that we can interpret these a little bit better, you know. And so that’s important, a lot of people will give me an answer, they go, “Oh, my God!” And so that person, because they had a major surgery, were on antibiotics, or something else, but whatever. They’re really, really, really behind the eight ball. And so they’re going to need a lot more help getting across that finish line. And especially, I can’t say, I mean, you’re probably a lot more diligent than most people, but most people just aren’t going to eat like a cow. And really just eating like a cow. And eating plants all day long is really going to get your gut microbiome to where it is. And then even it might not. And that can take like a long time, like a year or more. So I always support the patient, especially Americans, we’re really impatient anyway. But I always support the patient, I want to lay the foundation, I want to start getting rid of the bad stuff. We inoculate it with the good stuff, and then giving them the fertilizer and the things that they need to get that all growing fast and stick. And it can be hard, it’s not always the easiest thing.
Lindsey:
Okay, so I’ve pulled us up to page 10.
Dr. Rose:
You’re in the right spot. Okay, so let’s think about this page for a second, right? So we know that they’re severely dysbiotic, right, they have severe dysbiosis, they have an imbalance, we definitely have all of the good phyla that they should have. Plus they have good significant amount of pathogens, right. And as a result, those pathogens and the lack of the good commensal organisms are going to affect structure and function. So we know for a fact they have leaky gut, like screaming leaky gut, actually. So that gut barrier is significantly impaired. They definitely have gut barrier dysfunction. And now we’re going to look at the metabolic function, right?
And let’s see, let’s see how that’s probably destroyed systems. Because we already see who’s taking up real estate there. And it’s not a good situation, right. So now we’re going to look at metabolic functioning. And so the bacteria, there’s two different sources of fuel that they utilize, and it’s through either breaking down and eating carbohydrates, resistant starches or high fibrous foods, right? And that’s their preferred energy source. Okay, this is the saccharolytic fermentation is what they want. Proteolytic fermentation is like a backup that was evolutionarily developed by these organisms, because I guess when there was feast or famine, right, because we were walking along eating plants picking this but and I guess, if there was drought, you know, of some sort, and like, nothing was really growing, then they had game for food, right? So they had this proteolytic fermentation as a backup. But the problem is, it doesn’t prefer it, it doesn’t want it. And a lot of the byproducts of this fermentation process are toxic to the gut lining, you know, the amines, indoles, sulfides, and they do other things in your body that aren’t great. So when we are seeing these things, it’s okay if we see them in a certain amount. It’s like that Goldilocks theory, because some of them, the amines and the indoles particularly, they do some good things for us. But it has to be just the right amount, right? So let’s see what this person’s doing with their saccharolytic fermentation. So the major byproduct of saccharolytic fermentation is short chain fatty acid production, right. So let’s look at what happened here. So it looks like they’re doing pretty good, which is sort of interesting, let’s see. So there’s three short chain fatty acids they’re going to make.
Lindsey:
Page 11.
Dr. Rose:
Okay, wow, they’re making butyrate. And that’s good because this person is suffering in so many other areas, so whatever few commensals they have, or whatever is there, they’re really doing a good job spewing out and making some butyrate. Okay. And then propionate, propionate is really good for T cell regulation. And not terrible. I mean, it could be worse. I mean, it’s a little low, but it could be way worse. So that’s not so bad. And then acetate’s your third short chain fatty acid and when you have acetate, so if you have some of these species, if you have enough of them like Roseburia, and the Faecalibacterium prasnitzii, what they do is they convert the acetate into butyrate. Okay, so if you have enough of acetate, that’s maybe whythis person has some butyrate too, because they have enough of the acetate that’s converting it to butyrate. Alright. And you know, why butyrate is so good. It’s great for everything like oxidative stress, metabolism, your immune system, all those wonderful things that we need and obviously, to help with that gut barrier dysfunction, right, and keeping our gut lining intact.
Lindsey:
So do you supplement with butyrate for people who are deficient?
Dr. Rose:
No, no. If people really have none, I do like one or two supplements that can give you back butyrate and/or proprionate. There’s a lot of stuff circulating about that and how good it really is. But I feel like people just need it – I’ll do it for just a short period of time. While I’m sort of again, like planting new seeds, right, and getting those good commensals to start growing back so that then they can start making the butyrate. But I’ll do it for just a limited amount of time if people are really that depleted in that division. Okay. And then this person’s lactate, I find that the lactate will be on the higher side. And to me, I don’t like to see people’s lactate really more than 40%.
Again, this makes sense because this person has a lot more lactate producers, and then they have a lower abundance of the lactate utilizers. And lactate utilizers tend to be the short chain fatty acid producers, which are those keystone commensal organisms. So you know, you don’t want to have too much lactic acid production, which was just like how we hear it being toxic to our muscles, it also is toxic to the gut lining. Okay?
Okay, here’s our proteolytic. So this is now using protein as their source of energy. And the byproducts includes amines, so you can go down and we’ll look at these guys. So there’s three different polyamines, there’s putrescine, spermidine, and cadaverine. Now, putrescine, and spermidine are good; cadaverine can be sort of a bad guy. But these guys are important overall for helping us stabilize RNA and DNA. And so you want to have some of it, this person’s on the lower side, it’s okay rather than be lower than higher, but maybe get a little bit more be fine. This person has a high amount of phenols, which is not good, you know, it is extremely, extremely toxic to the gut lining. It impairs the intestinal barrier function, and P-cresol, which is the main byproduct. It can be very toxic to your skin, like a lot of people that have really elevated levels of phenols or P-cresols, they’ll have a lot of inflammatory skin conditions too.
Lindsey:
So phenols are not the same thing as polyphenols?
Dr. Rose:
No.
Lindsey:
The names could get you confused. Now, P-cresol, is that not a marker on the Organic Acids Test?
Dr. Rose:
P-cresol. I feel like there is a P something; you’re right. Yes, I think it is. Yes. I think it is on the OAT, I wish I had it in front of me.
Lindsey:
I could tell you right now, but I don’t if I could pull one up real quick.
Dr. Rose:
Yeah. Okay. So now look at that. Ammonia production is sky high in this person, likely because of the really high C diff, you know, although there’s a bunch of other organisms that also produce ammonia. This person should definitely not go on glutamine. That’s going to push even more ammonia production. So we’ll leave that person alone with the glutamine for now.
Lindsey:
Interesting. Okay, so that gives you a good marker about whether that should be good for them.
Dr. Rose:
Hydrogen sulfide production: they’re having a little issue with their vendor that does all the raw data for them and the hydrogen sulfide hasn’t really been positive and people that have it negative, but this person definitely I can promise you is producing hydrogen sulfide based on their high level of Bilophila and also that they have that other rare bacteria, the Desulfovibrionaceae. I’m sure this person and again, hydrogen sulfide is so toxic again to that intestinal lining. And again, people that have high protein, low fiber diets and sulfate reducing bacteria are going to eat up that stuff. So you basically don’t trust their hydrogen sulfide marker at this point. Yeah, they’ve got to work out-they are working on it. I don’t know why. Okay, no, methane didn’t surprise me. They didn’t have any methanogen producing organisms. So that’s good.
Lindsey:
Okay, other than Methanobrevibacter smithii, what might be the other ones you’d be looking for?
Dr. Rose:
Oh, there’s a lot of methanogens. I don’t have them committed to memory. They fall under the Eukaryota. There’s a lot of different species. Okay. Okay. Psychobiome.
Lindsey:
So we’re on page 14 for the listeners.
Dr. Rose:
So now we’re looking at neurotransmitter hormone production. So GABA we know is a really important neurotransmitter, like a vast majority of it is made in the gut. And they’re using it as a psychobiotic. They use certain strains as a psychobiotic. Like, I know, Lactobacillus rhamnosis is one and I can’t really name the other species, but they potentiate GABA production. We know that GABA is the calming hormone, the hormone that helps us sleep. And it balances out glutamate and glutamate’s the excitatory neurotransmitter, right ,and so really important to have a lot of this around. So some people see that they have none. And but that doesn’t necessarily mean that correlates with the GABA levels that are found in their brain, right? We know that there’s this bidirectional communication between the gut and the brain, where even the gut is communicating, I think even four times more with the brain than the brain is with the gut. But still, we don’t know, we’re still teasing out all that information, right? So, but having a healthy gut is going to help us have a healthy brain.
Lindsey:
So I am assuming that you must see low levels of GABA in people with ADHD?
Dr. Rose:
So the thing is, it doesn’t always correlate right now, not on this test.
Lindsey:
But I mean, in general.
Dr. Rose:
Yeah, probably, absolutely.
Lindsey:
Yeah, like I give it to my son to help him calm down. But he doesn’t want to take it much. I mean, I give him I also give him phosphatidylserine. He doesn’t want to take the GABA. But he seems to think that that it kind of makes him not be him. And it’s funny. So when I was I had sciatica last year, and I was so desperate to fall asleep that I was taking literally everything in the kitchen cabinet that I could find to make myself go to sleep since I would have excruciating spasms. And I was taking GABA for a bit, like I’m like, okay, we’ll do the GABA, we’ll do the melatonin, we’ll do the ibuprofen PM, I mean, it was everything. Anyway, I found that after some time, I was beginning to feel kind of depressed. Like I was sort of not taking a lot of pleasure in life. And I’m like, I think that GABA has dialed me down a hair, like that was not something that was out of whack for me.
Dr. Rose:
Yeah. The other thing too that for the listeners to know the difference. So basically, melatonin is what is going to help you go to sleep. So there’s different people, different types of insomnia, right? You know, people that have trouble falling asleep, people that have trouble staying asleep. And then a combination of both, right? Melatonin is what helps you fall asleep. It doesn’t help you necessarily stay asleep, although there’s some extended release versions, but don’t know how good that is. But GABA is what helps you stay asleep. So that’s the difference. So it’s good to always know that distinction.
Lindsey:
Okay, that’s good to know.
So now we’re on to the glutathione and this person has a massive amount of this too, which is great. I mean, it’s the most powerful antioxidant in the human body. And it also acts as a hormone. It can potentiate the release of GABA and dopamine. And, you know, it does a lot of other amazing things in our body, like obviously gobbling up free radicals, helping with oxidative stress, all those things. So, this person has a lot of that, which is good. Not terrible. Okay, I’m not going to be like, that sucks. It’s good. So, let me say a few good things. Not many, but where else we go next.
Lindsey:
Okay, so we’ll go to page 16.
Dr. Rose:
Yeah, so indoles. Again, it’s the Goldilocks so you don’t want too much of this. I would say this person might have a little bit too much. I’d want them more in the green. But again, the production of indoles, it’s through the degradation of tryptophan, which is what we find in usually meats, especially turkey, you guys all know, it’s like the sleepy hormone, right? So basically, we want this guy because he helps increase the expression of the enzymes that help break down xenobiotics or toxins in our body. So you want you definitely want to have, again, that Goldilocks rule, just the right amount of this is important. Okay, so this is a good estrobolome. I see a lot of my females I find hug around this 20% which I think is good, just from my experience, my females that are premenopausal. I’ll see some people go up into the 30s. I think once you get it up into the 40s, then you’re dealing with estrogen dominance, that can be an issue, and then probably women that start to fall below like 15%, 13% that’s like, you know, you’re probably getting more postmenopausal or perimenopausal maybe. You might want to do a metabolomic test, like look at a Dutch or something to look at hormones.
Lindsey:
Okay. So we’re on page 17.
Dr. Rose:
Now, vitamin A. So now we want to see how well are your gut bacteria synthesizing vitamins, right, or making vitamins. So it’s different. There’s a distinction between making the vitamins and having vitamins, right. So you can supplement, but that doesn’t mean you’re synthesizing them. It’s two different things. This is really showing us how well they’re being made in the gut. So let’s look and see how each vitamin is doing here. So B1 is decent, it’s not terrible. It could be way worse. I like it into the green area, like 40, 50, 60%. But that’s fine. B2 is good. They have a lot of riboflavin. So that’s great.
Lindsey:
And if it’s not totally clear, the important part is that the gut bacteria are producing these.
Dr. Rose:
That’s right. So this is another snapshot of metabolic function, right? And because of who’s there and who’s not there, and the imbalance of the current gut microbiome state that this person has. So again, B5, which is pathothenic acid, they don’t really have any of that.
Lindsey:
So they’re probably fatigued, I’m guessing. As you need that to produce energy.
Dr. Rose:
B1, thiamine too, that one’s very important for energy as well. They had some of that. B6 looks pretty decent. I’m happy with that. Let’s see B7, they have a lot of B seven. And that’s good. Let’s see what else we got here.
Lindsey:
Page 19.
Dr. Rose:
B9 not bad, folate. And B12, not bad. I mean, I’d like to scooch it up a little higher, but not terrible. And K2, not as good. You know, again, K2, not only for helping us put the calcium in the right places like in our teeth and bones and making sure that they don’t get deposited in our soft tissue and our vessels. But also very important for VO2 max, cardiac output, energy, things like that. So you know, this person’s doing well here too.
Lindsey:
Can you explain VO2 max?
Dr. Rose:
Cardiac output. This is really cardiac output like how well is your heart working right now. Well, is your heart pumping the blood to your extremities and to your tissues and your nerves and cells and all those things? And so when you give K to the people, there’s different forms of K2. The most commercially used is K27. Although the jury’s out on that. I’ve spoken to people that think we should be using the 4, M4. But that being said, they’ve done studies where and I know Kiran and Microbiome Labs has a product that they’ve done studies on and they increase VO2 max when they gave them the K27 at the dosage that was in the supplement by like, I feel like it was up to 20%, but it was like 15 to 20%. But it was a pretty big number.
Lindsey:
And isn’t VO2 max something you can measure when you’re exercising?
Dr. Rose:
Yeah.
Lindsey:
So how do you do that?
Dr. Rose:
I think that there’s a device you can wear that calculates it. That’s how they do it in the studies, but I don’t know.
Lindsey:
Because I listen to another podcast that talks about VO2 max all the time and it says . . .
Dr. Rose:
It’s an equation it’s like VO2 equals blah blah blah or something. [added later, it’s: VO2 max = maximum milliliters of oxygen consumed in 1 minute / body weight in kilograms]
Lindsey:
I thought it had to do with like the max heart rate.
Dr. Rose:
I can see it in my head but I’m like, what’s the calculation?
Lindsey:
Okay, so now we’ve looked over this entire report and you’re seeing this so what do you do with this person?
Dr. Rose:
So I’m going to go after the C Diff first, because that’s going to have a lot of die off. There’ll be a lot of toxins released. So I’m going to put this person on binders, binds up whatever is going to die off. And I’m going to give probably a more specific, maybe supplements like a spore former that is good at basically cleaning up C Diff.
Yeah, that’s B. subtilis. I like that product. Another one I really like is Cleansxym by US Enzymes (find in my Wellevate Dispensary*). It’s shown that there’s activity against C Diff, and it’s ozonated magnesium. That’s really giving your whole gut a nice cleaning. It has built in binder as well.
Lindsey:
You’re not getting into microbials, though.
Dr. Rose:
So I find that when I have people that tend to constipate, the MegaIgG 2000 (Find in my Fullscript Dispensary*), that’s the binder that I’ll use from Microbiome Labs, I need to balance it out. And the Cleansxym does the trick. Because it if you titrate it up, you can titrate up to like whatever, whether it’s two doses or two caps or four caps a day, you can titrate it up to having a good complete bowel movement. It will balance out the binder, the constipation side effect from binders sometimes, so I like using them in combination, and they’re both sort of cleaning up the house a little bit.
Lindsey:
But no, wait, did you did you say the you use the MegaIgG as the binder?
Dr. Rose:
The MegaIgG 2000. Yeah, right.
Lindsey:
Right. Which is like a derivative of colostrum?
Dr. Rose:
Yes. And then I’ll use that in combination with the Cleansxym.
Lindsey:
With the Cleansxym, like at the same time?
Dr. Rose:
A lot of patients I will, unless the patient has significant diarrhea, then I’ll just leave them alone with the MegaIgG 2000. But a lot of people have the opposite issue. And then I find that they get even more constipated. So I like the Cleansxym because it helps you poop and it also helps with C diff, so I’ll use that with HU58. then.
Lindsey:
Okay, yeah. So the MegaIgG 2000, I’ve always thought of that as sort of, you know, if you’ve got low Secretory IgA.
Dr. Rose:
I think you’re thinking more the Mega Mucosa (Find in my Fullscript Dispensary*). The Mega Mucosa has all the different immunoglobulins in it. And the IgG 2000’s just more specific and an acts as a binder.
Lindsey:
Okay, because it essentially pulls out any toxins.
Dr. Rose:
Yes, exactly. So I’m talking about that. That I’ll give later, I’ll give the Mega Mucosa a little later after I’ve cleaned it up, you know, just to keep their gut lining intact. You know what I mean? And keep that gut barrier function optimal. Okay. So I’ll do that upfront for that person. Let’s see what else so then I want to clean up that Bilophila too. So there’s a product by Master Supplements also called TruFlora (find in my Fullscript Dispensary*). And it really shows it does a lot. It has a lot of activity in the small intestine and helps with SIBO. And reversing SIBO and stuff. So I’ll use that for like eight weeks or so after I get them off the HU58 and the person’s feeling okay. And I’ll get them off the binder, I’ll keep them on the Cleansxym. I’ll put them on the TruFlora. At the same time, while I’m doing this, I’m usually trying to give them some sort of prebiotic, also, right. Because I’m trying to feed the good bacteria that’s being established now so that they keep thriving and growing.
Yeah, I’ll use the Mega Pre. I use that and I use another product called Sun Spectrum. There an ingredient in that that’s excellent. There’s so many studies that show it increases butyrate production and those butyrate producing organisms.
Lindsey:
Is that Sun Fiber?
Dr. Rose:
Yeah, it’s Sun Fiber in that. Yes, you got it.
Lindsey:
Do you find that that’s better for people who are constipated though than people who have, you know, soft stool?
Dr. Rose:
I haven’t found a difference really, to be honest with you. And I have a lot of both. The one I noticed the main thing is with the IgG2000 with my constipated patients. But with the Sun Spectrum, the only complaint I will get is they’ll get really bloated, if they use too much too fast. Same with the Mega Pre. So what I do is I have them put it a in a protein shake or something and they’ll do like a quarter of a scoop for 3,4 days. And if they feel fine, then they’ll go to half a scoop for three, you know, they just titrate, you know, go low, go slow. And then you get them there and they’re fine. I literally barely ever get a complaint if I do it that way. Now the ones that go off on their own and they didn’t listen to us and I’m like, “Oh, you didn’t titrate it up, did you?” And they’re like “No.” Okay, so I start over. Yeah. It’s funny. I haven’t noticed. Why had you noticed the difference? I’m so curious.
Lindsey:
Well it’s just I personally felt like, well, because I was thinking about the, so I know that the Sun Fiber is partially hydrolyzed guar gum. And so I know that that’s an adjunct for Rifaximin for SIBO. And so I got some
Dr. Rose:
But did you feel like they were going to make you more constipated? Is that what you were going to say?
Lindsey:
No, no, the opposite. Well in my personal experience it felt like it kind of just went right through me and sort of sped up the bowel movements or increased them. And I thought that’s not what I want.
Dr. Rose:
I haven’t had that. Do you think you just used it too quickly?
Lindsey:
I’m trying to think, did I start with, I probably started with a full pack.
Dr. Rose:
Go slow, go lower.
Lindsey:
I wasn’t using Sun Spectrum brand I don’t think. They were in individual packets.
Dr. Rose:
I love Sun Spectrum. And Sun Spectrum has other products in it that are really healthy for the gut lining. I think it has curcumin. Does it have vitamin in it? No, I can’t remember the other main thing and it’s like curcumin.
Lindsey:
I don’t know. I’m the worst patient for myself though. Like I never follow the kind of advice I give my clients.
Dr. Rose:
No, try the Sun Spectrum. And try to just do a little like just a little bit, or try the Mega Pre. Either one.
Lindsey:
Yeah, I’ve never done the Mega Pre either.
Dr. Rose:
Just try the Mega Pre, again, like just do like a quarter for like a few days. And just go slow and you’ll be fine.
Lindsey:
So I kind of struggle though with like, philosophically, the idea of giving somebody a prebiotic powder. I sort of feel like they could and should be getting that from their diet and their food. Right? And that I should be getting it from my food.
Dr. Rose:
You’re 1,000% right. But the problem is, like I really tried to be plant based, right? Like I even think about myself, right? Let’s look let’s look at myself. So I do time restricted eating. Okay, so I do a 16-8. Usually that’s just my life pretty much, you know, except maybe like on one of the weekend days. But I’ll tell you, I just don’t even have time to get enough of the plants in. I mean, I’m not getting enough of those. Like, if we’re really being practical here. I’m just not getting enough of the servings in. I feel like to really help my microbiome to the best I can. I feel like I agree with you 1,000%. And everything we do in the practice is getting people to understand why it’s so important to be more plant centric, right? And I’m like, okay, I believe in moderation, everything. I am not really one of those people to demonize any one macronutrient even right?
But and you think about if you’re a vegan, this and I don’t judge anybody if that’s what they prefer, that’s fine. But I would say for the most of my patients, I’m like, “Listen, get like your plate to be at least 60% [plants].” Right? When you look at your plate, like 60, or if it’s 70, awesome, like to be the plant, right to be all those beautiful vegetables, different colors, your salad with all these different, colorful vegetables in it. And then the smaller portion of your plate can be a piece of wild salmon or an organic piece of chicken or organic ground turkey meatball or, you know, I don’t know, like, I guess, God, once in a while or once every two weeks, you want a beautiful piece, like a small piece of ground, grass-fed, grass-finished beef. It’s okay. As long as you’re talking about regenerative farmed animals, and then you’re not putting crap into your body. Right. And so, yeah, it’s like creating balance, you know, and I think once the people get used to having the plants as most of their plate that I feel like you’ve done such an amazing job, right? Because it’s so hard to get so many people there.
Lindsey:
So yeah, where do grains fit into that?
Dr. Rose:
Yeah. So I’m fine with grains. I’m not against grains. I am in certain instances when I’m trying to heal up a patient and they have something going on. Maybe with some sort of autoimmunity or something like that. Right? But I’m fine with like little portion of your plate to be a little bit of like, quinoa, right? Or like maybe a little bit of brown rice or a little bit of, you know, like my kids even like, we don’t eat conventional pasta anymore, right. I don’t know how I did it, but I did it.
Lindsey:
You must either be single or have a spouse who is compliant, right?
Dr. Rose:
Yeah, well, he doesn’t know it’s so hard to do. And listen, they’re all full of, any of the pastas out there will have so much carbohydrate in them. But the sugars aren’t so bad, right? Which is good, which I look at even more. Right. But I found this great brand that does a brown rice pasta. And we don’t really eat pasta that much. But when I serve it, it happens to be delicious, right? And so we make it with a really good homemade tomato sauce. And, you know, we make it with olive oil or whatever, and garlic and blah, blah, blah, and we mix it with a bunch of vegetables. And it’s great.
Lindsey:
It’s great that they’ll do it becauseI can’t pass that stuff off on my family. I mean, it’s like complete mutiny, starting with my husband, then my older son, then the whole place mutinies.
Dr. Rose:
So I got all three of my kids to eat it, and my husband, they all love it now. It is such a good brand.
Lindsey:
Which one is it?
Dr. Rose:
I’m going to send it to you. It is so good. It’s Jovial.
Lindsey:
Okay. I’ve seen that in the store.
Dr. Rose:
Oh, good. Listen, my kids know when it’s chick pea. They know. And it’s like, when I give them the brown rice, they gobble it up.
Lindsey:
I’ve just I’ve just given up. We have two pots.
Dr. Rose:
I got everyone in my family. We don’t have any more conventional pasta in the house. It’s brown rice. And it looks like regular pasta. It tastes the same. It’s really good. And they make the penne, they make farfale. They make elbow macaroni. I’m telling you.
Lindsey:
No, you see, here’s the thing about my family is even if you don’t tell them and you try and just fool them, somebody is going to begin to sniff that out. Because if I’m eating it, and they’re eating it, there’s a problem. And so even if it tastes perfectly fine, somewhere in the middle, somebody will be like, “Wait a second, you’re eating this too? Somethings not right. You fed us . . .” and then I’m going to get reminded of the time when I tried to pass off turnip fries as French fries. And then it all goes south.
Dr. Rose:
No, really, honestly I’m telling you. You cook it for like eight minutes. I am telling you they will all like it. Put a yummy marinara sauce on it. I’m telling you, okay, there is no way. You have to let me know; you have to try it because I went and I gave it to all their friends. All of their friends eat it. Nobody doesn’t eat it.
Lindsey:
Okay. Okay. I’ll trust you on this one. We’ll give it a try. Okay, so I’ve kept you much longer than I should have. How should we wrap this up? Any final thoughts on how you might help this person?
Dr. Rose:
Yeah, so basically, after I’m done with the C Diff, I’m going to go after the Bilophila like I just said with that [ProFlora], two, four [months]. I’ll probably keep them on the Cleansxym, I’ll keep them on a prebiotic, keep them on digestive enzymes. And I’ll probably retest them in six months.
Lindsey:
Okay, but nowhere in here did I hear any antimicrobials? You’re just using probiotics, prebiotics, enzymes?
Dr. Rose:
I’m not, I’m not.
Lindsey:
Okay. Now is that for most people or just this profile?
Dr. Rose:
I don’t use any antimicrobials, unless I see some weird pathogen.
Lindsey:
Okay, so you’re using the spore-based probiotics to cull and shape the microbiome?
Dr. Rose:
A combination of those, or maybe some other type of probiotic, depending on what the situation is. Yeah.
Lindsey:
Interesting. Okay. Well, so I will link to Microbiome Labs’ stool test*. This is the BiomeFX and products, if people want to use that and they can get a 20% discount using my affiliate account.
Dr. Rose:
Nice. And they have great products.
Lindsey:
Yeah, I recommend Megasporebiotic to a lot of my clients.
Dr. Rose:
Yeah, it works great. It works great. I would say, like I said, everyone’s different. I had a person the other day that I did a consult on this through Microbiome Labs, and he was like, it just doesn’t work for me, the Megasporebiotic doesn’t work. So I’m like, okay, we’re going to try something different. Not everything’s going to work the same for everybody. So we have a lot of tools in our toolkit, and we’ll just try something different for that.
Lindsey:
I give almost everybody at least a month of it, but they’re so expensive, the good brands are expensive.
Dr. Rose:
All of them, everything is expensive.
Lindsey:
On top of everything else, I feel like it’s just a lot to ask of people sometimes.
Dr. Rose:
Yeah, yeah. But listen so when you get this is done, you got to give it to me. I’ll get it to Kiran. Okay, I’ll get you a stool test. And then we’ll have to do a follow up.
Lindsey:
That sounds great.
Dr. Rose:
We’ll see what your proteobacteria looks like.
Lindsey:
Because, you know, I never knew if I could trust it or not. I’ll have to make sure my SIBO is not acting up when I do that.
Dr. Rose:
You should get rid of your SIBO.
Lindsey:
Oh, I keep trying. I just did the ibssmart test and found out that I do have autoimmune IBS, essentially. It was positive for the anti-vinculun.
I just did it like a week ago. I mean, I got the results a week ago.
Dr. Rose:
Well, did you you know that usually results if you’ve had an infectious an infected . . .
Lindsey:
Right. And I did have a couple of nasty incidents of food poisoning.
Dr. Rose:
Yeah. And it’s funny that we were talking about before, I was I was hospitalized for E coli 0157 when I was in medical school.
Lindsey:
Wow. And yeah, no, I had never had anything that had me hospitalized. But I lived in Costa Rica a couple different times. Once I got one some weird thing. I don’t know what it was, but I had to take some strange antibiotic for it. And then the other time was the full on food poisoning because I left mayonnaise sitting for two days, then made tuna salad.
Dr. Rose:
What are you going to do with your anti-vinculin antibody?
Lindsey:
I’m sort of working on the prokinetic question right now. I’m playing with Iberogast. But I’m thinking I want to see if I can get somebody to prescribe me something. So we’ll see. I’m launching into a study on prokinetics now.
Dr. Rose:
Okay, that’s awesome. Let me know how that goes.
Dr. Rose:
Yeah. Thank you so much for coming on. And all this great information about this test. Nobody’s talked about this or, or worked on it before. So this is an interesting approach.
Dr. Rose:
Yeah. Thank you. It was a pleasure. Thanks so much for having me. I really, really appreciate it.
If you’re struggling with any type of gut health problem and are ready to get some professional help, you’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
*Product, test and dispensary links are affiliate links for which I’ll receive a commission. Thanks for your support of the podcast and blog by using these links.
Today I’m talking about the naturopathic treatment of inflammatory bowel disease or IBD with Dr. Steven Sandberg-Lewis, a practitioner of Naturopathic gastroenterology in private practice at Hive Mind Medicine in Portland, Oregon. He has been in practice for 40 years and in 1996 he joined the full-time faculty of the National University of Natural Medicine in Portland. Now adjunct faculty, he continues teaching, seeing patients and supervising student doctors in complex digestive disorders. His areas of special clinical and research focus include irritable bowel syndrome, SIBO, GERD, hiatal hernia, inflammatory bowel disease, biliary dyskinesia, the sterolbiome, gastroparesis and chronic nausea/vomiting. He is also the author of the textbook entitled Functional Gastroenterology: Assessing and Addressing the Causes of Functional GI Disorders
So today we’re going to be talking about inflammatory bowel disease. And I know you’ve got Crohn’s and colitis under that title, and that there’s different types of colitis, including ulcerative, microscopic and collagenous. So if you could just go over the different types of IBD, and how they differ in terms of what’s going on and the symptoms, just to start us off.
Dr. Steven Sandberg-Lewis:
Well, if you use the term colitis, you’re focused on the colon. And, of course, Crohn’s disease, can cause something called Crohn’s colitis, which is when Crohn’s disease is present in the large intestine. It can also be present anywhere else in the gut, and most commonly in the small bowel, but there is Crohn’s colitis. There’s also ulcerative colitis, which, by its name, is always in the colon. The big difference between these two main forms of inflammatory bowel disease in terms of the actual location and nature of the disease, the biggest one is that in Crohn’s disease, you typically have areas of colon that are completely normal. By biopsy, by visible exam on a colonoscopy or any other form of imaging, you have these areas that look completely normal interspersed with areas that are diseased. Whereas in ulcerative colitis, it’s a continuous process. It starts in the rectum, if it’s the mildest form, which is called ulcerative proctitis. And then if it’s going to get more advanced, it moves gradually up into the sigmoid colon, the whole left side of the colon, or even the entire colon, it’s called pancolitis. So they look very different in that you don’t have any areas that are spared, like Crohn’s colitis would have. There are a lot of other differences too, like one of the most striking differences in terms of lifestyle is smoking tobacco. It doesn’t even have to be smoked. It could be a transdermal patch, or some other delivery of tobacco, but tobacco actually reduces the risk of recurrence and severity of ulcerative colitis, whereas tobacco increases the risk for bad outcomes, the need for eventual surgery and general aggravation of the condition in Crohn’s, even though they affect the same areas and they’re both called inflammatory bowel disease.
Lindsey:
That’s interesting that you brought up the tobacco right off the bat. Because I sort of think of that like, okay, now we’ve tried absolutely everything out there, and then maybe say, hey, maybe a nicotine patch? Is that something that you use with patients?
Dr. Steven Sandberg-Lewis:
I’m not supposed to say that we do that. But I certainly remember very clearly a patient who was not responding to any standard medicines, or natural medicines, and she came in to see me. And after we talked, she started smoking five cigarettes a day, and it completely put her in remission. And she stayed that way for years. She could have used the patch, she could have done something else, but she thought that was cheaper, and just did that. So yeah, I’m not telling people to do that. We don’t tell people to do that. But an interesting finding is that the nicotine receptors in the gut do respond to nicotine and have opposite effects in Crohn’s and ulcerative colitis.
Lindsey:
Interesting, and so how is collagenous colitis different from ulcerative colitis, or microscopic colitis?
Dr. Steven Sandberg-Lewis:
Some writers and researchers still don’t put microscopic colitis in the same category as IBD, or inflammatory bowel disease. But I do, I make a little Venn diagram with Crohn’s and ulcerative colitis. And I put microscopic colitis over on the side as a separate circle. But I do call them all inflammatory bowel disease and the difference, microscopic colitis is the general term. And by the name, you can tell that it means you can only see it with a microscope. This is the kind of thing that gets biopsied for when someone, especially someone over 50, starts to have copious many times a day, non-bloody diarrhea. It can be very serious and can be a lot of weight loss and nutrition.
So microscopic colitis is a term for – it’s a normal colonoscopy for this kind of condition – but when you biopsy it, either the left or the right side of the colon, you take a biopsy, you will see microscopic inflammation, and that shows up as many lymphocytic white blood cells in the lining cells. And there’s two forms. As you mentioned, one is called lymphocytic because you just see those lymphocytes, and the other is called collagenous. You see the lymphocytes there, too. But in addition, there’s a thick layer of collagen tissue, which is a tissue that normally makes up most structural parts of the body, but a thickening of that collagen protein in the deeper layer just underneath all those lymphocytes.
And to the best of the research, it seems as if collagenous colitis is probably a later stage, because it has that same inflammation that you see with the lymphocytes, but now it’s starting to thicken up. Generally, what happens in the body when there’s chronic inflammation is there’s a thing called fibrosis, or you might call it scarring, where fibrous tissue is laid down to try to patch things when there’s long-term inflammation. And I mean, that’s one of the things that destroys the liver in cirrhosis. It’s actually the healing process that can affect the function of the liver because of this fibrosis. So that’s what’s happening in microscopic colitis, both collagenous and lymphocytic.
Lindsey:
Got it. And then in just regular ulcerative colitis, like on a colonoscopy, you’ll see visible ulcers along the colon?
Dr. Steven Sandberg-Lewis:
Right, you see either redness which is called erythema, you might see erosions, which are shallow denuding of the surface, or you may see actual ulcers, and bleeding and other signs.
Lindsey:
So, in terms of treating these diseases, functionally, which ones do you see the most success with, and which the least. Or are they all potentially reversible if patients are willing to stick it out and follow your treatment plans?
Dr. Steven Sandberg-Lewis:
Well, I used to say that I have a three-pointed approach. My latest lecture that I did a couple months ago, for our gastroenterology course I made it into a five-point star. But for most people, I like to just talk about a 3-point approach of treatment. So that involves number one, diet. The next one is some kind of immunomodulation, something that helps to balance the immune system in the gut, which is where most of the immune system is anyway. And then the third corner is stress and coping. I tell people that right away that these are the things we’re going to be focused on, you know, see if they want to buy into that kind of approach. I don’t like to leave out anything that’s essential if it’s there.
So what’s the most effective depends on the person. You know, I’ve had people who really needed to go to a counselor or have some hypnosis or self-hypnosis or mindfulness. And they put that piece off, and it just had to wait until they finally did that for things to really improve. If you’re walking on eggshells every day of your life because your boss is a jerk, or your primary relationship at home makes it so you don’t ever really relax, you always feel on edge and ready to jump. If you have old tapes playing in your head, and colon, from childhood or earlier in life, that haven’t been resolved, those are key things to work on. I teach a course at the naturopathic college within the university called gastroenterology lab. It’s a lab course, because we do things, physical things. I teach them how to use Emotional Freedom Technique to clear unresolved emotional states. And eye movement clearing techniques for the same thing. I teach them other physical techniques like ileocecal valve and hiatal hernia syndrome techniques and things like that – visceral manipulation. I just think it’s really important. I think of gastroenterology as a physical medicine process as well as emotional and organ based. That’s one thing. That’s one corner.
The other corner, like I said, would be diet. And the gold star, first, when you think of diet , would be either the Specific Carbohydrate Diet that was created by Sydney Haas back in the 1940s, New York pediatrician. Before they knew what celiac disease was, the Specific Carbohydrate Diet was invented by Dr. Haas as a way to treat celiac disease. Gluten had not been discovered; they didn’t know what caused celiac disease. Celiac means abdominal. So it was the abdominal disease. It’s not anything they knew. And gluten wasn’t really discovered as a substance until I think 1952. So kids were dying of malnutrition because of celiac disease. And he created this diet that had only specific kinds of carbohydrates, hence the name, ones that were not highly fermentable by intestinal bacteria. And that was extremely successful in treating celiac disease as well as IBD.
Lindsey:
Now why would that be for celiac?
Dr. Steven Sandberg-Lewis:
Because it’s a gluten free diet. Gluten is highly fermentable. And especially wheat because of the fructans in it. That’s the primo diet, and then other diets have been designed off of that. So there’s the GAPS Diet, the Gut and Psychology Syndrome Diet, which took the Specific Carbohydrate Diet and added Price-Pottenger types of high fat to support the brain and fermented foods and bifodobacter was added, before that only lactobacillus-containing foods were on the Specific Carbohydrate Diet. So just kind of advanced it to work more on autism and bipolar and depression and other mental conditions.
Also, the brilliant Dr. Allison Siebecker, who I work with a lot and teach an advanced gastroenterology course with, she put together the Monash University FODMAP diet together with a specific carbohydrate diet because we know based on research that both the FODMAP diet and the specific carbohydrate diet are very effective at treating both irritable bowel syndrome and inflammatory bowel disease and getting people out of flares.
So she put the two of them together into one diet and one set of charts, which is really helpful.
And then Dr. Nirala Jacobi took it a one step further in Australia, again, like a FODMAP diet, and she created what’s called the Bi-Phasic Diet, which is basically Dr. Siebecker’s diet. But it has two phases, one that’s a little stricter that you do first. And then the reintroduction phase is the second phase. Some diet of some sort like this is extremely important, and really helps in every way. It helps emotions, helps the physical structure, helps the microbiome. And it’s really hard to get around not using diet. Often you can use a diet all by itself and get excellent results.
And then the third piece, immunomodulation. In standard gastroenterology, this is all done by suppressing different parts of the immune system either with prednisone, which kind of lays down a blanket over the almost entire immune system and decreases its activity to bring down inflammation, or more specific types of immunomodulators. But they all are designed to suppress the immune system.
In my approach, if I don’t need to use something like that, because we don’t have time and there’s too much tissue damage going on, I’ll get them started on the diet, which can work as fast as prednisone in my experience. But also, if I have time, I’ll do something different. And that might be something like low dose naltrexone. It is a prescription drug, but we use it in 1/10th to 1/15th of the normal dosage. And it works to raise endorphin levels in the body which helps to balance the immune system’s function. I like to say to people that the opiate receptors, that’s what you’re stimulating with your endorphins in the digestive tract and in the nervous system. These endorphin receptors, when you block them for short periods of time with low dose naltrexone, it actually stimulates the immune system and the pituitary gland to make more endorphins. And when you have higher levels of endorphins, it helps to sort of orchestrate the whole immune system so that you don’t have one part overreacting and another part underreacting. It helps balance it by stimulating certain types of cells called regulatory T cells. And the low dose naltrexone is really good at doing that. So, we’ll use something like that. Or we’ll use herbal medicines such as turmeric or boswellia.
Lindsey:
So just to back up and sort of state the obvious. These are all autoimmune conditions?
Dr. Steven Sandberg-Lewis:
Right. It’s funny though, they’re autoimmune conditions, especially Crohn’s and ulcerative colitis – we know there are specific autoimmune markers that you can measure in the blood. The interesting thing is that a lot of textbooks of medicine still don’t admit that, in articles as well, it’s not known. We call it idiopathic inflammatory bowel disease, which means we don’t know the cause. Really, I think there’s almost overwhelming proof to say that these are autoimmune.
Lindsey:
And what are the markers that you look for with the various conditions?
Dr. Steven Sandberg-Lewis:
There’s a lab called Prometheus that specializes in GI tract and they do all kinds of advanced GI testing. They test interestingly enough for Crohn’s disease, upwards of 60 to 70% of people with Crohn’s disease will have a marker in their blood, which is an antibody against saccharomyces cerevisiae, which is baker’s yeast. So, they’re called ASCA, anti saccharomyces cerevisiae.
Lindsey:
They have that in a basic IgG panel even through Lab Corp now though.
Dr. Steven Sandberg-Lewis:
Other labs have started to do it. For me, this was the one that initially did it. And then in ulcerative colitis, a large percentage of people will have p-ANCA antibodies which is a substance made by neutrophilic white blood cells that you can have antibodies against, which is an autoimmune marker for ulcerative colitis. You can do this panel where you check for these. And there are other ones as well, but these are the main ones where you can check the blood for these different antibodies and see if there’s a pattern that looks more like Crohn’s or ulcerative colitis or neither.
Lindsey:
And in terms of your treatment, your natural treatments, does it matter whether it’s one or the other?
Dr. Steven Sandberg-Lewis:
It really matters. Now with the diet, not so much. Although, if we know someone who has Crohn’s, we’re going to make sure they don’t get gums and thickeners. I mean, that’s true for probably both conditions. But carrageenan is a definite no-no for people with Crohn’s. So, they want to make sure that’s not in their diet.
Lindsey:
Including thickeners, like partially hydrolyzed gaur gum? Or is that an OK one?
Dr. Steven Sandberg-Lewis:
Well see that one’s modified. It’s like modified citrus pectin. It’s different, rather than xanthan gum or carrageenan, or guar gum, which can really be problematic. The partially hydrolyzed gaur gum, as far as we know, is not fermentable the way regular gaur gum is.
Lindsey:
Oh, okay. So, that’s the issue is that it’s fermentable. So Crohn’s patients are more susceptible to having problems with those gums and things. This is like polysorbate 80, and other things, too, right?
Dr. Steven Sandberg-Lewis:
Well, there’s even some very fascinating research articles that look at the kinds of substances that help water and soap kind of sheet out in layers, like you use in your detergents. Detergents definitely often has surfactants in them. And there is some very interesting evidence from research that that may be a factor in either type of IBD.
You know, again, when we talk about the differences between the diseases, ulcerative colitis really appears to be a mucus problem. In Germany, they’ve done a series of studies to look at phosphatidylcholine, common name lecithin, normally produced in the last portion of the small intestine, the terminal ileum; it’s secreted there. And it becomes part of the mucus that then flows in through the ileocecal valve through into the large intestine. You know, the large intestine has a special kind of mucus, it has two layers of mucus, the stomach and the large intestine have these two layers of mucus because the stomach has to protect itself from acid so it doesn’t get digested because it produces acid.
And the large intestine, you really don’t want the billions of bacteria per gram of material in the large intestine to touch the mucous membrane to actually touch the cells that line the colon, because that could stimulate an immune reaction, which looks a lot like ulcerative colitis. So, the large intestine has a very dense, deeper layer right up against the cells that line the intestine that’s very dense and hard for bacteria to move through. And then it has a less dense, more superficial layer that some bacteria can live in it, especially things like akkermansia, a type of bacteria that really likes mucus. Then others live out in the opening in the air, so to speak, even though there’s no air there. It’s an anaerobic environment, but in the space. We think that, at least according to these series of German studies, that if you’re not having phosphatidylcholine, which is the stickiest gooey substance in the world, mixed in with your mucus, and then have that flow through your large intestine, you’re not going to have normal mucus in there, you’re not going to have these very important layers. And then bacteria are more likely normal flora, of which, like I said, there are billions per gram, in the large bowel it’s normal to have that much. They can actually end up touching some of the cells and that’s a no- no; that’s going to stimulate a big reaction by the immune system.
Lindsey:
Is that something that you tell people to supplement with?
Dr. Steven Sandberg-Lewis:
Well, we’re not doing that. Mostly because I think we would pull that out if nothing else was working, but we have to have it specially formulated and triple encapsulated.
Lindsey:
To get to the large intestine?
Dr. Steven Sandberg-Lewis:
Yeah, to make sure it isn’t absorbed too soon.
Lindsey:
So, in other words, if you’re eating processed food with soy lecithin, that’s not going to be helping you.
Dr. Steven Sandberg-Lewis:
That’s right, that’s good for your gallbladder, it’ll go to your liver and get used and put into your gallbladder to help prevent gall stones, but no, not otherwise. It’s also a good source of choline, which your body can turn into acetylcholine, which is a very important neurotransmitter for the gut. So, it’s really helpful thing, but not for the colon.
Lindsey:
Let me just back up and ask about the antibodies to S cervisiae because, you know, I think about Saccharomyces boulardii, which is Saccharomyces cervisiae subspecies boulardii, as a very common probiotic. Is that a problematic one then for people with Crohn’s?
Dr. Steven Sandberg-Lewis:
I’m not aware that it is. But certainly, yeast overgrowth in general and Candida and rhodotorula. Some of these other forms of yeast that can overgrow in the gut can definitely be a big problem. Bacterial overgrowth, normal flora, especially in the small bowel, as well as yeast overgrowth in the small or large bowel can be a big issue in Crohn’s, even more so than ulcerative colitis, right. I don’t tell people never take Saccharomyces cervisiae or boulardii because it will make your Crohn’s worse.
Lindsey:
But you do tell them presumably to avoid gluten as part of the SCD diet? Or which one? You sort of gave me a series of them, but do you use the Bi-phasic Diet then?
Dr. Steven Sandberg-Lewis:
Depends on the patient. One thing I want to mention too is I highly, highly, highly suggest that if they’re eating gluten on a regular basis, before they just continue it, get a thorough blood test for celiac, non-celiac and wheat allergy. Because you’ll never be able to get an accurate test again if you quit eating it.
Lindsey:
And a thorough test would go beyond just tissue transglutaminase. Or what all would you test to get a thorough test?
Dr. Steven Sandberg-Lewis:
So, a basic test that would test everything that would make it thorough. I mean, there’s some really thorough tests by Cyrex Labs and the Wheat Zoomer that’s done by Vibrant America that are incredibly detailed and check for every possible kind of reaction you could have to gluten. But the basics would be tissue transglutaminase, both IgA and IgG, deaminated gliadin peptide, IgA and IgG, and total Secretory IgA.
Lindsey:
And that’s to check if the immune system is working in the first place?
Dr. Steven Sandberg-Lewis:
That’s just to make sure they don’t have an IgA deficiency, which is quite common in celiac, right. And also, so you’ll know to forget, you’ll know to ignore the TTG IgA and deaminated gliadin IgA because they’re not accurate if total IgA is low.
Lindsey:
And they would then be low as well?
Dr. Steven Sandberg-Lewis:
Most likely, I mean, if they’re still high, then they’re high, but if they’re normal doesn’t mean anything. And that’s why you have the IgG to back it up. Also, if you wanted to check for non-celiac gluten intolerance, which I think is a great idea, you would do antigliadin antibody IgA, and IgG.
Lindsey:
And that’s blood. Right?
Dr. Steven Sandberg-Lewis:
These are all blood.
Lindsey:
Just because I know there’s in the GI Map, there’s an anti-gliadin from the stool. Is that worth anything?
Dr. Steven Sandberg-Lewis:
Yeah, there are two labs that I know of that do that, the GI Map, and then also the original lab that does all the testing from stool. It’s been so long since I saw one of those that I can’t even remember the name of it like, EnteroLab. I think It is. And they do the TTG in the stool as well, as well as anti-gliadin antibodies. So the last one if you want to check for wheat allergy is wheat IgE. That’s the only one that’s IgE because it’s an allergy.
Lindsey:
But do you think that the stool ones are useful markers?
Dr. Steven Sandberg-Lewis:
I don’t know. They’re not standard. I certainly take them to heart, but they’re not standard ways of diagnosing celiac. If it’s anti gliadin antibody that’s elevated, that’s pretty indicative of non-celiac gluten intolerance. And I think it makes sense to use saliva or stool rather than blood to do these tests. Because you’re in the right compartment. You know, you’re in the gut. But the standard tests are the ones to also do, and those are blood.
Lindsey:
Do you as a naturopath, do you do endoscopies and colonoscopies and that type of thing? Or do patients come to you having already typically seen an allopathic doctor and gotten a diagnosis?
Dr. Steven Sandberg-Lewis:
I don’t. Our license allows us to do that. But most gastroenterologists, they spend several days a week doing these procedures. And I just don’t think that’s the highest calling for a naturopathic doctor when we have so many tools for actually, once we have the diagnosis to treat it. But yeah, we could if we wanted to, in fact, Mark Davis, a former student of mine, who specializes in IBD in Bethesda, Maryland, he took the training, the 80-hour training, to do it. And he just decided after that, that he probably had other things that he should do. But yeah, we can do it. But we don’t.
Lindsey:
What is the typical functional testing regime for someone with IBD?
Dr. Steven Sandberg-Lewis:
The first thing I do, if I’m thinking, hmm, does this person have IBD? Let’s say they have Crohn’s, or they have the rare kind of ulcerative colitis where there’s no blood. And still, Crohn’s can have blood or not, ulcerative colitis almost always does, sometimes doesn’t. And you’re not sure, but based on their other symptoms, you’re really thinking about it. The first thing I do is a stool calprotectin. I think of calprotectin as a really good way to decide if somebody needs a colonoscopy and biopsy or not. And if the levels are under 50, then we’re thinking about other things besides IBD. Definitely, I think all labs at this point, for some reason, use that number 165 and above, seems to be a really accurate number for indicating someone’s in a flare. Definitely when calprotectin is over 250, that’s definitely an active flare of Crohn’s or ulcerative colitis. Anyway, levels between 50 and 100, usually repeated again in three or four weeks and see if it’s going down or up. Because it’s kind of in the equivocal, maybe range. I do that. And, again, if it comes back high. And if there’s not time, because someone’s really acute, you’re going to just start treating them as if, right?
But you can also get a stool sample and send it off, as you’re starting to treat them and see what the calprotectin is. I’ve had patients with calprotectin over 2000. That’s almost typically someone has a really severe flare. And so it’s a great marker, noninvasive. And I like to use the calprotectin. Once I start treating someone, I like to do it every six to eight weeks, to see if the treatment is working. You know, someone’s symptoms could be better, but they could still have pretty severe inflammation if you’re kind of controlling it with the treatment. So, I like to see if the markers actually coming down. Calprotectin is another immune substance produced by neutrophilic white blood cells. And it’s a really accurate marker for that. So how else do we diagnose? We send for colonoscopy if we think that’s what’s going on.
Lindsey:
Yeah, no, I’m saying assuming they have the diagnosis. They’ve seen someone, you know that you have some form of IBD. I’m talking about what kind of testing you might do to look for other things going on?
Dr. Steven Sandberg-Lewis:
Oh, yes. And that’s where stool testing can be really helpful. Like I said, I will use the calprotectin as a marker of inflammation but then also going to call for yeast, we’re going to look under the microscope for yeast, because it doesn’t always culture, if it cultures, the labs will give us culture and sensitivity, the sensitivity testing will check for natural substances that would kill that particular yeast as well as prescription. It will also check for certain kinds of viruses such as cytomegalovirus, which can really kick up inflammatory bowel disease in ulcerative colitis patients. If diarrhea is a strong component, we’ll do a Clostridium difficile toxin test, because you got to really treat that specifically. If they have that, they won’t get better until you do. And we’ll check for small intestine bacterial overgrowth, especially if they have significant bloating and abdominal pain, which in Crohn’s disease sometimes all you have is sort of a tendency toward constipation, bloating and abdominal pain, and abdominal pain can be the main symptom.
Lindsey:
And will you check for SIBO with a breath test like the triosmart?
Dr. Steven Sandberg-Lewis:
So, the breath test, of course, measures for hydrogen and methane. And the triosmart adds the third gas, which we had a lot of trouble getting a test for. They worked on that for over 15 years. And that’s hydrogen sulfide. And actually, I meet with physicians and researchers around the country, every third Wednesday of the month for an hour, and we talk about the triosmart tests that we’ve done in this previous month. And we’re trying to really understand how to use this and how to treat it, because it’s treated a little differently than other kinds of bacterial overgrowth.
Lindsey:
So, when you were talking about the stool testing, whose stool test do you use typically?
Dr. Steven Sandberg-Lewis:
Well, if I order it for a patient, or who has come to see me in Oregon physically, then they can actually be a patient, I can order lab work and prescribe medicines, I’m usually going to use Doctor’s Data. I like culture based testing. First of all, because like I said, you can get a sensitivity. If you can culture the organism, you can get a sensitivity, for a stool test, and see what would be most specific for treating that bug to bring the numbers down. You can’t do that if you just check PCR, the gene testing, the DNA testing. Many of the other labs have dropped the culture altogether and just do the genetic testing. Genova is probably the oldest lab. I’ve been using them since the 1980s. I think it was started by naturopathic doctors, which is kind of cool. But they still have options for doing culture, as well as testing for genes.
Lindsey:
So just to make sure people understand what sensitivity means, that is where it tells you which natural substances and antibiotics and such would kill the thing that you’re testing?
Dr. Steven Sandberg-Lewis:
I really need to ask how they do it. When I was being trained back in the 1970s, they would take the stool and spread some on a petri dish, and they would grow the bacteria or the fungus. And then once they grew it, they would put little paper circles that were impregnated with the different natural treatments or drug treatments, they lay those on top, and they’d see how big an area of clearing occurred around those treatment discs. And that’s how you knew if the bug was sensitive to it, and it would be killed by it or not.
Lindsey:
When it comes to culture, I’ve heard it argued that it’s not as valid as PCR, because it tends to just culture those bacteria that are aerobic, and those will grow and proliferate, whereas the anaerobic ones won’t.
Dr. Steven Sandberg-Lewis:
Yeah, it also grows the facultative anaerobes, the ones that can, like lactobacillus, live in some oxygen. But you’re right. If you want to check all the anaerobes you really have to do both kinds of testing. That’s what I would suggest until we know more about what to do with some of these dozens and dozens of fully anaerobic organism markers. I think at this point, you know, we have the microbiomes kind of mapped out for both the colon and now for the small intestine. We know how to test for all kinds of bacteria using their DNA. But the thing to know about the colon, when you’re looking at stool, you’re looking at colon. It doesn’t tell you about the small bowel. And according to researchers and all the textbooks, about half the bacteria in the colon are dead. So it’s like 50/50, living and dead. When you’re looking at DNA, you’re looking at dead and live bacteria. That’s what you’re looking at. When you do a culture. It won’t culture if it’s dead, you know, it’s only living that will grow. I still like that idea that I’m looking at what’s alive, and what’s able to grow, as opposed to everything dead and alive. Because I think it’s a real shame when doctors do PCR, this DNA testing on stool, they find something that’s high, and then treat it with strong drugs to try to kill it, or even strong herbs to try to kill it. I think they may be doing nothing, except maybe some damage, you know. They’re going after something that’s already dead, at least half of its dead. I just think that we have a lot of information about the microbiome. But we’re like little infants, you know, squashing bugs that they see on the floor. And we’re not really doing anything very intelligent, not that infants aren’t intelligent. But we’re not doing anything that’s maybe that meaningful or intelligent at this point by strictly using PCR. Until we have about 20 year’s experience with this, I think we’re probably going to be making a lot of mistakes. So I like to go with what I know is alive. That’s just my prejudice.
Lindsey:
Okay, do you find that there are certain root causes that you find commonly with Crohn’s and colitis, when you do these types of tests?
Dr. Steven Sandberg-Lewis:
I mean, there’s one piece and that is, almost all these stool labs will check the short chain fatty acid levels in stool. And we know that short chain fatty acids are produced by friendly bacteria, the microbiome, when they metabolize fiber, or mucus. They make short chain fatty acids and we know that butyric acid is the best understood, and probably, at this point, the most important of the beneficial short chain fatty acids produced in the large intestine. As a food source, you can actually get, I think it’s like 20% of your calories, from your own bacterial production of short chain fatty acids. And it does many things. We know that in research, it really seems to help reduce the risk of inflammatory bowel disease. So certainly, when you see someone who has very low butyric acid levels, that in itself isn’t the cause. It’s whatever’s not producing the short chain fatty acids, which might mean, they’ve got a really low diversity or low number of bacteria in the large intestine. So, they don’t have enough bacteria to produce it. Or maybe they don’t take in the right kind of fiber or enough fiber to give the bugs what they need. Or maybe they don’t produce enough mucus because they have some issue with them.
Lindsey:
That always strikes me as ironic that a lack of short chain fatty acids that are produced from eating fiber can be a problem. And yet the solution is eat less fiber and go on these diets like SCD that has virtually no fiber, right?
Dr. Steven Sandberg-Lewis:
I wouldn’t say it has virtually no fiber, and it depends how you do it. And I certainly recommend working with a knowledgeable nutritionist that can help you individualize the diet. But there can be plenty of fiber on these diets. It’s just specific carbohydrates. So it’s not all fiber, and it’s certainly not insoluble fiber like bran, because that’s quite irritating. You know, soluble fibers, some are less fermentable than others and certainly vegetable fiber. If someone is lucky enough to have the ability to process vegetables and fruit fiber in a healthy way, when they have IBD. These kinds of diets can have plenty of fiber from fruits and vegetables and nuts and seeds. You’re just choosing the lower FODMAP versions of those things.
Lindsey:
Which sort of points to the fact that an overgrowth of bacteria in the small intestine is likely at the top of the train – that stopping that fermentation in the small intestine is the beginning of trying to solve the problem in the large intestine.
Dr. Steven Sandberg-Lewis:
Right, the small intestine and the large intestine are a whole different world, like I say, they have different microbiomes, when you study them. Also, the small intestine isn’t small. It’s the largest part of the digestive tract, by about a factor of four or five, it’s 18 to 20 feet long, some say 22 feet long, and the large intestine is only about three and a half feet long. It’s all about the diameter of the opening, right? That’s why they call it small, as opposed to large intestine. And the small intestine is designed to have very low numbers of bacteria in it, because it’s got stomach acid, bile, and pancreatic enzymes, all dumping into the top of it, and really creating an adverse environment for the bacteria. So it really keeps their numbers down. And then the migrating motor complex that moves things through the small bowel also helps kind of flush out the bacteria, so they don’t just sit there and multiply. So the numbers in the small intestine shouldn’t be more than 1000 to 10,000 per gram of material, whereas in large intestine, you have millions or billions per gram. And that’s normal, it just depends whether you’re on the upside or the downside of the ileocecal valve, whether that’s going to be normal.
Lindsey:
Are you seeing then that the majority of people with IBD have either SIBO or SIFO?
Dr. Steven Sandberg-Lewis:
I think that those conditions are extremely common, especially in Crohn’s disease. But they can also be an aggravating factor in ulcerative colitis, and microscopic colitis. I’ve seen really good results by treating adrenal problems, which we haven’t talked about yet, as well as bacterial overgrowth in the small bowel in people with microscopic colitis as well.
Lindsey:
And so, I imagine some of your patients come to you already taking pharmaceutical immunomodulatory drugs and steroids and such. If that is the case, and you work with them, and they seem to be doing better, how do you know when it’s the right time to try and get off of those?
Dr. Steven Sandberg-Lewis:
In large part that depends on the patient. Not all patients come to me saying my goal is to get off this drug, right? Assuming they had that goal. Yeah, if they come in, they say, yeah, I want to get off my biologic or I want to get off my Pentasa, or whatever. First of all, I look at the fact, is the drug working? Does it do what it’s supposed to do? And sometimes it’s really not. So I have patients who are on biologics, which are injectable drugs at this point, either as infusions at an infusion center or self-administered every couple of weeks at home. And what I’ll ask them, say they’re on a biologic drug that has eight-week cycle, they have an infusion every eight weeks, I’ll say, “So how are you immediately, you know, the first week after you have the infusion?” And how are you the last week or two, when you’re needing the next infusion? And they say, no real difference, doesn’t get better after the infusion, and it doesn’t get worse, as it’s wearing off, then I’m going to figure you know, this drug really isn’t working.
That’s very different than someone who comes to me and says, oh, I just feel like I got my life back the first two weeks after I have my infusion, and the last two weeks while I’m waiting for my next one, I’m kind of wondering if I should go in early because I’m getting so bad. And then that’s a drug that’s doing something. So, it really makes a difference. If the drug’s not doing anything, there’s less need to worry about starting to withdraw it as long as we have something else in place. I always, if I can, like to get the diet in place. The emotional states starting to move in the right direction if it needs to, or coping with stress, as well as some kind of immunomodulator. And usually the first one is low dose naltrexone they’ll be trying because it’s often so effective. I’ll get that started. And then we’ll work with the doctor who prescribed the biologic to wean it.
Lindsey:
Okay, so one thing that I’ve found challenging with clients with IBD is that some of them just don’t believe that healing is possible because they come from that allopathic background in terms of who they’ve seen that they don’t want to stick it out, like they’re not willing to stick out the diet for an extended period of time. So I’m just wondering if you have any tips for patient adherence?
Dr. Steven Sandberg-Lewis:
You know, I have gotten less and less skilled at that, I think, because I don’t have to, by the time people see me. I have this one guy. He keeps telling me he’s seen 50 gastroenterologists before he saw me. I’m not primary. I’m not secondary. I’m not tertiary. I’m probably quaternary care.
Lindsey:
So you’re getting the people who really want to get better and will do anything.
Dr. Steven Sandberg-Lewis:
Yes, yes. So I’m probably not as good as a primary care doctor at getting people motivated.
Lindsey:
So, we talked beforehand that you have a song about the Bristol stool chart.
Dr. Steven Sandberg-Lewis:
Oh, doesn’t everybody?
Lindsey:
Yeah, but I’m wondering what your version is like. I’m looking forward to hearing the Bristol stool chart song. And just in case anybody doesn’t know what the Bristol stool chart is, it’s the chart of how your stool looks on a scale of one to seven that can help you determine what’s going on. Maybe you’re constipated or have diarrhea.
Dr. Steven Sandberg-Lewis:
We use it to just get a good, quick way to write it in the chart. So we know what the form of their stool is. Because one thing I could say about constipation and diarrhea, people will start talking about their condition. They’ll say, yeah, I’ve got constipation. So, I say so what, what’s the Bristol stool type? And you know, seven is liquid, and one is a little hard ball. And they’ll say, let’s see. They look at the pictures, and they say six or seven? And you think, well, wait a minute . . .
Lindsey:
What aspect of that is constipated?
Dr. Steven Sandberg-Lewis:
So the thing is, the definition of constipation, according to the Rome criteria, is it’s a number of things. It can be frequency of less than two to three stools per week. It doesn’t matter what the form is, right. And often, people who have constipation take a lot of vitamin C or a lot of magnesium or Miralax, or something else. And they end up overdoing it. And go from having a Bristol one hard round ball stool to having sometimes explosive diarrhea. If you were to just take their history, and not know that they were constipated to begin with, and start taking all these laxatives, you’d think they have diarrhea. There is also by the way, have you ever explained overflow diarrhea?
Lindsey:
No, but I know about it.
Dr. Steven Sandberg-Lewis:
So, for those who don’t know about it quickly, it’s when people have diarrhea, often children have diarrhea. But they’re really constipated, you have to treat them as if they’re constipated, because they have built up stool that can show up on CT or X ray of the abdomen, in the colon, and all that can get through that narrowed space, because of all that hard stool in there is liquid. And so the only thing they have is liquid stool. And that’s called overflow diarrhea. It’s not exactly straightforward all the time. But the Bristol chart does help us at least get a sense of what the form of the stool is. It doesn’t necessarily tell us whether it’s truly constipation or diarrhea. I’ll see if I can remember the chords (to the tune of Do a Dear):
One a ball, a hard-round ball
Two, a clumping form of one
Three, a log with three gold lines,
Four, a snake that’s smooth and done
Five an unformed bunch of flecks
Six, a pile of soft serve mess
Seven, a fully liquid stool
That will bring us back to one
Lindsey:
Wonderful. Well, thank you so much for sharing all your knowledge with us today.
Dr. Steven Sandberg-Lewis:
All right, it was fun.
If you’re struggling with IBD or any type of gut health problem and are ready to get some professional help, you’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
This blog isgeared towards people who are interested in maintaining their gut health, learning how their gut health impacts their overall health or who only have minor or occasional gut issues. This is not one of my advanced level topics for people who’ve got longstanding gut issues and who make a minor career of studying gut health and the gut microbiome. So, for my longtime readers, please be patient as I spell things out in detail, and for new folks, welcome!
If you’re a person who generally has had good gut health, and by that I mean good digestion, regular stool, and you only have indigestion or bloating or feel bad occasionally when you overeat, eat a lot of junk food, or eat something that seems to disagree with you, then you may be interested in maintaining your good gut health or hearing about easy remedies for basic issues. Or maybe you’re a person who seems to have good gut health but has other issues, like autoimmune disease, mental health challenges, headaches or skin issues. I’m going to talk a little about how all this relates to your gut.
Could my gut be at the root of my autoimmune or mental health issues?
The gut is host to both good or commensal and bad or pathogenic bacteria that generally stay in balance, because the good ones or the general diversity of good ones keep the bad ones in check. Now since 70% of our immune system is housed in our gut, an overgrowth of bad bacteria can lead to an elevated immune response, which is what inflammation is. Inflammation can cause fatigue, depression, brain fog, migraines, autoimmune disease, acne and other skin issues, among other symptoms. And the gut-brain connection goes both ways: just as an unhealthy gut can affect the brain, mental stress can upset the gut. I talk a lot more about that in episode #30, Food for Thought: Mental Health and the Gut.
Given the food that we eat, at least in the US, our stress levels and the medical system we have, today more people are likely to have an imbalanced gut microbiome than not. Antibiotic overuse, overuse of proton pump inhibitors (acid-reducing medications), higher intake of processed foods and added sugar, stressful lives and jobs, and a more sedentary lifestyle all contribute to gut health issues. Most people associate bloating or acid reflux with the gut, but you might not make the connection between gut health and fatigue or depression, but the reality is the gut is absolutely central to our entire well-being, with a connection to both the brain and nervous system, so if you’re feeling off mentally, it may be time to look downwards, not upwards.
How does diet impact your gut?
Diet is going to be the single most important factor in restoring or maintaining a healthy gut and a healthy body overall. Nothing will move the needle as much as what you’re eating day in, day out. I had a client who came to me with what she thought was irritable bowel syndrome or IBS, as well as to lose weight. When we moved her to a low carb, anti-inflammatory diet (which essentially meant gluten-free and sugar-free in her case) and got her blood sugar into balance, all the IBS symptoms disappeared. So step one if you’re just a little off is eliminating or starkly reducing processed food, sugar and for a time, gluten. There are so many good quality gluten-free options now that many people find it doable and worth it to be mostly or completely gluten-free so they just feel better. You may not necessarily need to eliminate gluten for good, but it’s good to give your gut a break for a month or so and then retest eating it a couple days in a row, 2-3 times/day before deciding how you do with it. I personally don’t do well with gluten and I’m kind of happy about that because most of the food with gluten in it isn’t really healthy to begin with, so it gives me an excuse to opt out of all those empty carb calories. I did a whole podcast on gluten, it’s episode 21.
How does sugar impact your gut health?
In terms of sugar, your best bet is to find healthy, sugar-free alternatives that you like, of which there are tons these days like stevia*, monk fruit extract*, and if they don’t bother your gut, sugar alcohols like erythritol*, xylitol*or allulose* (also available in liquid* form). Use those for more regular consumption when you want something sweet and limit desserts with actual sugar to occasional, maximum once or twice a week treats, if absolutely necessary. Sugar causes inflammation and feeds yeast and unhealthy bacteria, so eating daily dessert can ultimately lead to gut health issues, especially if that is on top of other processed carbs like bread, bagels, pancakes, tortillas, pasta, etc.
But if you love to bake like I do, the sugar alcohols substitute well for regular sugar and taste exactly like sugar with no bitter aftertaste. Xylitol substitutes 1:1 but does cause loose stool for some people and erythritol and allulose are less sweet than sugar, so about 1 cup of each is equal to ¾ cup sugar, and they lead to less or no digestive upset for most people. We don’t digest them and neither does our gut bacteria so they just pass through us harmlessly. And I’ve found with both myself and my clients that you can lose weight and lower blood sugar even while consuming these safer sugar alternatives, which is not the case for artificial sweeteners like aspartame and acesulfame potassium which are found in diet sodas.
In addition, if you sense that you have issues with the lactose in dairy, like gas, bloating or soft stool, I’d suggest trying lactose digestant tablets* or dairy digestant tablets with soft cheeses and milk, or large quantities of any kind of cheese. Some folks are also sensitive to casein – I personally found that eliminating all dairy got rid of my acid reflux, so for some people, that’s a necessary step to having consistently good gut health.
Does processed food negatively impact your gut?
One more word about processed food – because a lot of people fancy they don’t eat a lot of it – if it comes in a box, can or bag, it’s processed food. That being said, there are totally crappy, non-organic, additive-laden foods full of unpronounceable ingredients, and there are organic processed foods with few ingredients that independently would be considered healthy. So if you’re choosing bread, pasta, ice cream, chips, etc. obviously there are better and worse choices and you don’t need to be a rocket scientist to figure out which those are. But if you need help figuring it out, Environmental Working Group’s Food Scores database can help you determine if there are questionable ingredients in your food, and which are the most problematic ingredients and foods overall.
Speaking of organic food, eating organic is important for many reasons related to gut health, including that organic foods contain fewer pesticides, like glyphosate, which is designed to kill bacteria. They also contain fewer heavy metals, and include more healthy fats, with organic meats and dairy containing 50% more anti-inflammatory omega-3 fatty acids than conventionally-produced products. Organic foods also come without antibiotics and synthetic hormones, and contain more antioxidants. While it would be ideal to consume all organic products, this can be expensive. So if you need to prioritize, check out Environmental Working Group’s Dirty Dozen produce list, which includes strawberries, apples and grapes, which have been found to contain the highest amount of pesticide residues and their Clean 15 list, or the least polluted produce. It is also recommended to buy organic and even better, pasture-raised eggs, dairy and meat whenever possible.
Eating farm fresh and organic foods starts from the bottom up. Literally. For years, chemical fertilizers, pesticides and fungicides have destroyed the soil microbiota in which conventional crops are grown, which are essential to plant health and nutrient content. Fortunately, microbial species are beginning to be reintroduced into soil to help repair damage, but until our farming system changes, organic, pastured and local where you know your farmer foods are a good place to find these chemical-free products. For some people, just making the switch to organic foods may be all you need to resolve not just gut health but overall health issues.
Which diet is best for my gut health?
In terms of overall eating patterns, my personal bias based on all I’ve read and heard is anything from a lower carb Mediterranean diet, which would be higher in seafood and include complex carbs like beans, lentils and whole grains and lots of fresh fruits and vegetables, to a paleo diet, which is grain-free and totally processed food free, for the average person. I am generally not in favor of vegetarian or vegan diets, other than perhaps a vegetarian diet with some inclusion of seafood for people of blood type A, who tend to do better with that type of diet. If for ethical reasons you need to follow a vegan diet, you’ll likely need to supplement with l-carnitine* and B12* at minimum, but in the long term, this kind of diet, unless it’s very carefully monitored, can lead to protein deficiencies that can ultimately break down the gut lining and lead to a host of other random bodily problems that occur when the body can’t do everything that it does with amino acids, the building blocks of proteins. I’ve started using a new test called the ION profile with 40 amino acids with some clients and for my vegetarian clients, I have seen many specific amino acid deficiencies, each carrying potential negative health consequences. But if you’re doing well on a vegetarian diet and you’ve been doing it long-term, just ignore me – there are plenty of advocates out there for plant-based diets.
Does coffee cause gut issues?
In addition to food, caffeine and alcohol are common gut irritants. In general, coffee has actually been shown to have numerous health benefits. It’s full of antioxidants and micronutrients and studies have shown it to promote longevity, lower rates of heart disease, cancer, and a whole bunch of other benefits. Coffee has also been shown to boost energy, fight depression, lower risks of certain gastrointestinal diseases, and even prevent diabetes. However, like most things, coffee comes with its own set of cons. Coffee is infamous for its laxative effect, due to the release of gastrin, which stimulates movement in the digestive tract. The same adrenaline triggered by coffee that gives people energy can also lead to anxiety and nervousness. Studies have shown that coffee can worsen GERD, or gastroesophageal reflux disease, also known as acid reflux, and cause nausea, vomiting and diarrhea. Pregnant women and children are discouraged from consuming large amounts of coffee – up to 400 mg of caffeine a day is considered healthy for the average adult, which is around 4 cups of brewed coffee. People with certain gut health issues like IBS, SIBO and IBD should also be more careful. Quitting coffee can support better sleep, whiten teeth, improve mood and increase weight loss, as many people add lots of sugar to make coffee palatable. If you’re overwhelmed by the thought of giving up your daily coffee fix, you should be encouraged knowing that once your gut heals, you can try to reintroduce it in moderation. In the meantime, caffeinated teas like green and black tea, along with yerba mate can serve as substitutes.
How does alcohol impact gut health?
Alcohol is another popular yet problematic beverage for gut health. A review of the peer-reviewed literature on alcohol and the gut found that alcohol can cause both dysbiosis, or an imbalance in bacteria and fungi in the gut, as well as bacterial overgrowth, also known as SIBO or small intestine bacterial overgrowth, the cause of 70-80% of IBS or irritable bowel syndrome. This can lead to symptoms like bloating, soft stool or diarrhea, constipation, loss of appetite, uncomfortable fullness after eating, nausea, unintentional weight loss and nutrient deficiencies. Alcohol-induced bacterial overgrowth also leads to inflammation and contributes to intestinal permeability. Intestinal permeability, also known as leaky gut, is when the tight junctions in the intestinal wall that allow nutrients out and keep toxins, microbes and undigested food in, open up too wide and allow some of those last three items out. This means that undigested food particles can enter the bloodstream, provoking an immune response and causing food sensitivities, and if left long enough, autoimmune disease. Many Americans will be surprised to discover that they are considered heavy drinkers. For men, that means consuming more than 4 drinks on any day or more than 14 drinks per week and for women, that means consuming more than 3 drinks on any day or more than 7 drinks per week. If you’re concerned about your gut health or are beginning to notice symptoms, you should watch your alcohol consumption and the effect it might be having on your body.
Like coffee, not all alcohol is toxic, or better said, alcohol can have some benefits. For one, red wine has been linked with health benefits because of the antioxidants called polyphenols it contains. One of them, resveratrol, has been associated with lowering the risk of heart disease. However, research is mixed, with other studies not finding any significant relationship between resveratrol and lower chances of heart disease. The key is to drink in moderation, and for pregnant women, people on certain medications, those with a liver disease or a history of alcoholism, to not drink at all. There are also ways to consume alcohol in a more responsible manner. It is unwise to drink alcohol on an empty stomach, and people should always make sure they are hydrating with water between drinks or drinking a glass of water alongside every drink.
How does stress impact my gut?
Lifestyle and stress are also really important for your gut health. Digestion disorders often go hand and hand with mood disorders. One study of 23 healthy, undergraduate students took saliva and fecal samples at the beginning and end of a semester. As stress increased throughout the semester, certain healthy bacteria decreased. Both depression and stress weaken the immune system, which in turn weakens the gut barrier which ultimately leads to leaky gut. Certain lifestyle changes like reducing work hours, taking regular vacations, practices like meditation, EFT, yoga, tai chi or other such modalities and regular exercise can help combat stress levels, as can seeking therapy or life coaching to deal with bigger issues.
Another lifestyle factor that can impact gut health is exercise. Studies link exercise with enriched gut microflora diversity, which is touted as the most important factor in all the recent studies on various aspects of health and the gut microbiome. Some of the specific preventative health benefits of exercise on the gut include its ability to lower chances of colon cancer and inflammatory bowel disease, that is, Crohn’s and colitis.
Will antibiotics ruin my gut health?
Speaking of prevention, let me return to what I believe is one of the principal driving factors in poor gut health: antibiotics. Obviously antibiotics are a very effective modern medicine that can save lives, but these days, doctors often overprescribe these drugs for even the smallest issues. Common conditions for which you may be prescribed antibiotics include ear infections, urinary tract infections, throat infections and sinus infections, many of which are in fact viral in nature, and antibiotics do not kill viruses. So if you have a cold or the flu, don’t go to your doctor looking for a prescription. Antibiotics are also not beneficial in treating some ear infections and sinus infections, so be sure to ask your doctor to culture what’s in your sinuses or ears before prescribing anything.
Overuse of antibiotics is a problem because while antibiotics kill off bad bacteria, they can also kill off good bacteria. This weakens your body’s ability to fight off infections, and can lead to overgrowth of more harmful bacteria like E. coli and C. difficile or just lead to general dysbiosis, like an overgrowth of proteobacteria, streptococcus or other clostridia species beyond C diff. Antibiotics come with a whole host of side effects, like diarrhea, yeast infections, vomiting and constipation. Just one week of antibiotics can change the makeup of your gut microbiota for a whole year. So the first thing you can do is always question your doctor before taking antibiotics. Are these absolutely necessary? Is this the narrowest spectrum antibiotic I can take for this issue? Could we wait and see a few days or run a culture before I start them or should I stop them if the culture comes back negative? Could I take a shorter course of antibiotics? On a side note, I think that many of my health issues started after taking two 10-day courses of Cipro in one year for urinary tract infections. I later learned that the usual course of Cipro for UTIs is only 3 days.
What can I do if I have to take antibiotics to protect my gut microbiome?
If avoiding antibiotics is not an option, there are several measures one can take to promote a healthy gut. Maintaining a healthy diet full of fermented foods, high fiber foods like nuts and berries, and prebiotic foods is essential. Avoiding sugar, processed white carbs and junk food while taking antibiotics is also important. Taking probiotics both during and after a dose of antibiotics is controversial since a study from 2018 showed that people’s microbiome’s took much longer to recover while using probiotics after taking antibiotics. One alternative you could consider is to take butyrate while on antibiotics, to keep a bacterial phylum called proteobacteria from overgrowing, which is a common result of taking antibiotics. Butyrate is a short chain fatty acid that feeds the cells lining your colon and the best and most palatable formulations are probutyrate* or tributyrin*. 1200-1500 mg/day all at once has worked well for me as I have a tendency towards proteobacteria overgrowth most of the time. You should reduce the quantity of butyrate, however, if you start to get constipated. But if you do experience antibiotic-associated diarrhea, one probiotic that I think is relatively safe is Saccharomyces boulardii, the most studied strain of which is Saccharomyces boulardii CNCM I-745 sold everywhere as Florastor*. In studies, it has been shown to help alleviate antibiotic-associated diarrhea, and it’s a beneficial yeast that also keeps candida in check, so for women it may help to prevent a post-antibiotic yeast infection, which is a common problem for many women. You can take it while on antibiotics too because it’s a yeast, not a bacteria, and won’t be killed by your antibiotics.
Are probiotics beneficial for your gut microbiome?
But for people who have been having gut issues and are not trying to recover their previous gut microbiome but change their current one, probiotics may be warranted as they can help alter your gut microbiome in a positive way or just help maintain a healthy balance of bacteria in your digestive system in the face of the inevitable insults it may experience, as well as improve mood and mental health. In one randomized, double-blind study of patients with clinical depression, taking probiotics for 8 weeks significantly improved the mood of patients compared to ones administered the placebo. One probiotic for general good health that I’m particularly impressed by lately is Seed Synbiotic** (get 15% off your first month with my affiliate discount code PARSONS15), which I started taking about a month and a half ago to good effect. Seed’s scientific advisory board includes some of the big names in microbiome science (think Martin Blaser and Alessio Fasano).
Of course, probiotics can also be found in fermented foods like kefir, yogurt, kimchi and sauerkraut and it’s always best to get your nutrition from food if possible. However, probiotics won’t work to their full effect if you’re just taking them alongside a high simple carbohydrate diet. You need to include lots of healthy prebiotics like complex carbs, beans, legumes, fruits and vegetables that are high in fiber and aren’t easily absorbed in the upper intestine, and therefore make their way down to the colon. That fiber provides food for your healthy bacteria, which then produce short chain fatty acids like butyrate that nourish the gut lining. Some other prebiotic foods include onions, garlic, spinach, oats and you’ll be excited to know, dark chocolate, just to name a few. I did a whole episode on fiber and prebiotics, episode 28.
Can NSAIDs cause ulcers?
Antibiotics aren’t the only common drugs to be more cautious about. NSAIDs or nonsteroidal anti-inflammatory drugs are over-the counter drugs like aspirin, ibuprofen or Advil and naproxen sodium or Aleve. When overused, NSAIDs can cause milder symptoms like nausea and dizziness, while more extreme symptoms such as ulcers and liver failure are rarer but possible. For elderly people and those on certain medications, NSAIDs put them at a higher risk of developing potentially fatal reactions in the stomach and intestines, like bleeding and ulcers. When I was going through sciatica last year, I was in so much pain that I found myself taking as many ibuprofen as my doctor allowed me, which was I think 600 mg 3 times a day for several weeks. I started having consistent pain in my stomach after taking them and I knew I had to stop or I’d end up with an ulcer. So do be careful, especially if you start having stomach pain or other symptoms of an ulcer like nausea, vomiting, bloating, feeling full easily, weight loss, burping, acid reflux or heartburn while taking NSAIDs, and stop and see your doctor if you do experience those symptoms.
How does sleep impact gut health?
On another topic, you may be surprised to learn that good sleep is essential to maintaining a happy gut. If you start losing out on sleep, this can increase your stress levels, which can unbalance your cortisol, which can lead to leaky gut and all that follows. Lack of sleep can also lead to GERD, as the hormone our body produces to help us go to sleep, melatonin, also regulates gastrointestinal mobility. If your melatonin levels are off (and by the way, serotonin is a precursor to melatonin, so you may also experience anxiety with your insomnia) you may end up with acid reflux. So be sure to get some full sunlight each day for 15 or 20 minutes without sunscreen to keep those melatonin levels up. And I hate to give this advice because I can’t seem to follow it myself, but you really should avoid eating for 3 hours before bedtime. Eating closer to bedtime can disrupt your sleep and leave less time for your body to do essential detoxification and cleanup tasks in your brain and body while sleeping. This includes autophagy, or recycling of older cells, which only kicks in after 13 hours of fasting and is preventative for cancer and dementia, just to name a couple of conditions.
When should I see a doctor for my gut issues?
Moving from prevention to diagnosis, it’s important to recognize when you may be starting to have some gut health issues that could get worse if not addressed. First, let me talk about the difference between healthy bowel movements and more serious gut issues. Signs of a healthy bowel include passing a well-formed, soft but not loose or mushy stool 1-3 times a day and finishing with a clean wipe. This would be a number 3 or 4 on the Bristol Stool Chart. You should be able to pass a bowel movement without pain, and hold onto a bowel movement for a short time once you feel the need to go. Constipation versus diarrhea and urgency sit at opposite ends of the stool spectrum. It’s normal to have occasional bouts of each extreme, but if you experience constipation or diarrhea for weeks or months that doesn’t resolve with diet changes or the addition of fiber like psyllium husk or Sun Fiber, you should start by seeking out a gastroenterologist to see if you have any physical gut problems. You should also seek out your doctor if you find blood in your stool, have foul smelling stools or are experiencing incontinence. These signs could point to inflammatory diarrhea caused by something like C difficile, IBD, or even colon cancer.
Upon meeting with the gastroenterologist, they will likely conduct one or more exams to find the root of the issue. Colonoscopies are performed by inserting a tiny camera into the rectum so the doctor can see the inside of the colon wall and look for inflammation. Endoscopies give the doctor a sense of the rest of the GI tract by inserting an endoscope down the patient’s throat in order to examine the esophagus, stomach and small intestine. To detect for an autoimmune disease caused by a reaction to gluten, celiac testing can also be done, as well as something called a Stool Antigen Test to determine whether you are symptomatic for H. Pylori, which is more accurate than a breath or antibody test. H. pylori may be the issue with GERD or upper GI symptoms like nausea or burping, as well as abdominal pain or burning, especially when your stomach is empty. And an ova and parasites exam, which is not likely to find anything as they rarely do when done from regular doctor’s offices, may be done if you have ongoing diarrhea.
What kind of alternative health practitioners can help with a gut problem my gastroenterologist can’t?
Despite all these methods used to diagnose a patient’s gut problems, often I find that GI doctors are unable to make a diagnosis, or they give you a diagnosis like IBS, which in my opinion isn’t a diagnosis, it’s just a name for a constellation of symptoms that allopathic doctors don’t know how to resolve. If you have a GI doctor that follows current research and developments, you may be lucky enough to get a SIBO or small intestine bacterial overgrowth breath test (the best of which is the trio-smart test) and a prescription for rifaximin (antibiotic that helps resolve SIBO), but for many people this leaves them feeling worse and doesn’t resolve their problems. In these cases, it is useful to look for alternatives to western medicine like a naturopath or someone like myself. I help my clients get functional gut health tests like the GI Map*, which uses DNA testing to test for parasites and bacteria, as well as testing markers of gut organ function, or the Organic Acids Test*, which tests not just for bacterial and fungal overgrowths but also looks at whole body functioning, including neurotransmitters, which can point to why you may be experiencing anxiety or depression, the functioning of your energy production from carbs, fats, and proteins, which can point to the cause of weight loss resistance, markers of high oxalates which can cause not just kidney stones but problems like UTIs, interstitial cystitis, cardiovascular and brain issues; levels of antioxidants and B vitamins, and detoxification markers, which can signal incipient liver issues.
To conclude, just because you haven’t received an official diagnosis doesn’t mean your gut health issues are not worthy of being addressed, because if left alone, gut issues can get much worse. Often, the difference between a good and bad day boils down to simple lifestyle and diet choices. Each of you needs to find the unique combination of choices that works for you. Although the routines we’ve maintained our whole live may be hard to break, after the initial push, healthier practices can easily become your new normal.
If you’re struggling with any type of gut health problem and are ready to get some professional help, you’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my gut health coaching 5-appointment program in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
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**I am an affiliate of Seed but do not receive commission on product sales.
