Unlocking the Power of Herbs for Gut and Overall Wellness: A Conversation with Bill Rawls, MD

Unlocking the Power of Herbs for Gut and Overall Wellness: A Conversation with Bill Rawls, MD

Adapted from episode 118 of The Perfect Stool podcast with Bill Rawls, MD, Medical Director for Vital Plan* and Lindsey Parsons, EdD, and edited for readability.

Lindsey: 

So I understand that you have your own story of illness and healing that moved you from practicing obstetrics to what’s now a more holistic practice and a focus on herbs. So can you share about that with us?

Bill Rawls, MD: 

You know, I started my journey as a conventional physician, went into OB/GYN because it was more dealing with health and wellness. But at the same time, a small town practice, at that time, required me to be on hospital call every second to third day, and every second or third weekend. So if you can imagine most of my nights on call, I got very little sleep. And then, on top of that, balancing family and community, and I just went for 20 years without any sleep at all, hardly. And I crashed, and first identified with fibromyalgia because I had all the symptoms. But that’s kind of a nowhere diagnosis that really just gets you treatment of symptoms. And that’s about it. So like a lot of people, I kept searching. I finally found that I was carrying the microbes associated with Lyme disease. Now, I don’t really look at any of those things the same way that other people do. I think most illnesses have a microbe component. And Lyme disease. Yeah, that particular microbe is associated with a lot of other things. So the margins start to blur when you really get into it. But anyway, conventional therapy failed me, antibiotics made me sicker. And I finally turned to herbal therapy and became certified in holistic medicine and over about a five year period got my health back. And I was severely ill, you know, I had gut issues, heart issues, brain issues, neurological issues, everything, and got my health back completely. That’s been almost 20 years. I’m now 66 and in great health and really enjoying every minute of it. Now I spend most of my time really preaching that message and trying to get people to listen.

Lindsey: 

Right! Yeah, well, I got your book in the mail, the Cellular Wellness Solution. So I’ve been reading that and enjoying it and love your thinking and approach to herbs. I know that a lot of our pharmaceutical products are derived from plants and herbs. And of course, since I’m not an MD, I use herbs and nutraceuticals primarily, but can you explain the difference between pharmaceuticals and the herbs themselves?

Bill Rawls, MD: 

Well, yeah, it is true. I think we have this idea that our pharmaceutical scientists are these brilliant people that sit in a lab and develop these chemicals that have all these actions in the body. Quite frankly, we’re just not that good. Most everything that we use is pulled from nature. But the difference between what we’re using an herbal therapy, and what might end up being a plant, or a plant extract that ends up being made into a drug is that we’re using the synergy of the entire plant system of defense and protecting itself. So it’s hundreds of chemicals working in synergy. And typically, the things that I use for herbal therapy really don’t have drug like effects. They exert their actions by balancing systems in the body, protecting cells, suppressing microbes, and balancing the microbiome. Whereas most of our drugs actually come from plants that we would define as poisons. Very true. So when you get out on that spectrum, there are a lot of poisonous plants out there, actually, there are more plants that are good for you. And that will help you more than poisonous plants. But there are a few that are poisonous. And typically that’s where drugs come from. But it’s not the whole plant. It’s one chemical that they pull to do a specific targeted action, whether that’s an antibiotic or a heart drug, it all comes from just one specific chemical. So you lose that synergistic system that the plant is using to take care of itself. You don’t get that. You just get this targeted, potent action plant. Typically, then we take that chemical and we manipulate it in various ways to make it more potent.

Lindsey: 

And patentable, right? Well I guess you can probably pull one chemical and patent it.

Bill Rawls, MD: 

Right. Yeah, and that’s the other thing you can’t plant in a plant. You can patent a single chemical that’s been manipulated in some way. Not to say that drugs are bad. I think there is a very important purpose for every drug. But you have to understand that the drugs are restricted to affecting manifestations of illness. They are good for blocking symptoms or blocking abnormal hormone pathways. But they don’t address any causes. And they don’t affect things in a positive way at the cellular level. So most drugs really don’t actually promote healing, they can be important in acute phases of an illness to prevent someone from dying to block those really bad manifestations. But it’s unlikely that the drugs themselves or drugs alone are actually going to cause someone to heal.

Lindsey: 

An example that that I see a lot is that people will take antibiotics that just kill bacteria, and then they’ll have yeast overgrowth as a result of multiple courses of antibiotics. Whereas an herbal supplement that is antimicrobial tends to have a wide range of effects over both bacteria and yeast and fungi.

Bill Rawls, MD: 

It’s true, you know, all antibiotics come from a natural source. They either come from a bacteria, a plant or a fungus, and a lot of them come from a fungus. And then they manipulate those chemicals. So sometimes they’re far removed from the plant, but there’s always an origin. But it’s not that organism’s system of protecting itself. It’s a single chemical. And then they potentiate that chemical to kill a bacteria or a virus or a protozoa or whatever, in a very specific way. And because it’s so targeted, and so limited in its actions, bacteria find ways to get around it pretty rapidly. So we have bacterial resistance, but it’s not selective. I mean, it kills everything. And it tends to kill the fastest growing bacteria the quickest. So antibiotics are best for fast-growing, acute infections. Like if you develop a an acute pneumococcal pneumonia. Or if you’re on a battlefield, and someone has a wound that could potentially get infected in the wound, that’s an acute infection, those are fast growing bacteria. And as we know, antibiotics like penicillin back in World War II and beyond can be lifesaving in certain situations.

But anytime you’re talking about a chronic or prolonged infection of any kind, the problem with antibiotics is the longer you use them, the more you kill your normal flora, and your normal Flora are a very important part of your defense system, because they keep those rogue pathogens that we all have in our system from taking over, from flourishing and causing us harm. And you take antibiotics for any more than 10 days, and you start to kill off your normal flora enough that these pathogens can start flourishing, which can be a real problem. That’s a key element that makes herbal therapy very different. All herbs have antimicrobial properties against viruses, bacteria, protozoa, everything. It’s a broad spectrum, it affects a lot of different pathogens, but herbs don’t destroy normal flora. In fact, there are studies showing that while simultaneously suppressing pathogens, herbs have the effect of actually promoting the growth of normal flora, so they balance our microbiome, which is really cool. There’s just nothing else on earth that can do that for you.

Lindsey: 

Yeah, we’ll come back to that in a little bit. But I wanted to ask you about what a stealth microbiome is, and why we should worry about activating it.

Bill Rawls, MD: 

There are a lot of names for this idea that we have bacteria in our gut, you know, everybody knows that right? And on our skin and body openings, and we’re finding well, they kind of creep into other areas of the body too. But it turns out that in our internal pathways, our bloodstream, our tissues, it’s more like a freeway, things are constantly coming and going. So bacteria from the gut are constantly trickling across into the bloodstream, from our sinuses, from our skin, through all these reservoirs where we have bacteria that are technically outside of us, right. So part of our defense system is barriers, you know, we have skin to keep microbes out or keep microbes on the skin and not in the deeper tissues. We have the gut lining to keep the food, that foreign material and the bacteria that are are a part of it contained inside the gut. So we want to be separate from our bacteria. But things are constantly trickling across. And that’s part of our immune system’s job is to constantly stay on guard and mop these things up.

So it’s happening throughout our lives. Right now as we’re talking, there are bacteria that are part of us that are on our skin and in our gut and other places in our body that are trickling into our bloodstream. And most of the time, if you’re healthy, the immune system does a pretty good job of protecting you from those microbes, but also foreign microbes that try to enter your body too. But some of them get through. And this is a really interesting, a bit of science that is taking place only over the past five or 10 years that we’re realizing the extent of it, that bacteria, viruses, other things get through, they get past our defenses, and they enter our cells and invade our cells. And our cells aren’t defenseless. Our cells are part of our immune system. So if a cell is healthy, sometimes it can expel or kill invasive microbes. But another possibility, and it’s as a defense system that most microbes use very readily is they can just become dormant inside our cells. And studies are showing that healthy people, everybody, we have dormant bacteria inside our red blood cells. We have it throughout different tissues in our body, our brain has a microbiome. But most of these things, if we’re healthy, they’re dormant. They stay quiet. We don’t know that they’re there.

But go for 20 years with no sleep, and a bad diet and constant stress. And you stress your cells and you weaken your cells. And these things activate. And they start killing off the cells, you know, they basically use the cells for food, and then they start invading other cells. Well, at that point, the immune system looks at the thing and says, oh no, we’ve got all these bacteria emerging from the cells, and it starts attacking the cells. That’s what autoimmunity is. And it’s a key element of most any chronic illness where the microbes are emerging. What kinds of things you pick up has a greater bearing on what chronic illnesses you might end up with than anything else in your life. But if you keep your cells healthy, if you stay healthy through your whole life, that won’t happen, it’s really important to look at chronic illnesses from that point of view. It’s a really big incentive to have good health habits.

Lindsey: 

Yeah, no, I definitely see a lot of people whose illnesses started with a period of stress that obviously weakenek their immune system and started the cascade of poor health.

Bill Rawls, MD: 

Yeah, most people I talked to with a chronic illness, it’s a perfect storm of factors. And sometimes it’s acute, like they were in an automobile accident and ended up with a long hospitalization. But a lot of times, it was just things adding up and just getting worse over time to allow this reactivation. And then you know, once a thing starts boiling over, it’s hard to settle it back down.

Lindsey: 

Yeah. Are there particular herbs that you like using for gut health issues like SIBO or candida?

Bill Rawls, MD: 

I like herbs, but I think that there are a lot of really great herbs that we can use, or really any herbs are going to help balance the gut microbiome. There’s no doubt about that. But I think one of the first things is, let’s ask what the problem is, you know, what’s going on here. And when you look at virtually any gut dysfunction, most of the problem is rooted in slow motility. And that can can be associated with chronic stress. I had a lot of GI issues when I had so much stress. Also, diet, you know, these processed food diets that are high in carbohydrates and fat slow down motility. When you slow down motility, things get backed up. And you have to think about this thing. We have bacteria throughout our GI tract. We have bacteria in our stomach, not very many, the lowest concentration of anywhere in the GI tract, but they’re still there. And we have low concentrations of bacteria in our small bowel. Anything we eat is food for bacteria. And if you don’t keep things moving, you’re going to have bacterial overgrowth, bacteria grow as long as food is present. So it’s really important to keep things moving through our GI tract, because we’re going to keep growing bacteria and we need to get  them moving on down the track and out.

But when things are slow, when you have slow motility, you know in the stomach what that manifest as is you don’t empty your stomach and food just sits in there splashing around and it causes reflux,  it splashes up into the esophagus, but it’s also food for bacteria and just food sitting in there a long time starts to erode the protective barriers of the stomach. Well, bacteria like H Pylori, and others are just sitting there waiting. You know, when that stomach lining starts to erode, they start digging in. And so that’s where ulcers come from. So it’s not the H. Pylori as much as the H Pylori has an opportunity. So moving down to the small bowel SIBO, slow motility, when bacteria grow, they ferment. So you have overgrowth of bacteria, and that produces gas. Well in the small bowel, it can’t go back up. And it’s a long way for it to go all the way down and get out. So it gets stuck. So you get bloating, you get gas. But not only that, that overgrowth of bacteria starts to erode the lining, that protective mucus barrier that protects the cells in the gut. So you start to get a leaky gut and other kinds of problems. And it just works, it’s all the way down with irritable bowel syndrome and gut dysfunction and everything else.

So the first thing is addressing some of those issues of stress and diet, cutting out those processed foods, a more wholesome diet made of whole foods and fresh vegetables, the right kind of fibers, vegetable fiber, not whole grain fiber. Now some grains are okay, like rice is tolerated well by most people. But we tend to, if you have this going on, if you’ve got this irritation of the gut already, it really irritates the gut more. So you end up with issues of gluten intolerance and that sort of thing. Moving on to herbs and then we want to reduce the concentration of bacteria, we want to help things move through, and we want to protect the lining of the gut. So three herbs that I often use are slippery elm. Slippery Elm has a substance called mucilage. And it basically replaces that deficient mucus barrier that’s protecting the cells that the gut lining is made of, really important.

Berberine or berberine-containing herbs like golden seal and coptis and others. Berberine is exceptionally good, just exceptionally good for suppressing pathogens in the gut. Certain kinds of garlic preparations that can be good, ginger, wonderful for calming the stomach and suppressing some of those bacterial overgrowth. So those are just a few herbs. Dandelion is good for promoting liver function. But also it’s a really nice bitter so bitter herbs promote motility. So we want to restore that motility, we want to get that gut moving again because that’s the only way we’re going to get better. Bitter herbs like berberine, like dandelion. Another favorite herb is andrographis, we use andrographis for a lot of things. It’s got exceptionally good antiviral properties. It’s got some adaptogenic properties. But there was actually a study, there been a couple of studies actually, showing that andrographis works as well as drugs for managing ulcerative colitis. So even far down in the gut, andrographis is exceptionally good for protecting the liver and promoting bile function flow. So there’s just a few herbs that are just really nice herbs to have. There are many others, you know, peppermint, cardamom, others can just slow some of that. You want calm, some of that cramping and distress that can be associated with it. So all of those things are important.

Lindsey: 

Okay, thanks. So the dandelion, just curious, is that, I don’t know that I’ve ever seen pills of dandelion, is that used more like a tea or . . . ?

Bill Rawls, MD: 

You can do it either way. It comes as an extract, but you can also use dandelion teas.

Lindsey: 

I have heard concerns about certain herbs like oregano and berberine that they’re too strong and can impact beneficial microbes. And I’ve definitely seen clients who’ve taken many rounds of herbal antimicrobials and ended up depleting certain microbes like Akkermansia muciniphila. Any thoughts on that?

Bill Rawls, MD: 

I haven’t seen it as much with berberine. Now, oregano is an essential oil. Yes, it has some pretty strong properties. But you have to respect that there’s a difference between an essential oil like oregano oil, and an herb. So what you’re getting in an herb is chemicals that the plant is using to protect it cells and balancing chemical signaling agents and balance its microbiome and protected cells from various kinds of microbes. So that’s what you’re getting with an herb – a cell protectant. So what you’re getting with an essential oil are chemicals that the plant is producing as a deterrent. So typically, you’ll find these oils in leaves and stems in little vacuoles that the plant walls off, and it does that because they have a lot higher toxicity. So clove essential oil, any of your essential oils are going to have higher toxicity than herbs that can have similar properties. They have wonderful antimicrobial, anti-inflammatory properties, what they’re there for is to deter insects. So when an insect comes along and starts munching on the leaf, it releases these noxious chemicals and chases the insect away, you know, the plant is not using them to protect itself, particularly. So they do have a higher level of toxicity that must be respected. So you can use certain oils like oil of oregano in little gel caps in the GI tract, but it’s a lot stronger than most of your other herbs.

Lindsey: 

So I find that a lot of my clients are deficient in common minerals like magnesium and potassium, and often vitamins to like vitamin C, or the B vitamins, despite having ideal diets in terms of eating organic, grassfed, pasture-raised meats and eggs, or usually more like a paleo type diet, and good amounts of fruits and vegetables. So why would that be?

Bill Rawls, MD: 

Well, first of all, any testing you do is going to have issues. It’s really hard to measure vitamins and minerals very specifically. You have to remember that most of these things are inside cells. And typically they try to measure them in just the red blood cells, but they’re distributed throughout the body. So the only way to get an accurate measurement of those vitamins and minerals is to take multiple deep biopsies from tissues throughout the body, which just isn’t practical. So when we do a blood test, we’re getting an indirect sampling that may or may not be very accurate. I use testing a lot less than most physicians, I tend to listen to the patient, talk to the patient, look at symptoms, look at the profile of the patient, and I put a lot more weight in that then I do testing. We do a lot of testing and all of the testing, it has marginal accuracy. Yeah, we’re highly dependent on testing and some testing is very, very good. But the vast majority of it is not as good as you would hope for.

Lindsey: 

For the minerals, I guess probably for magnesium, I’ve seen RBC magnesium. And then I’ve seen hair tissue mineral analysis for the magnesium and the potassium.

Bill Rawls, MD: 

All of those have their own drawbacks.

Lindsey: 

Yeah. For the vitamin C or the B vitamins, these are usually organic acids I’m looking at. Yeah, so not not the typical test you’d get at your doctor’s. But in terms of terms of just deficiencies, whether tested or not, why would somebody eating a healthy diet still have nutritional deficiencies?

Bill Rawls, MD: 

Well, if they’re not absorbing these substances, you have to get them to cells. Correct. So if they’re in the diet, but they’re not being properly processed in the GI tract, then you may have some deficiencies there. And that’s why I do typically supplement in patients with chronic illness, with you know, vitamins, minerals, etc. And healthy people that are eating really good diet, I don’t know that they need it quite as much; there’s not very much evidence that it really changes outcomes. But chronic illness, I think having that extra is worthwhile. But again, it’s really hard to get accurate measurements, that’s tough.

And you have to define what is a nutrient doing. And a nutrient is basically raw materials that cells use to function. And so when you look at vitamins and minerals, those are cofactors, used for different cellular processes or mitochondrial processes. You know, if we’re loading in even a lot of supplements, if cells have a ready supply of those things, they can only use so much. The first thing I do is try to get good food in people. And as far as any person, I think, looking at gut function, which is what you’re doing there, is supremely important. Supplementing in early stages, especially to make sure they at least have an opportunity to get everything they need. And kind of going from there. I’ve done more of that pathway than testing. I went through a phase in my practice that I did a lot of testing and found it didn’t make as much difference as I thought it might. Sometimes I was just kind of chasing my tail with it.

Lindsey: 

In your book, you outlined some herbs that you think are great for just maintaining health and restoring vitality, shall we say, for someone who’s just maybe a little rundown? What are those herbs that you think the average person who’s in good health should be taking on a daily basis?

Bill Rawls, MD: 

Well, there are a lot of different herbs, but over the years I’ve cultivated my own personal list and these are herbs that I put in some primary products that I just think, you look at the evidence, and you look at the broad spectrum of what they do, they’re really valuable for anyone. So one of those herbs is rhodiola. Rhodiola is is defined as an adaptogen. So an adaptogen is an herb that has the effect of basically protecting our cells, protecting our systems. So it has this overall balancing, restorative effect, it helps balance stress hormones, so it’s a normalizer. It pulls us back into balance from wherever we are. So Rhodiola is really good for that. It’s been used in athletes to optimize performance. It’s known to improve oxygenation of tissues, so it’s used when people go to altitude, I’ve actually used it in skiing in Colorado to reduce my risk of altitude sickness because there’s some good data showing that. So rhodiola is a really nice herb.

Second to that, reishi mushrooms are mushrooms in our herbs or plants, but we kind of throw medicinal mushrooms in with the group because they have similar properties. And reishi mushroom has been studied in Japan, it has some of the most potent anti-cancer chemicals known. It’s a good immune modulator. It helps balance our immune system functions. Excellent cell protectant has some great anitviral properties. turmeric, everybody’s heard of that one, the yellow in curry and turmeric is really nice as an anti-inflammatory. It has some really wonderful properties for protecting the brain. It reduces inflammation, but unlike a drug like ibuprofen, that actually helps to heal ulcers instead of cause ulcers and it just really has this wonderful range of protective effects. It has some antimicrobial properties that are really nice.

Lindsey: 

I think I read it had action against H Pylori in your book is that right?

Bill Rawls, MD: 

It has some effects on H. Pylori, but a number of other microbes too. So just to tell a little story, our company, we have a product called joint care. It has turmeric, boswellia, which is another herb, some really nice things for joints. And you know, it’s a product that I put together years ago that’s helped a lot of people. My dog is now nine and when they get to a certain age, they start developing arthritis and that sort of thing. My last dog started doing that at seven, this dog hasn’t but I thought, it’s time we’ll go ahead and start giving it to him, so I gave him a couple of these joint care tablets in the morning. He’s really vital. But the problem he’s been having is his teeth, for several years. His teeth had been terrible, terrible bad breath, having to have his teeth cleaned every three months, bad plaque, all this mess in his teeth. We were really afraid that he was going to lose his teeth. About six months ago, I started doing this joint care for his joints, right? His breath cleared, his teeth cleared. And he has no dental problems now, it’s like wow. So what it was doing was balancing his whole microbiome, including his gingival microbiome.

Lindsey: 

Were you opening up the opening up the capsules and shaking them on to his food?

Bill Rawls, MD: 

Just stuffed two capsules down.

Lindsey: 

Interesting. Easier for a dog than a cat.

Bill Rawls, MD: 

Right before he eats to make sure it all goes down. So he’s done exceptionally well with it. So other herbs on my list: goto kola is really good as a brain protectant, it has some nice calming properties we all now need. Shilijat is an herb from the Himalayas. It is well known. It’s been used for 1000s of years. It’s plant matter that’s been compressed in the soil with bacteria. So it has substances called humic acid and fulvic acid that are really good for gut healing and helping to balance the gut microbiome. So that’s a nice herb.

Lindsey: 

Before you go past shilijat, just let me ask you about that. Because isn’t it one of those that has the California proposition 65 warning on it?

Bill Rawls, MD: 

Yeah, I think you do have to be somewhat careful with shilijat because it’s collected everywhere. And we use a special extract called PrimaVie that’s by a company that they spend a lot of time looking for the purest form of this substance. And they do a lot of testing to make sure there are no heavy metals and that sort of thing. So yes, buyer beware with that one; you do have to be careful. But if you get good stuff, it’s really amazing. And it’s not just from the Himalayas. This substance has been used in Alaska. I’m in Canada, a lot of the northern latitudes, they find it. Milk thistle, everybody knows that one for protecting your liver, and it actually can enhance regeneration of liver cells. And that’s really important because one of the reasons our cholesterol goes up and we started having more problems is because we replace our liver cells with fat. And as we’re doing that, we lose our ability to manage our blood sugar, to manage our cholesterol and to process toxins, really important. So this herb that can regenerate liver cells is really important. It sets up a condition in which it protects liver cells so that they can regenerate. Basically, I’ve been taking it for 15 years, my cholesterol is better than when I was in my 40s. And so it really has nice effects. But there are always surprises. I was researching milk thistle the other day, and I found that it protects osteocyte cells that rebuild our bone. So it’s actually found to be favorable for protecting against postmenopausal osteoporosis. So we may pick an herb because it has this known effect, but then you find out well, it’s protecting cells throughout the body, it doesn’t have a specific effect like a drug. So that one’s really nice. Hawthorn, really good for the vascular system. I put some of that in there. And pine bark, also is very good for the vascular system. So that kind of rounds out everything in the body.

Lindsey: 

I had heard of the pine bark extract, pycnogenol.

Bill Rawls, MD: 

Pycnogenol is a particular brand of that.

Lindsey: 

Okay. And I’d heard of that for migraines, in particular.

Bill Rawls, MD: 

Yes, because it’s protecting the vascular system. And we know that migraines do have a vascular component. So that’s where the herbs really work. Well, you know, instead of addressing the symptom, they’re addressing the underlying causes. And that’s really important if we want to promote wellness, instead of just suppressing symptoms.

Lindsey: 

Tell us about Vital Plan*.

Bill Rawls, MD: 

Oh, Vital Plan is a company I started about 10 years ago with my daughter, Braden. I was still in my practice, then. You know, I had to stop doing obstetrics because I couldn’t do the night call anymore. So I started a wellness practice that ended up being kind of like what you would know as a functional medicine practice. Now, I was using a lot of herbs in the practice. So everything I was using I was passing along to patients. I found that I just had a really hard time finding the level of extract, the purity, the potency, and the combinations of herbs. Because I was by then looking at it differently. So much of traditional herbology is observational; they didn’t have science to see how things are actually working in the body. They just made observations, you take those hundreds of years of observations, and you apply that to herbs that might be beneficial. And it works pretty darn well. But where I was going is taking that one step further to say, okay, how is the chemistry of this herb affecting things at the cellular and biochemical level? What were we achieving with it.

So it was coming up with different combinations, guided by newer science coming out over the past 20 and 30 years that was helping me make those choices. And a lot of times, I just wasn’t finding the level of product that I wanted to achieve the goals that I had in front of me. So I found that I could actually have products manufactured. And I started doing that to very specific specifications. And that grew into a pretty significant business. And finally, we carried it online to take it to a larger audience. The bigger the company got, it gave me more power to have more and more control over the extracts and manufacturing process and everything else. So we have been growing it ever since, so far with a focus more on chronic illnesses like Lyme disease and things like that. But there’s so many applications that apply to every person out there. We’re growing much beyond that.

Lindsey: 

With herbs, there’s a synergy that happens when you bring multiple herbs together versus say taking just one at a time. Right?

Bill Rawls, MD: 

Absolutely, yeah. And you know, you look at traditional herbal therapy, it’s formulas, it can be anywhere from five to 12 herbs together and you get a synergy; the analogy I use is a symphony orchestra. If you went down and sat down in the audience and you looked up on stage and there was one violin playing it would be nice, but you put two violins and then add in some other strings and the brass section and everything else and you suddenly start getting a sound that’s much bigger than any individual instruments. And that’s the way I think of the herbs working together. They’re each contributing in their own way. And you’ve got this complex defense system of a plant that synergizes with other plants. And nature’s really made to work together like that, then you come up with just this wonderful thing that can do extraordinary things for our health.

Lindsey: 

And how can you tell the difference when you’re looking at an herb, whether it’s a good quality extract, or if it’s just a cheaper version?

Bill Rawls, MD: 

Testing. Yeah, that’s what it takes. And a lot of companies don’t do the level of testing that you need, a lot of them do, probably about 50/50, I see a lot of products that I can tell they’re not doing testing. And typically, you find that if you look on the website, or look on the bottle, and they’ve just got a list of herbs under a proprietary blend, that’s a red flag right there. So what that tells me is they’re using the lowest grade preparation possible. And they’re going to put more of the least expensive herbs in there than anything else. And they’re going to try to wow you with marketing and scientific jargon to get you to buy that. To really make it work, you’ve got to have potent botanical extracts. So the extracts that we use in our products are typically 10 times more concentrated than what you’re going to find in average grade products. And you’re going to get the potency and purity. We do actually three levels of testing, when we get a certificate of analysis, when we purchase or wire an extract, which is from the supplier to say, okay, and it costs more to get something that has had a study, but then we take a sample of that and send it to our own labs, just to make sure it was really telling the truth. And then we test it during the manufacturing process to make sure that all those herbs are being blended properly. And again, there are other companies that do that level; it’s not the industry standard by any means.

Lindsey: 

Is Vital Plan on Fullscript by any chance?

Bill Rawls, MD: 

No, we’re not. And there is a reason for that. For the price that we wanted to charge, we had a choice, we can give a better quality product and take less margin, we can do a lower grade product and sell it through Fullscript at 50 to 70% off. Now we’re trying to figure out a way that we can actually do that and maintain the quality. But right now, we just haven’t quite gotten there. We do affiliate programs. But with the quality we’re trying to offer, we haven’t been able to have the margins to actually make the company work.

Lindsey: 

Yeah, no, I understand you have to sell a lot to make it, especially to go through them with the wholesale. Are you still seeing individuals or . . . ?

Bill Rawls, MD: 

What I’ve been doing for the past five years is doing consults that I really define as a high level health coaching. Because I don’t write prescriptions. I don’t manage medications, per se, I’ve been doing that. But I’m I’m taking a break from it right now to build a course that would teach people how to go through all those steps. So I’m taking everything that I’ve learned and building it into a stepwise course, that people would basically learn how to take care of themselves or learn how to recover from a chronic illness, and it would complement anything they’re doing with any other provider. But yeah, it’s so that’s kind of a labor of love that I’m in the middle of right now. To put together something that really takes that 20 years of knowledge and puts it in a form that everybody can use. The book, The Cellular Wellness Solution*, is kind of the backbone of it, that will be the handbook. But take people through that process of how you do the detective work or understanding why a person is having symptoms or why they’re ill. So often when we start with a patient, we start by focusing on the symptoms, because nobody likes to feel bad. Nobody enjoys their symptoms. As a society, as our medical system, we tend to focus more on symptoms than anything else. And how do we get rid of the symptoms? And what I want to know is why did the person become ill in the first place? Because illness doesn’t just happen. There’s always a reason. If you can define what’s going on, why that person became ill, then you have a pathway to start to reverse those things. So if I can create a course that can help people on that journey, we can get more people there and put people in a better place for how they think about their bodies.

Lindsey: 

And if they want to hear about your course when it’s ready, where would they find you?

Bill Rawls, MD: 

Oh, Vital Plan. Yeah. And so it’ll all be through that I probably got another month or two. I got a lot of other things going on.

Lindsey: 

But by the time this comes out, it may it may very well be out, because this will probably publish in a few months.

Bill Rawls, MD: 

Go look for it then. Yeah, it may already be there.

Lindsey: 

I signed up for the affiliate program through Vital Plan* (use code PerfectStool20 for 20% off your first Vital Plan order). And I noticed on the website that those five herbs that you think are like the great, maybe this is like the equivalent of an herbal multivitamin for you.

Bill Rawls, MD: 

The multivitamin industry has been so unbelievably successful convincing people that they need to take a multivitamin every day. And you know, half the population does it and they’ve been doing it for 70 some years. There’s not a lot of evidence, though. There’s a little bit of evidence that it’s a good idea, especially if you are struggling with some kind of chronic illness. But the power that you get from a multivitamin, yeah, pretty scant. It’s going to do very little to protect you from the kinds of illnesses that people have. Herbs, there’s so much evidence, there’s just so much evidence, and I detailed it in the book. It’s just overwhelmingly in favor of herbs that, yes, every person on the planet would be better if they were taking herbs every day. If every person took that assortment of herbs and a high grade supplement our risk of chronic illness would go down. I think the rate of cancer would go down, it would do some pretty remarkable things. And I know that because of the scientific evidence, but also just watching in action with 1000s and 1000s of people over the past decade of how much they’ve benefited just from these basic assortments of herbs. It’s good. It’s just truly powerful. So yeah, I’m trying to buck the norm and trying to get people to say, yeah, if you want to take that multivitamin, it is fine. It’s not going to hurt you. But if you really want to protect yourself, take a daily herbal of some kind.

Lindsey: 

And I noticed that there’s a product that has those five herbs, it was five, right, combined? What’s that one called?

Bill Rawls, MD: 

You know, because everybody needs a multivitamin. And because I couldn’t put everything I wanted in a bottle, we typically sell it as a pair. So there’s Daily Herbal, which has those five herbs. And then there’s Daily Multi that has the basic vitamins and minerals in a form that is best assimilated in the body, which isn’t what’s in most typical multivitamins. But that’s where I put the milk thistle and hawthorn and maritime pine bark and lutein for eyes and other kinds of things. So yeah, you know, it means taking a few capsules a day. But gosh, you get so much out of it.

Lindsey: 

Any final thoughts before we sign off?

Bill Rawls, MD: 

Well, that’s a lot of information right there. And I really appreciate the opportunity to talk to folks.

Lindsey: 

Yeah, well, thank you for being with us.

Bill Rawls, MD: 

Yeah, I encourage people to read my book*, if they get an opportunity. It’s a big book, don’t be intimidated. It’s like four books in one.

Lindsey: 

It’s more like a manual.

Bill Rawls, MD: 

Yeah, it’s like the first book is just looking at health at the cellular level. And everybody’s telling me it’s easy to read. The second is like an herbal primer to help people understand herbal therapy from a scientific point of view. The third is just all those things that we need to do with diet and lifestyle and everything else. And then the fourth section is applying those principles to specific problems like brain and gut and heart. Yeah, so there’s a lot of information in there.

Lindsey: 

You know, I’m really enjoying it. I wouldn’t say I get sent a lot of books, but I occasionally get sent books and sometimes I read them sometimes I don’t, but I was immediately pulled in when I started reading about your story and how herbs really just set you back on a path to health. So anyway, I’m enjoying it.

Bill Rawls, MD: 

Well, I’m very glad to hear that.

If you are struggling with bloating, gas, burping, nausea, constipation, diarrhea, soft stool, acid reflux, IBS, IBD, SIBO, candida overgrowth, fatigue or migraines and want to get to the bottom of it, that’s what I help my clients with. 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 3- and 5- appointment health coaching programs 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. 

Schedule a breakthrough session now

*Product and dispensary links are affiliate links for which I’ll receive a commission. Thanks for your support of the podcast by using these links. As an Amazon Associate, I earn from qualifying purchases.

Bloating Beyond Dysbiosis: If it’s not SIBO, SIFO or IMO, What Is It?

Adapted from episode 117 of The Perfect Stool podcast with Lindsey Parsons, EdD, and edited for readability.

My fellow bloating friends, if there’s anyone who can relate to bloating, it is most certainly me. Although I haven’t had SIBO my whole life, I have certainly dealt with bloating at least since my teens, when anytime I ate too much, I’d have a food baby and feel miserable. But once I got SIBO, it was on a whole other level, with the bloating happening before I even got up from the table, with almost any meal, and often continuing through to the morning, waking up bloated. Some clients don’t really know if they’re bloated, and I usually say, then you’re probably not, because it’s just a distinct feeling that is not like extra fat on your belly that’s soft and giggly, it’s like distension that’s tight and sort of hard and feels like you have a balloon inside you. At my worst I can easily pass for 6 months pregnant after eating.

So I’ll start with the most obvious causes of bloating just to get them out of the way, but this podcast is specifically about why you may be bloated if you don’t have one of these functional causes falling under the label of dysbiosis, or the wrong bugs in your gut. If you’ve already done functional stool and organic acids testing and nothing came up, you can jump down to the question: “Does low stomach acid cause bloating?” and continue reading from there.

So the most common cause of bloating is SIBO, or small intestine bacterial overgrowth, which is usually caused by stagnation in the small intestine due to a variety of causes, the principal being an episode of food poisoning in the past, and by that I mean it could have happened years before, as well as medications like PPIs, steroids and antibiotics. Any stagnation in the small intestine leads to a buildup of excess bacteria and general dysbiosis, or an overgrowth of the wrong types of bacteria. If you have mostly hydrogen producing bacteria, you’ll usually also have occasional diarrhea, usually soft or loose and messy stool, but sometimes you’ll have normal stool, depending on what you’ve eaten.

If your overgrowth is of hydrogen sulfide producing bacteria, then you’ll likely also have gas that smells like sulfur or rotten eggs and excessive belching and diarrhea or loose stool. I just did a whole episode on that, number 114 from early February 2024. Other possible signs of hydrogen sulfide SIBO include intolerance to sulfur-containing foods and supplements, weight loss, brain fog, exercise or stress intolerance, burning bladder syndrome, elevated heart rate, insomnia and low blood pressure after eating.

And then if you’re constipated and bloated, you may have IMO, or intestinal methanogen overgrowth, which used to be known as SIBO-C, or SIBO with constipation, which is an overgrowth of archaea (which are like bacteria but of a whole different domain) usually Methonobrevibacter smithii, which produce methane gas by metabolizing the hydrogen produced by bacteria fermenting carbohydrates. You’ll often have bloating and gas with a metallic smell when this happens, although often gas gets trapped with bad constipation so my IMO clients will often say they don’t have much gas or gas that smells.

Or if you have negative SIBO breath tests and are bloated, you can have an overgrowth of candida, or small intestine fungal overgrowth or SIFO. Candida is a normal resident of your gut but can overgrow and even become systemic in severe cases, and which can form hyphae or tail-like structures that go out between cells lining the small intestine. This can be caused by a diet high in sugar and starches, post-antibiotics, from estrogen dominance or supplementation through the pill or hormone replacement therapy or from low secretory IgA or stomach acid, which may result from chronic stress. Usually bloating after eating sweets or carbs, food sensitivities, skin issues and brain fog are signs of invasive candidiasis.

And finally, you can have parasites, which usually come with diarrhea or loose stool, anal itching, stomach pain or tenderness, nausea or vomiting, fatigue, abdominal pain or cramping, teeth grinding a night, or you may pass strange things in your stool like worms or flukes. Suspect that if you’ve recently come back from a trip to a developing country where they tell you not to drink the water and you didn’t realize that meant not to eat salads or washed fruit or brushing your teeth with the water. I’ve done podcasts on all of these things; see the show notes or you can scan back over old titles in your favorite podcast app.

Okay so on to the meat of the episode, other reasons for bloating.

Does low stomach acid cause bloating?

Let’s start with low stomach acid, which is the beginning of the digestive process. If you have bloating issues when eating meat or eggs or feel like meat just sits in your stomach and nothing moves, it may be low stomach acid or hypochlorhydria, which incidentally can lead to SIBO, because sitting food will breed bacteria. Other signs that hypochlorhydria may be at play are bad breath, no hunger in the mornings, feeling tired or nauseous after eating meat, indigestion, rotten egg smelling gas, acid reflux, hair loss in women, anemia which can be from low iron or B12 levels or hunger after eating. I actually experienced this a lot – I would feel what felt like hunger but sort of in the upper middle of my chest like mid-way up my esophagus, which was really a feeling of reflux, not hunger. Also, weak, peeling or cracked fingernails, stinky sweat, acne, and either constipation or diarrhea can be signs. There are also signs on your standard blood tests called the CMP, or comprehensive metabolic panel and CBC, or complete blood that you may have low stomach acid. So if you see one or more of these signs, you may want to test yourself: chloride levels under 100, high or low serum protein or serum globulin levels, low phosphorous levels, especially with a vitamin D deficiency, high BUN levels of 20 or more, abnormal MCV, MCH, MCHC or below normal Hematocrit or Hemoglobin, indicative of iron deficiency.

You can test yourself with a trial of Betaine HCl. Take one capsule of Betaine HCl (most of them are between 550 and 650 mg) halfway through a meal with 6 oz. of animal protein. If you feel burning or warmth in your chest, you probably have adequate stomach acid. You can always neutralize the acid with TUMS or a little baking soda in water if the burning is uncomfortable. But you should check at a few different meals to be sure. If you don’t, you can add another pill every couple days until you hit a max of 5 per meal with animal protein.

Another way to check is with the baking soda test, although I have no verification that this is actually a legitimate test. But it’s done by drinking a mixture of ¼ tsp of baking soda with 4 oz. of cold water first thing in the morning before drinking or eating anything. Time how long it takes for you to burp after drinking it. If it takes longer than 5 minutes, your body likely produces insufficient stomach acid. If you have immediate burping or you burp several times, it may be due to too much stomach acid. But just be careful you’re not having small burps from taking in air when you drink. Some possible causes of low stomach acid include chronic stress, an overgrowth of the bacteria H pylori, aging, zinc deficiency, food sensitivities, stomach cancer, autoimmune gastritis and allergy medications, specifically H2 blockers, which include Famotidine (Pepcid AC, Pepcid Oral, Zantac 360), Cimetidine (Tagamet, Tagamet HB), Nizatidine Capsules (Axid AR, Axid Capsules, Nizatidine Capsules) and Ranitidine (Zantac), which has been removed from the US market due to safety concerns.

Could low digestive enzymes be causing your bloating?

Another common reason for bloating is poor digestive enzyme production, which would be more suspect if you have issues eating vegetables, especially cruciferous ones, fruit and legumes. Signs beyond bloating that this may be the case are diarrhea or constipation, abdominal cramping, gas or poor tolerance to high fiber foods or high FODMAP foods. One possible way to test it is by eating a bowl of plain steamed broccoli and seeing how you do. You could also try digestive enzymes with a meal to see if you feel better. While many people with gut health issues have low digestive enzymes, there’s a more serious condition called exocrine pancreatic insufficiency or EPI that a doctor may diagnose you with. It may be diagnosed through a fecal elastase-1 or FE-1 test, which is also included in the stool tests I use like the GI Map* and my new favorite, the US Biotek Advanced-GI stool test*, which seems to combine the best of the GI Map and GI Effects and is in between the cost of those two. I’ve just added it to my Rupa Health Lab Shop* if you’re interested in looking at a sample report. Keep in mind, however, that low stomach acid is often at the root of low digestive enzyme production, because it’s the release of the stomach acid that triggers the release of enzymes from the pancreas. But causes of full blown EPI include chronic pancreatitis, pancreatic cancer, cystic fibrosis, nonalcoholic fatty pancreas disease, surgeries including pancreatic and gastric resections, short bowel syndrome, Crohn’s Disease, diabetes and obstruction of the pancreatic duct, celiac disease or Zolinger-Ellison syndrome. But SIBO and dysbiosis can also cause insufficient pancreatic enzymes, so that’s usually an area I support with digestive enzymes when helping people with SIBO and related gut issues. My favorites are the Pure Encapsulations Digestive Enzymes Ultra*, which are nice and small and come in big bottles at a reasonable price and there’s also ones with Betaine HCl included*, or Enzyme Science’s Critical Digestion*, which specifically have a lot of lactose and gluten digesting enzymes. And then there’s a formulation called FODMATE*, which is specifically designed for people with FODMAP issues, which are fermentable fibers found in grains and vegetables, and which would be especially relevant to someone with SIBO. And note that because food is not digested well with low pancreatic enzymes or EPI, it can also lead to SIBO.

Poor Bile Flow

Another reason for bloating is poor bile flow. Since bile’s role is to emulsify fat to prepare it for digestion, you’ll mostly likely experience this bloating and possibly stomach pain and nausea after fatty foods like pork belly, my personal downfall, and other fatty cuts of meat, cheese, high fat meals and deep fried foods. You may also have light-colored stool, greasy stools that may be foul smelling or float, diarrhea or erratic bowel movements, weight loss, stomach cramps, itchiness or jaundice, which is yellowed skin or eyes. Of course if you’ve had your gallbladder removed and aren’t supplementing with ox bile or bitters, you may need to address that. While the liver produces bile, the gallbladder stores it so it can send out a bolus when fat is detected in your duodenum. Low bile flow can also result from low stomach acid, which prompts the release of bile. Decreased secretion of bile can also come from certain drugs, sex hormones, inherited defects and ductal diseases like primary biliary cirrhosis and primary sclerosing cholangitis. There’s a long list of drugs that can cause liver damage and impact bile flow, including estrogens, NSAIDs, antibiotics, statins, metformin, antifungals and many more. I’ll link to an article on drug-induced cholestasis that lists them in a chart. And then bile ducts are most commonly blocked by gallstones, but could also be from cancers of the bile duct or pancreas, but usually you have severe abdominal pain either in the center or on the right side under your ribs, possibly spreading to your side or shoulder blade and lasting from 1-5 hours if that’s the case so the bloating won’t be your most obvious symptom. If you’re on a ketogenic diet and get this kind of pain, that’s a pretty good sign that it’s not for you, as some people’s bodies just can’t handle a high fat diet. Bitter herbs like arugula, dandelion and radicchio, lime or lemon water and rind, beets, artichokes, coffee and dandelion tea are great for promoting bile flow. Then supplements like gentian or bitters can promote bile flow and ox bile can supplement bile or you can try a Betaine HCl supplement that contains gentian like the Doctor’s Best one*. Note that low bile flow can also lead to SIBO.

Do food sensitivities cause bloating?

Food sensitivities and intolerances are another reason for bloating. While it’s not specifically a food sensitivity but rather an autoimmune disease, I’ll mention that celiac disease that’s undiagnosed and untreated through the avoidance of gluten can cause bloating, as can gluten sensitivity, dairy sensitivity, lactose intolerance or other food sensitivities. And it could take several days for other symptoms to manifest so sometimes it’s challenging figuring out what you’re sensitive too, but my general rule is, it’s usually what you eat the most of, because you won’t develop a sensitivity without eating something. Some of the other most common food sensitivities are to eggs, soy, sugar, corn and nuts. Personally, I know for sure I’m lactose intolerant. I used to just feel unwell after eating ice cream. My stomach would hurt and I’d just have a miserable, sick feeling, but it took a while to separate that from feeling sick from eating too much, which invariably I had done when eating ice cream as it was usually a dessert some insufficient amount of time after a meal. But once I targeted it through taking lactose digestant tablets or lactase enzymes and avoiding dairy, it became really obvious when I had dairy, as I would have painful, liquid, voluminous stool that burned as it came out and often had me having hot flashes and collapsing on the bathroom rug in pain. See if you are lactose intolerant and still eat dairy, you’ll still have some gut bugs that will help break it down, but when you give it up altogether and those gut bugs decrease or disappear, then eating is much worse. But when I stopped eating dairy, I also saw most of my issues with acid reflux disappear, my mucous production decrease significantly and a good amount of bloating decrease. The easiest way to test for lactose intolerance is just by taking cheap lactose digestant pills you can get at the drugstore or nicer ones like Enzymedica’s Lacto* that also has enzymes that target casein, a potentially problematic protein in dairy, while eating dairy and seeing if it changes your symptoms. The highest lactose foods are milk, ice cream and soft cheeses; hard cheeses, butter and yogurt or kefir have much less and ghee is lactose free.

And I’m sure you recall that I’ve mentioned that I don’t really put much weight into IgG food sensitivity testing because the things that tend to come up are basically everything you’ve been eating if you have a leaky gut, which dysbiosis can cause. However, there is one test I do think is valid, which is the Mediator Release blood test from Oxford Biomedical Technologies, which tests for all 7 types of food sensitivities at the cell level. One of my recent guests mentioned it and I thought I couldn’t get access to it, but then I was very excited to find out that I was able to establish an account and get training on it, so if you’re interested in that testing, you can contact me to get it at lindsey@highdeserthealthcoaching.com. They also create a LEAP food plan for eating the foods that will help you heal that’s very successful in helping people with digestive issues that aren’t otherwise identified.

There are three other food-related issues that may be causing bloating: fructose malabsorption and intolerances to inulin and sorbitol. For fructose, some people can only deal with a small amount of it, and then any unabsorbed leftovers are fermented by microbes, creating bloating. You may also see irregular motility, abdominal pain, gas or nausea. There are only small amounts of fructose in fruit, so usually this isn’t where you’d have an issue – a medium apple has about 10 grams of fructose. But a Coke has around 40 grams of high fructose corn syrup in a 12 oz. can. Foods that may impact you if this is your issue are sodas, dried fruit, added HFCS, foods with added sugar, sauces like ketchup, pasta sauce, honey, fruit juices and desserts. An easy test would be just drinking a can of soda alone. You can also use the Food Marble* to test, if you get their food intolerances kit. You may have heard of it – it’s an at-home SIBO testing device that you can use multiple times and test and retest yourself for SIBO and food intolerances. Some of the top SIBO doctors seem to be getting behind it and I have an account, so if you want to get one with the SIBO test kit and get a discount, you can find a link in the show notes to take a look and then email me at lindsey@highdeserthealthcoaching.com so I can submit a request for you. Its price is about the same as getting one commercial SIBO test, so I think it’s a great idea if you’re starting from ground zero or have recurrent SIBO or IMO issues so you can test and retest before and after treatment.

In the Food Marble webinar training, they said that 84% of those with IBS find that food triggers their symptoms. And while most of IBS is in fact SIBO or IMO, something like 60%, for the remainder of folks, it’s not, so finding out the specific foods you react to is important. You can test your reaction to individual foods using it, as well as getting the kit to test food intolerances. And for most people, while a low FODMAP diet may be great for reducing your symptoms, you may not in fact need to avoid all high FODMAP foods, as usually only one or two types of FODMAPs cause issues, and the Food Marble could help you identify those.

If you get the device, you can get a kit to test all four food intolerances: lactose, fructose, sorbitol and inulin. And interestingly, what they have found in their test results is that lactose, which most people think is the cause of their issues, has the lowest rate of intolerance at 36%, whereas sorbitol, which is in fruit and is used as a sweetener in various things, has the highest rate at 74%.

How can I tell if I’m intolerant to sorbitol?

Symptoms of sorbitol intolerance are bloating, gas, stomach pain, diarrhea and nausea. Fruits with the most sorbitol are the fresh stone fruit like peaches, cherries and plums and dried fruit, but there’s also sorbitol in apples and pears. It’s also found in juices and jams made from those fruit, most chewing gum, light or low-calorie packaged products and processed meats. Of course it’s easy enough to look at a label to find sorbitol in packaged products, but also look for the word sorbitan. It is also used in bread baking as a humectant and will be listed as E 420 on the label, if you get a label, but if bread is sold freely from a bakery, sorbitol doesn’t have to be declared. Of course even if you’re intolerant, you will probably still be able to deal with a small amount.

And the final food you can test for intolerance with the Food Marble is inulin, which is found in garlic, onions, wheat, bananas, leeks, artichokes and asparagus, among other foods. In the Food Marble testing, inulin has the second-highest positivity rate in every country in their dataset except Spain (where it has the third-highest positivity rate). You may not suspect inulin however, because it ferments more slowly, so you may not have digestive symptoms until later in the day or even the next day. And many foods high in gluten, like bread, also have inulin, so you may have issues with bread, but for a different reason than gluten. I’ll link to a blog from Food Marble on inulin intolerance that may be helpful.

Of course doing an elimination diet is also a great way to find out if you have common sensitivities. To do that, for 3 weeks take gluten, dairy, refined sugar, corn, soy, eggs, and if you really want to be thorough, all grains, vegetables oils, shellfish, tree nuts, legumes and nightshades, which are tomatoes, eggplant, peppers and potatoes and their derivate spices, out of your diet. Then add them back, one eliminated group at a time for 2-3 days to check for a reaction. If you react, stop eating that and move to another one, if you don’t, keep it in and add another. The hardest part of an elimination diet is after the 3 week deprivation to not just add everything back in at one time because you don’t seem that improved, but often you can’t tell how badly you react to something unless you’ve had time off of it and you can’t quite recall how bad you were feeling before you started. So keeping a symptom diary with how often and how severe your symptoms were is also helpful. But an elimination diet will be less useful for more uncommon food reactions.

What else can cause bloating?

Constipation

There are several other additional things that can cause bloating. First, constipation that isn’t from IMO but rather just from a poor diet with too little fiber, some physical issue impeding motility, lack of magnesium, insufficient water intake, insufficient movement, ileocecal valve dysfunction, vagus nerve dysfunction, or hypothyroidism can cause bloating. That backup of stool can block gas from exiting and cause bloating by itself, so if your intestines are full of stool, that may be your issue. Getting the bowels moving with vitamin C (and you can always start out with a Vitamin C cleanse to clean things out entirely and determine your best dose of C (Perque C Guard for cleanse*) and magnesium citrate. I like the Natural Vitality Calm powder* starting at ½ tsp. and increasing by ½ tsp. every two days before bed in water until things get moving – it’s magnesium carbonate but turns into citrate in water. Other forms of magnesium that help with motility are magnesium oxide, sulfate and chloride.

For vagus nerve dysfunction, you can check if that’s an issue by looking at your uvula in the mirror and saying “ah ah ah” and seeing if it pulls to one side or another or goes straight up and down. If it pulls to one side, you should check out the book Accessing the Healing Power of the Vagus Nerve by Stanley Rosenberg* for exercises to fix it.

Regarding ileocecal valve dysfunction, it’s the valve that goes between the ileum, the last part of the small intestine and the cecum, the first part of the large intestine, and it can get stuck. You’ll usually have constipation (but diarrhea is also possible) and pain in your pelvic region on the right side, if that’s the case. But you could also have flu symptoms, nausea, dizziness, fainting, lower back pain, heart pain, tinnitus, bad breath, a pale face, headaches or dark circles under your eyes. If you think this may be your issue, there’s a manoevre you can do yourself to unblock this value, which I’ll link to in the show notes.

Hypothyroidism

Another possible cause of bloating and constipation as mentioned above is hypothyroidism, so if you have other symptoms like hair loss, dry skin, weight gain, feeling cold all the time and tiredness, you should get your thyroid checked to see if that may be at the root of it. Ideally that would include a TSH, Free T3, Free T4, reverse T3 and both thyroid antibodies (that’s thyroglobulin and thyroid peroxidase antibodies) if you’re symptomatic.

Meal hygiene

Another reason you could have bloating, and this is more if it’s intermittent, not constant, is poor meal hygiene. This means eating while under stress and not in rest and digest mode, but while working, multitasking, watching TV or scrolling social media, eating too much at a meal, eating too quickly or not leaving enough time to digest and let your stomach empty between meals. Ideally you’ll spend at least 20 minutes eating a meal, chew each bite 25 times, pause between bites, limit water to small sips or drink most of your water away from meals, and focus just on eating. One trick is if you tend to arrive at the table full of stress, try taking 3 breaths before starting to eat – in for 5 hold for 5, out for 7. This will switch your body into a parasympathetic state and maximize your digestive processes. Then you should leave at least 3 but more ideally 4 to 6 hours between meals, and stop eating after dinner and at least 2 hours before bedtime.

Physical Issues

And of course there are physical reasons you may be bloated, so while most people I talk to get frustrated when they see a gastroenterologist because they may not be well versed on the functional reasons for bloating, they are best suited to diagnose physical reasons for bloating. Of course some you’d be aware of but others would require an endoscopy or colonoscopy to diagnose. So physical reasons include prior gastroesophageal surgery (such as fundoplication or bariatric procedures), gastric outlet obstruction, gastroparesis, ascites (which is fluid buildup in your abdomen, usually as the result of cirrhosis of the liver), a gastrointestinal or gynecologic malignancy, small intestine diverticulosis, chronic intestinal pseudo-obstruction (a rare disorder in which intestinal nerve or muscle problems prevent food, fluid, and air from moving through the stomach and intestines, which appears to be primarily an issue discovered in childhood), or an abnormal viscerosomatic reflex, which controls gas clearance through the contraction and relaxation of the diaphragm and the muscles in your abdominal walls. I always recommend people start with conventional doctors when they have gut health issues like bloating and once they’ve exhausted their arsenal, then you can come and see me or another functional medicine practitioner about what we call functional digestive issues.

What can I do about bloating for now?

If you just need some immediate relief from bloating, you can take 2 to 3 capsules of activated charcoal* in between meals – wait at least an hour after eating or other supplements and another hour before eating again to relieve bloating. But note that activated charcoal can suck up nutrients so not something you want to take in the long-term to deal with bloating, and it can also cause constipation. So better to find the root cause.

If you are struggling with bloating, gas, burping, nausea, constipation, diarrhea, soft stool, acid reflux, IBS, IBD, SIBO, candida overgrowth, fatigue or migraines and want to get to the bottom of it, that’s what I help my clients with. 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 3- and 5- appointment health coaching programs 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. 

Schedule a breakthrough session now

Navigating Bloating in Perimenopause: Insights with Lara Frendjian

Navigating Bloating in Perimenopause: Insights with Lara Frendjian

Adapted from episode 116 of The Perfect Stool podcast with Lara Frendjian, Registered Holistic Nutritionist, and edited for readability.

Lindsey:

So let’s start with your story, because I know you went through a period of uncontrollable bloating and weight gain in your 40s that you dealt with sort of indirectly. I think this is an approach that I don’t often consider for my clients. So let’s hear about that.

Lara Frendjian:

Okay, sure. So I was a practicing nutritionist. Nutrition is my second career, I started off in finance and accounting; I was a comptroller for many years. And nutrition was just a passion of mine. So I started to practice, I was practicing for a number of years, I was feeling great energy, everything was working really, really well. Until I started to approach my 40s. And things just suddenly seemed to shift. And it felt like a little bit overnight. But if I think back, I know that there were signs that things were starting to shift. So you know, my cycles were changing. For instance, after my second daughter, who I had in my early 30s, my periods were just closer together. And then they suddenly became really close together and a little bit erratic. But I didn’t think much of it because it was just sporadically that it would happen. It’d be like 26 days, and then I would miss a period. And I’d be like, “Oh, I wonder what happened?” And then it would continue. So I didn’t think much of it. And this happened for a number of years. And then suddenly, everything shifted, meaning I started to not feel like myself anymore. I started to notice that I was putting on weight, especially in my midsection. I noticed that my energy was lower than it used to be, like I feel like I need a nap. Now I would push through it. But I felt like I needed a nap. And I hadn’t felt like that since my kids were little and I was up with them all night. And what got me the most is that my mental health was not good. I was feeling anxious and irritable and just wanted to cry and didn’t know why. And of course I was bloated and everything was uncomfortable. My clothes didn’t fit me the way they would. And I developed eczema. I’ve never had eczema before and all of this just felt like overnight, which of course it wasn’t. Now if I think back, there was something that tipped me off. But I went to my doctor, I explained what was happening. She checked some of my labs, and she said everything is okay. It’s perimenopause. If you want, you can go on the birth control pill, there’s really nothing else that I can do for you. And that was the first that I really thought about perimenopause. Because I was a nutritionist that was helping just generally people, I was focused on gut health, actually. And all of this was happening to me. And internally, I felt like a fraud, because here I was helping other people and my body felt like it was falling apart. And that’s when everything shifted. And I shifted my focus. And I started to study other things and learn other things. And I realized that I was doing some wrong things that were impacting my body in a negative way. And I needed to do things a little bit differently now that I was in this phase of life. And here I am, fast forward a number of years. And yeah, all of that has gone, behind me. And now my health isn’t perfect. I know my hormones are still shifting, but I don’t have any of the symptoms that I was experiencing before, even though things are still changing. So we are going to go through changes. It’s just we can thrive through the changes or really struggle through the changes. And I want to get people on the other side of thriving versus the struggling.

Lindsey:

Yeah. And how what turned it around for you?

Lara Frendjian:

Okay, well, so I understood first what was happening in my body. So I recognized that there were hormonal shifts that were happening, and that I needed to address them. And the crux of it for me was stress, lifestyle stressors. I had traveled to Cambodia with a colleague and we had done work there. And when I came back, and I thought I picked up a bug or something there. And we were so cautious and careful. Now, in retrospect, I realized that it was not a bug. It was just the travel; the things that I experienced there were extremely stressful. And I know me and I realized back then that it was stressful, but I didn’t realize the implications that it would have on my body. Because my body was already under stress with all the hormone shifts that it was starting to go through or that I had been going through for a number of years. But that kind of just tripped things up. So that’s one, I recognized the importance of stress management, because we can’t get rid of stress. I recognize the importance of nutrients. So I was supplementing with some of the generic things that we think of, like, zinc let’s say for example to boost your immune system and vitamin C in the form of ascorbic acid. And what I didn’t realize is that these were causing other nutritional imbalances. So what I learned was, it’s very detrimental to just supplement with just generic stuff that you hear. So what I learned was that there’s a real connection between minerals, and hormones, and understanding what is happening to your body is really important and supplementing with the things that your body needs is really important. So I studied these things, I delved into it, I studied, I researched, I came under other people and learned from them. And I learned how to read the hair tissue tests and blood work in terms of understanding your nutrient status and things like that. And then I’ve moved away from fully plant based. So I was eating a plant-forward diet, which I still do, but I integrated animal proteins, and I integrated animal fats back into my diet, because my body needed it, and everything shifted. So those were the three main things that I did.

Lindsey:

 I do find that a lot of clients who were vegan or vegetarian will eventually realize their body’s not getting as much protein as they need on that system, or even more specifically, people who are on vegan or vegetarian diets, or who end up with some type of a methane SIBO or IMO presentation. And that diet is just not working for them, because they’re eating the things that are feeding them. They are fueling that growth.

Lara Frendjian:

Yeah, yeah, for sure. And, it’s really important to listen to the . . . like if I were to go back, it’s important to listen to the whispers that the body gives you before it starts yelling, because they are there. I just was choosing not to hear them out.

Lindsey:

Yeah. It’s very easy to underdo protein, because we sort of been told, oh, animal protein is bad for you. I don’t object to people having a vegetarian diet if they can somehow pull it off. But you probably are going to need some protein powders, because you’re just going to have to eat so many carbohydrates to get the protein you need. Then what do you think of as a minimum amount of protein?

Lara Frendjian:

Right now I’ve moved towards higher at the end of protein. So I’d say 25% minimum. Thirty-five percent is where I’d like to see it.

Lindsey:

Of calories?

Lara Frendjian:

Of calories. Yeah.

Lindsey:

So how do you start working with clients who have got health issues like bloating?

Lara Frendjian:

So the first thing is I do an intake; I understand what’s happening to their hormones. So I understand if they have histamine issues, if they have cortisol issues, if they’ve gotten any diagnosed diseases related to their gut. So I approach it from a different angle. Where I used to attack the gut, specifically, I approach it from an overall, and only if we need to address the gut directly do I go there. Because the women that I’m working with aren’t necessarily coming to me because they have Crohn’s or colitis or SIBO. They’re just not feeling well. And it’s just that they’re tired or they’re gaining weight. A lot of the things that I described that I was experiencing, those are the women that I’m seeing. Usually nine out of 10 times when we address all the other stuff, we reduce the stress, we work on the minerals, we replenish the nutrients, we balanced the iron, etc., reduce the histamine load, estrogens. Once that happens, usually nine out of 10 times I’m able to help them with it. And where I can’t, that’s when we go deeper into the gut health. So I ask them to run panels/bloodwork through their doctor. I do run a hair tissue test through the services that I provide. They send it into hair tissue analysis, and then that, in addition to their lifestyle intake, gives me a really good picture of what’s happening. If we need to, we do the Dutch hormone test. But because I’ve worked with so many, based on their symptoms, I’m able to decipher what’s happening with their hormones. And only if the situation is really stubborn and we can’t deal with it do we do the Dutch hormone tests, just to save them money really is why I put off some of the lab work. So when you had bloating and then when your clients do who are not coming specifically about gut, but bloating is part of the picture, is this more bloating associated with their cycle or is this bloating like every time they eat? Every time they eat. Yeah.

Lindsey:

And that resolves from a hormonal perspective then?

Lara Frendjian:

Yes, yeah. It’s often related to cortisol, right? Stress causes an impact on your gut bacteria. But so do our shifting hormones, especially in our early 40s. Up until menopause, what’s happening is estrogen is declining. But progesterone is declining even faster. What happens is we have this estrogen dominance picture, so we have more estrogen in relationship to progesterone. And this estrogen dominant person will have more histamines in their body, their histamine load; they won’t be able to clear the histamines. So there’s a real correlation between histamines and estrogen. And once we’re able to increase their progesterone in terms of the ratio, that histamine generally goes away. And once we’re able to balance the cortisol levels and bring them down, their histamine load will go down, and they won’t have those reactions that they used to.

Lindsey:

And so are you starting from addressing cortisol imbalances when you’re dealing with estrogen?

Lara Frendjian:

Yes, that’s where we’re starting. So we work on it hand in hand. So I take them through this process of understanding what is happening to their body from a hormonal perspective, reducing their stress load. It’s multifaceted. Okay so when I say reducing their stress load, I’m talking about eating the right food.  Ninety percent of the women that are coming to me, they’re like, I eat healthy, most of them are undereating. Most of them have a predominantly carbohydrate rich diet. So just shifting that around and having a balanced meal and eating enough, well, their cortisol levels come down, their energy levels go up, and they feel better. And they’re able to move more; it’s just this snowball effect of these shifts. And I was going to say tiny shifts, but for most of us, they are quite big shifts because just to wrap your head around . . . you know, I’ll talk about carbohydrates. Everybody thinks of bread, right? Bread and grains. No. All our fruits and vegetables, all of them are carbohydrates, and understanding the differences in the carbohydrates, and s ome of them are low, etc. Yeah, just doing that, the nutritional stuff, adding a little bit of movement, getting sunshine, getting access to red light, breathing, having a healthier mindset, right? I get a lot of chronic dieters who are in or out, 100% in their dieting, or they’re not at all. So just shifting these mindsets reduces our stress load. So what I do is multifaceted, and I have a program that I run them through. But everyone’s starting point is a little bit different. And everyone’s focus could be a little bit different, because someone can have a really healthy mindset and they’re not dieters. It’s just where I was, the body just did what it did, because of some things that happened in their life. So my starting point would be different than your starting point, because I have different issues than you.

Lindsey:

Yeah, of course. Everyone’s so unique. Yeah, I always find it funny when people say I’ve got a healthy diet. And mind you, I don’t see a lot of people like this because by the time they found me, they’ve done everything diet wise a human being can do, they’ve gone through the paleo, they’ve gone through the keto, some of them have gotten to carnivore; whatever they can do to reduce their gut symptoms. But that being said, occasionally you do happen upon a person who’s like “I’ve got a healthy diet”, but they’ve really had no interaction with functional medicine; they found my podcast because they were looking for gut problems. And you’re like, “Okay, what’s your diet?” Bagel for breakfast, then I have a sandwich for lunch. And maybe I have a meat and veg and grain for dinner of some sort. And then whatever they may add on to that, snack-wise. And you’re like, “yeah, that’s not actually healthy diet.” That’s a healthy diet compared to going to McDonald’s every day, but that’s far from healthy.

Lara Frendjian:

Yeah, yeah, it’s true.

Lindsey:

But what I should just ask is: ‘What do you do for grains and carbohydrates?’. Like that’s the big question because that’s always where the crux of the problem was. And then of course when you pull those out, it’s now fill it back in with the stuff you’re supposed to be eating, the protein and the fruits and vegetables and the healthier grains and such that has some nutrients,  nutrient-dense foods right? That’s the key.

Lara Frendjian:

Yeah. And then there are nutrients. Like one of the things I do is I get them to track their meals. And I’m not just looking at their proteins and carbs and their macros, I’m looking at their micronutrients. So suddenly, their potassium levels like skyrocket when they start to replace their bread with this sweet potato or squash or something, their nutrients just skyrocket.

Lindsey:

Yeah, everybody I test is low on potassium, everybody.

Lara Frendjian:

Yeah, I know. It’s quite exciting when it happens. Yeah, it’s really hard to get the level of potassium that you need, unless you’re eating the rainbow and eating a range of foods and reducing your grain, your pasta and your bagel and your sandwich.

Lindsey:

Yeah, I think the only person I had who tested high in potassium was somebody who was using one of those potassium salts that you use when you’re on a keto diet. That was the way. Are the folks that you’re seeing also having issues with their moods or their emotions and things like that as they head into perimenopause?

Lara Frendjian:

Absolutely, yeah. That’s one of the things because a lot of us can handle, let’s say, the weight gain, right? We can deal with it. And we find our old thing that we used to do; we find our thing. I find that the issue that gets most of my clients is the mood changes, the depression, the anxiety, the irritability, the place where I was, where I felt like I was losing my mind. Like, I went to my doctor, and I’m like, I don’t know what’s happening to my brain. I just feel crazy. Like I just didn’t know how else to describe it. I just was losing my mind. And nobody else knew, right? I wasn’t even talking about it to my family. But internally, I felt like if someone put another to-do on my desk, my reaction would be like to just burst out into tears. I had nothing left. And I don’t know, like if a deadline moved up, it would be like the end of the world. It was really strange. So yes, absolutely.

Lindsey:

Yeah. That’s funny. I never went through any of that in perimenopause. And perimenopause was like a non-thing for me. I just went straight to menopause. And then it was just hot flashes that were insufferable. So I ended up, I started with hormone creams to see if that would be enough for me and to help with hot flashes. But ultimately, I had to go for the estrogen patch. And for the progesterone pills, which I believe are all bioidentical. I hope I’m doing it the right way, so my doctor said. So I’m curious, do you use creams at all? Or do you get at estrogen and progesterone indirectly?

Lara Frendjian:

I don’t start off there. So I’ll start off with progesterone-boosting foods and estrogen-balancing foods. So we’re we’re focusing on things that are going to help clients’ liver and help the body clear estrogens better, like lemon, ginger, turmeric, rosemary, beets, beet greens, carrots, raw carrots. So these are all clearing foods. Flax seeds I do like to include because they do have some researched benefits to helping with estrogen levels. Whether they’re high or low, they do help them. And then progesterone-boosting foods, like all your potassium-, magnesium-rich foods. And of course, some supplementation. Everybody needs magnesium in their diet either through food, topically, depending on your gut status, and/or supplemental magnesium. So this is where I start and it looks a little bit different for everybody and some people will need other nutrients but that’s where I start. Ultimately with some, myself included, I do progesterone cream over the counter, or a bioidentical, very small dose, supplemental progesterone cream, which is extracted from wild yam. There’s one company that I love and I do use theirs. And I find it’s very low dose.  So yes, progesterone creams and progesterone drops, they’re very low dose, especially when you look at the prescription and generally that truly does it. If their blood work is still coming back wonky or their symptoms are still existing, then they work with their doctor because I can’t prescribe, I’m a holistic nutritionist. So then they work with their doctor in order to get bioidentical progesterone or estrogen. Ninety percent of them don’t have to go there. Once their lifestyle and diet is dealt with. And then that’s not something we have to deal with. But some of them still do. Some people still do and that’s okay. As long as they’re bioidentical and you’ve got both the estrogen and progesterone together, because that’s where we are in our research right now, is that when the two are together, then it’s safer.

Lindsey:

Yeah, safer because you don’t want the lining of the uterus getting too thick.  And so what kind of interventions do you use for unbalanced cortisol and DHEA?

Lara Frendjian:

So the lifestyle will help. Potassium, sodium, magnesium are your friends for cortisol, balancing your cortisol, and lifestyles shifts for the ones that we can’t, or are having a hard time or they’re having these reactions, these cortisol spikes. So we will do some saliva testing through the Dutch hormone test. And for some of them are spiking, cortisol spikes, and then it spikes further and that’s not supposed to happen. It’s supposed to come down through the day. So often changing our lifestyle will help. It’s like looking at what is your morning look like? What are you doing? Are you having coffee on an empty stomach? Are doing a HIIT workout first thing in the morning?

Lindsey:

High Intensity Interval Training?

Lara Frendjian:

Exactly. Thank you. Are you staying up late at night watching TV or scrolling on your phone and you’ve got this blue light infiltration in your life? Truly I find these lifestyle interventions, they it sounds like oh whatever, I’m not stressed. They have a profound impact on our lives. They have a profound impact on how we sleep, how we feel, how our digestion functions. The way that we live today is the most abnormal way of living, in the walls with heat and without sunlight, without stepping outside. We can go on for days now. A lot of us work from home; many of us don’t, but I work from home, my husband still works from home since the pandemic and this is our life. So we don’t necessarily have to step outdoors. But we need access to air and natural light and all of that. So it’s really being aware of your day and shifting things around. And it sounds very simple. It’s very hard to do. But once we do it, I find cortisol, DHEA – they all behave and we don’t need to do anything further. I do work with the adrenals and adrenal tonics and maybe some herbs that we introduced to the body, but bang for your buck, the best place to start is to look at your lifestyle. And just think back to if this was 150 years ago: What would I be doing? What would my day look like? We’d wake up with the chickens. We’d go outside, we’d feed our animals, we’d collect some eggs, we were forced to move first of all, and to go outdoors. It was just part of our lives. And we didn’t think about it and our lifestyle was very different.

Lindsey:

Yeah, so you recommend getting out in the sunlight first thing in the morning or doing some HIIT training?

Lara Frendjian:

Yeah, don’t look at your phone. First thing, for the first hour of every day.

Lindsey:

But isn’t that the same kind of blue light that wakes you up?

Lara Frendjian:

No, what should be waking us up is red light. So the sunrise is red light. So getting access if you can to that.

Lindsey:

I can’t remember the last time I’ve seen the sunrise.

Lara Frendjian:

Well and now we have red light machines that we can turn on to mimic that.

Lindsey:

I used to have a sunrise clock and it didn’t have a red light but it slowly got light because I couldn’t bear waking up before the sun rose. I felt it was so unnatural.

Lara Frendjian:

Yeah, it isn’t natural. And I don’t necessarily do that. I just don’t turn on my phone in the morning. It’s not on for the first hour, and I step outdoors. As soon as I wake up, I turn on my red light machine, it’s my best friend. It’s in my bedroom, I turn it on at night, as we’re getting ready for bed. It’s mimics basically sunrise and sunset.

Lindsey:

And is it a special thing? Or can you just buy a red bulb?

Lara Frendjian:

I think there are different wavelengths. And so there are companies, it’s still cheap, it’s $30, you could go by a red bulb and stick it in, turn it on in the morning, turn it on at night, before bed, and they’ve done some sleep studies and it improves the quality of your sleep. So I actually always start with the night before. So what are you doing before you go to sleep, because if we can improve the quality of our sleep, we improve all of our hormones, and a lot of women are coming to me for weight loss. If you improve the quality of your sleep, you will improve your metabolic rate. They’ve researched this, your detox pathways are clear at night. And there’s cancer-fighting cells that are scavenging during your sleep. So if you’re not getting good quality sleep, you’re really setting yourself up for things down the road, which you don’t want. We start at night. So don’t scroll on your phone, put the red light on, read, do some deep breathing, meditate, pray, whatever you do to calm down your nervous system, don’t have your TV in your room. Just keep your room cooler. And put the covers on. There’s research that starting with sleep is a really important piece. And then how are you starting your morning? If we could just get those two right, things function better during the day. Our mental health is better.

Lindsey:

I have a lot of folks who tell me, and I am a bit familiar with this myself, that they have trouble with waking up, maybe not so much in the middle of the night, but that’s also a situation, but waking up maybe just a little bit too early and not being able to get back to sleep. What do you recommend for people in that situation who’ve already done all the sleep hygiene things?

Lara Frendjian:

Looking during the day to make sure that they’re getting enough sodium, potassium, magnesium. Okay, that’s really important because if you’re waking up and you can’t fall back asleep, it doesn’t matter when, right? Three, between three and five I think in Chinese medicine is the liver hour when the liver is most active. And from a hormonal perspective, cortisol is just spiking when it shouldn’t or spiking a little bit too early. So is that what you normally see, when people are waking up between three and five?

Lindsey:

Yeah, I would say so.

Lara Frendjian:

Yeah. So cortisol is spiking too early. And what you want to do is make sure that you’re doing the other stuff, right, that lifestyle stuff that we talked about: changing your morning. The morning dictates what happens to cortisol later on in the day. What happens to cortisol and melatonin later on in the day. If you fixed up your night and you’re still waking up in a panic, going on your phone, checking your email, getting access to this nice blue light first thing in the morning, which is not nice, right? If the morning is messed up, that will impact you. Okay, so let’s say we clean up the morning. We’ve got a nice relaxed morning, we’re doing our thing, we’ve got a rhythm, you go outside, you’re walking or some breathing and red light and all of that. So it’s a nice calm morning, and a nice calm evening, then we look to see what’s happening during the day. Is your stress crazy during the day? Do you have any coping mechanisms, stopping, breathing, etc.? And then we look at the nutrients. Are you getting enough of the minerals that I just talked about? That usually does it, so if it doesn’t, then progesterone cream would definitely help. Because it could be progesterone and cortisol. And when progesterone is low, you feel a lot of the anxiety that we talked about before. And it’s really stressful on the body when progesterone is really low. So cortisol naturally spikes. And if that’s not helpful, then putting in maybe a magnesium bath, foot soaks, taurine. Taurine is a mineral that helps with relaxation, and it also helps with magnesium absorption. We have to be careful with it because some people are really reactive if their other minerals are out of balance. Basically magnesium moves way quickly and the taurine causes more heart palpitations and anxiety. So if you’re going to experiment with taurine, I would start with a little tiny amount. And I would try it in the morning to see if your body reacts well to it. If it does, then you can test it out at night.

Lindsey:

That’s good to know. And since you do the hair tissue mineral analysis, do you find that a lot of people are low on sodium?

Lara Frendjian:

Yeah, definitely, sodium and potassium are usually low. Magnesium, it’s a toss up, a toss up between being really low or they’re leechers, meaning it’s through the roof high. Calcium, magnesium is really high. And that means they’re just not . . .  magnesium is supposed to be inside the cell, intracellular, and it’s just leaching outside. So we have to do other things in order to help the body absorb the calcium and the magnesium. But yeah, so to answer questions, yes, usually nine out of 10 times sodium and potassium are both really low.

Lindsey:

And why would somebody not be absorbing magnesium?

Lara Frendjian:

Usually potassium. So all of our minerals work hand in hand. So if potassium is low, then their magnesium absorption rates are going to go down. And because of the deficiencies in our food, not only magnesium, but potassium, boron. Boron is a cofactor for magnesium absorption and taurine is a cofactor for magnesium absorption. So all of these things really work together, hand in hand. And then we see like nail breakage, nails not growing, osteoporosis, hair not growing and breaking and things like that.

Lindsey:

Okay, you brought up a topic that I’ve been struggling with for forever. My nails are terrible. I shouldn’t even admit this because this is like the one problem I can’t solve. I’ve solved every problem, but this one and I have tried every nutrient that I could possibly imagine to try and get them, well actually I haven’t really ever tried that hard on potassium. What do you think could be at the root of this? It’s not iron.My TSH is totally normal. But I do have Hashimoto’s but never had to medicate for it. Tried collagen, tried biotin, multivitamins, they just break and they’ve got lines, and they’re terrible.

Lara Frendjian:

So what I normally see helping with that is enough magnesium in the body. So enough magnesium supplementation.

Lindsey:

Taking 340 mg a day.

Lara Frendjian:

Okay, of what form?

Lindsey:

Glycinate.

Lara Frendjian:

Glycinate. Good. Next would be boron. So you would need some boron. And then finally taurine and possibly some vitamin K, have you done a hair tissue test?

Lindsey:

I did.

Lara Frendjian:

You did? Okay, how was your calcium?

Lindsey:

It was high.

Lara Frendjian:

It was – like through the roof high or?

Lindsey:

It was – I’ll open it up, and I’ll tell you. Might as well. Calcium: I was at 1190 on a reference interval of 300 to 1200.

Lara Frendjian:

1190. Okay, so you were just at the high end. So you weren’t through the roof, right? Like it wasn’t off the charts. Okay. That’s still too high. Right?

Lindsey:

Yeah. I cut back on the supplementation. Since I didn’t eat dairy, I was supplementing several times a day, so I dropped to once a day more or less.

Lara Frendjian:

You were supplementing. Okay. Okay. Unless I see calcium shell like through the roof high. . . Have you done it again? Have you repeated it?

Lindsey:

No, I haven’t.

Lara Frendjian:

Okay. So I’m very careful. I hardly ever recommend calcium supplementation, because I do know that once we balance the other nutrients, calcium behaves just fine. So vitamin K?

Lindsey:

I take K.

Lara Frendjian:

You do?

Lindsey:

I take K regularly. Boron was actually was sort of on the low-ish end of the scale, it was .25-1.5 and I was .38

Lara Frendjian:

Okay. Yeah.

Lindsey:

Magnesium was right in the middle of the range. Potassium was sort of on the low end, 8-75 and I was 20. Yeah, I was hoping that this was going to be the something was going to help me with my nails. So this whole thing and nothing really came out other than that my iodine was high and my iron was low, but this isn’t a good way to measure iron, right?

Lara Frendjian:

No, for sure.

Lindsey:

Hair tissue mineral analysis is not the ideal way to measure iron.

Lara Frendjian:

Neither is it for the other things, so I don’t rely very heavily on it for anything outside of the four electrolytes: sodium, potassium, magnesium, calcium. So those show up really well on the hair tissue test. Everything outside of the heavy metal, I’m not really looking at it. I’m just looking at it as, okay, is everything high? Or is everything really low? And generally, everything is low. So what I would focus on for you is making sure that you have the boron, maybe upping the magnesium and trying another form of magnesium. I know that it’s good to have different forms through supplementation.

Lindsey:

Like a threonate or a malate

Lara Frendjian:

I like malate and I like taurate. So those are the two that I like.

Lindsey:

I guess that would get you some taurine.

Lara Frendjian:

Yeah, some extra taurine. And then so I would start there. And then see if that’s enough taurine. I’m surprised. I wonder which K – yeah, we could talk offline. I could give you the vitamin K that I like.

Lindsey:

I’ve done the K2mk7 for a while and now mk4 is really the one I try and get.

Lara Frendjian:

Okay. So, okay, I’ll share a company that I like.

Lindsey:

You can share it online. I mention brands.

Lara Frendjian:

Yeah Lifeblud. I love Lifeblud products. They have got great products. My mom has osteoporosis. She’s extremely tiny. We are just very small-framed women in my family. And so osteoporosis is prevalent. We were doing the magnesium, we were doing the boron and then I finally put her K, and we’ve done vitamin K from other brands before and nothing helped. She is on some calcium supplements, very low dose. But I put her on the Lifeblud vitamin K, the drops, 10 drops, they’ve got two different forms. Her nails used to split. So they would just grow to a certain length and then just split down the middle in two; they no longer split. Every time she comes over she shows me her nails that are now growing. She’s in her 70s.

Lindsey:

So how many micrograms is that at 10 drops?

Lara Frendjian:

I don’t know. I’m not sure. I just follow the dosage that he recommends, which is 10 drops. And she’s actually not even taking it every day. I think she keeps forgetting but she at least three to four times a week she’s doing 10 drops. And she’s seeing the benefits. And with the boron though it did help the lines diminish on her nails and she’d show me you could see through her nails. But they would still split. Once we introduced the K, they no longer split.

Lindsey:

And is this boron doses like you would get in a multivitamin? Or is this like extra-physiological doses?

Lara Frendjian:

Three milligrams, you can start with three milligrams. Yeah.

Lindsey:

Yeah. Okay. I’ll try that. I’m like, if I could just solve the nails, everything would be. . . That’s probably an exaggeration. There’s always those tiny little things we just can’t quite fix in our health, even as we manage to help others.

Lara Frendjian:

No, I know. For sure. You know what, and we’re human. Right? These are human bodies that are imperfect. It’s okay. I say that. Because sometimes as practitioners, we feel this, we have expectations of our bodies to be perfect. And they’re not. But they are getting better and better and better. And that’s versus the opposite – 90% of the population is getting worse and worse and worse. 99%, right? As we age, we should expect things to get worse. That’s what the world tells us. But you’re not, right? You’re improving your health. And kudos to you. Yeah, Hashimoto’s . . .

Lindsey:

Yeah. So I think people find us because we’ve had the kinds of things that they are feeling or experiencing and they want to find somebody who’s experienced what they’ve experienced. Because it’s not just about how can we fix your problems, but how can we empathize with your problems as well.

Lara Frendjian:

Yeah, for sure, yeah, absolutely. It makes us better practitioners.

Lindsey:

Yeah. Okay, any final thoughts about your work with clients and all that and then tell us how people can find you?

Lara Frendjian:

Sure, I guess final thoughts is, I guess if you’re listening to this, you know, that you don’t give up on your health. And you don’t want to throw in the towel. I just want to encourage people that there is hope. I find the body is like holding its breath, giving you all these signals for help. And it’s like holding its breath just waiting for you to give it what it needs. And then once you do, it starts to thrive, and I work with women in their 40s. And a lot of people feel like as things shift and are getting worse and we’re told that, oh, we’re just going to grow old and it’s downhill from here. It’s really not. I’m 47. And I feel better than I did even in my 20s. I can honestly say that I have more energy and more vitality, I have a more positive mindset. So there’s just hope. And it just takes a little bit of time and a little bit of guidance from the right people. And it’s trusting that your body can heal, and trusting the practitioner that you’re working with, that they can guide you down the right path.

Lindsey:

Okay, and where can people find you and your work? Do you work with people one on one?

Lara Frendjian:

So I work with people in a one-on-one setting. I have also courses that they can go through on their own. So different ranges of products, depending on where your budget is, and where your time is. They can reach me on my website, nutritionherway.com, as well as on Instagram and Facebook. And I do offer free weekly trainings on where to get started every Thursday, from 1-2 p.m. Eastern Time and it’s just to help you get started on your health wherever you are on your journey.

If you are struggling with bloating, gas, burping, nausea, constipation, diarrhea, soft stool, acid reflux, IBS, IBD, SIBO, candida overgrowth, fatigue or migraines and want to get to the bottom of it, that’s what I help my clients with. 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 3- and 5- appointment health coaching programs 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. 

Schedule a breakthrough session now

The Effect of Stress, Sleep and Food Sensitivities on Gut Barrier Function with Reed Davis, HHP, CNT

The Effect of Stress, Sleep and Food Sensitivities on Gut Barrier Function with Reed Davis, HHP, CNT

Adapted from episode 115 of The Perfect Stool podcast with Reed Davis, HHP, CNT, Founder of Functional Diagnostic Nutrition® (FDN), and edited for readability.

Lindsey: 

So why don’t we start with, what is Functional Diagnostic Nutrition?

Reed Davis: 

Well, it’s a name I gave something I had been doing for 10 years. When I first started teaching again, after spending 10 years in a clinic, I put a course together finally, by popular demand, and had to call it something, so I just dreamed it up. Functional: is very functional, it’s all about how we function. We use a lot of lab testing for function, how are things working, etc. And then diagnostic in nature, but never medical diagnosis. So that’s a bit weird, but functional and diagnostic in nature. Because we’re using data, we’re running lab work. And then nutrition because I was a nutritionist, nutritional therapist. And nutrition is included in our protocols, although it’s not all of our protocols. So it’s more like nurturing, but that would have sounded even weirder.

Lindsey: 

Okay. But the program is called Functional Diagnostic Nutrition and people can get certified in that?

Reed Davis: 

Yeah, we’re popularly known as FDN. And there’s a lot of FDNers or the practitioners really all over the world now. And again, I started teaching in 2008, I just needed a name, and now we’re stuck with it.

Lindsey: 

And is this in addition to studying something else, then people add on this certification? Or is this the entire course? Can you do this course?

Reed Davis: 

That’s a good question. So most of the graduates, it takes 10 months, I can teach you what I learned in 10 years, took me 10 years to learn, in about 10 months. It’s self-paced, so you could do less, but you know,  anyone could do it. And it’s the kind of thing that most people do have a college degree but not all, and you don’t have to. Some have a certificate or two or three or four in something, whether it’s nutrition or personal fitness and the things that go along with those certifications; people get more. And then this is kind of the coup d’état. You know, it’s an upleveling in every way.

Lindsey: 

Great. That sounds like a cool program. So we talked about maybe talking a little bit about stress and how stress can start the downward spiral of health that often terminates in gut health issues. Can you talk a bit about that?

Reed Davis: 

Sure. Yeah, it’s very popular and common to say, all disease begins in the gut. I think even Hippocrates, Muhammad, a lot of people said that, but I found that it actually begins with some stress, or some possibly hidden stressor, possibly the stress doesn’t exist anymore. But it has started this downward spiral that circles around to the gut so often. That’s why we think disease begins in the gut. But I can show you on paper, you know, with the lab test, how stress in its various forms causes breakdown, causes what we consider a catabolic condition. So it throws us out of balance, and the body starts to break down. And I can show you a progression, various of these downward spirals, again, on paper with the lab testing, and it does circle around the gut, the immune system and digestion and things like that. So we get a lot of symptoms and disease processes are going in that area. But when we get out of balance from anabolic to mostly catabolic, then that’s when the body starts to break down.

Lindsey: 

And can you dig more into the actual details biochemically of what’s going on?

Reed Davis: 

Yeah, well, for 25 years I’ve been using, we just call it a Stress and Hormone panel, because it looks at the major stress hormones, cortisol and DHEA. And these are both made in the adrenal glands and they counterpose each other, one is a kind of counter balancer to the other. Well you need both, so your body’s supposed to break down and rebuild. That’s how we get rid of old cells and get new ones. So there’s catabolism, which breaks down, that’s measured by cortisol. So if your cortisol is elevated, you may be in a catabolic state, unless you have enough DHEA, which again, is counter regulatory, which will be building you up. So you’re breaking down, building up, breaking down, building up. And so it’s cortisol and DHEA. When we see those out of balance, and especially in cortisol dominance, well, we know that you’re breaking down and guess what the people who come to us for testing feel like? They’re breaking down. So it totally correlates. We call that clinical correlation. And it’s very, very important in our world, Lindsey never to treat the paper. It’s not about the paper. That just tells us something about a person, and it’s about that person. And so from there, there’s lots of downward spirals that can occur. One that’s obvious and by the way, we measure on the same test, which is saliva, which is done at home in the convenience and safety and you know, it’s not expensive and things like that. A lot of what we try to use are self-tests. So this easy to use, not expensive saliva test gives us a catabolic to anabolic, but also will show us the sex hormones, the progesterone and estrogen, of course, the testosterone, and so on. You can bring it down as far as you want, but those three alone are pretty good markers. And they’re out of balance, in many, many cases, and guess what? Very high clinical correlation with how people are feeling. So finally, from a test result, people find that instead of a typical standard medical bloodwork, oh, nothing’s wrong with you, or your bloodwork looks normal, we actually see the subtle changes in the saliva, which is a bioavailable marker, or analyte, and we do it on every single person. And from there, you get into the other tests, there’s urine and there’s stool, and there’s finger stick, blood testing for all kinds of other functions that we would consider downstream from those that are kind of a measurement of stress.

Lindsey: 

So I have a question that I’ve been curious about for a while. I have done these tests, saliva, cortisol, you get the four spits, it’s like what 9:00, 12:00, 3:00, and something like that anyway. So there’s four spits, and then the DHEA-S. And what I’m wondering about is, what kind of test retest reliability is there? Like, if we did that the next day, are we going to find the same thing? Or what if they just happened to have a stressful day that evening, and then their cortisol is elevated?

Reed Davis: 

Well, there are instructions along with the tests to try to mitigate that potential. So you know, you will take an ordinary day, if there’s such a thing, not a day, when you have a wedding, and not a day after you got kicked out of your house, you know, some godforsaken thing. So you take a typical day, and there are patterns that are fairly reliable. But regardless of that consideration that you just mentioned, one day to the next, everything’s relative. So we don’t measure the tests in a vacuum. We measure them relative to a person and what was going on that day? So we might see a high afternoon cortisol, for instance. Well, if that’s going on every day, it would really tell us something important, like you’re eating something at lunch that you’re sensitive to, and your body’s reacting to it. Or your blood sugar is low; you’re eating the wrong food; your insulin is spiking and crashing and your blood sugar, cortisol kicks in to try to raise your blood sugar. These are the things that we know about. Because again, for 25 years, we’ve been studying the use of these labs, clinically; they’re not done in a vacuum. And you can’t say because one person had this, it means the same thing in the next person. You have to go back to the person and get clinical correlation. So while there are some variations, that’s a great consideration, Lindsey, very smart question. The answer is the test results are interpreted relative to that person that day. And I’ll say this, to summarize, everything, every client is a study of one. There’s no courts. There’s no lineup 10 people and that’s fine. There’s you and your test results. And does it relate? Does it tell us anything about you? And so that’s why we use it, saliva, because it’s bioavailable in the moment.

Lindsey: 

So will you typically ask someone to record anything about their day that they do that test? Because I often send people off to do tests and then I don’t see them for six weeks. So by the time the test comes around, they don’t remember what they did or didn’t do that day.

Reed Davis: 

Well, likely, you want that person to jot down some things. As a matter of fact, some of our tests, we do even have journals. They ask you those questions. So yeah, they include a questionnaire, we have our own questionnaires. And so it would be appropriate to do that. It isn’t always done. Six weeks is a long time. We’re looking at usually to get all of our labs back in about three weeks, sometimes four, because we don’t run just one test on anybody; that just wouldn’t tell you enough.

Lindsey: 

So we talked about then the DHEA and the cortisol, so say that gets dysregulated, how does that then lead to gut health issues?

Reed Davis: 

Oh, it’s quite interesting how that works. So when you’re catabolic, you’re likely going to start losing the mucosal barrier. So matter of fact, cortisol suppresses secretory IgA, that is the main immunoglobulin, main defense element in the gut. It’s very abundant; it’s there to protect you. And that layer, we call it the mucosal barrier, gets very thin and it loses its ability to fight against those things that we want to fight against. And so yeah, you measure that actually on the same lab test. So the secretory IgA is included in our saliva test. These are tests we developed over the years that we asked labs to do for us. Say we want the secretory IgA on there. We also want melatonin on there, which is another hormone that comes into play, all these things are in play to some degree or other. Remember, this is really important as us we’re not looking for a medical diagnosis; we think people have had enough of those. And so instead, we want to find out just what are the healing opportunities? What are the opportunities? What can we do together with our clients to improve things? So these are not, they don’t reach the threshold of a medical diagnosis. And again, many people are told you don’t have one, you’re not a medical case. And I might add, yet.

Lindsey: 

So what is the name of the test then that you do and whose test is it?

Reed Davis: 

So we use Fluids IQ, we just call it the Stress and Hormone Panel. Fluids IQ is the name of the lab out of Canada. They ship their kids everywhere. They have catered to us to some degree with adding markers, adding analytes that I think are very important in all my experience.

Lindsey: 

The Fluids IQ Stress and Hormone panel. And does that include sex hormones, as well?

Reed Davis: 

Oh, yeah, cortisol, DHEA, testosterone, progesterone, estrogen, secretory IgA (sIgA), melatonin, all on one easy-to-do, at-home lab test kit tells us a lot about you. Does it tell us everything we want to know? No, the idea is to run tests that cover an entire constellation of healing opportunities. Because again, you’ll run up to people who, “Oh I ran a test like that, I ran it”. And you’ve worked on that one thing, but it didn’t work. Because the way stress works, it’s multi causal, multifactorial, and these multi causal factors weigh upstream, sometimes, sometimes really far upstream, happened a long time ago. And all of these causal factors are having an effect on each other. And that’s not even measurable, sometimes not singly. And so you have to get the whole constellation. So hormones, yeah, for sure. The immune system. Yeah, we talked about sIgA. But there are other immune system markers. And those are on the other tests. So hormone, immune, digestion, detoxification, and some other things, we want to get as many healing opportunities as possible and sorted all out, give people the things they can do at home, an epigenetic lifestyle program that will make improvements to every cell,, tissue organ, system in the body. Why single one thing out? We know that certain diagnoses: “Oh, I found your problem”. Yeah, right. You know, you found a problem, you think a marker that’s out of place, and you can treat the paper if you want to, the person might even feel better for a little while. But if you don’t address all of it, which is our job, then likely those same symptoms will come back. You have to increase dosage on the medications and different things, the symptoms will come back, or new symptoms will appear. And that’s just another endless cycle. So we want to end the cycle of trial and error by getting a very comprehensive outlook.

Lindsey: 

So when you see that decreased Secretory IgA are you approaching that by starting with addressing the adrenals? Or are you dealing with that directly? How do you how do you handle that?

Reed Davis: 

Well, our protocols address every cell, tissue, organ, system at once. And so it just gets swept up in the lifestyle and epigenetic program. But that, in particular, if it’s low, what does that mean? Well, it means your mucosal barrier likely is worn thin, and you don’t have the same immune system you used to. But what if it’s high? Ah, different problems, more like a current infection, something it’s responding appropriately to some offender, some overgrowth, bacteria, parasite, something, and it’s actually responding quite appropriately. So high or low tells us different things about that person, and indicates a certain course of action. Where that person could self-treat, we hope, or sometimes we send people right back to their physicians. Say, hey, you doctor missed this. So let’s go see what that doctor says about it. And if they recommend something, we might concur. Might want to go more natural. Who knows? It’s all up to the person.

Lindsey: 

Yeah. So what kinds of other tests then do you like to do with your patients?

Reed Davis: 

To get the entire or not the entire, but a big picture, the constellation? If I showed you two stars and said “What constellation is it?” You’d say “I don’t know. It depends. Where’s the other stars?” So we want to get as many as possible so we can actually look at hormone, immune, digestion, detox. You’ve got a lot of room for improvement here; we identified numerous healing opportunities. And now we can set forth on a path that would correct all of it. As long as there’s no downward spiral that’s really contracted, which is where doctors fit into the picture. So they fit in very nicely. If the downward spiral is really contracted, if there’s time, then we expect your body will heal. It wants to; there’s an innate intelligence, and we would play to that let’s coach up function, while we cut down contributors to what I call metabolic chaos.

Lindsey: 

So which specific tests do you order?

Reed Davis: 

There’s the Mucosal Barrier Assessment, the Metabolic Wellness Panel, and there’s a GI Map stool test*. And there’s a food sensitivity test. And along with this Stress and Hormone Panel, that’s five really good panels. And you know, it’s an investment in the lab work, we can’t help with that cost. We work with good labs who have reasonable prices, we think, and no one makes money on lab work, not us, we simply charge you for the interpretation on top of that.

Lindsey: 

Right, whose test is the Metabolic Wellness Panel.

Reed Davis: 

So for that, we use Fluids IQ as well. And that’s a urine test. So it’s got three main markers on it, urinary bile acid, sulfates, it’s 8OHdG, which is eight hydroxy deoxyguanosine. There’s a mouthful; that’s why we call it 8OHdG. So and then indican, which is a really good old test. And when I say indican to some practitioners, they go, “Wow, I forgot about that test.” So I learned it in school and we never run it. While your doctors could all run it in their office if they wanted to. It’s a simple urine test. I don’t know, when I was a kid, we used to give the doctor some urine and they do it in in-office testing. Now there’s none of that; it’s all farmed out, you know. So it’s pretty interesting. Well, there’s not as much of it as it used to be anyway. And they don’t do anything anymore. That tells you if you’re breaking down protein or not to bacterial action, in order to break down, absorb protein, whatever you’re eating, the protein needs to be broken down by bacteria, in addition to the pepsin and the hydrochloric acid in the stomach. Going into the small intestine, you need this bacteria breakdown to get proper absorption of protein, and protein is where you get your amino acids from. And by the way, that’s what makes neurotransmitters. You know what neurotransmitters are made for. So there’s a whole long, again, downward spiral or chain of events, list of symptoms that can occur just from having positive indican. And it’s great, it could indicate dysbiosis; you don’t have enough good bacteria to get proper digestion. So that’s remember I said hormone, immune, digestion. And by the way, that tells you there’s something going on with your immune system too, because now you don’t have enough good bacteria. And you have an abundance probably of the unwanted bionts. And then from there it just goes worse if you don’t find it up and do something about

Lindsey: 

Oh, sorry, I was just going to ask what the name of the immune test was.

Reed Davis: 

Well, the secretory IgA is a really good marker that’s in the saliva test. So now you’ve got it. You got a couple of markers now with the indican. Now you add the 8OHdG. That’s a measurement of oxidative stress. There’s lots of things going to be oxidizing; lipid peroxides would tell you if you have oxidization of cell membranes, which is never a good thing. Then there’s also on that test urinary bile acids. Now if those are in excess, you likely have spillover from the liver of the bile acids, telling you you’ve got a congested liver. Haha, now we’re looking at detoxification problems. So you’ve looked at hormone immune, digestion, detoxification, and you can we do it on every person. It’s a little finger stick. So you just prick your finger and you drip some blood to a blotter. It dries, you send it into the labs, not expensive. And that will tell us. We look at the zonulin, we look at histamine and the diamine oxidase or DAO, and the histamine to DAO ratio is very important. So this tells us more about that mucosal barrier. So we’re looking at stress, looking at ooh, that’s your immune system sliding down. That’s affecting digestion and the liver is getting congested, especially if you have that high zonulin and leaky gut kind of a thing. And the mucosal barrier is further breaking down in that your villi are atrophying or the crypts are becoming swollen. We call it crypt hyperplasia. So you get an unhealthy situation, lots and lots of healing opportunities. And that’s just three simple tests one saliva, one urine and one finger stick.

Lindsey: 

What’s the finger stick test called?

Reed Davis: 

Mucosal Barrier Assessment.

Lindsey: 

Okay, is that also a Fluids IQ test?

Reed Davis: 

That’s Fluids and that’s the three Fluids tests we use. They’re a good foundation to find out what’s really wrong so that you can go about fixing it.

Lindsey: 

Okay, and then there was a GI Map, which I’m well familiar with. And then what was the last one called?

Reed Davis: 

The Mediator Release Test or MRT for food sensitivities, just for 172 foods. So why would you run that? Well, because you’ll never heal the gut, and reduce your stress markers back to normal, which by the way, regulates blood sugar, and a lot of things, insulin levels and things. So there’s a lot of connectors, we care much more about connecting the dots than the dots, we don’t single one or two or three out and say, oh, here, take this for that and take this for this.  No, it requires looking at it in concert. It just works. It outperforms every other system. It’s why it’s so popular. So those three tests tell you what’s wrong. The other two, that GI Map tells you what else is going on inside the gut microbiome and you can find parasites, bacteria, funguses, even test for a couple of viruses. And then the microbiome itself, the balance between certain families of bacteria need to be highly balanced. So that the dysbiosis you found on the urine test is actually identified, further speciated to some degree with the GI Map, which is a stool test. So far, we haven’t had to go for a blood draw and get our veins poked. And then the food sensitivity test, the really good one does require a blood draw. But there’s all these drive by vampires, I mean phlebotomists, who do the at-home blood testing, come out and help you get the kit done.

Lindsey: 

Yeah. So I had heard of the MRT. And I’ve never used it with anyone. I’m curious, are you at all concerned if somebody is doing this testing initially, that if they have a leaky gut, they’re just going to have everything they eat show up on it?

Reed Davis: 

No, it’s really surprising. That’s true with certain tests that they’re IgG or IgA or something like IgM, might be elevated to an awful lot of things that aren’t really a problem. There’s all these cross-reactivity possibilities. The MRT is a completely different form of measurement. So Mediator Release Tests aren’t as dependent on that as some of the other tests. That’s why we prefer it. There’s always green foods. So that’s the good ones. There’s green, yellow, and red. You avoid the yellows and reds, but we try to get our clients to focus more looking on the green. There’s green vegetables, there’s green fruits, there’s green forms of produce, and it even measures condiments and spices and things and it’s really valuable. I’ve seen people completely turn around. And I would attribute a lot of it to that one test. I mean, talking about almost miracle, I can’t use the word cure and don’t want to, but turnarounds, kids, oh my goodness, so much. And by the way, you say it can change a bit, and as you get heals, you may have a few less sensitivities to answer your question a bit. And I’ve tested people who are on immunosuppressants, you know, for joint, skin, and other problems, and it will throw the test off, certain tests. It’ll look like you don’t have a lot of sensitivity because your immune system is being suppressed. So that’s another reason we like to use MRT; it’s not as affected by those kind of medications.

Lindsey: 

I think one of the things maybe my hesitancy in ever using it was that it was, I think it was pretty expensive compared to some of the other ones, which I also don’t use, IgG tests, but also that I think you have to go through a dietitian or somebody who’s . . .

Reed Davis: 

It’s expensive if you go the retail route, but the lab fee for practitioners actually, I think is reasonable. You know, I always say to people, if you think getting well is expensive, try staying sick. Because the loss of work and the unhappy –  having no joy in one’s life – to me is way too much of a price to pay.

Lindsey: 

Yeah, I often say this to my parents who I test and advise yearly on what to do and not to do as they’re in their early 80s. And I keep getting push back because they’re so used to the regular medical model that they followed their entire life, especially for my father, and he’s like, “I don’t want to take any more than seven pills at any one meal.” You know, it’s like “Yeah, okay, but how about stop smoking a cigar a day, drinking three drinks a day?” You know, you might have to take some pills to make up for the lifestyle habits you’re insisting on continuing.

Reed Davis: 

With you 100%, I used to work with my parents, my father passed away at 85; but my mom is 93 and still living well. And I say, well, she’s the one that listened to me most.

Lindsey: 

Well, that’s what I say. I say, how much is your life worth? And it’s amazing that you’ll still get pushback like, well, if I have to live like this, it’s not . . . I’m like, “Really? Really? Like swallowing two swallowfuls . . . “, cause he can toss down four or five pills at once, like “two handfuls of pills is not worth a year of your life?”

Reed Davis: 

Yes. And, you know, if you eat really good food and supplements, you can really supercharge the process, the healing process and the maintenance, you know, there’s just not enough nutrition in food anymore. The food is grown in depleted soils so you’re not getting  – you need vitamins, minerals, essential fatty acids, antioxidants, phytonutrients, trace elements, and whatever else is in there. And that’s a mouthful there. It’s not in the food. So you can only supplement, you get all that. And by the way, if you’ve done the lab work, you have a much better idea of what would be helpful, right?

Lindsey: 

Right. Of course. No, I’ve heard that said a lot. I mean, I listen to all sorts of health podcasts and I have a little bit of a push back in my head, which is okay, but what if you’re buying the best quality, organic foods? Is the soil depleted there too? Aren’t they composting? Aren’t they doing what you’re supposed to do?

Reed Davis: 

It’s hard to figure, if you know, the farmer, you know, that’s one thing. But the reason we buy organic food in the grocery store is mostly to avoid the herbicides and pesticides and the bad things. So if for no other reason buying organic, you’re avoiding the chemicals. And that alone is worth paying the extra to buy organic. But are you getting much more nutrition? It’s pretty hard to say because we don’t know who the farmers really are. We know that they can’t use the poisons. And that’s good thing. But is it enough? I don’t think so. I mean, I eat organic. Just every time. I mean, my wife and I are very meticulous. we will not eat the food if we think it has poison on it. But also, even you can take that to a step further, like seed oils and things. We have a problem with labeling. Sometimes on some of our products, especially in restaurants, you can’t figure out what they’re using to cook with and things that are not very good for you. So can I give your listeners a tip? It’s an app, I have it on my phone right here. It’s called Seed Oil Scout or SOS. It’s in the app store. There’s a free version. And it will tell you, you can punch in your favorite restaurant and it will grade it in terms of seed oil. Why do you care about that? Because we’re eating way too much Omega 6 in this country, versus the Omega 3s. And this 6 to 3 ratio is critical for long-term longevity. It’s not going to show up tomorrow or the next day, or even this year. But year after year, you start getting the cardiovascular disease and other problems. So that long list of other long-term markers on top of what I just told you about the more immediate need healing opportunity markers are very critical in our world.

Lindsey: 

Yeah. So talk a little bit about Omega 6s. So I run on a lot of people Metabolomix or NutrEvals. And so I see their omega 3s and Omega 6s and I have noticed this phenomenon over and over where at some point they went on omega 3s maybe, or maybe I see that they are short on omega 3s. And I suggest that might be a supplement they try. And so they do that for a bit. Then they take the test. And then I see the Omega 3s are way high. And now the Omega 6s have gotten pushed down because they’re trying to do everything perfectly. They’re staying away from the seed oils, they’re eating nothing but extra virgin olive oil and eating avocados or maybe avocado oil. And then all of a sudden their Omega 6s have tanked. So what’s the balance? What’s the perfect ratio for the person who’s just trying to eat healthy, who is not like severely impacted? Like what is the right balance?

Reed Davis: 

Yeah, the right balance will be less than four to one ratio of omega 6 to 3. So these are fatty acids that are essential. You have to have the polyunsaturated fatty acids or PUFAs. And the ratio again, you just take the six divided by the three and that’s your ratio. So if you had a four to one or three to one ratio of 6 to 3 you’re in good shape. People in America walk around with 10, 20, 30 to 1 ratios; this is not good. They say the Western diet’s approximately 15 to one. And we have seen much worse because of the processed foods, which are rich in these vegetable and seed oils. And so testing that can lower your risk for a lot of chronic diseases, but very high prevalence of cardiovascular disease, even cancer, all kinds of inflammatory and autoimmune things. You can reduce your omega 6s by eating less seed oil. But you can’t avoid them completely, because they are in food.

Lindsey: 

Right, they’re in meat.

Reed Davis: 

So you’ve got to increase your omega 3s and you could do that through fish, seafood or supplementation. I think everyone, and I take two capsules every single morning, little pearls. And I just want to make sure my omega threes are up there.

Lindsey: 

So I like the Nordic Naturals ProOmega 2000*. So each one is basically 1000 mg of EPA and DHA in one pill – pretty well balanced. And I find though if people are on two of those a day, that their Omega 6s start getting pushed down. And mind you these are not people who are eating a lot of processed foods, like by the time they find me, these people are already on almost the perfect diet. Most of the people I see they’re already eating all unprocessed food, they’re not . . . you know if they’re going to restaurants, it’s probably higher quality restaurants, or not often. So they’re not eating the processed food, the standard American diet. So I’m trying to figure out what’s the . . . and then I’m telling them okay, if I first see them, I say yeah, so avoid the seed oils. But then it gets to a point where I’m thinking they actually need some more omega 6s. So it’s like, well, should you cook with canola oil every fourth day or you know, what’s the balance?

Reed Davis: 

You can get tested, we don’t guess, we test, right? So there’s a good place if you’re having trouble. It’s called Sunbasket.com. And anyone can go to Sunbasket.com and they ship you the food in little bags. You make it yourself.  Meals can take 20 minutes or up to half an hour because you still, if it comes with an onion, you still have to chop it. But it’s everything in balance. And it’s all fresh, and it’s all organic. And it’s all pretty balanced in terms of these, no cheap seed oils and things like that – these things go rancid by the way. And they’re just very good. So they’re paleo. You can also get the vegetarian or gluten-free, keto-friendly, Mediterranean-friendly; you can get the pescetarian version and only eat fish if you want. Personally, I like a full broad spectrum of foods and it’s all fresh. So you can get it down to about five bucks a serving. So if you’re cooking it for a family of four, you can have really good meals. The order, remember it comes fresh, not frozen. But they ship it right to your door. You get two or three days’ worth, four days’ worth, five days. You can cook it all at once. And of course cooked food lasts a lot longer in the fridge.

Lindsey: 

Cool. hadn’t heard of that one.

Reed Davis: 

Your kids can be pulling it out of the fridge in your little containers. We use glass. It’s got a plastic top but it’s glass and you can pop that right in your little micro – we don’t use microwave in our house but we put it in the little oven thing.

Lindsey: 

Do they recollect to those glass containers from you or?

Reed Davis: 

No, no, it comes in plastic. It comes in bags.

Lindsey: 

Oh, you reheat it in glass?

Reed Davis: 

What I’m saying is we’re preparing two or three days in a row on say a Sunday. You cook Monday, Tuesday, Wednesday’s meals and you put them in glass and you put them in the fridge and you can pull them out. The kids could if you’ve pre-prepared it, come home from school and eat really good, nutritious food instead of whatever else they might be wanting to eat. You teach them. And plus, they can participate in the making of food. It’s actually pretty meditative. You know, it’s good for you feel like you’ve accomplished something.

Lindsey: 

Oh, yeah, I’ve taught my children how to cook. My youngest was making meals for the whole family by I think 13 or 14. He would do one meal a week.

Reed Davis: 

Wonderful. Yep. You just need to have seven kids so that you never have to cook!

Lindsey: 

Well, we had a down to a science. Well, we had four meals, each of us did one meal a week and then we would go out probably once a week and then leftovers and maybe at a friend’s or something. So it worked out.

Reed Davis: 

Yeah, I know. We eat out a little bit more often, but not much.

Lindsey: 

Yeah. So if somebody does have a co promised mucosal barrier, from what you can tell, what kind of supplements or approaches would you recommend?

Reed Davis: 

Yeah, so we have what we call a DRESS for Health Success System. Matter of fact, I think we could give all your listeners a free booklet on the DRESS for Health Success System if they want. DRESS stands for diet, rest, exercise, stress reduction, and supplementation, DRESS. So if you eat right, the right diet for your type, we have a way of figuring it out, diet, and you rest, you know not just sleep, but during the day, if you need to rest your emotions, your mind, whatever you need to do, we teach you some techniques for midday. You know in Italy, they do siestas, because it’s good for your soul, not just because you got up too early. And so diet, rest, and exercise goes without saying. And then the last the two S’s are stress reduction and supplementation. Stress reduction is too big to go into. Now, I’d love to spend a whole show on it sometime. Because it’s so ubiquitous, there’s so many different kinds of stress. And the body doesn’t care what kind, it responds with the stress response, whether it was a mental, emotional, psychospiritual, whether it was bad food, or you got punched in the face, or a car accident, or these chemical stressors like new furniture or something. So you got all these stressors, and you got to handle them, learn about how to sort them out. So you got diet, rest, exercise, stress reduction, finally, then supplements would actually have a good chance of helping you when you’re doing other things, right? If you’re trying to supplement your way to health, it’s not going to work. If you try to supplement, you have a bad habit. In other words, well, yeah, I like to eat gluten, you know, I’m allergic to it. But I’m going to take my Gluten-ease – it doesn’t work. So supplements are applied intelligently for the nutritional needs, but also to support for maybe a short period of time, certain systems or organs, or to stimulate, like, if you’re going on a trip, take some immune support with you. Because you’re going to get exposed to bacteria your body might be a little sensitive to. So you can substitute for what’s not in the food anymore. You can stimulate like the immune system, you can support your adrenals or your digestive system. And you can even self-treat with, they’re not really supplements, but they’re available in the same store, self-treatment for parasites or bacteria or fungus or these kinds of things. So there’s four reasons to take supplements.

Lindsey: 

And so supplements for a leaky gut? Oh, yeah.

Reed Davis: 

So we want to coach to up function. So the gut needs a lot of circulation, it needs some immune support, it needs some soothing, and things. So we want to support the proper function. So there’s all kinds of ingredients for that. I use a product from Biomatrix called Support Mucosa*. What a name, think of that. And it soothes and helps the healing process. But you also need something and maybe coach down the bugs and dysbiosis and the biofilms that might occur. So it just depends what we see in the test results. So Coach up function, coach down the contributors to metabolic chaos, and you’d be in pretty good shape with anything that you’re looking at. We don’t like the word treatment; we like to say support, you know, coach up function. When it comes to the gut, you got to run a test and get rid of the bad foods, they’re irritating. So if you’re going to keep eating the same way, your supplements aren’t going to be as effective. Diet is really a key there. And so is exercise or reduce exercise. People exercise too much, believe it or not. And so there’s lots of ways to look at DRESS, regardless of what the main complaint is, like leaky gut or irritable bowel or migraines or psoriasis, or ADD in kids. I had a kid once, I’ll just tell you a quick story. So with the lady, he comes in the office, and she says “Reed I’m just curious, do you work with children?” I raised four kids, I’ve been coaching football for 15 years, and I work with kids. And she goes no, I mean they’re trying to send my kid home from school if I don’t put him on drugs. They say, back then it was Ritalin, was the drug of choice for bad behavior. And this kid was poking the other kids and disrupting the class and hey, put this kid on drugs. The first thing I said really was, well, was this a medical person at the school, nurse at least? No, just the teachers and principal are diagnosing and recommending treatment to a mom, which I thought was pretty not very good. But I said I don’t know if I could help her out. Let’s run a couple of tests and see. After we got the results, changed some things, by the way this kid was nine, they wanted to drug a nine year old. And the parents were about to do it. Yes, the thing is, well, what do you do? So, you know, they’re desperate. And within three weeks, I’m telling you within three weeks, I got a call, the principal of the school tracked me down and said, you know, Mr. Davis, tracked me down with through the Mom, “this is a different kid”. He’s paying attention. He’s not poking around the other kids. He’s not disrupting classes. He’s actually paying attention. And then he said, “What did you put him on?” We were not getting anywhere with this guy. He just wanted to know what’s the magic pill.

Lindsey: 

And what were the big movers for him?

Reed Davis: 

The big movers were the food colorings. Some of these foods and food colorings and the sugar and all the crap, the chemicals and preservatives, were neurotoxins to this boy, exciting his nervous system, and he couldn’t come out of sympathetic dominance. For one thing. He also had other irritation, again, the nervous system acts where there’s probably some inflammation and things going on, and some gut issues and stuff like that. We also got him going to bed on time, you know, some disciplinary things. But in three weeks, I got a call “What did we put him on?” I said we’re putting him on a better lifestyle. And he didn’t “well that doesn’t . . .”

Lindsey: 

. . . didn’t want to hear about that. Yeah, well, you’ll love this. What I used to do, my previous job, I started a nonprofit in Montgomery County, Maryland, outside of DC, and one of the largest and most prestigious school systems in the country, in order to change the school food, it was called Real Food for Kids – Montgomery. And we got them to remove all the artificial colors from the school food.

Reed Davis: 

Oh, my goodness, yeah. Well, good for you. And that is a step in the right direction for sure. Hopefully, they got rid of the sugar too.

Lindsey: 

Oh, I tried so hard on the sugar, let me tell you, but until the USDA, or the FDA, well, until they change the labels, which they finally did. Now they show the added sugar on labels. That was a key mover because you have to be able to somehow actually track what’s added vs. naturally occurring sugars in order to then say, okay, we want you to limit. But what was happening was, if you added it all up, the kids were getting something like 10 teaspoons of sugar in a typical school breakfast. So like on a bad day, maybe where they served, of course, they served juice, but it had to be all natural juice. So only naturally occurring sugars there, but they would serve of course the flavored milks with added sugar, chocolate and strawberry typically. And then cinnamon roll, and then a pack of Craisins that by itself had five and a quarter teaspoons of added sugar. So that combo. And so they’d already had more than the maximum recommended daily allowance of sugar in their school breakfast already.

Reed Davis: 

You know, I totally get it and you’re doing fantastic work. And just another quick one. I had a patient coming into our office who was a principal of five Montessori schools, so five private schools for kids. And she went to one each day that week. And she started sitting in on the disciplinary meetings between parent, teacher and kid. And she just started asking one question of the kid. And the question was, what did you have for breakfast? These were disciplinary, like bad kids, you know, kids doing this or that or whatever, call the parents and try to correct the behavior. And what did you have for breakfast? What percentage do you think was sugary cereal?

Lindsey: 

Oh, probably 95%.

Reed Davis: 

100%. They’re eating Pop Tarts or Cocoa Puffs or, you know, whatever they’re eating today. I don’t know. But it’s bad. And actually, that was 20 years ago. So isn’t going away, this problem. And if you ask my 93 year old mom, what’s your secret to longevity? She goes, no sugar.

Lindsey: 

Good for her. I can’t get my parents to listen to that one.

Reed Davis: 

Well, she says that, but then I see a box of chocolates in the freezer.

Lindsey: 

Hopefully it’s 70% at least.

Reed Davis: 

Yes, she knows about that. She’s still drives for gosh sake. Yeah, she’s funny.

Lindsey: 

Okay, one more gut health question. So do you take an anti-microbial approach or something more conservative when it comes to things like SIBO or IMO?

Reed Davis: 

It’s just blown up dysbiosis and there’s questions about the source, how’d you get it? But it’s not a test where there’s any kind of speciation whatsoever. They don’t know what the bugs are just plenty of bugs, you know, bacterial overgrowth. So I think it’s really important to dive in little deeper, and you can self-treat, you can, remember what I said, coach up function while you coach down the contributors to metabolic chaos. So, like overgrowth, bacterial, fungal or parasitic and these things, biofilms occur. They develop over time where they all kind of get together in a big orgy and move up and down around inside your small intestines. And they also produce toxins, so lipopolysaccharides, you know, so they’re toxic. And so you have a lot going on. And so to say, what’s the one remedy? No, but coaching down bugs, we call them generally, is a good thing. Chase away the bad guys, while you support the element, the good things in this, the mucosal barrier, the structure and condition of the villi, and in between the little villi, the crypts are called. And there are tests that can tell you how those things are going before, during and after treatment. And as I said, if you’re not eliminating the food sensitivities, you’re missing out on a big opportunity for improvement.

Lindsey: 

So tell people where they can find you and find the program?

Reed Davis: 

Yes, sure. So well, you know that what we do is called FDN, Functional Diagnostic Nutrition. And so we have a website, it’s FDNtraining.com. So if you go to FDMtraining.com/theperfectstool that’s named after your program, then you would get a free booklet. And if they don’t give you a free book, hopefully it gives you something. Okay, we want everyone to learn about the DRESS for Health Success Program, simple steps for health success. Yeah. So you can you can get that book, download it for free.

Lindsey: 

And what about you? Do you practice virtually? Or are you in a one set location?

Reed Davis: 

No, I have a few hundred people I’ve trained to refer to. So I do that mostly. And I don’t see any one to one anymore. Although, if somebody got a hold of me, I’d give my best shot. The problem is that without the labs, there isn’t much to talk about. From the point of, yeah, there’s just not much to say.

Lindsey: 

So if they want to find an FDN practitioner, would they go to that FDNtraining.com?

Reed Davis: 

We’re about to add a list. But if they go to that URL, and sign up for the free book, and then follow up to that email, hit reply and say, “Hey, I’m really interested in in hiring an FDN in my area.” And really, we’re in 50 countries, we’re in every state, and at least every time zone and plenty of people to choose from. Right? And they’ll actually try to hook you up with someone whose work . . . so we have FDNs who are personal trainers, say young men 25 to 35, who work in the gym, and they help people get more fit and improve performance. That might not be the same FDN that a postmenopausal woman with weight gain and fatigue and irritable bowel would want to talk to. So we’ll help you pick somebody.

Lindsey: 

Yeah. Great. Well, thank you so much for your time. I really appreciate it.

Reed Davis: 

A pleasure. Good to be here, Lindsey and if there’s anything I can do for you, let me know, we’re always willing to come back and talk some more.

If you are struggling with bloating, gas, burping, nausea, constipation, diarrhea, soft stool, acid reflux, IBS, IBD, SIBO, candida overgrowth, fatigue or migraines and want to get to the bottom of it, that’s what I help my clients with. 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 3- and 5- appointment health coaching programs 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. 

Schedule a breakthrough session now

A Deep Dive on Hydrogen Sulfide SIBO: Symptoms, Testing and Treatment

A Deep Dive on Hydrogen Sulfide SIBO: Symptoms, Testing and Treatment

Adapted from episode 114 of The Perfect Stool podcast and edited for readability.

I’ve done multiple other podcasts on SIBO and IBS, so do see episode 36: IBS Treatment: Addressing an Irritable Bowel Naturally and Episode 83: Recurrent SIBO: Symptoms, Causes, Testing and Treatment for an in-depth treatment of all types of SIBO and IBS, but today, I’m going to focus on hydrogen sulfide SIBO (H2S SIBO).

You know how when you learn a new word, all of a sudden you hear it being used all the time? That’s kind of going on right now with me and hydrogen sulfide SIBO. It kind of feels like everyone I’ve seen lately has suspected or diagnosed hydrogen sulfide SIBO. And it’s funny because before now, it wasn’t that common in my experience.

But I’m starting to recognize the type, and if I had to say one thing that tells me that someone might have hydrogen sulfide SIBO, other than a positive breath test or a stool test showing elevated levels of hydrogen sulfide producers or what are called sulfate reducing bacteria, it’s how miserable they are. From a painful, gurgling gut, known as increased visceral sensitivity, to bloating and distension, to excessive burping, to urinary urgency, a burning bladder or interstitial cystitis, to systemic inflammation, rampant food intolerances and often histamine reactions, my hydrogen sulfide clients are just some of the worst suffering. Other symptoms you might see include weight loss, post-prandial hypotension, meaning low blood pressure after meals, weight loss, an elevated heart rate, exercise intolerance, brain fog or insomnia.

Hydrogen sulfide overgrowth is also associated with ulcerative colitis, Crohn’s Disease, colorectal cancer and Parkinson’s Disease, so definitely not something you want to let fester.

And what I’m finding, surprisingly, is that some of my toughest cases of what I though was an overgrowth of methanogens, is in fact an overgrowth of hydrogen sulfide alone or in combination with methanogens. This is because while the overwhelmingly common presentation of hydrogen sulfide is diarrhea or loose stool, it can also present with constipation if there’s an overgrowth in the large intestine or if you have a simultaneous overgrowth of methanogens, which pretty much always causes constipation. The classic example of this is someone with a mixed type IBS where constipation is the usual presentation, but then occasionally there will be bouts of attacks where they have diarrhea and often all-over body pain or extreme abdominal pain, often requiring a trip to the emergency room.

And what a lot of these clients have had in common, if they have constipation, is that they have slowly but surely stopped eating everything besides meat or meat and a limited number of vegetables and maybe a very limited quantity of rice. And they often have histamine intolerance or signs of sulfur intolerance, like the inability to stand cruciferous vegetables or alliums, like onions, garlic, shallots, chives and leaks, which have sulfur. A few have noticed they don’t tolerate red meat, which is particularly high in sulfur. Ironically, all of this may actually stem from a deficit of sulfur, which is a new theory I’m testing out, so I’ll get back to you on that, but this is theorized because of the impact of glyphosate on food, which impairs a pathway in gut microbes called the shikimate pathway. This pathway produces the very important amino acids l-tryptophan, our serotonin precursor, and l-phenylalanine and l-tyrosine, our dopamine precursors, as well as other nutrients. And it’s been shown that glyphosate also impedes sulfur production by causing a deficiency in molybdenum, a cofactor for the enzyme sulfite oxidase, which produces sulfate. Then if you have homozygous copies of the CBS (cystathionine beta-synthase) enzyme, which drives the recycling of sulfur-containing compounds, you may have too much unusable sulfur in your body, which can lead to sensitivities, while simultaneously having a deficiency.

But suffice it to say that hydrogen sulfide is very important in the human body, playing roles in inflammatory, neuromodulatory, immune, endocrine, vascular and respiratory actions. However, at high levels it becomes toxic to cells, inhibiting cytochrome oxidase, a hemeprotein which an important enzyme in the electron transport chain in our mitochondria, which is the way we produce energy in the cells. It also damages the intestinal mucosa and inhibits the oxidation or use of butyrate to feed the colonocytes or cells lining the colon. So upregulating hydrogen sulfide production in the gut may be a compensatory mechanism, but I’ll have to get back to you on my experiments with that.

Which bacteria produce hydrogen sulfide?

So lots of common genuses of gut bacteria produce hydrogen sulfide it turns out, including Escherichia as in E coli, which is not just the pathogenic E coli you’ve heard of, but also includes many commensal species, klebsiella, which is known as the big histamine producer, proteus species and Citrobacter freundii (but not all citrobacters), all of which are part of the family Enterobacteriaceae, some of which are hydrogen sulfide producers. Also the genuses streptococcus and staphylococcus, which I see elevated on virtually every GI Map I see, pseudomonas, H pylori, salmonella, some Clostridium, and Yersinia Enterocolitica. But the two that have been most highlighted as potentially overgrown and relevant to the hydrogen sulfide SIBO picture are Desulfovibrio species and Bilophila wadsworthia.

The interesting thing is that hydrogen sulfide producers come from a number of different phyla, including Deltaproteobacteria, Proteobacteria, Pseudomonadota, Thermodesulfobacteriota, Fusobacteriota and one genus from the phylum Euryarchaeota called Archaeoglubus. And while most are gram negative, one genus, Desulfotomaculum is gram positive and is a spore former. But the majority of the sulfate reducing bacteria are from the genus Desulfovibrio, around 66%, hence why you see those species listed separately on the new version of the GI Map under the heading Commensal Overgrowth Microbes, right above Methanobacteriaceae, the methanogens responsible for intestinal methanogen overgrowth (IMO). And then Bilophila Wadsworthia is in the class Desulfovibrionia and the order Desulfovibrionales but a different genus. And can I just say, bacteria nomenclature is really confusing, even for me? And then finally, Fusobacteria, which is from the phylum Fusobacteriota and the family Fusobacteriaceae, is another one that’s well known to be a problematic one in hydrogen sulfide SIBO, including Fusobacterium nucleatum, known to be responsible for periodontal disease and all sort of other mischief.

What do hydrogen sulfide producers eat?

So the next thing you might want to know about H2S producers is that most of them use hydrogen (H2) as a fuel source, through a process called oxidation. The hydrogen is coming from other gut bacteria that produce hydrogen, which you will certainly be familiar with as the more common type of SIBO. And while hydrogen gas is odorless, hydrogen sulfide gas is smelly like rotten eggs. But again, one of the difficulties in recognizing hydrogen sulfide overgrowth is that many people with it will not say they have gas, smelly gas, or gas that smells like rotten eggs. Or they’ll only occasionally have gas like that, like after they’ve had a meal heavy in animal fat.

But other sulfate reducers use different fuel sources or multiple fuel sources. So for example, Bilophila wadsworthia metabolizes the amino acid taurine. Fusobacterium, Desulfovibrio, E coli and Klebsiella metabolize the amino acids cysteine and methionine. Which makes finding food to eat much more complicated (e.g., protein), but I’ll get to that in a minute.

The other thing you might want to know is that methanogens also use hydrogen as a fuel source. So although you may be negative in a breath test for hydrogen, if you have methanogens and/or hydrogen sulfide producers overgrown, if you kill them off, you may end up with a hydrogen overgrowth. So don’t think that it’s likely to be a one and done program to get rid of these pathogens; sometimes it requires several rounds of treatment with testing in between to see where you are.

How do you test for Hydrogen Sulfide SIBO?

So there is only one breath test out there that tests for all three possible gases in SIBO/IMO, including hydrogen sulfide, and it’s called the triosmart test or order from my Rupa Health Lab Shop*. But stool tests, like the GI Map or GI Effects, can also point to the presence of H2S SIBO in conjunction with symptoms, when you see elevated bacterial markers for H2S producers. You can find all these tests in my Rupa Health Lab Shop*. Although I have been partial to the GI Map in working with clients, I’m beginning to think that the triosmart might make more sense for clients who are constipated, both because you can differentiate between the rarer H2S overgrowth or find out if it’s present alongside IMO, and because then you can track the level of methanogens and determine exactly how bad the overgrowth of methanogens is and have some sense of how long a treatment protocol someone might need. With the GI Map, you’re just seeing stool levels, which isn’t necessarily indicative of small intestine levels. But if you happen to have taken a SIBO breath test that only included hydrogen and methane, the sign that you might have a hydrogen sulfide issue is that you have a flat line or no growth on either of those gases.

I’ve also heard that you can use sulfite urine testing strips* to test for the presence of free sulfites, which may help you diagnose H2S SIBO, but I don’t know the details of how to use the strips in this way.

How do you treat hydrogen sulfide SIBO?

So the bad news for those of you who are on a paleo or carnivore type diet is that the diet for hydrogen sulfide SIBO is actually a plant-based diet. To start with, you want to reduce your animal fat completely, and ideally your animal protein as well, other than fermented dairy, which seems to be helpful in reducing levels of Bilophila wadsworthia, per two studies, one on probiotic yogurt consumption and the other on consumption of a fermented milk product. There may also be benefits for yogurt and kefir consumption in the reduction of Fusobacteria, as an in vitro study found they inhibited its growth. But no animal foods ideally for 3-4 weeks, then you can start reintroducing those foods one by one, starting with the lowest fat types.

But otherwise, you’ll want to decrease fat entirely for 2-3 weeks, definitely avoiding butter and tallow and lard and fatty cuts of meat. Coconut oil and coconut milk in moderation are okay after your initial low fat period. And small amounts of olive oil or omega 3’s are the best choice for fat throughout. MCT oil may also be okay in that initial period and after as it doesn’t require bile for absorption. You also want to avoid simple sugars or high fructose and focus on whole foods with lots of fiber. And then avoid animal protein as much as possible. So basically, you’ll have to incorporate sources of protein that are not animal based, but not including soybeans or quinoa if you have overgrowths of Fusobacterium, Desulfovibrio, E. coli or Klebsiella, as those two foods are high in cysteine. You’ll want to sustain this diet until such time as you are feeling better.

And if the sulfur-containing vegetables like garlic, leeks, onions, scallions, and shallots and cruciferous vegetables bother you, you should limit those as well.

Now if you are one of the unlucky ones who has both a hydrogen sulfide overgrowth and a methane overgrowth and a high level of constipation, you may be asking, what can I eat, especially if that coincides with histamine issues and food intolerances. In those circumstances, I tend to recommend a diet that’s more in between, with a limited quantity of low-fat sources of animal protein like skinless chicken breasts, white fish and shrimp, with low-fat, fermented dairy, nuts, seeds, and any high fiber carbohydrate foods you don’t react to, like lentils, chick peas or beans, starting with small quantities and working your way up, as well as fruits and veggies you can tolerate. Another option of course is doing an elemental diet, which consists of just a liquid diet for 2-3 weeks, which mostly likely you’d want to combine with antimicrobial supplements in order to help it along. I did a podcast on elemental diets, which is episode 100, called Give Your Gut a Break.

This may seem like a scary idea if you have had trouble keeping on weight, but in fact, my guests from that episode, Debbie and Roy Steinbock, maintained that people maintain or gain weight if they have had trouble putting on weight while on the diet. But people wanting to lose weight simultaneously lost weight. So it’s good for any weight circumstances. Or you may just use the elemental diet “shakes” as a supplement to the food you’re eating in order to make sure you’re not losing weight, or to replace 1-2 meals a day. You can find the Physicians Elemental Diet* powder in my Fullscript Dispensary.

What supplements to avoid with hydrogen sulfide SIBO?

So as you’re decreasing sulfur in your diet, you’re also going to want to avoid supplements with sulfur or bile. This includes ox bile, bitters, bile stimulating herbs, carrageenan and additives with sulfur, glucosamine and chondroitin sulfate. You should avoid protein powders with high levels of sulfur amino acids like taurine, cysteine and methionine, although collagen is okay.  And then of course avoid NAC (n-acetyl cysteine), glutathione and anything with a -thiol or sulfur group, including alpha lipoic acid. Thiamin or B1 and Biotin also have sulfur, so avoiding high doses of those might be a good idea. Also, certain probiotics are known to produce hydrogen sulfide, so best to avoid those, including Lactobacillus reuteri BR11, Lactobacillus delbeueckii ATC4797 and possibly Bacillus subtilis. There are a couple of others that produce H2S, L plantarum 299v and L rhamnosus GG, but I’ve heard recommendations and studies in which foods or supplements with those strains were helpful in H2S SIBO, so the jury may be out on that.

What supplements are helpful for H2S SIBO?

So what is helpful to take for H2S SIBO? First, there are several herbs that are helpful, including gymnostemma, codonopsis and Korean ginseng, which is panax ginseng*. Then minerals may be deficient that are necessary for repairing bodily processes that aren’t working properly, in particular molybdenum*, 50-150 mcg per dose but no more than 500 mcg/day, or a multi-mineral supplement. I like the Jigsaw Essential Blend Multimineral* as it has zinc, copper, selenium and molybdenum in it at good doses, all of which are recommended for H2S SIBO. Hydroxocobalamin*, a form of B12, is also recommended, as opposed to methylcobalamin, a form I recommend to most clients because of the prevalence of MTHFR SNPs. Then beyond that, butyrate is important (although go easy on it if there’s constipation, only taking one 300-500 mg pill every 3 days if you’re constipated to start). If you’re not constipated, you could use my Tributryin-Max, 1-3 daily, decreasing if you get constipated, or any other tributyrin or CoreBiome based product, although you’ll need more of a lower-dosed butyrate supplement.

Then the prebiotic FOS* is also helpful, 2 grams a day with meals if you don’t react to that. Be careful not to choose one with inulin though as many people with SIBO are reactive to that. And finally, something I’m recommending to most people these days, serum bovine immunoglobulins*, which help bind to and remove gut pathogens without impacting commensal bacteria. The dose that’s been studied is 5 grams a day, which is recommend in two doses of 2.5 grams on an empty stomach, usually first thing in the morning and last thing before bed.

And let me not fail to mention good old Pepto Bismol* or a generic equivalent* or a supplement containing bismuth. MDs will use 500 mg of bismuth three to four times a day with H2S SIBO in addition to Rifaximin, the antibiotic for SIBO. There’s only one product in Fullscript with bismuth that isn’t full of dyes and additives you might want to avoid, which is called Biofilm Phase-2 Advanced*, and has 200 mg of bismuth in two of them, along with some other stuff though that may not be great in H2S SIBO, like alpha lipoic acid. I’m just beginning to experiment with this product, so I’ll let you know how it works out in a subsequent podcast.

And also, I shouldn’t fail to mention that exercise and stress management are also important in managing H2S SIBO.

Well I hope this helps some of you get to the bottom of your gut health or all over body suffering and find a way out.

If you are struggling with bloating, gas, burping, nausea, constipation, diarrhea, soft stool, acid reflux, IBS, IBD, SIBO, candida overgrowth, fatigue or migraines and want to get to the bottom of it, that’s what I help my clients with. 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 3- and 5- appointment health coaching programs 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. 

Schedule a breakthrough session now

Finding the Perfect Stool . . . Donor

Finding the Perfect Stool. . . . Donor

Adapted from episode 113 of The Perfect Stool podcast and edited for readability, with Michael Harrop of HumanMicrobes.org.

Lindsey: 

So I had you on episode five of The Perfect Stool when I was just starting out, where you described doing 9 Do It Yourself fecal transplants on yourself using various donors and your efforts to find the perfect donor and the things that you had done at that point. So I thought this would be a great time to do an update and hear what you’ve been working on. And if you’ve had any changes to your health, so why don’t we start there with your health? And if you can just briefly describe what conditions you would say you had at the last time we spoke and what has changed since then, and how you did it.

Michael Harrop: 

Well I’ve had irritable bowel syndrome, chronic fatigue syndrome for most of my life, those are the main things that I’m trying to treat. I can’t remember actually what exactly was different since the last time; there have been like so many different ups and downs. But mild Alzheimer’s symptoms is also something I’m dealing with now, in recent years.

Lindsey: 

Like brain fog type of thing, or memory loss?

Michael Harrop: 

So there’s actually some really interesting papers on the connection between diabetes and Alzheimer’s. And they call it type three diabetes, I think. And based on the symptoms of what they’re describing, that’s what I have, a mild version of that.

Lindsey: 

Do you also have issues with blood sugar regulation?

Michael Harrop: 

Not yet that I know of.

Lindsey: 

Okay. So, last time, we had talked, you had done nine fecal transplants, have you done more since then?

Michael Harrop: 

Yeah, I’ve definitely done more.

Lindsey: 

How many are you up to?

Michael Harrop: 

I think I’m around like 14 or 15 different donors at this point.

Lindsey: 

Okay. Multiple times with single donors?

Michael Harrop: 

Yeah, many FMTs from each of those donors.

Lindsey: 

Okay. And so did you have any successful ones?

Michael Harrop: 

Yeah, I did. I actually pretty much cured my irritable bowel syndrome from one of them. And then I tried another one, which I thought was a 1 in a 100,000 donor. And they turned out to be detrimental for me. And they reversed most of the benefits that I got. And then I continued on with other donors, and I saw continued improvements with them.

Lindsey: 

And was your IBS more of an IBS-D type or IBS-C type?

Michael Harrop: 

Yeah, it was IBS-C, and then I took an antibiotic called Rifaximin. And it changed to IBS-D. And also I was unable to tolerate proteins and fats.

Lindsey: 

That’s a big part of the diet.

Michael Harrop: 

Yeah.

Lindsey: 

Okay. And now, can you?

Michael Harrop: 

So the donor that cured my IBS, they allowed me to reintroduce protein and fat for the first time in a very long time. Other donors were able to restore the fat tolerance, but not the protein so much. At this point, I am still able to tolerate fat, but I haven’t really tried high protein stuff. I don’t have a craving for it.

Lindsey: 

So you just eat primarily a diet of what?

Michael Harrop: 

My diet right now is, almond milk, malto meal, butter, cheese, fruits, sweet potatoes. Yeah, that’s my diet today.

Lindsey: 

Okay, and where did you find the donors that you used?

Michael Harrop: 

So in the past, I was just individually trying to find donors. I was going to friends, family, I was passing out flyers at local universities, going online to whatever communities. I was even trying online dating profiles to try to find donors. So I was trying everything I could think of. And eventually, I started up a website called humanmicrobes.org. To officially go into it. And I tried to get the community involved in it at first, because there were hundreds of other people also trying to find a high quality donor. But that didn’t seem too effective. I assumed that people would be enthusiastic about helping and trying to work together to find good donors. But, you know, they didn’t really seem to get involved much.

Lindsey: 

Like you wanted other people to help review applications or . . . ?

Michael Harrop: 

No, just help spread flyers. Help give advice on how we should go about this, designing of the website and recruiting donors methods and stuff. So when that didn’t work, I decided to try to raise the prices that we were charging recipients and also paying out to donors. And that seemed to be pretty effective. At that point there were only maybe around 25,000 applicants. And then as soon as I raised prices and payouts, we started getting these huge influxes of hundreds of thousands of applicants. And currently, we’re up at almost nearly a million donor applicants.

Lindsey: 

Wow, how in the world do you screen that? Do you have some sort of a computer program that helps screen?

Michael Harrop: 

Yeah, so thankfully, one of the other IBS patients helped me. They set up a spreadsheet, Excel program that I just input the data into there, and it scores it automatically. So I can score about 10,000 at a time. And that’s really, really helpful.

Lindsey: 

Oh, cool.

Michael Harrop: 

I wouldn’t have been able to do it without that, I’m sure.

Lindsey: 

And so do you feel confident that people are answering questions, honestly?

Michael Harrop: 

Yeah, for the most part, people seem to be doing it honestly. But even for the ones that don’t, it’s not really a big concern, because there are other steps that are arguably more important, which is verification of stool type and physical fitness. So even with most people that pass the screening questionnaire, most of them don’t pass the stool and physical fitness verification point.

Lindsey: 

So did they send a photo of the stool?

Michael Harrop: 

Yeah, we asked for a few days of consecutive samples, along with some physical fitness photos.

Lindsey: 

So stool sample photos.

Michael Harrop: 

Yeah, right.

Lindsey: 

Okay. And then at that point, you’re eliminating them if they’re not fit enough, or they’re stool doesn’t look perfect Bristol, type 3 or 4 kind of thing?

Michael Harrop: 

Yeah, so I’m actually looking for some very specific stool type, stool characteristics. It’s more complex than the Bristol stool chart. But that chart is very useful as a basic outline.

Lindsey: 

So what does the perfect stool look like to you?

Michael Harrop: 

You know, it’s not something that I advertise because I want people to just submit the most accurate photos.

Lindsey: 

Okay, fair enough. So how many people have gotten beyond the initial screen, and then the second level of screening?

Michael Harrop: 

So about 10 to 20%, pass the questionnaire and go on to the stool and fitness verification. And then from that, I would say, a majority that turn in their submissions either don’t rank high or don’t pass.

Lindsey: 

Okay, and how much were you offering to pay donors for each sample?

Michael Harrop: 

We are currently offering $500 per sample.

Lindsey: 

Okay, and how much are you charging recipients?

Michael Harrop: 

$1,000.

Lindsey: 

Okay. So, how many people actually have gotten through and qualified as donors?

Michael Harrop: 

So we have a list of potential donors that we send out to recipients and recipients get to choose from that list. It kind of depends on supply and demand. I have thousands of possible donors. But right now, there’s only demand for a handful of the very top donors.

Lindsey: 

And have they already had their stool sequenced, or what testing are you using after that?

Michael Harrop: 

So we’re just using the basic recommended tests, which are just pathogens. The other stool tests, I don’t find them very useful.

Lindsey: 

So you’re just doing like, basic GI pathogens plus, are you doing blood testing for infectious diseases and STIs and such?

Michael Harrop: 

Yeah, exactly.

Lindsey: 

Yeah. Okay. So the donors have to do those at their own expense to be donors and to be on the list?

Michael Harrop: 

No, no, we cover all the costs associated with applying to be a donor.

Lindsey: 

Oh, okay. So by the time they get through the process, then they have the opportunity to make money but no cost to them to apply. Yeah, that’s correct. Okay. Interesting. And so how many people have you been able to recommend, where there’s been a connection between a donor and a recipient?

Michael Harrop: 

Currently, we have three or four donors that have sent out shipments to recipients.

Lindsey: 

To how many different recipients?

Michael Harrop: 

Well, the two most active ones have sent out to over 100, maybe like one to 200 different recipients?

Lindsey: 

Wow. And so are they putting their stool on dry ice? Or what’s the procedure for their stool donation?

Michael Harrop: 

Yeah, so they just collect it in a Ziploc bag. And then, depending on what the recipient orders, they’ll then process into capsules, perhaps or maybe an enema solution.

Lindsey: 

The donors will do this?

Michael Harrop: 

Yeah, we teach the donors how to process their own stool.

Lindsey: 

Wow, okay. So the recipients have the option for capsules and the option for . . .

Michael Harrop: 

Yeah, recipients can basically choose. We really give a lot of leeway to recipients to customize their orders however they want.

Lindsey: 

And for the enemas, are they mixing that with anything or is it just straight stool?

Michael Harrop: 

That’s all optional. It’s really up to the recipient. By default we do saline with an antifreeze, either maltodextrin or glycerol.

Lindsey: 

Okay. And those are things people can just buy online or where do they get ahold of those things?

Michael Harrop: 

Yeah, they’re very easy to obtain. Maltodextrin is a supplement and . . .

Lindsey: 

 . . . food additive. Yeah. Okay. And what kind of success have you heard about? Do you keep, I assume you keep track of that when you have a recipient?

Michael Harrop: 

Yeah, we’re actually the only source of stool donors that’s publicly tracking and reporting results.  So anyone can go on our website and see what other recipients have, what results they’ve gotten. Most people I would say, are either getting mild improvements or no improvement. Very few people have adverse events.

Lindsey: 

And what are the typical conditions that people are looking for stool donations for?

Michael Harrop: 

It’s usually a wide variety of general symptoms. I guess bowel problems are a common one, but not a primary one, I would say.

Lindsey: 

Are there a lot of people with say, chronic fatigue looking, or with other sorts of chronic conditions?

Michael Harrop: 

Yeah, it’s a wide variety of chronic conditions really.

Lindsey: 

Do you have some sort of database or catalog so that you can systematize the responses and analyze them statistically?

Michael Harrop: 

I’m not doing any kind of statistical analysis on our results. But since they’re public, anyone is able to analyze them.

Lindsey: 

But in terms of the conditions, do you have specific condition lists or specific symptom lists, or are people just describing their own conditions?

Michael Harrop: 

Yeah, they’re just describing them however they want.

Lindsey: 

Okay. And you mentioned a few adverse events. What kind of adverse events have you seen?

Michael Harrop: 

The one I remember is someone just got generally worse. And then I think the worst rating someone gave to a donor was because they got severely constipated. I think those are the only two. They are probably some where they just got generally worse.

Lindsey: 

And so you weren’t doing any metagenomic sequencing or anything like that of the stool? So what the contents were of the stool is sort of still a mystery?

Michael Harrop: 

Yeah, it’s largely a mystery. But I think for both of our active donors, or the two most active ones, we did the GI Map. And that comes with a few other test results on the gut microbiome makeup, I don’t find it particularly useful.

Lindsey: 

Why is that?

Michael Harrop: 

Most of those tests are not actionable, and current knowledge is just too limited to do anything with that information. And the information itself is not very useful. It mostly gives information on the genus level or the species level. And there’s just not much you can do with that kind of information.

Lindsey: 

What kind of information would you like to see on a stool test that would be more actionable?

Michael Harrop: 

I mean, I just don’t think it’s possible with current knowledge, even if you . . . I think Viome might be one that gives the strain info. But even with their tests, and that kind of info, there’s just not really anything you can do with it.

Lindsey: 

Because the research is just so early in most strains that are in the gut microbiome?

Michael Harrop: 

Right, there’s just no information out there of what you should do, what’s good, what’s bad, because it’s just a very complex ecosystem that interacts together. So maybe you have one strain, if you label it good. But what if it’s not interacting with another strain, then maybe that changes it, and now, it’s bad. So it’s just really complex, and so much is unknown.

Lindsey: 

Do you see hope in the future given the rise of Chat GPT and these AI tools for perhaps being able to get further along in integrating the microbiome research?

Michael Harrop: 

Yeah, I think AI is the only hope for that.

Lindsey: 

Yeah. It’s so complex.

Michael Harrop: 

Yeah, there’s too much information for humans to process. It would definitely have to be a computer.

Lindsey: 

I’ve done various stool tests over the years. I think I did one, maybe Genova GI Effects with a functional medicine doctor years ago. And then when UBiome was an entity, I did a couple of theirs. And then I did a Thorne, which had meta genomic sequencing. But at some point, I realized . . .  oh, and I did one with Biohm. And I realized at one point that there was some 60% that was just not mentioned. And those were the strains that had no name or description. I was like, wait a second, so we don’t actually know what 60% of this is? So we’ve got all these tools in which we’re sure that this thing is a major component of the gut microbiome, it’s super important. But the other 60%, we can’t even identify? So yeah, I guess it is really. . . I mean, I do find some useful things personally, in working with clients on the GI Map, in particular the intestinal health markers, because you can at least see, you know, how’s their output of pancreatic enzymes or their Secretory IgA, so you can get some sense of whether their gut is dysfunctioning and in what way? But yeah, how different microbes interact, and what to do to bring up one microbe, break down another, is still very much only at the beginnings of study for relatively few microbes that are particularly well known. So tell me about what you think about antibiotics and how that relates to people’s gut microbiome?

Michael Harrop: 

I think they’re overused, severely. Many of the current studies put it at like 30 to 50% overuse. And that’s according to current guidelines, which I think are way too lenient. So it’s probably way higher than that. And one frustrating way that that’s manifested is that I recently screened a donor that is basically like a one in a million. And they would have had zero lifetime antibiotic use, if not for a week’s use after a dental appointment. And that’s actually one instance, dentistry, where dentists are giving out antibiotics where . . .

Lindsey: 

prophylactically . . .

Michael Harrop: 

Yeah, it’s not an evidence-based use. They’re just giving it out because . . . I don’t know why.

Lindsey: 

Heart murmurs and things like that. I’ve had that before, because I have a super subtle heart murmur. And you’ll only even hear it if I’m lying down. And all of a sudden, I mentioned this, and then I start getting recommendations for prophylactic use of antibiotics. And I’m like, hold your horses. I’ve been having dentist appointments my entire life, and I haven’t had any antibiotics. I don’t intend to start now.

Michael Harrop: 

Yeah, I think it even goes beyond that. There were some papers and articles by some reputable websites, where they covered doctors just giving it out where there is no evidence-based use for it at all. So that’s really frustrating to see, especially now that it’s actually interfering with what I’m trying to do with getting super high quality donors that can potentially reverse the effects of antibiotics. Now, this one, the super rare one has been unnecessarily damaged. So that’s kind of frustrating.

Lindsey: 

This was somebody who, while you were screening them, had to go and get antibiotics.

Michael Harrop: 

No, they got them prior to me screening them. So hopefully, in the future, I can let them know that this is not really an evidence-based use of antibiotics. So you can probably ask your dentist next time, “is this really necessary?” And if you say it is then, what are you basing that on?

Lindsey: 

But you don’t allow any donor who’s had antibiotics at all?

Michael Harrop: 

I wish I could have a rule like that. But no, that’s so rare to find someone that’s never taken them. So I can’t really impose that.

Lindsey: 

Yeah. I think one of my children, I think my older son, but I wouldn’t recommend his stool. But I think my oldest son has never had antibiotics.

Michael Harrop: 

That’s nice. Yeah. I think it’s quite strange how there’s this huge anti-vaccine movement, but there’s no anti-antibiotic movement, because the scientific consensus on vaccines seem to seems to be pretty strong in favor of them. However, there’s a pretty strong scientific body of literature showing the harms of antibiotics. So that’s something I find pretty strange.

Lindsey: 

I think there is a reasonable anti-antibiotic movement amongst people who are gut microbiome enthusiasts and naturopaths. And that sort of thing. But it’s not anti for any use, of course, because obviously people can die from the infections that antibiotics help them with. I know that for the resistant strains of bacteria, that are resistant to different antibiotics, there’s phage therapy and I have tried to get somebody on here to talk about phage therapy, but that doesn’t seem like a super available alternative to most people.

Michael Harrop: 

Yeah, it’s still really early in the research.

Lindsey: 

Yeah. So with your donors, the recipients, do you recommend a protocol of a certain number of donations, a certain number of times, antibiotic pretreatment, etc.?

Michael Harrop: 

I don’t like to give recommendations because I’m not a doctor. And we try to avoid giving out anything that may be construed as medical advice. But I do have humanmicrobiome.info, which is a website that anyone can use to see what the latest research is on a wide variety of topics related to the gut microbiome. So I recommend that people go there.

Lindsey: 

So you keep that separate from Human Microbes just so there’s no conflict?

Michael Harrop: 

Yeah, I try to keep them. . .

Lindsey: 

. . . liability. Yeah. Okay. Now I know that you have for so many years been documenting research on the microbiome and on fecal transplants, and how do you keep up with all that research?

Michael Harrop: 

It’s just like a daily ongoing thing that I’ve been doing for many years.

Lindsey: 

And at the time we last spoke, you’d left high school and hadn’t been able to further your education or anything because of your physical issues. Is that still the case? You’re just self-taught on the microbiome and reading science and such?

Michael Harrop: 

Yeah, that’s exactly it, yeah. I’m still not able to do much.

Lindsey: 

You’re on disability?

Michael Harrop: 

Yeah, I’m getting off because I’m making enough money from my business now. But I’m still kind of homebound.

Lindsey: 

Right, right. And you look very pale to me. Do you get out in the sun ever?

Michael Harrop: 

Exactly. Pretty rarely. Yeah. Oh, actually, one antibiotic I took damaged my skin and made it more susceptible to sun damage. So ever since then, I’ve actually had to avoid the sun more.

Lindsey: 

So when we last spoke, I am sure I must have asked you about this. But I’m wondering if anything has changed since. Have you gone through functional medicine testing and providers at all to see if there might be other ways that you can attack your problems?

Michael Harrop: 

So in the past, I spent a decade or more just going to whatever doctors I could, and basically they did what they could and I basically learned at the end that they’re really limited in what knowledge and capabilities they have. So it’s up to me to figure out stuff and the gut microbiome may be a solution. But doctors don’t really have very many tools to diagnose and correct a gut microbiome yet.

Lindsey: 

And do you take supplements or do things to help your health?

Michael Harrop: 

Personally, I’m very limited on the supplements I’m currently taking. I’m just taking zinc and iron, just really basic stuff. I’ve experimented with a lot more supplements in the past. But currently, I’m not really seeing any benefits, any big benefits from most of them.

Lindsey: 

Okay. Just curious. So any anecdotes or stories you have from donors or recipients that are worth sharing?

Michael Harrop: 

Well, the best result actually came from someone with severe eczema. They said they completely cured it. And we haven’t actually had that many people with eczema or other skin diseases do FMT from our donors. So it’s very possible that we actually currently have a cure for severe skin disorders. But we don’t really know because we don’t have enough recipients trying it.

Lindsey: 

Right, interesting. So in your materials online, at Human Microbes, can people find the person with eczema and find the donor and be able to say, I’d like that same donor?

Michael Harrop: 

Yeah, they can definitely do that.

Lindsey: 

Wow, that’s great. I’ll definitely have to tool around the website and look at that. And we can link to that and then also the HumanMicrobiome.info site. Any other sites that you maintain or have to share info?

Michael Harrop: 

Those are the primary ones. Yeah, it’s mostly those two, and I recently set up a forum on the HumanMicrobiome.info website.

Lindsey: 

So people can talk to each other?

Michael Harrop: 

Exactly.

Lindsey: 

Okay. And you also are pretty active on Reddit, right?

Michael Harrop: 

Not anymore. Not anymore. And I recommend people avoid that website, actually.

Lindsey: 

Oh really, why’s that?

Michael Harrop: 

I set up the forum to allow people to get off that website.

Lindsey: 

Okay, how come?

Michael Harrop: 

They’ve been going on the path of pursuing profit at all costs, and they’ve been degrading their site in that process. And it’s just become a really problematic site in so many ways. I wrote a blog with more info about that.

Lindsey: 

So like through advertisements and paid posts, and that kind of thing, or . . .

Michael Harrop: 

No. I feel like there’s really nothing trustworthy on that site anymore. It just seems like so much bots, astroturfing.

Lindsey: 

What’s that?

Michael Harrop: 

Astroturfing is when special interests try to manipulate content in a seemingly organic way.

Lindsey: 

Okay, yeah, that’s sort of inevitable in any of these tools, right?

Michael Harrop: 

Yeah, but it seems like a big site like Reddit really attracts that type of manipulation. And the Reddit admins don’t really seem interested or able to control manipulation of content on their website.

Lindsey: 

So you don’t maintain the microbiome Reddit or . . .

Michael Harrop: 

No, I’m pretty much off of Reddit completely right now.

Lindsey: 

Okay, you handed it over to somebody else?

Michael Harrop: 

Yeah, it’s just being modded and kind of referencing the forum. Let people know that they can go to the forum now.

Lindsey: 

Okay, that’s good to know. So what are your plans for the future, personally and professionally?

Michael Harrop: 

That’s a big one. So at this point, I’ve really done most of what I can on my own. It would be really helpful to get funding for an AI to allow the whole screening process to go through an AI. It’s very difficult. I can’t really pass on most of the screening to another person. And it’s very difficult for a single person to screen almost a million donor applicants at this point. And an AI might be able to learn new things as well, and probably do a better job than me even at the screening process. So would it be great to get funding for that.

Lindsey: 

Are your donors coming from multiple countries? Or where are your current donors?

Michael Harrop: 

Most of the donors are coming from viral social media videos. So it’s all over the world. In the past, I tried to reach out specifically to top professional and college athletes. And I did contact a few hundred, and got a few applicants from that, but none of them really ranked high. And currently, I’m trying another attempt to contacting top professional athletes; I would welcome help.

Lindsey: 

So if somebody is sending from a different country, that’s got to add up in terms of the costs of mailing, no?

Michael Harrop: 

Well, our donors mail directly to recipients. So it doesn’t really matter where in the world you live, it’s pretty much the same no matter where they are.

Lindsey: 

I mean, how do they keep the sample viable, for whatever length of time it takes the mail?

Michael Harrop: 

Generally, they’ll just store them in their home freezer. But recipients can customize their orders, the donor can store it on dry ice immediately, possibly even other things if the recipient needed.

Lindsey: 

So they’re storing it in their freezer, and then putting it in the mail for how long?

Michael Harrop: 

We do all shipments via dry ice. And usually they will ship around the world in under five days. So we keep them on dry ice all the time.

Lindsey: 

So dry ice holds out that long?

Michael Harrop: 

Yeah.

Lindsey: 

Okay. But you don’t do the shipping. They ship. You’re saying they ship it directly?

Michael Harrop: 

Yeah, our donors ship directly to recipient.

Lindsey: 

Right. Okay. Well, this is an amazing service that you’re providing for the world. I know that I, for a long time, was really fixated on fecal transplants and the potential they offered. I think they still are a potential goldmine of cures, but I think we are we are still far away from the point of being able to say, well, this is the exact donor for you, which I think is the complex part, right? Because you have these positive effects from one donor that appears not as good as the next donor, and then you have negative effects from that donor. So that’s the tricky part, right? It’s, well I’m deficient in butyrate producers, I need someone who’s really rich in those or I’m deficient in, you know, some other type of microbe or function.

Michael Harrop: 

Yeah, possibly. But so far, from what I’ve seen from both our donors, and just other reports that people are sharing from either their personal donors or other donor sources, it seems like donor quality is more important than donor matching. But of course, donor matching does have some importance. But if we can find a 10 out of 10 donor, then possibly donor matching won’t matter at all. But we don’t really know yet, because I haven’t found a donor of that quality.

Lindsey: 

What makes you call a donor, a 10 out of 10, something from the original screening or . . . ?

Michael Harrop: 

Yeah, so it’s basically the specific criteria that I’m looking for. It’s mostly actually a very, very specific stool type. And I haven’t really found that yet. One interesting tidbit is that, since we pay so much more than everyone else, like virtually every donor that’s been covered in the news, has applied to Human Microbes. And donors from all major clinics, stool banks and companies, they’ve all applied and the vast majority of them either don’t qualify or don’t rank high. I think that only a single donor ranked in the top tier. And that was actually a surprise for me. There’s one donor that’s kind of famous and they didn’t rank high.

Lindsey: 

Has the word gotten out in developing countries where there’s a lot less perhaps use of antibiotics or people who are more isolated from Western diets?

Michael Harrop: 

Yeah. That’s an interesting question actually, that a lot of people wonder about. It has a lot of problems going that route. The first problem is developing countries are now overrun with antibiotic overuse, because they can get them over the counter. And then another problem is that even as you go to very secluded tribes like the Hadza, which many researchers are doing, they have pathogens from their environment. So it’s not necessarily a great source of FMT. And even if they were, the logistics would be very difficult. Sure, and actually, one of my recipients has gone to the Hadza personally, and did FMT from them. And from what I recall, he got temporary benefits, which were pretty substantial. But then, his long term results were quite poor. And he thinks it was because of their pathogens. He did some testing when he got home, and he tested positive for a wide variety of pathogens.

Lindsey: 

Right, right, which they would otherwise be protected for, perhaps because of who knows what else like? I know a lot of a lot of there’s a lot of theory around worms, that worms are a natural part of the human microbiome and prevent, say, allergic reactions to things and people use helminth worms for treating various conditions.

Michael Harrop: 

Yeah, the helminth community is pretty interesting. A lot of people decide to do that. There seems to be more research on FMT, though, then helminths?

Lindsey: 

Yeah, I was trying to get somebody on to talk about that as well. But they backed out and disappeared.

Michael Harrop: 

Yeah, the recipient who went to the Hadza actually got better results from my donor. And it seems because my donors are generally safer, pathogen free.

Lindsey: 

Right, right. Yeah. Well, this is all interesting stuff you’re doing and I’m sure that many people appreciate this access to donors, because otherwise they’re not findable. So thank you for your service to the world.

Michael Harrop: 

Yeah, absolutely. And I welcome the participation from organizations, philanthropic organizations, such as the Gates Foundation. I would love it if they would help out. Yeah, I think FMT is actually something that would be right up their alley of what they are trying to pursue. And not a lot of other organizations are pursuing FMT, because there’s not much profit to be made. So hopefully, the Gates Foundation is an organization that doesn’t need to pursue profit. So it seems like something that would be good for them.

Lindsey: 

Have you reached out to them?

Michael Harrop: 

I looked into it before, and it’s something that you have to apply for funding, I’m not sure that I would qualify for funding, they don’t offer just general help. They offer funding for big projects.

Lindsey: 

Yeah, I think they’re pretty large scale.

Michael Harrop: 

Yeah, I did reach out on Twitter recently, though.

Lindsey: 

Yeah, I think maybe a smaller foundation that’s a little bit more out there about what they’re willing to do. But there’s probably plenty of risks, and they probably would want universities to be involved and the approval of medical boards and all that. So that’s the tricky stuff with funding. But it sounds like though, that you’re getting a decent amount of funding now, just via the donations and the recipients in the project itself.

Michael Harrop: 

Well, it’s actually not that much, just like enough for basically one person to get minimum wage. As demand increases, it can increase as well.

Lindsey: 

Well, I hope it works out and you find your 10 out of 10 donor and are able to completely recover your health. You look at you look a little better to me than the first time I interviewed you, you sound a little bit stronger. So I hope that’s not just my impression, but the reality.

Michael Harrop: 

Yeah, I’m not really sure. There’s so many ups and downs that it’s hard to keep track of, but I do publish my detailed results that other people can look through.

Lindsey: 

Okay, is that humanmicrobiome.info?

Michael Harrop: 

Yeah, I publish them on the forum and then also know that I’m using the Human Microbiome donors; all my results are up there as well.

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Fasting Mimicking Breakthroughs: Research on ProLon and Autoimmunity (IBD, MS, Type 1 Diabetes), Type 2 Diabetes and Longevity with Joseph Antoun, MD, PhD

Fasting Mimicking Breakthroughs: Research on ProLon and Autoimmunity (IBD, MS, Type 1 Diabetes), Type 2 Diabetes and Longevity with Joseph Antoun, MD, PhD

Adapted from episode 112 of The Perfect Stool podcast and edited for readability, with Joseph Antoun, MD, PhD, CEO and Chairman of the Board of L-Nutra .

Lindsey: 

I’m excited to have you on the podcast. I’d heard about ProLon and the fasting mimicking diet at least a couple years ago. And then when it fell into my sphere of potential podcast guests, I was really excited. So anyway, can you tell us about what a fasting mimicking diet is? And how it’s used currently, clinically, in terms of a general overview of conditions and the duration and frequency?

Dr. Joseph Antoun: 

Yeah. So as you know, fasting became very popular in the last seven, eight years. And a lot of what was coming from our research – I lead a company called L-Nutra, that produces the ProLon, but we’re a spinoff from University of Southern California where a lot of the research on fasting started. So there’s now 18 universities doing research on fasting. And what they discovered some 10-12 years ago is that intermittent fasting, doing that for a few hours, or extra hours, or 16, or 18, you know, can help people lose some weight. And there’s a lot of clarifications to do there and how to do it the right way. But the biggest discovery was that if you go longer, you know, how about one day, two days, three days, four days, five days, what happens to the body. And one major discovery, which ended up winning the Nobel Prize in Medicine in 2016, was that when you cross the third day, when you go on a third day of fasting, there’s another layer of benefits that happens in the body, which is cellular rejuvenation. So basically, the first two days of fasting, your buddy has enough glycogen in the muscle, I call those then, the checking account and the bank, when you need money, you go first to them, and then you have enough fat, which is the savings account. And then if you need a little bit more on your credit card, the liver can also some can do some neoglucogenesis.

So the first two days, you go to glycogen and fat and to the liver, and they can help the body sustain. And they when you cross day two, and you’re getting into day three, the body is declaring crisis. It’s saying, well, I’m using my bank account, I’m getting depleted. So it tells the cells that you’re on your own. Now you have to consume the debris, the organelles. You’re going to detox, you’re going to improve how you operate, how you function, otherwise, we’re going to die. So on day two and three, we call this the cellular rejuvenation, and the body is rejuvenating the cells. And if you go long enough, you get to day four and day five, the cells tell the body, hey, I’m using the debris, the organelles, I’m trying to fix and now what’s next. What’s next is there’s some old cells that the body doesn’t need and it kills them, and pushes the new young cells to replace those. So there’s a third layer: the first two days is a metabolic fast, the second, day three, day four, we called it rejuvenation and then as of day four onwards, there’s a regeneration. The body kills the old cells, the senescent cells, which are behind a lot of inflammation and aging in the body, and pushes the young cells to replace them.

Lindsey: 

And that’s called autophagy. Right?

Dr. Joseph Antoun: 

Autophagy is a second one, the rejuvenation. The regeneration one, which very few people talk about, is all coming from the science of USC and Valter Longo, which he very well described in his Longevity Diet book. If you get anything out of this podcast for those listening to us, go and read The Longevity Diet book, it was an international bestseller. It explains why to go a little bit longer. And what we’re going to talk about it, because we do it to close the question with nutrition. We’re not here recommending that people go and water fast for five days, because it’s so difficult. It’s sometimes risky, and it’s very difficult to comply with. But I’m explaining why we got to the nutritional phase. So the biggest discovery was that two days of fasting, the first two days, is good for your metabolism. Second, day three and day four, cellular rejuvenation and autophagy, Nobel Prize in Medicine. Day four onwards, the way actually that the benefit stays is the body starts killing the old cells, making more structural more deep change and pushing the stem cells, the younger cells to replace the older cells, which is a full regeneration of the body. So it’s a big body detox clean up. And cellular rejuvination makes the body a little bit younger.

That is what made fasting actually very popular is when those cellular changes were discovered. People were like wow, fasting can be a preventative or intervention for many chronic diseases. It can reverse aging, and it can be a very good medical intervention. Medical fasting for people who suffer with from overweight and diabetes, for people with cancer because you starve the cancer, for people with other chronic conditions. And then USC, University of California and the other universities, they went to market trying to tell people to fast for five days and they were trying that with certain conditions, including autoimmune disease and cancer and it was very difficult, nobody was able to do that. But the trials in mice were unbelievable. The cure rate from many chronic conditions. And improving mouse health was very beneficial. So they took the mice data, and they talked to the National Institutes of Health. The NIH funds a lot of research across the US. And they asked for a big grant to develop the fasting mimicking diet, basically, how can we help people eat something during the five days, but mimicking the benefits of fasting on the cells.

So that was the big endeavor, and it took $36 million, actually, of the grants and donations, it took 12 years for those researchers to sit and say, okay, how much of every macro and micro-nutrient can I give you and at what time of the day and combined with which other micronutrients, what we call the nutrient sensing pathways, the cells have receptors to food so that we don’t trigger the receptors of the cell so that the cells do not recognize their eating so that the cells stay in the fasting mode. So it took 12 years, a very precise precision nutrition formula that gives you all plant-based, healthy ingredients, no chemicals, no extra processing, it’s just literally high-end, premium, clean food that is made of ingredients tested to not trigger the satiety of the cell and therefore keeping your body in the fasting mode. Although you’re eating for five days, and this is why they call it the fasting mimicking diet, probably the biggest oxymoron you’ll hear in nutrition, it’s a fasting food basically, much better than fast food, by the way.

Lindsey: 

So can you give me some examples of the types of food that are in the ProLon Fasting Mimicking Diet?

Dr. Joseph Antoun: 

Yeah, the way the consumer would see it, and ProLon is the brand name of the fasting mimicking diet. So if you consume ProLon, you’re having a fasting bar in the morning. You can actually buy by the bar separate, it’s called the fasting bar. So you get a bar for breakfast, then you get a soup, and some olives and then supplements for lunch. You have a small snack, that chocolate crisp, in the afternoon. And for dinner, you will have another soup and crackers. And you have a drink that you take throughout the day and your supplements, minerals and an algal oil as well. And it’s all vegan. And this is the presentation level. But the ingredients themselves, the macro ingredients, a lot of them are coming from high end nuts. So you have macadamia, you have almonds, pecans, because they have the right proportions of healthy fats for the brain when you’re fasting. They have the complex carbs; you don’t want to have short carbs, because they spike insulin, they spike the detection of the cells. And they have plant-based sources of proteins, which is very effective for actually maintaining lean body mass.

This is one of the biggest surprises with ProLon is when you do fast and you do it a little bit longer term, you lose a little bit of muscle here and there. But when you do ProLon and there’s two clinical trials on ProLon and patents filed, you protect lean body mass. So what happens is the cells of the muscles are rejuvenating and then what makes fasting different than all other diets, it’s a stress reaction that is induced in the body, it’s why the cells rejuvenate. Whereas any other diet is a calorie deficit. So the body adjusts by losing fat and losing a little bit of muscle. But with fasting it’s a stress, and stress increases stress hormones, one of which is growth hormone. So when you’re doing ProLon, growth hormone is high in the body. And now because you’re doing a fasting mimicking nutrition, you’re getting proteins to the muscle, and we have a secret in it, where we spike the carbs a little bit in the soups, which spikes insulin little bit, without going off fasting. And now the muscle is seeing a mini spike of insulin, it’s seeing a spike in growth hormone because of the stress and it’s getting fed because it’s a nourished fast. So the muscle gets maintained and in many cases, actually increases. So it’s one of the most important features of doing fasting with nutrition versus not. And it’s helping a lot of people when they get off of ProLon to still have high metabolic rate, to still be vibrant, to still exercise, to not pick up the weight right away.

A lot of the metabolic benefits with ProLon last three to four months, so 90 to 100 days after just doing that five days of fasting mimicking nutrition. We’ve tested it against the Mediterranean Diet, against a lot of pills for diabetes, including the Ozempic’s and Wegovy’s and the insulin and the effect is by hundreds of percentages better, mainly because cell rejuvenation, when you’re getting younger, a lot of the chronic diseases we suffer from today are due to aging. So you want to hit on two things. You want to get your body a little bit biologically younger. There is nothing today that you can take that is proven to get you get your cells younger and fixed, except fasting. Right so that’s one of the biggest impacts and people need to understand that 90% of us are dying from four conditions today, right? Cardiovascular, diabetes, cancer and Alzheimer’s. These are not independent diseases. These are not genetically driven. To a certain extent, yes. But these are mainly diseases of aging. Even if you have the APOE gene, if you’re not 70, you’re not going to get Alzheimer’s. You know, most people have diabetes at age 60, they were still a little bit overweight at age 40, and 30. But they did not get diabetes, because they had younger cells, they had better muscle, they were able to deal with excess carbs.

So reversing biological age is key to escaping or preventing or better dealing with these chronic conditions. And this is why we’re seeing the fasting mimicking diet and the clinical trials, we now have over 32 clinical trials and 18 top universities globally, we’re showing major health benefits in chronic conditions because this is the only intervention that is rejuvenating the cells, getting you a little bit younger. A younger you has a much better body and biology and metabolism to deal with conditions. And the second biggest secret is protecting the muscle, the muscle is very important for viability, for burning carbs, for decreasing insulin resistance. And as you know, 73% of us have a certain level of overweight and now the latest statistics are showing that 90% of us have certain metabolic issues. So getting the body younger, protecting the muscle, turns out to be way superior to the Wegovy’s and the Ozempic’s and the chronic dieting. And this is what’s behind the success of ProLon and fasting today.

Lindsey: 

That sounds amazing. One big question that hits my mind because when I think of fasting, my biggest fear is hunger pangs. So do you still get the hunger pangs with ProLon?

Dr. Joseph Antoun: 

Different people have different experiences. So if we take 100 people, the statistics show that a third will say it was very easy, and I’m used to it. And these are typically people who are metabolically flexible, they exercise or they try to keto, meaning their body easily switches to ketones, easily breaks down fat, easily calls for liver for executing. They flex, they do exercise, they are in general healthy, and sometimes they’ve done some ketogenic diet. So they find it very easy. There is a good 40% that find it, okay, it was challenging, and especially on day three, when now the pressure’s on the cells to rejuvenate, but then they go through it. And there’s a good 20% that say it was very difficult. And these are typically people who are not metabolically flexible. They’ve addicted their body to carbs or others and they find it difficult to jump and do it.

But then every cycle you do it, we show that it becomes easier and easier, because your body now, it’s like exactly when you go to the gym, right? If you’re used to going to the gym, it’ll be easy. If you’re not used to it, the first time, you’re going to have a little bit of muscle ache, and you’re going to feel tired the next day. And we see the same. Fasting is actually like intensive training; it is the same mechanism. It’s the same way they tell you to do intensive training now, and then it opens new vessels for the heart, it takes your body to the next level. It’s just a stress imposed on the body. When you impose a stress, the body elevates its defense mechanism. And a lot of those are great mechanisms for aging, the same way fasting does the same for the cells. At a much more advanced level. Obviously, we talked about rejuvenating yourself. Because you’re going five days, it’s not few hours of stress, it’s a five day process. But over a million boxes now consumed. It’s only five days. Statistics show that 91 to 93% of people would be able to complete it. But again, some people find it difficult the first cycle.

Lindsey: 

And so I’m thinking about the fact that obviously somebody who is a bigger man versus a small woman typically consumes a lot different number of calories. Is it in any way calibrated to weight?

Dr. Joseph Antoun: 

It’s not and I get this question very frequently. And we tested it on different BMIs. We tested it on different body weights, on different muscle mass, and why we don’t calibrate it is because it actually auto corrects, meaning if you’re a bigger weight, you have a lot more reserves, you will get into autophagy towards day 4 not day 3. Because you have more reserves, you can cope more. And your metabolism is not probably as active as a person who’s skinnier and who has less reserves and has a lot of muscle. And so what happens is, if you’re bigger, you get autophagy on day four. And if you have a higher metabolic rate and you have less fat and your BMI is lower, you get into autophagy towards day 2, but why we don’t want to autocorrect because for the person who has a lot of reserves is you’re going to give him even lower calories to get him into autophagy sooner and the lower calories becomes a risk to that person. Because that person is addicted to the carbs a little bit more and has a bigger volume intake, so it self corrects. And the same way you don’t want to rush an already skinny person who already has a high metabolic rate into autophagy. So what happens? It self corrects and it works for each one, balancing compliance, safety and efficacy together.

Lindsey: 

Okay. So let’s talk about the research on the fasting mimicking diet and inflammatory bowel disease or Crohn’s and Colitis.

Dr. Joseph Antoun: 

Well, yeah, this is a very current topic. Stanford University is doing a trial on Crohn’s and University of Miami is doing a trial on ulcerative colitis. And we don’t have yet the results published. But what we have studied extensively is in mice first, we studied fasting, water fasting. We studied the fasting mimicking diet, ProLon and we looked at the benefits and in at least in mice, again, I cannot confirm it, in humans until we have the results of the clinical trials, and with compliance we don’t want to over . . .  although we have a lot of cases reported to us of a lot of benefits. But I’ll stick to the results in mice. And in mice, what we showed is that water fast doesn’t actually . . .  so inflammatory bowel disease, or autoimmunity, and you also mentioned ulcerative colitis, the common factor is inflammation. And some of it is an immune reaction to the gut lining. Some of it is also leaky gut, and we can talk about it; there’s so many root causes to each.

But what fasting is showing, water fasting is helping decrease inflammation across the body. We see that all the time. And why is that so? When you do a water fast, the body cannot spend calories right? So the body tells all the white cells, hey, do not . . . inflammation is replication of white blood cells and secretion of cytokines which increases inflammation, it’s like getting the engine of your heart a little bit heated. And when you fast, if you don’t have gas in the tank, you don’t want to to accelerate and hit the engine, because you’re spending it. The same way every time you fast, we see the body dropping inflammation. Now with water fasting, we haven’t seen a lot of benefits on leaky gut. We did see microbiome changes and we saw some stem cell healing in the gut with the fasting mimicking diet and we’ve published that.

We showed it superior to water fasting; this was one of our biggest surprises. Initially, we thought the fasting mimicking diet will give you a portion of water fasting benefits, but it is actually giving more benefits in many cases because it’s funding the rejuvenation. So it’s something to tell a cell do autophagy and I’m going to going to give you minerals and vitamins, you just go and figure it. And it’s something to tell a stem cell or young cell go replicate, fill in the gap for an older cell, but I’m not going to give you any minerals or any macros, versus with a fasting mimicking diet or ProLon, you’re giving them macronutrients and micronutrients. So you’re funding the correction, it’s the same thing.

So we saw a better closure with leaky gut, we saw better stem cell regeneration, or younger cell replication when you do the fasting mimicking diet in mice with IBD, which was a big surprise to us, actually. And we filed a patent on it and we published an article on it. So in general, if we zoom out, why fasting, if you read all books, for autoimmune disease, including IBD: ulcerative colitis and Crohn’s, even the old old book of medicine had fasting. And why is that, it’s very interesting. So we talked about decreasing the immune attack, because when you fast the body doesn’t want to fund any replication of white blood cells, it doesn’t want to secrete cytokines and increase temperature, but also actually, we see the body killing the active T cells and regenerating new naïve, we call them naive new cells, because they’re not going to do that attack. So it’s part of the body’s human evolution and natural selection of hey, if by mistake I have white blood cells, T cells doing a lot of attacking, let me just wash them out and bring new T cells.

So we see this all the time, immunity and limit drops, and limit increases, showing the regeneration, so very interesting to swap active cells with naive new cells that will not do the attack, but also on the heat on the damaged organ. You know, whether it’s psoriasis, whether it’s rheumatoid arthritis, whether it’s all sort of colitis, we talked about autophagy and cellular regeneration, so we see healing happening at the damaged organ, and this is why fasting has been so effective in autoimmune diseases. It decreases the attack and it helps the damaged organ to heal. And I was just fascinated. I’m a physician myself, but we never learned that. But when I went back and one night I was looking at the old interventions in autoimmunity and fasting was core to those. So now with the fasting mimicking nutrition, we are testing in humans whether we can get the same benefits or maybe it could be better could be not, before we announce officially announce and launch our autoimmune programs.

Lindsey: 

You have studied MS though, correct?

Dr. Joseph Antoun: 

We have studied MS. In same concept what we’ve seen in MS. We studied in humans and we studied in mice. And in humans, we studied one cycle, followed by the Mediterranean diet. One cycle of fasting mimicking diet, followed by the Mediterranean diet. In MS, the same as other autoimmune systems, you see the immune attack goes down pretty fast in mice, actually 20% of the mice reverse all the immune attack in the first cycle of the fasting mimicking diet, which is striking. And then when you go and we’ve shown on MRIs, the damage, you know myelin around the axons also gets rejuvenated and gets healed. So, again, I cannot confirm all this in humans, were a science company. So we have to do clinical trials. This is why we have 32 clinical trials, we take every condition and we go with it.

Lindsey: 

Okay, so only so far you have mice results?

Dr. Joseph Antoun: 

We have mice results showing, because this is you know, invasive, we’re showing the rejuvenation in the myelin of course. In humans, we do have an early human trial. It shows symptomatic improvements, but we haven’t done an invasive, big trial on humans to show full rejuvenation happening.

Lindsey: 

Okay, and that was with one cycle. There were symptomatic improvements.

Dr. Joseph Antoun: 

It was a feasibility study. So typically, when you do mice trials, and you go to human trial, you start with a small trial in humans just to show safety and feasibility. So we’ve done a quick one, we show it’s safe for people with MS to do the fasting mimicking diet, it was ProLon that time. And then we show it’s feasible; at least it’s not making them worse or putting them at risk. Then you go to phase two, phase three, which are the bigger, bigger interventional, bigger volume of fuel. We haven’t done that.

Lindsey: 

Okay. So I know that the most recent paper published or at least when we originally spoke was on diabetic nephropathy, and the fasting mimicking diet. Can you tell me about that study?

Dr. Joseph Antoun: 

Yeah, and now we just published another one, two days ago. So this is diabetes, we have launched what we call the L-Nutra Health for Diabetes Program or fasting mimicking diet for diabetes program. We’ve done two clinical trials on diabetes. And diabetes, we’re most excited about, number one, because it’s the one of the biggest diseases, so we can help so many people, and hopefully millions of people.

Lindsey: 

Type two diabetes?

Dr. Joseph Antoun: 

Type two diabetes. We’ve study type one in mice, we’ll talk about that. But yes, type two, and then what we’re excited about also is that diabetes is a actually a combination of four things. And again, I am an MD PhD, but I’ve never been taught these four things behind diabetes. I’ve been taught that blood sugar increases, you give them pills, they’ll take them for the rest of their life, right? I’ve never been taught the true root causes of diabetes and how we can reverse those. So diabetes is, for people listening to us, a pillar of four things. Number one, aging. Again, when you were diagnosed at age 50 with diabetes, you were also eating the same at age 40 and at age 30 and you were a little bit overweight. I’m generalizing, right, most people, or a little bit less weight, but you were younger, your metabolism was higher, and you wouldn’t amass insulin resistance as much as you want to at age 50 or 60 or 70.

Number two, it’s a disease related to muscles. So protecting muscle, and keeping the metabolic rate is very important. It’s a disease of lifestyle, right? And then number four, yes, it is genetic predisposition, but it’s mainly lifestyle as well, and how you eat and how you exercise and stress and sleep. And so the the fasting mimicking nutrition, we’re so excited about it, because it hits on three out of the four pillars. You cannot change genetics yet. But what you can do is you’re helping with the cells getting younger, you’re protecting lean body mass, you lose preferential fat. This is so critical, and I’m repeating myself, but it’s so important, you lose a lot of fat with the fasting mimicking diet. With ProLon you don’t lose muscle, or a tiny bit because glycogen is in the muscle.

And then number three, you’re inspiring the person. A lot of people when you ask about the number one benefit when they finished ProLon or the fasting mimicking diet, they say it changed my relationship with food. And this is a big unlock, because we know that diet and exercise can reverse diabetes if you sustain them for the long term, but it’s very difficult to sustain. And you lose muscle as well when you go on a low calorie diet. But when you do ProLon or the fasting mimicking diet, it’s five days, right? So five days, 90% of people can do anything for five days, right? And then and I always say it’s short enough for people to complete, but it’s long enough to inspire you now to say, wait, is it because when you start ProLon day one you’re like okay, if I’m going to feel hungry on day six, I’m going to have a party. I’m going to eat all the pizzas and burgers. And here comes day four and day five, and he’s like, I just I cannot even see a pizza or a burger. I just want to eat healthy on day six. So that changes the relationship with food, understanding he can go more plant-based, understanding he can eat lower portions, understanding that I don’t have to snack big at night. And I can wait till tomorrow to have my food are very big inspirational steps.

And I’m a big believer in the science coming from Stanford and BJ Fogg about tiny wins, right? So, every time a patient or a person feels like I did something for five days, I think I’ve succeeded, because typically we fail on diets, so they’re chronic. This is a very short diet, right, it’s just five days. I succeeded, I felt that I can go five days on healthy food, why not continue a little bit and then the next cycles reminds you, and then the next cycle reminds you. So it’s very important to inspire people with diabetes to become healthy, rather than just scare them. When they leave the clinic, put them on a very hard diet, and then they just fail, and they learn helplessness, they get acquired helplessness, and they just keep needing more medication and swaping every time muscle with fat. And this is what Ozempic and Wegovy are now doing, accelerating muscle loss and, and we’re waking up now to say, okay, if you stop them, you’re picking up all the fat faster, and you’re not developing the muscle. And this is creating a big issue that we’re facing with these drugs.

So we’re very excited with the fasting mimicking diet for diabetes, because you lose the weight, you protect the muscle, you reverse the bio age, all three big pillars for diabetes remission, we’re seeing a lot of patients in the first clinical trial, two thirds of the patients, reduce medication on month six, meaning they just done it six times, five days, 30 days. So once a month, it’s once a month for six months. And then you maintain just once every three or four months. So very high degree of compliance, that 12 month compliance rate was 83%. Very high chance of reducing medication. This is huge for diabetic patients, because the story for diabetic patients, we start you with metformin, and then we only add, and then you have to inject and then you have to go on insulin, and then you die. This is how diabetes was taught in medical school. And here’s how it’s practiced today versus somebody telling the patient, let’s take you off medication. And so we’re seeing a very high chance of what we call regression, reversing the disease and needing less medication. And a double digit chance of actually remission, which is getting off medication.

Lindsey: 

And I assume you’re also tracking hemoglobin A1C and insulin and that kind of thing. What results are you seeing there?

Dr. Joseph Antoun: 

Yeah,so within six months, as we mentioned already, a decrease of 1.4 points in HBA1C. And this includes, you know, doctors typically see their patients every three to six months to measure HBA1C, so not only reducing HBA1C, reducing HBA1C on top of taking medication off, because you have to adjust to that effect as well. And so within six months, people on average are dropping 1.4 points of HBA1C, they’re losing 22 pounds on average. 67% are needing less medication at that level.

Lindsey: 

And this is with no specific diet in between the five day fasting periods?

Dr. Joseph Antoun: 

Zero request to change the diet, zero requests to exercise more. Zero requests to do any changes. We just do the five-days fasting mimicking diet. It’s how we do it with all our trials, otherwise you bias the results and you would not be published in a high-ranking journal or getting any patents on those right?

Lindsey: 

Now, I originally asked about diabetic nephropathy and that obviously is different than neuropathy. Can you tell me the difference? And then what you showed in your paper?

Dr. Joseph Antoun: 

Nephropathy is the kidneys, neuropathy is nerves, right? And so in that article, we were showing that it’s not only metabolism that you’re improving: blood sugar and HBA1C. But actually transitionally, it wasn’t permanent, but transitionally for patients who tried the fasting mimicking diet that already have diabetes, already have damaged the kidney, because the kidney is the biggest, one of the biggest side effects of diabetes, right. There’s a lot of side effects that happen from diabetes, microvascular. But part of the microvascular is the kidneys start getting damaged. And as you know, a lot of diabetic patients end up with kidney failure and dialysis. We’re trying to see if we can help them temporarily. And we started measuring proteins. Part of the measurement of damaging the kidneys with diabetes is they start leaking albumin. So what we showed is that actually we improve kidney function transitionally in that arc. It was a short term, it was a very short-term intervention. But we saw that after every cycle, we’re showing an improvement in kidney function, which gives us hope to do a longer one.

Lindsey: 

Like the eGFR?

Dr. Joseph Antoun: 

Yes, and the albumin in the urine, right. So one of the biggest symptoms of damage that diabetes can do.

Lindsey: 

Cool. And what is the mechanism of action that the fasting mimicking diet has on diabetes remission and nephropathy?

Dr. Joseph Antoun: 

This is what we detail, there’s actually three mechanisms of action right? You lose fat significantly versus protecting lean body mass, number two. Number three is you are rejuvenating the cells, which is very important for metabolism, and then vibrancy of the body to deal with diabetes. And it’s feasible. It’s not a long term diet so people can complete it, patients successfully complete it, and it inspires them to leave a healthier and a better life. All these combined are showing this high effectiveness on the condition.

Lindsey: 

Alright, well, let’s talk about type one diabetes, because that is an autoimmune disease. And I do definitely have listeners who are interested in autoimmune disease and have one client who has type one diabetes.

Dr. Joseph Antoun: 

And in type one it’s tricky because they are dependent on insulin and you’re fasting them. So it’s always tricky on hypoglycemia. And this is why we haven’t done a human trial yet. And, again, we have stories, but I don’t want to report you successes, because then it will be like as if I’m claiming, and again, we’re a company of science, if anything. If anything, people also want to take from ProLon today, it’s a nutrition product based on science, on NIH money and universities and double blinded, randomized clinical trials, published in top journals. So, I behave the same, we have to be compliant. So I’m not going to recommend anyone with type one diabetes do it today.

But we have seen in mice, because we wanted to test the concept before we go and do it in humans. We’re talking with Harvard University to do the human trial. But we haven’t gotten, we need the funding for it. So we haven’t been able to move forward yet. We’re funding 14 other clinical trials at the same time. But in type one, the theory is the same way we explained it for IBD and Crohn’s and other autoimmune diseases, right. If the premise is that immunity is excited, is attacking the pancreas and the beta cells are not producing insulin, if you fast, are you taking the aggressor, rejuvenating the white blood cells so that you taking the temper and you slow down the aggression, and you give time off for the pancreas to heal and rejuvenate for autophagy and reproducing insulin. So what we’ve done with mice, with a major article in Cell. Cell is the number two science journal in the world after Nature. We have multiple Nature articles, but in Cell, we have seven or eight articles there, we published an article talking about the regeneration of the beta cells of the pancreas, which is the cells that produce insulin. And what we did, we destroyed the pancreas of the mice. And then we put them on cycles of the fasting mimicking diet. And we saw them regenerating beta cells and reproducing insulin and normalizing their blood sugar. It was a huge article for us; it was a big, big achievement. For the first time something describing rebuilding the pancreas and reproducing insulin, it’s amazing. And we’re going to work with the patent on treating diabetes because of that.

But in humans, you have to go and test and maybe in humans, we can reproduce it, maybe not. Or maybe you produce a fraction of it. We have over 15,000 clinics in the US that recommend the fasting mimicking diet. So we have stories, but we cannot base any claim on stories. We have to wait to hopefully find some funding and fund it well, and maybe then be able to help patients either do it or not do it? It’s a tricky one just because these patients are very dependent on insulin and therefore the risk of hypoglycemia with fasting. You’re going to have to do the clinical trial under supervision.

Lindsey: 

So back to autoimmunity and IBD. Is there any advice at this point? I know you’re still underway in the human clinical trial. But any advice at this point of how best to implement the fasting mimicking diet in IBD? Like once a month or . . .

Dr. Joseph Antoun: 

Yeah, unfortunately, I cannot claim if I don’t have the results. But what I see with some physicians, they do ask these patients to do it once a month. But again, up until I don’t know ‘til when, I don’t know efficacy yet.

Lindsey: 

Like when people are flaring or not flaring?

Dr. Joseph Antoun: 

Again, this is a tricky question, what answer to help people, but I cannot answer because we sell the product. What I’m going to say is my sister has one, and she does it initially every month and now every three to four months as a maintenance.

Lindsey: 

And she has IBD?

Dr. Joseph Antoun: 

No, a different autoimmune disease. Again, I don’t want to mention it because I’ll look like I’m claiming . . .

Lindsey: 

Right, right, of course . . .

Dr. Joseph Antoun: 

Unfortunately. But I can invite you guys listening here to go to your doctor, give him the science. You can go to prolonlife.com (go to https://prolonfmd.com/HighDesertHealth to buy ProLon with Lindsey’s discount). There’s a science section and you can take the articles and then you talk to your doctor. At the end of the day, this is not a chemical, it’s not biotech, it’s vegan five days of healthy food. We’ll have the doctor look at the science and if he decides to supervise you and do it, then it’s his decision but we could not today push that direction.

Lindsey: 

Okay, fair enough. So I know that a lot of biohackers use fasting for longevity and such. Has the fasting mimicking diet been compared to water fasting for this application?

Dr. Joseph Antoun: 

We talked a little bit about it. Well there’s no randomized clinical trial on water fasting versus the fasting mimicking diet. Nobody has done that. But the goal is again, intermittent fasting is more tested than water fasting. Because there’s no trials where people fast for five days. It’s too difficult. This is why we exist, we actually were a water fasting company, right? And remember, I told you the story and we started at USC, we went into human trials to try it and nobody wanted to fast for 5 days.

Lindsey: 

Hard to do you sell that one, though? You can’t make a lot of money off of water fasting, can you?

Dr. Joseph Antoun: 

No and it wasn’t a money project at all actually. The founders of ProLon are USC and Professor Valter Longo, again, the author of The Longevity Diet Book, and he donates 100% of his shares to the Create Cures Foundation. I’m happy you mentioned that because this is exactly the opposite of people who found large companies, even in nutrition, and always this device of making money and why our story is always science. And you hear me talking about science and trials, because the founders, they don’t care about the revenues, they actually predonated their shares to the Create Cures Foundation to help patients access new novel innovations.

So we’re sitting on a company that is funded with science, and we have to give back the profits. Yeah, it was a pure need. Actually, this is why the National Institutes of Health stepped in and said, okay, I’m going to give you the funds to create the fasting mimicking diet, because there was no way to get people to water fast for five days. So this is why it exists, right? It exists to help you do a longer fast to reach cellular rejuvenation on day three, we talked about that, versus people can do intermittent fasting on their own 12 hours, and 14 and 16. And you don’t need to always do that with nutrition. Actually, we do have a fasting bar and a fasting shake to do that, because we don’t believe you should starve your body for 18 hours on water, especially when you skip breakfast, because you’re just starving your brain, your heart and your kidneys, the essential organs at their peak performance, which is in the morning.

We’d rather you starve yourself at night rather than you starve yourself in the morning. So we have developed the fasting bar and the fasting shake, just to help people in the morning, consume those as breakfast and then stay in a fasting mode. But we’re less interested in intermittent fasting, it just it helps you with losing weight, it helps if you do it right. With your metabolism, we’re more interested in the longer fast. Again, we don’t recommend anyone do water fasting for a long period. We do it with the prolonged or the fasting mimicking diet. This is why we exist, it was out of the need. And it was to make fasting safe and compliant for most people.

Lindsey: 

So this is just a hair off topic, but I have heard people make different claims about when autophagy starts once you start fasting, you know, like how many hours at night to not eat? What is the official word on that? And obviously, it sounds like it differs by body weight.

Dr. Joseph Antoun: 

They’re wrong. I used to be politically correct; they’re all wrong. Because it was speculation, right? You know, and I’ll tell you why they’re wrong. Number one is we’re 100% sure they’re wrong. The NIH just deployed eight machines to measure autophagy. So why there’s different theories when autophagy starts, because there was no way to measure it in humans. And now there are eight machines that the National Institutes of Health funded to measure autophagy. One of them is at University of Texas, San Antonio and ProLon was the first product to be tested by the way. And we’re now showing that day one, there’s no autophagy, day two, there’s no autophagy, it’s day three that happens to most people. And so now we have proof and a randomized clinical trial, randomizing people and showing that it happens as on day three. So I can 100% say yes, we got the data last week, so it’s fresh.

But we always knew that. Why because again, the cell rejuvenates. When the when the body tells us, I cannot feed you, you’ve got to go and eat your inside and rejuvenate. And if you skip breakfast in the morning, you still have a lot of fat, you have a lot of glycogen, your liver has a lot of extra reserve, why the cell going to rejuvenate? When you’re not stressed, right? It’s the same way like going into company and telling the CEO, okay, you need a million dollars. I’m going to give you a million dollars but wait for me six hours, he’s just going to wait. He’s not going to go restructure the company. Now if he if you tell him I’m going to come in two weeks, he’s going to be in deep trouble. And he’s going to go and restructure the company and try to fix it and try to save and try to cut. So there’s always a basal rate of autophagy. Every minute of the day, stem cells are rejuvenating just out of normal function and vibrance of the body. But to spike autophagy is definitely not skipping breakfast, not even skipping lunch, not even skipping dinner, you would barely start touching it because it makes sense. You know, you’re not in a stressful mode to go and do it.

Lindsey: 

Yeah, so it doesn’t really matter then other than the fact that you’re simply not consuming as many calories that you fast for say 13 hours at night versus 16. Because I know there are some trials on that on intermittent fasting and its impact on blood sugar and all that.

Dr. Joseph Antoun: 

Yeah, of course so again, go back to the CEO example. If he needs a million dollars per month, and you’re delaying now for hours, then he has to go and take some money from the banks, the same way, to cover these few hours. Same way the body goes into the fat and breaks a little bit of fat every time you do it. Now, we can talk two hours about that because some people binge eat. So whatever they try to use, they can overabuse after. And it’s very important which time of the day again, we can do a full session on just fasting, a lot of people are doing it wrong, because a lot of the early influencers, told everyone skip breakfast, skip lunch, do OMAD (one meal a day) or do 18 hours. And this is not a longevity practice because you’re basically starving your body in the morning when it needs the calories. And a lot of longevity trials are showing that risk of cardiovascular disease increases if you skip food for a long period during the day and then you binge eat after that. This is what happened.

So why intermittent fasting grew in that sense, because of two wrong pieces of information. They told people they’ll have autophagy if you skip breakfast, which is wrong, and number two, they told them you can lose weight, which is also not always true. And it depends on if you’re eating dinner late. And then you’re skipping breakfast, lunch, and then you’re eating at 4 or 5 pm. What you have just done is you’re stuffing your body and food in the evening time and you go sleep. When you sleep, your insulin and your growth hormone are high at night actually. So you’re in anabolic so you’re storing everything you took in to fat versus and then you go you starve yourself during the day when you need to use these calories for your essential organs. This is a big mismatch. What you want to do, the right intermittent fasting, is you eat your dinner early, and then you stay overnight fasting and then your breakfast, you should get breakfast or get a fast bar or fasting shake. Eat something in the morning because this is when your body needs it. So the right intermittent fasting is 12 to 14 hours max front loaded, sleep on an empty stomach and get your breakfast or delay breakfast. That’s the one that helps longevity. When we study centenarians, people living 100 and beyond, no centenarians do one meal a day or do the crazy starvation stuff. They actually, most of them though, say we eat early, you know, we go to bed early as well.

Lindsey: 

Early like five or early like three?

Dr. Joseph Antoun: 

Three is an afternoon snack. And honestly, I mean, you can go all the way, the extreme cases. Brian Johnson, he only eats between 8 and 11 in the morning, right. And, you know, we don’t want to go extreme in any way. We believe the best longevity, you get it from harmonization, from harmony, from matching your body with your environment, with the circadian rhythm. This is why intermittent fasting 12 hours overnight works very well, right. So, so what you should do, don’t eat late at night, eat your dinner early, as early as you can wait, and then go to bed on an empty stomach. This is when your body will rejuvenate at night without storing fat. And then the next day you wake up, I always say if you’re sleeping hungry, and you wake up hungry, this is a great longevity practice, and then get your breakfast in the morning. Your brain will be happy because you’re going to work or you have your kids and you need to function. Your muscle is happy because you’re walking, your kidneys are happy, your heart is happy because your heart rate increases when you’re moving. They’re fed on time. And then you go in the afternoon, you eat a little bit or at night and then you sleep and that’s the right practice versus people snacking late at night and then trying to stay 16-18 hours the next day to eat in the afternoon. Your body tells you that you feel weak. You feel the headache, and then you binge eat and then you say I’m not losing a lot of weight and it’s difficult to practice.

Lindsey: 

Yeah. It’s a lot more in tune with the European or at least the French way of eating, where the biggest meal of the day is lunch and then dinner is usually just more of a snack.

Dr. Joseph Antoun: 

Well, I can give you an advanced trick. How about you do breakfast and dinner and a light lunch like this you would have done two 12 hour fasts. You would have gone overnight to breakfast. And then from breakfast to dinner. That’s another almost intermittent fasting with 12 hours. This is what our founder Professor Valter Longo and again, the Time Top 50 Most Influential People in health care. He’s the number one longevity expert and fasting expert. This is what he does, he eats breakfast, very light snack in the middle of the day to get his body going. And then he eats dinner. Dinner is social. It’s difficult to skip. And so he’s is genius in that sense. He does double twelves in a healthy way rather than staying 18 hours.

Lindsey: 

So is he up at five in the morning, I’m just curious, to have an early dinner?

Dr. Joseph Antoun: 

No, because you can have your breakfast at eight and then have your dinner at seven. Okay. It’s difficult with work now to eat dinner at five. You’ve got to stay a little bit at work, we’re all really busy. You’re got to be practical. And then you go eat at seven.

Lindsey: 

So that’s actually a relatively late dinner.

Dr. Joseph Antoun: 

Depends on when you sleep again. But yes seven, in the summer seven, the sun is not down. Early and late depends on circadian rhythm at the end of the day. Because the body follows, I mean, we talked about the Nobel Prize in Medicine 2016 was on autophagy, right? In 2017, it was on the biological clock of the organs. And it follows circadian rhythm. So when the sun is down is the time for dinner. That’s how I say it. And this is why seven is not that late. I mean, winter is 5-6 pm. And in the summer, it’s 7-8 pm.

Lindsey: 

But that’s because of daylight savings time and spending time. Right? We altered the clock.

Dr. Joseph Antoun: 

No, not the clock.

Lindsey: 

Well, okay, that’s true. The sun does naturally . . .

Dr. Joseph Antoun: 

Yeah, naturally the position of earth versus the sun.

Lindsey: 

But we exaggerated it by adding in daylight savings.

Dr. Joseph Antoun: 

One hour in biology is not the end of the day. It’s one hour plus or minus, I’m just saying around that time. You know, having dinner at 5 pm for many people is impossible. They’re still at work. But it should not be at 10 is what we’re trying to say so anywhere from six to seven and eight.

Lindsey: 

So you’re telling me my 10 o’clock ice cream snack is not good for me? I at least eat the Keto ice cream or the sugar-free.

Dr. Joseph Antoun: 

Yeah, but the calories are being stored. Right. And this is one of the next biggest lies in super, super low carb or low carb, your body lives on carbs. And this keto thing is another podcast that we can talk about. But your body lives on carbs. And if you get the calories from fat and you’re sleeping and you’re in an anabolic state, you’re going to store those. So yeah, definitely don’t go high carb. But you didn’t change much when you eat late at night. It’s the biggest, if you asked me like, and we can talk a lot about what to do to live healthy, long life. But one of the things I always recommend is sleep a little bit hungry. And then everything gets fixed. You’re going to feel like even if you’re eating big breakfast and eating a big lunch, you feel it’s getting burned and you feel you’re going to gain the weight. Sometimes most of us, oh, I don’t eat breakfast. And I’d stay all the way and I only have one meal at night. And I’m not losing that stubborn weight, because you’re eating the calories at the wrong timing. What fasting brought to us is the importance of not just calorie counting, but the timing. During the day you’re catabolic, you’re spending, right, your muscle is moving. During the night you’re storing. Don’t feel the storage, fuel expenditure.

Lindsey: 

Right. Okay, well, I think that was a lot of good information that people can use both about the fasting mimicking diet and about just what time of day to eat. So thank you for that. Any final thoughts before we go?

Dr. Joseph Antoun: 

No. I appreciate you, Lindsey. I think for those listening here and wanting to enhance the chances of living a healthy, long life, I recommend you do the overnight fast 12 hours, max 14, but just do it in a natural way. Every day there are a lot of people living 100 and beyond who do that. When we study them, eat your dinner a little bit early and stay hungry overnight. You don’t eat overnight, you do two or three times per year the fasting mimicking diet, it’s part of human evolution. This is not our artificial request here. Our ancestors migrated during the winter, they didn’t have food all the time. And they used this time to rejuvenate right? It’s like spring, even in nature. ProLon is like spring; it is when you go and you rejuvenate and then make sure you stress less and sleep better. And then improve your happiness and serenity and social capital. These are the pillars of longevity.

Lindsey: 

Awesome. I’ve got links to the various papers in the show notes and to the website to purchase the ProLon, so thank you so much for being with us.

If you are struggling with bloating, gas, burping, nausea, constipation, diarrhea, soft stool, acid reflux, IBS, IBD, SIBO, candida overgrowth, fatigue or migraines and want to get to the bottom of it, that’s what I help my clients with. 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 3- and 5- appointment health coaching programs 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. 

Schedule a breakthrough session now

Gut Health and Weight Management: Beyond Dieting

Gut Health and Weight Management: Beyond Dieting

Adapted from episode 111 of The Perfect Stool podcast and edited for readability, with Lindsey Parsons, EdD, Gut Health Coach.

If you’ve been struggling with feeling comfortable in your body, weight gain or weight loss resistance, and wondering if maybe your gut health or gut health issues might have something to do with it, beyond the obvious regarding your diet, I wanted to address that today.

Before I go into that, I should mention that before I focused in on gut health, I worked with clients on sustainable weight loss without dieting, because I think it’s really important that any lifestyle changes you make be sustainable in the long-term. I’m not in favor of, nor do I recommend, low-calorie diets, crash or fad diets, because severely restricting your food intake can disrupt normal bodily functions, doesn’t promote sustainable long-term weight loss and can result in muscle loss and a reduction in your basal metabolic rate, which plays a crucial role in calorie burning. And even worse, undereating often causes your body to store calories as fat. It is not recommended for individuals to consume fewer than 1,200 calories per day unless you’re being supervised by a doctor and I’ve often seen people on such low calorie diets that started to lose weight only when they started eating more.

I also rarely recommend long-term extreme diets like carnivore or ketogenic diets, perhaps with the exception of people who have diagnosed type 2 diabetes that’s in need of immediate and extreme attention. And I think that self-acceptance is very important at whatever size your body naturally rests when you’re eating a healthy diet 95% of the time and exercising regularly, getting good sleep, managing and reducing stress and practicing all of the health-supportive behaviors we all hear so much about. And part of that self-acceptance is consuming media that highlights and supports diverse body types and sizes and reducing exposure to media that exclusively promotes a certain body type or filtered or altered images of unrealistic bodies. And I also think it’s very important, especially if you have any disordered eating behaviors like binge eating, emotional eating, anorexia or bulemia, to address the mental health component of weight gain, especially if you have a high level of Adverse Childhood Events, known as ACEs, that are highly correlated with obesity. If that’s part of your history, I’d recommend looking into trauma-focused therapies, which include modalities like somatic experiencing, AEDP, EMDR and neurotherapy. If you’ve gone through therapy but only traditional CBT-type talk therapy or Cognitive Brain Training, I’d recommend you look into these other modalities in conjunction with whatever other interventions you’re considering.

That being said, research over the last 20+ years into gut bacteria has shed light on its pivotal role in regulating weight and weight loss. So you may have heard about early studies suggesting that a key marker in the microbiome of obese individuals was an excess of gram positive bacteria in the Firmicutes phylum, in particular as it related to gram-negative Bacteroidetes and a high Firmicutes to Bacteroidetes ratio, the two principal phyla of bacteria in the human microbiome. However, these results have been called into question in a resequencing of the DNA from 9 of those previous studies. It was found that methodological differences in sample processing and DNA sequence analysis, interpretive bias and confounding factors that weren’t accounted for such as exercise and altitude, which have been shown to impact the gut microbiota, may have been responsible for these results. Further studies in animals and then in humans over the course of 5 days have shown that the composition of the gut microbiota can change rapidly when subjects are fed different diets. In particular, one study showed that a 5-day animal-based diet increased the abundance of bile-tolerant organisms from the genuses Alistipes, Bilphila and Bacteroides and decreased the level of Firmicutes from the genus Roseburia as well as the species Eubacterium rectale and Ruminococcus bromine, which metabolize dietary plant polysaccharides.

What I believe is a more important factor to consider with regard to weight loss resistance and/or weight gain is lipopolysaccride or LPS, an endotoxin that creates inflammation in the body and is released by and is a component of the cell wall of gram negative bacteria. Studies have shown that elevated blood levels of LPS are associated with prediabetes, diabetes and obesity, while additional studies have shown that translocated gut bacteria are the origin of that LPS. One of the reasons beyond diet that many people end up with elevated levels of gram negative bacteria, in particular from the Proteobacteria phylum, is use of oral antibiotics. As I’ve described in previous podcasts, antibiotics reduce the body’s ability to produce butyrate, the primary food for the cells lining your colon, which comes form the fermentation of fiber in the colon by butyrate-producing bacteria primarily from the Clostridium cluster of the Firmicutes phylum. In animal experiments, 3 days of oral antibiotics decimated the gut’s ability to produce butyrate from fiber and increased oxygen levels in the colon, which is an alternate fuel source for these cells lining the colon. This oxygenation of the colon produces a wonderful habitat for gram negative proteobacteria because they are facultative anaerobes, meaning they can exist in the presence of oxygen. This can then lead to a vicious cycle where proteobacteria continue to dominate, and the colon fails to recover its preferred hypoxic, or oxygen-free state, because of lack of butyrate, and butyrate-producing bacteria that are obligate anaerobes are wiped out. What’s more, a high-sugar diet in rats has been shown to increase proteobacteria, one of the reasons for which I recommend that people eat a super healthy, sugar and flour-free diet while on antibiotics.

The domination of proteobacteria then creates a vicious cycle of high LPS in the body, promoting inflammation, blood sugar dysregulation and increased weight gain. Likely because of this phenomenon, probiotic bacteria that restore the balance of butyrate producers and also mucin-degraders like Akkermansia muciniphila, which reside in the mucous lining of a healthy colon and live in symbiosis with the butyrate producers, have been shown to decrease hemoglobin A1C, a longer-term marker of blood sugar. The first product on the market of this kind, which contains 3 strains of anaerobic, butyrate-producing bacteria, was Pendulum’s Glucose Control*, which has the strains Clostridium butyricum, Clostridium beijerinckii, Anaerobutyricum hallii and Akkermansia muciniphila. While it’s not inexpensive (a monthly supply will run you $177/month via my Fullscript Dispensary, which includes the discount I give my followers), the company’s study on it showed a reduction in hemoglobin A1C of 0.6% and a 32.5% reduction in post-pradial glucose spikes after 12 weeks. You can also get just the Akkermansia* and the Clostridium butyricum* in separate products that are more reasonably priced, which I’ll link to in the show notes.

Because SIBO or small intestine bacterial overgrowth can also cause an overgrowth of proteobacteria, with Klebsiella, Citrobacter and E Coli being three of the most common overgrown bacteria in SIBO, I have also struggled with an overgrowth of proteobacteria, since I have post-infectious IBS which is essentially autoimmune SIBO that keeps recurring because of poor small intestine motility. As a result, I’ve tried Butyricum*, Pendulum’s Clostridium butyricum probiotic, and have found that it is very effective in firming up stool, which is a good indication of butyrate-production in my colon, which slows colon motility. I have found, however, that I can only handle ½ capsule a day, as a full capsule lead to downright constipation and sometimes pain and cramping. At ½ capsule it’s a perfect adjunct for keeping me in steadily perfect stool, along with tributyrin supplementation, the preferred form of butyrate for supplements, which I also have found indispensable in the face of a likely lifelong recurrent Hydrogen SIBO issue.

In addition, direct supplementation with butyrate in various forms has been shown in animal studies to positively affect the function and metabolism of fat tissue, increase insulin sensitivity and help with body weight control. For humans, results have varied between individuals, and I personally only recommend butyrate to people who have loose stool or diarrhea, as it will constipate you unless you use it at very small doses. Its success in weight control in animal studies is likely due to its help in turning around the vicious cycle of proteobacteria dominance in the colon and the subsequent release of LPS. Because of its unpleasant taste and odor as well as absorbability, the preferred forms of butyrate are tributryin, which is what I put in my tributyrin supplement Tributyrin-Max, which is 750 mg a capsule of tributryin, or the CyLoc™ form, an alpha dextrin fiber matrix butyric acid complex, used in Probutyrate*, which is only 300 mg a pill if you want a lower dose, which is more appropriate if you’re starting with firm stool or AuRx*, if you want a powder. Both Probutyrate and AuRx are Tesseract products, and you can find all of these in my Fullscript Dispensary at a discount. If you do have firm but incomplete evacuation or a sense that there’s more to go, I’d recommend starting a low dose butyrate supplement like Probutyrate once every 3 days.

Of course, along with taking probiotics or butyrate, I’d recommend increasing fiber intake through 5-9 servings a day of fresh fruits and vegetables, vegetables primarily, including ½ cup of beans, chick peas, peas or lentils on a daily basis to feed the microbes you’re working to restore in your colon.

Another way in which gut health is connected to weight loss resistance is through low stomach acid. Because sufficient stomach acid is necessary for breaking down proteins into amino acids, if you have low stomach acid, you may become deficient in an amino acid called l-carnitine. L-carnitine is found primarily in animal foods, most abundantly in beef and lamb, as well as formed by the body from the essential amino acids lysine and methionine. Because of this, I often find vegetarians and vegans are deficient in l-carnitine as well. L-carnitine is one of two molecules necessary for bringing fatty acids into the Krebs Cycle for production of ATP or energy. The other is vitamin B2 or riboflavin*. While researching for the podcast, I also happened upon a study that showed that riboflavin supplementation at doses of 50 mg or 100 mg a day also increased butyrate production in the colon, coincidentally. So if you’re struggling with weight loss resistance coupled with low energy (which happens when your fats are being stored and not converted into ATP), and you don’t have a blood sugar dysregulation issue indicated by high fasting glucose or high hemoglobin A1C, you may want to check your fatty acid metabolism through an Organic Acids Test* and/or try supplementing with l-carnitine* or acetyl-l-carnitine* to see if it will spark some weight loss. Typical doses are in the range of 3000 mg/day for l-carnitine when there is a deficiency, some of which can be taken in the form of acetyl-l-carnitine* if you’re also struggling with brain fog or poor memory or other signs of low energy in your brain. And a B complex is often also helpful, so a good quality B complex with appropriate amounts and forms of the various B vitamins is the best choice if you’re trying to cover all your bases with fatty acid metabolism. You’ll be wanting to get at least 50 mg of B2 if you have an identified deficiency.

And then on top of that, you could also start a trial of Betaine HCl*, or supplementary stomach acid, to see if that will help you digest protein better. The usual way is by taking 1 pill with meals with animal protein for a couple days, then moving to 2 pills per meal and up to 5 per meal until you feel reflux, warmth or burning in your chest, then you will want to back down to the previous dose.

Then you should looking at causes for low stomach acid. First, maybe your sodium intake is too low. Salt or sodium chloride, is one component of stomach acid. If you eat no processed foods and salt lightly, you’re likely falling short of the goldilocks levels of sodium, which is between something like 500 and 2300 mg/day, although some sources recommend keeping it under 1500 mg/day. And of course it’s better to choose a high quality salt like himalayan pink salt* or Redmond Real Salt* or one of these good quality salts that have trace minerals rather than just regular store-bought salt.

If you have any signs of gastritis, or inflammation of the lining of the stomach, like gnawing, aching or burning or pain in your stomach (and note that’s different from reflux in your esophagus which can be from low stomach acid), nausea, vomiting, a feeling of fullness in your upper abdomen after eating, trouble with acidic foods, or a known history of H. pylori or ulcers, this can also be at the root of low stomach acid. Healing H pylori, or addressing gastritis first may be necessary as you don’t want to add Betaine HCl or digestive enzymes for that matter, to a stomach that’s already inflamed. You can learn more about that in episode 34 called Upper Digestive Issues.

Next, Candida overgrowth in the gut can also be related to weight gain and weight loss resistance, causing sugar cravings and hormonal imbalances. This can come about from overuse of antibiotics as well as a diet high in sugar and simple carbohydrates. If you have a history of heavy antibiotic use, have a white or yellowish coating on your tongue, crave carbs and sugar, have a history of yeast infections, are usually cold, have fungus in your toenails or have brain fog, these are some of the key symptoms pointing to possible a systemic candida infection. While candida is a normal resident of your gut, an overgrowth of this yeast can lead to systemic candidiasis, where it forms hyphae or tails that poke out holes in between cells lining the intestines, giving it entry into the bloodstream. The only reliable way I’ve found to assess candida in the gut is through an Organic Acids Test. The D-arabinitol marker on the Organix, Metabolomix or NutrEval tests by Genova* is the most studied marker of candida, but I’ve also had good results with the Mosaic (formerly known as Great Plains) Organic Acids Test*, which has a marker called Arabinose. You can get some sense of how systemic and entrenched the candida infection is by how high your level is on these markers. The reference range on Arabinose tops out at 29, and for D-arabinitol it tops out at 36, and I’ve seen clients with results in the 300’s, just to give you some sense of how high it can go, although I’d consider anything in the yellow or red on the Organix or above the reference range on the Mosaic OAT to be treatment-worthy.

To combat candida overgrowth and facilitate weight loss, antifungal herbs and fatty acids are usually needed often for as long as 8 months in more severe cases, along with binders like GI Detox* to catch diet off at first and prevent severe Herxiemer reactions, which is when you feel like you have the flu, as you start killing off bacteria and candida with antimicrobials. And then often I’ll add in a biofilm disruptor into the protocol, often in the second round of antimicrobials. And note that I will typically change antimicrobials for each two-month round in order to prevent any resistance to the products. For a lighter case of candida that’s less symptomatic, serum bovine immunoglobulins might be sufficient to reduce levels. After treating candida, you can restore the gut lining by supplying essential building blocks for mucosal lining repair like glutamine and herbs like DGL, marshmallow root, aloe vera and slippery elm and nutrients like zinc l-carnosine*. I usually add the probiotic S boulardii* as well for candida, as it inhibits candida’s adhesion, morphological transition and virulence. Along with that, I recommend a diet free of added sugar, refined grains, dairy, gluten, yeast, white potatoes and for 2 weeks, fruit, after which time all fruit but bananas are okay. I prefer people follow this diet while on antimicrobials for as long as they can, knowing that realistically if it will take 8 months of antimicrobials, they may not be able to persist the whole time on such a strict diet.

If none of the above work for you, one more drastic method for changing your gut microbiome for weight loss may be through fecal microbiota transplantation, or FMT. FMT is the process of using a healthy stool specimen and transplanting it into the gastrointestinal tract of a recipient for the purpose of improved health. This counteracts the dominance of pathogenic bacteria in the intestines, ideally creating permanent changes to the microbiome. FMT from a healthy donor has demonstrated a remarkable 90% success rate in curing the antibiotic-resistant bacterial disease Clostridium difficile (C. diff), which is a prevalent infection that occurs in hospitals in the United States, affecting over 500,000 Americans annually and causing 14,000 deaths a year. The transplantation of stool from a healthy donor introduces protective bacteria, overwhelming pathogenic bacteria and offering a potential cure for illnesses originating from an unhealthy gut microbiome.

Regarding weight loss, I do have to say that results are mixed and more research is needed to fully understand the relationship between FMT and weight loss. In one study involving 41 patients undergoing bariatric surgery in Finland, researchers investigated the effectiveness of FMT for weight loss. The findings from the clinical trial suggest that FMT did not demonstrate significant benefits for weight loss in patients undergoing bariatric surgery, although its known that bariatric surgery alone changes the microbiome. In this particular study, there were no substantial differences in weight loss outcomes between patients who received FMT from a lean donor and those who received an autologous placebo, meaning they had their own stool put back in. While this study did not find evidence supporting the efficacy of FMT in enhancing weight loss in the context of bariatric surgery, it’s important to note that research in this field is ongoing, and results may vary across studies.

Other studies have shown more promising results. For example, one such study investigated the impact of FMT on weight loss in patients with obesity, considering clinical and microbial factors. The researchers compared mixed-donor nonintensive FMT with single-donor intensive FMT. Results indicated that 13.2% of patients in the mixed-donor group achieved a weight loss of at least 10%, whereas no patients in the individual-donor group reached this threshold. Despite engraftment in all patients, there were no sustained differences between the two groups, suggesting that intensive individual-donor FMT did not induce lasting weight loss or microbiome changes compared to non intensive multi-donor FMT. Notably, mixed-donor FMT led to a durable increase in the abundance and diversity of butyrate-producing bacteria, once again pointing at butyrate as a key player in the question of obesity and the microbiome. The study also identified associations between weight loss and specific microbial changes. Higher initial amounts and reduction after FMT of Bacteroides dorei were linked to overall weight loss, while a weight loss of 10% or more correlated with increased amounts of butyrate-producing bacteria, including Anaerostipes hadrus, Collinsella tanakaei, and Roseburia hominis.

These findings, suggesting differential impacts of FMT regimens on microbial composition and weight loss, highlight the value of personalized microbial-based therapies for obesity based on donor and recipient selection. This personalization could include matching donors with specific microbial profiles to recipients to enhance the success of FMT interventions, although the evidence seems to point more and more to butyrate and butyrate-producing bacteria as a key mover in weight loss. Additionally, the frequency and duration of FMT sessions, as well as associations with specific bacterial species, could be factors influencing the weight loss response. While these findings provide valuable insights, further research is needed to establish broader guidelines for the application of FMT in weight loss interventions.

Another area in which the gut may be affecting weight loss is around gluten sensitivity. One randomized clinical trial aimed to investigate the effects of a gluten-free diet on components of metabolic syndrome. The results indicated that the gluten-free diet led to a significant reduction in waist circumference and improved glycemic control and triglyceride levels compared to the control diet. The findings suggest that a short-term gluten free diet can positively impact some key features of metabolic syndrome, specifically reducing abdominal fat, improving blood glucose levels, and lowering serum triglycerides.

Many individuals without metabolic syndrome may have slight gluten sensitivity, not to be confused with Celiac disease, and this gluten sensitivity could lead to weight gain or hinder weight loss. Leptin, a crucial hormone in signaling feelings of fullness to the brain, plays a key role in regulating hunger and satiety to maintain a healthy body weight. However, individuals classified as overweight or obese often experience leptin resistance. This condition, characterized by high leptin levels without a corresponding cellular response to satiety signals, hinders the body’s ability to manage hunger effectively. A study conducted by Swedish and Danish researchers and published in the December 2005 issue of “BMC Endocrine Disorders” suggests that grains, particularly those containing gluten, may contribute to the development of leptin resistance, potentially leading to weight gain and obesity.

Whatever the mechanism is, I can tell you one thing from my own personal experience. I eliminated gluten because it’s known to be a risk factor for autoimmune disease, and I was trying to reverse my Hashimoto’s thyroiditis. Anyone with an autoimmune disease is recommended to stop eating gluten, because of its role in creating a leaky gut (which also predisposes you to LPS leaking out). As a result of being strictly gluten-free, I avoided so many breads, cookies, cakes, pies, etc. that I would have otherwise eaten, thereby making it much easier to avoid sugar, which of course is related to weight gain. And when I knew I’d be going somewhere with desserts and would feel deprived, I’d make my own almond flour muffins with xylitol as a sugar substitute and eat that instead. And I did, by the way, successfully reverse my Hashimoto’s. I have had normal antibodies for like 3 years now and still have optimal TSH levels and have never had to take thyroid hormones, since my diagnosis in like 2013 or 2014.

So if you’re looking to lose weight, I’d recommend going off gluten, whether or not you have evidence of a sensitivity, because it’s just present in so many processed foods that are so addictive. Or if you want to check whether gluten sensitivity is actually a factor in your weight loss resistance, you can try a short-term elimination for 4 weeks. Without changing anything else, track on a weekly basis your weight, waist measurement at the belly button and any other symptoms from gastrointestinal to skin to headaches, brain fog, etc. and check if you feel better off gluten. If you want to make it super objective, try to replace gluten-based foods with equivalent gluten-free foods, although I wouldn’t recommend breads and desserts and regular pastas for someone trying to lose weight. Be sure to closely check your food, medication, and supplement labels for hidden gluten. Then you can try reintroducing gluten by eating a couple normal sized servings in a day and evaluate your response over the next 3 days.

Finally, I’ll finish up with the more obvious interventions for weight loss but with an eye toward developing and maintaining healthy gut microbiota. You’ll want to incorporate plenty of polyphenols into your diet, which are micronutrients recognized for their antioxidant properties, disease prevention and positive effects on the balance of beneficial gut bacteria. They are found in colorful fruits and vegetables, or products like Poly-Prebiotic powder by Pure Encapsulations*. Great food sources of polyphenols include cocoa powder, berries, dried herbs and spices, hazelnuts, chestnuts, pecans, and red, purple, orange, yellow and dark-green  vegetables, as well as beverages like green and black tea. Embracing these polyphenol-rich foods can contribute to a healthier gut microbiome and support weight loss.

Fiber, along with polyphenols, is also recognized as a functional food that provides food for the fermentation of beneficial bacteria in the gut, leading to increased short chain fatty acids like butyrate. Found in undigestible carbohydrates from fruits, vegetables, beans, legumes and nuts, fiber serves as an excellent nourishment source for beneficial bacteria. Gut health is extremely influenced by fiber, evident in the distinctive gut microbiota of individuals consuming animal-based diets versus those favoring plant-based diets. High intake of meat, eggs, and cheeses with low fiber content results in an abnormal gut microbiome characterized by reduced fermentation. Additionally, individuals consuming substantial amounts of animal fat face an elevated risk of pathogenic bacteria, potentially linked to increased iron consumption. In contrast, those with higher intake of plant-based prebiotic fiber from fruits and vegetables exhibit an abundance of healthy bacteria in their guts. Note, however, that this does not apply to ketogenic diets, which bypass the traditional production of butyrate through fiber fermentation  and instead produce ketone bodies like acetoacetate and beta-hydroxybutyrate and isobutyrate, a metabolite of protein fermentation, which also help with keeping the lining of the colon hypoxic.

That being said, I am generally a supporter of an unprocessed, omnivorous diet with adequate protein, which is basically one gram per pound of ideal body weight a day, including mostly lean animal proteins, at least 2 servings of fatty fish a week, limited saturated fats but from high quality pastured-raised sources like meat, butter or ghee from organic, pasture-raised animals. Dairy is okay if you have no sensitivity, again from pasture-raised animals, with priority going to fermented dairy like yogurt and kefir and hard cheeses in limited quantities. Then healthy fats from nuts, seeds, avocados and healthy oils like extra virgin olive, avocado, Zero Acre Oil*, which is a fermented oil high in Omega 3’s that tolerates high heat cooking, or flaxseeds or flaxseed oil or walnuts in particular for Omega 3’s if you’re not otherwise supplementing with Omega 3’s or getting them from fish. And then getting a rainbow of fruits and veggies with a minimum of 5 servings a day and preferably as many as 9 servings a day. And then for starches, the best choices are starchy vegetables other than white potatoes, so root veggies, winter squash, sweet potatoes, yams and legumes, quinoa and other whole grains, brown rice, black rice, wild rice or cooked, cooled and either eaten cold or only slightly reheated white potatoes and white rice, which are good sources of resistant starch, which functions like fiber in the body and in particular feeds those butyrate producers.

Generally, to lose weight, most women need to stick to no more than 2, ½ cup servings of these types of starchy foods a day and men may be able to get away with a little more. And if your diet is very far from this, I’d suggest picking one area to tackle each week to move more towards a diet like this so that the changes won’t be overwhelming and will be sustainable.

If you’re looking for help with weight loss, I still work with clients in this area both from the food, mental and lifestyle perspectives through a weekly program that runs for 12 weeks, as well as incorporating testing and interpretation to see what’s going on metabolically that might be impeding weight loss. Or if you are struggling with bloating, gas, burping, nausea, constipation, diarrhea, soft stool, acid reflux, IBS, IBD, SIBO, candida overgrowth, fatigue or migraines and want to get to the bottom of it, that’s what I help my clients with. 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 3- and 5- appointment health coaching programs 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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Personalized Health: Your DNA’s Role in Gut Health, Detoxification and Methylation with Bryce Wylde, DHMHS

Personalized Health: Your DNA’s Role in Gut Health, Detoxification and Methylation with Bryce Wylde, DHMHS

Adapted from episode 110 of The Perfect Stool podcast and edited for readability, with Lindsey Parsons, EdD, Gut Health Coach and Bryce Wylde, DHMHS, of VennMed in Toronto and co-founder of The DNA Company, who did a DNA sequencing report for Lindsey. To best follow along, download the PDF report.

Lindsey:

Before we launch into my DNA results and what they say about my gut health, can you first tell me about how you arrived at the conclusions that you make in the DNA reports from The DNA Company?

Bryce Wylde:

Well, I had the privilege of under studying with Dr. Mansoor Mohammed, who’s revered probably by most genetic experts, and genomists around the world as within the top 10. So I’ve been in clinical practice over 20 years, and we shared a significant degree of patients between us in this very eclectic multicenter practice called P3 at the time. We no longer practice under the same brick and mortar, but with his IP, and his insights was born a lot of what he would see in this particular DNA report.

Lindsey:

Okay. And this was based on patients that he saw and in their DNA reports?

Bryce Wylde:

Yeah, so Dr. Mohammed had a long standing company and had seen at the time, I believe it was about 2000 individuals, patients of his that he’d done genetic reports on. He has a double PhD from UC Baylor, and was a UC Davis graduate focused in genomic pathways. At that time, along with a team at the DNA company, we amassed another 6000 or so patient samples. Of course, some of this was from his actual clinical experiences, and his former education. From thousands of individuals, we were able to extrapolate a lot of what you now see within the DNA report.

Lindsey:

I think I heard you on another podcast, and you were talking about the fact that there were interviews with patients that was then cross referenced with their genetics.

Bryce Wylde:

You’d have to remind me of exactly what that podcast was, but we certainly would have had a lot of endpoints within any given patient that we consulted with as it pertains to them having gone through genomics. This wouldn’t be exclusively genetics, it would be on all types of functional genomic endpoints and laboratory studies and their full clinical medical histories that would have been taken in combination. Absolutely.

Lindsey:

Okay. I think maybe it was Chris Kresser. Have you been on his podcast? No, I haven’t yet.  Okay. It wasn’t Chris Kresser. I can’t remember whose it was then. I’ll have to look it up. So can you explain for people who may order their own reports what the letters mean for each gene. So for example, I show a list of relevant genes under the hormone section. Here’s an example: CYP17A1 and then after that, there’s an AA, and then there’s another one, SRD5A2, and after that, there’s a CG. And then after another one, there’s a CC, and after another one, a CT, and another one, there’s a 2.

Bryce Wylde:

It’s an alphabetical soup. So that’s going back to biology 101, grade 11. Most people that are concerned and are interested in this world of genomics, they’ll often come across the term SNP first or single nucleotide polymorphism. We all have them, they’re not the more revered mutations, but we’ve all started to come to learn to understand and appreciate them. They’re a natural occurrence, a variation of a particular gene, or your SNPs, Single Nucleotide Polymorphism variation. So how your particular gene expresses itself, given some genes are nonsense, or non code, and then others are actually making proteins and hormones and doing other things for us. So out of these important genes that we care to learn about, you have different variations. Some are more common to the population, some are considered to be the preferred variant, while others are considered the poor, or not-so-preferred variant, depending on the context. So when you’re thinking or seeing an A variant, given a particular gene, or an AG, or a GG variant, these variations may be, given that particular gene and whether what it does is optimal, sub-optimal, average, or poor. So it’s kind of like getting a report card, but I should say that there is no perfect combination. No one has the best genes. There’s simply variants that you have and knowing what those variants are can help you get through this game of life. I mean, genes are the cards that mom and dad have dealt you. I like to say that how you play them in this game of life is really what matters. So understanding what those cards are, is akin to understanding what variations or the numbers or letters that add up and how they pertain to your SNPs. So at the DNA company we go further than just looking at SNPs and the conglomerate of variations of those SNPs, we look at pathways. Inclusive within those pathways, often we’re looking at copy number variation. So to your question around numbers, these are like instruction manuals. We’ll talk about this a little bit later on as it pertains to detoxification, for example, the glutathionization pathway. So how our bodies manufacture glutathione and its detox process, you’re getting a whole manual of instruction on how to do that from mom, and from dad. Unfortunately, in some cases, we end up with only one or in many instances, zero copy number variations, or no variant. And then there’s the case of inserts and deletions, whole lines of code. So maybe not the entire instruction manual is missing, but sentences are missing within paragraphs. They’re just not there. Or in some cases, double sentences, so that’s two sentences being redundant. These are known as indels, or inserts and deletions. So we’re looking at SNPs with the AA, AG, GG variation, which one do you have. We’re looking at inserts and deletions, and we’re looking at copy number variations, and putting them all together. You can never take one gene out of context, I like to always add that. You have to consider numerous genes, in many cases, dozens of genes together before drawing even remotest of conclusions.

Lindsey:

Interesting. So when I look at this gene and the letters after it, I don’t know what the default preferred variant is for CYP17A1. I have AA, but I don’t really know if AA is good or bad.

Bryce Wylde:

Well, it’s good, let me tell you, but again that’s taking one gene out of context and looking at it on its own, because it depends on what we’re trying to accomplish in that instance. When we get to hormones, and we certainly will, we’ll cover that that. When we’re talking about the hormone pathway, most folks don’t understand that whether you’re male or female, which is decided by the XX or XY chromosomes, we all produce hormones with the exact same cascade. So look forward to talking about that. With the gene you described, it’s really more specific to how fast you might actually produce estrogen from progesterone. I mean, we’ll get into it. And it’s a really interesting pathway.

Lindsey:

I didn’t want to get to the details of that yet. My comment was more about understanding that as I look at the report, and I see those letters, there’s nothing to tell me right off the bat whether what I have is the preferred or not preferred variant, correct?

Bryce Wylde:

That’s because you’ve got to take them all together. You really look at this as a big book on you. This is your instruction manual. And there’s no such thing as good or bad, really. In instances where we reflect back to or refer back to the literature, and we look at these individual genes as optimal variants, or sub optimal variants, based on population dynamics, it’s very interesting. In some instances where someone has what might be considered the perfect gene, two of them might actually not only cancel each other out, but maybe create a suboptimal combination. So you have to take them all in context, considering where you live, your ethnicity, and your environment, all these things.

Lindsey:

One other question related to that. So if I see two, that means I have two copies of that gene, correct?

Bryce Wylde:

That would be correct. In this instance, we’re looking at copy number variations, or CNV, specific to glutathione, and glucuronidation. The specific ones we’ll be focusing on today are the pathways that are responsible for both detoxification and hormones.

Lindsey:

Let’s start with the detox pathways. How do they relate to gut health? And what does my DNA report say about mine?

Bryce Wylde:

Well, let’s just look. When we put all of these together, and we look at one full and complete list, it’s many pages long, so we’re going to take a minute just to get down to the very bottom of this. Just to summarize, one of our primary focuses being how do you intracellularly produce glutathione. Glutathionization is one of the most important antioxidants, if not the most important. Remember, I was telling you at the top, off-camera, that we don’t actually list a specific detoxification sub report. Detoxification is on page 10 of your hormonal report (p. 144 of PDF), since we’re going to come back to this momentarily. And so what we’re looking at in this instance is, as I mentioned, glutathionisation, GSTT1, or glutathionized theta. Before I get into the depth of your particular findings, you would probably agree with me that elimination of toxins, the liver-gut axis, the microbiome interaction, and the barrier function all play a role, and of course the gut plays a vital role in eliminating toxins and waste products. And efficient detoxification ensures that harmful substances are promptly removed from the system, safeguarding gut lining integrity. GST plays a huge role when it comes to the liver-gut axis. That’s the primary detoxification organ, and its function is very closely linked to gut health. Bile, produced by the liver, aids in digestion and carries waste products and toxins for elimination through the gut. This is also very much involved in microbiome interactions, so it can influence detoxification. Conversely, if you’re not able to rid yourself of toxins and metabolites, this influences the composition and function of the gut microbiome. This is good news for you: we see the number two here next to yours, GSTT1. I shouldn’t forget to mention barrier, so efficient detoxification eliminates the interaction or inflammation between the barrier and maintaining that gut barrier essentially prevents leaky gut, and even leakage of toxins into the system and substrates into the bloodstream. So GSTT1 is supposed to have a copy from mom, and a copy from dad, you got two, so you’re lucky, this is excellent. This is associated, as our report says here, with an increased enzyme function clearance of substrates. So that’s good. We’re also looking at how many GSTM1 or mu 1 copies you have now. This is the master gene that GSTT1, let’s call the GSTM1 a very close, but important, second. You’re supposed to also have a copy from mom and dad, which you also have, which is amazing. Therefore, relating to clearance and processing of xenobiotics and pharmaceuticals and reactive oxygen species, you’re doing very well. So in fact, you are gene blessed, as it relates to glutathionization. GSTP1 is a good example of some variation in a SNP or the Single Nucleotide Polymorphism that sits on this gene RS1695. This is where things may get backed up slightly with you. G variations in individuals we know relate to the ultimate clearance of some things like Tylenol. So that might get a little bit held up. Certain aspects of environmental xenobiotics, those that impact us as it pertains to hormone mimickers, and so forth. This gene, it’s a member, obviously, of the glutathione S-transferase gene family. But looking at this as a single phase two detoxification SNP you are a little more susceptible to certain things, certain health concerns that are associated with toxins, chemicals and certain heavy metal exposure and gut permeability. While there’s no direct evidence linking GSTP1 to gut hyperpermeability, we know that oxidative stress is known to influence the integrity of the gut barrier, obviously. And so it’s very likely that GSTP1 through that role in mitigating oxidative stress might very much influence gut permeability. Superoxide dismutase is very important, as we know, a manganese-driven enzyme and gene. Again, here we’re looking at a SNP, and yours being a CT variation. There’s this association of a 30 to 40% reduction of superoxide dismutase. When we’re seeing the essentially reduced clearance through the GSTP1 and superoxide dismutase, there’s that increased risk of reactive oxygen species accumulating. So you’re going to be interested in managing antioxidants. One of my favorites is the tocotrienols. I’ve done a lot of deep dive into this. Forgive me Lindsey, I’ve seen your whole report, so it’s hard for me to hold back. There’s some instances where we’re talking about gut health, we just mentioned the linkage to liver and that interconnectivity, but because I know about an aspect of your cardiovascular health related to the 9P21 gene. We look at three different SNP variants of that gene and anywhere there’s a G, it’s considered an elevated risk. What we’re talking about with this gene is the potential of inflammation to the endothelial lining. As we’ve known for a long time, the recommendation in this case is to suggest even something like tocotrienols is manyfold. This endothelial lining inflammation predisposition that you have signals to me appropriate consideration for tocotrienols, so not just because of SOD, you’ve got the CT, and GSTT1, you’ve got also the hybrid AG variant, which tocotrienols do a great job of eliminating or sweeping up the mess. This was the work by the way, Dr. Chandan K. Sen of Ohio State University who’s projects get funded $25 million year over year by the NIH, so we know there’s something to them. There’s really great work done there. They looked at post-MI, post-stroke, revascularization and recovery, and white matter lesion reversal. So it’s really amazing stuff. I’ve been to Malaysia, by the way, and I’m not speaking on behalf of the tocotrienols that might come out of Africa or Indonesia, because I’ve never been there. But I hear very terrible things about deforestation. Anyways, tocotrienols from Malaysian Sustainable Palm Oil might be the indication here for you, because of the 9P21 variation and the predisposition to your endothelial lining, and also how it might actually do a great job managing the very slight Achilles heel within your own detox pathways. By the way, the research shows tocotrienols have an amazing capability to reverse NAFLD or non alcoholic fatty liver disease. So there are a lot of little nuggets there to take away.

Lindsey:

Yeah, let me interrupt you for a second because I actually had Dr. Barrie Tan on the podcast, who discovered a source of annatto-tocotrienols. And we talked all about that, and I have subsequently suggested that for a lot of my clients, and I think I have my parents on them and my fiancé on them.

Bryce Wylde:

Well, we’re on the same page then. He has an incredible product that he talks about. The annatto derivative is perfectly good. It doesn’t have to be the Malaysian Sustainable Palm Oil. But the tocotrienols themselves are an incredible antioxidant. So it sounds like we both agree.

Lindsey:

Just so people understand what we’re talking about, we should clarify this is a form of vitamin E.

Bryce Wylde:

Correct. Thank you. And then GPX, glutathione peroxidase. . . . . . of that report. You’re going to scroll down until you hit the hormone report, and then it’s page 12 of the hormone report. We see GPX, and your variation here is a CC. First of all, this gene provides instructions for making the glutathione peroxidase enzyme, so that plays a very crucial role in protecting the body as well from oxidative stress. You’re doing well here. It basically takes hydrogen peroxide and other harmful peroxides in the body, turns them into a very benign and neutral water molecule. Here’s where I just took a quick peek as I scroll down to the end of page 12 and reminded myself of this 9P21 and the fact that you’ve got this between 4 and 6G association. Again, this is the endothelial lining, so this is all relevant within the context of hormones. We stop the detox conglomerate when we go through the GSTT1, GSTM1. You’re doing amazing there with both copies from both parents. On the other hand, GSTP1 and SOD2 are where we want to tweak things a little bit for you, and manage your clearance from phase 2 and just get this sweated out, pee it out, poop it out, get it out. If I’m talking to a client that has this variation combination, if they can afford it, obviously, I often recommend infrared saunas. It’s amazing. Your gut is like inverted skin, and so getting that skin active and sweating out certain things is really good for it. Especially studies show with heavy metals we might do a better job getting rid of them through our sweat pores than we do through our kidney clearance. So that would be the detoxification report in a nutshell.

Lindsey:

We’re on page 12 now (p. 148 of the PDF) Well, let’s move on to methylation. So I’m sure many people have heard about MTHFR. I know there’s a lot of confusion about what that means and how important it is, and maybe some exaggeration of its importance, as well as ignorance about other genes that play into methylation. Let’s dig into that.

Bryce Wylde:

I’m going to go back up a bit here to immunity. And I apologize for flipping all over the place here, but soon I’ll give you the page number within the immunity report.

Lindsey:

All right, and just note that the page numbers restart with each report. So the first one was within the hormones section, pages 10 through 12. And now we’re going to be inside the immunity section.

Bryce Wylde:

Going back to our earlier conversation, a lot of these genes and genetic genomic pathways, you will see some repetition. It won’t be exclusively in the hormone report that you’ll see detoxification, rather it’ll be scattered throughout all the reports. It’s also very relevant to cardiovascular health and disease. It’s very relevant to the hormone clearance that we just looked at. Let’s focus for now on the cardiovascular support. So rather than scrolling all the way up to immunity, because both immunity and cardiovascular involve methylation. Methylation is almost sort of synonymous with inflammation, but not quite. Without oversimplifying, because it is quite a delicate biochemical dance, I look at it like it’s a relay race, where in this race, you’ve got five racers and the baton stands for the methyl group, and the methyl group is CH3. If any of your racers obviously dropped the baton, that’s a problem. It’s not a problem that’s very easily solved by throwing more batons at the race. You’re disqualified if you drop the baton, but it’s of no use to just lay three or four batons on somebody, because more is not always better. So it’s a careful dance, these methylation, biochemical pathway circles. The endgame here for us is to understand what type of support you might need. Through the use of very specific types isomers of B12 and folic acid, we may support and fuel this particular pathway, given the various SNP associations that you might have. As they pertain to gut health, particularly, cellular health is huge, and our guts turn over at a very rapid pace. The immune function plays a role here. As does the microbiome that we already alluded to, in respect to detoxification. As it relates to cellular health, just for example, the methylation pathway and optimal methylation needs an availability of B12 and folic acid. They are imperative for maintaining the health and for repairing the gut lining with that speed of turnover. Obviously, for nutrient absorption, macro and micronutrient, and barrier function are important. When it comes to immune function, methylation plays a very important role in regulating the immune system at large, but it’s also crucial for managing gut health and preventing conditions like IBD, inflammatory bowel disease and leaky gut. The microbiome is a two-way street, but B12 status influences the composition of the microbiome and it plays a role in producing some of it. It also significantly impacts overall gut health in this dance with B12.

Lindsey:

We’re on page nine of cardiovascular report.

Bryce Wylde:

So MTHFR, or methyl tetrahydrofolate reductase. We’re looking at the SNP variant you have here being a CT. I don’t want to get overly complicated here, but this is the one people focus on most often. Sometime the single gene is presented to them, and they think this is the end all and be all even though it absolutely isn’t. I want to remind folks of that analogy I said before. It’s a race. It’s a circular race around the track. They’re really racers. MTHFR is just one of the racers, and it’s a really important racer. It’s part of the pathway catalyzing specifically the conversion of the 5,10-Methylenetetrahydrofolate to the active folates. This 5MTHF is then utilized as a methyl donor to B12 for the conversion of homocysteine to methionine. Homocysteine to methionine, this is the job that this is doing. In you, it’s associated with CT variant to a 30 to 35% reduction of enzyme activity with the intermediate 5MTHF production. We’re not just reporting on this saying that there might be a little bit of an issue here. I’m going to tell you at the end of this, what kinds of B12 and folate are the right ones for you. Because as I was alluding to, just throwing more batons at your racers is not the solution here. That’s called hypermethylating, that can be a problem as well. A lot of folks when they came to learn that they might have a CT or a TT as you do, just throwing extra folic acid at it may not be not only the right solution, you can also throw the wrong kind of folic acid at some some folks, depending on genes within the methylation pathway that are nonspecific to the variations of the MTHFR gene. You wouldn’t know what kind of folic acid to consume unless you went on in this report. Low blood folate is associated with elevated homocysteine levels and increased risk of cardiovascular disease. It’s relevant to you because of the 9P21 gene, and some others. We’ll talk about the maybe the APOE factor. We know all about early pregnancy and normal fetal development. The speed and turnover of the endothelial lining is important to manage. Folate serves as an ingredient to manage DNA turnover. You have this association of 30 to 35% of this enzyme activity and as folate’s crucial for synthesis and repair. And you know it’s vital in maintaining the health of these rapidly dividing cells in the gut lining. It doesn’t stop there. SHMT1 is a co-conversion of the L-serine and tetrahydrofolate, to glycine and the 5MTHF actual end results. So this is an intermediate, kind of little clinical pearl. The GG genotype that you’ve got here, when considered with the context of the MTHFR, is associated with optimal folate metabolism. This is looking at concomitant disease risks reduction associated with dysfunctional folate metabolism. Many who have a poor variant also have issues with the cellular processes, including this gut cell turnover and repair. But in your case, it’s associated with optimal bioavailability and efficient homocysteine to methionine conversion. So here’s the bottom line for you. It’s not the case with everybody, but you’re fine with methylfolate. If somebody didn’t have this genetic sequence, then they may want to be taking folinic acid where you’re getting down to the end of the conversion. In your case you’re fine with folate, methylfolate, more 5MTHF or quadrafolate. Really you’re fine with any of those types that are out there with the MTHF assignment. And then we’ve got MTR: you’re an AA. MTR catalyzes homocysteine to methionine and uses B12 to do it, as the methyl donor in this particular reaction. So this is associated with optimal enzyme activity and conversion of homocysteine to methionine. That’s the AA assignment. It turns out because of this, and I’ll explain some other variants in a second, that you’re fine with methylcobalamin, or the methylated form of B12. If you had any of these other variants down here, we might be wanting to give you a adenosylcobalamin so we’re not hyper methylating you. In studies done on autistic children who found that they had the 5MTHFR. They call it the SNP. Everyone’s got that SNP. It matters what variation of that SNP you have. Right when they found out they had this poor variation of this particular SNP, which is the TT variation, they were giving them in many cases methyltetrahydrofolate, in the methylated form. And in about 15 to 20% of them they were doing worse. And the question was why? And this was one of the answers that Dr. Mohammed was able to answer because they weren’t assigned these other variants that actually helped them to pass that baton in this race and effectively do so in a way that they were able to methylate properly. And then lastly, your MTRR, this reactivates methionine. You have the version AG associated with a slightly reduced enzyme activity, which won’t affect its precursor here, the MTR. So by the way, MTR and MTRR together influence B12 availability, which of course is crucial for DNA synthesis and maintaining the health of the gut lining. But just having this AG here does not all of a sudden screw you up and cause you to require the adenosylcobalamin. So again, we’re still giving you that form of methyl B12. It’s important because this can contribute to things like B12 anemia.

Lindsey:

Which I had following SIBO and and what turned out to be post infectious IBS and for a time positive for pernicious anemia. My hematologist recommended that I get on methylcobalamin. And I’ve essentially been on it continuously for the last 10 years.

Bryce Wylde:

And it would have worked, but guess what in some other combinations and in other folks with the same looking red blood cell count and differentiation, given that, they may not do as well. They may need adenosylcobalamin.

Lindsey:

Lucky guess for him!

Bryce Wylde:

Right. Then lastly, fucosyltransferase, FUT2 the AG is associated with slightly suboptimal enzyme function and plasma levels. This encodes for an enzyme basically, and this is releveant to you, by the way, found in epithelial tissues in the gastrointestinal mucosa and salivary glands. So this SNP shows a significant association with plasma B12 concentrations. And in your case, as you mentioned, this would be the gene that I would associate with poor enzyme function, and poor plasma and B12 levels. All G-allele carriers, whether you’re AG or GG, are associated with significantly lower plasma B12 levels, so what you said doesn’t surprise me at all.

Lindsey:

We’re on page 11 (p. 56 of the PDF). So those two markers that are in the suboptimal variant of AG basically mean that it’s not unusual that I should have to continue to supplement with B12 and folate, methylfolate.

Bryce Wylde:

Yep. And also by the way, combined with a vegetarian diet, these variants are associated with extremely clinically low, and vegan obviously, B12 level. So really important to get on the . . .

Lindsey:

Yeah, I’m not a vegan . . .

Bryce Wylde:

intramuscular in some instances or sublingual various forms of supplementation. Perfect. Yeah, so by the way, most folks that run this test the DNA, we should remind anyone who doesn’t know this, and I’m sure most of your listeners would definitely know this, DNA is one and done. You run this test once your DNA is going to change. The most incredible thing is that where you can’t alter your DNA, you can manage genetic expression, that’s epigenetic. And that’s what we’re talking about, through in this case, a perfect example, methylation. Manage this, by quelling the fire, I don’t care what you call it, subduing and mitigating inflammation, but you’re managing it in a way, your variations of methylation and how you’re able to carry the baton in this relay race with the right types and formats of B12 and folic acid. It really boils down to that for me anyways. There’s other implications here. But that’s really what it boils down to for me, for gut health.

Lindsey:

Yeah, I have always taken it sublingually since that time, because of the pernicious anemia and the SIBO. Right? Okay, so the third area you suggested we focus on is hormone pathways as it relates to gut health. So how are they related? And what does my DNA say about that?

Bryce Wylde:

Let’s just scroll right back down to the hormonal report to keep it simple. Toward the end, we call it hormones fitness and body type (p. 143 of the PDF). We use the traffic lights just to give a visual description of speed. What I want to emphasize here is that again, I alluded to this earlier, but everyone, whether you’re an XX or an XY individual born into this world with those chromosomal differences, we all have the same pathway, hormonally. It’s the speed at which we produce certain hormones that’s going to make the difference here. Again, this is not going to define whether you’re male or female. Within each of those categories, male XY and female XX, you’re going to have this spectrum of androgenized females through to estrogenized females and those in between. Same with men. There’s androgenized guys and estrogenized guys. The team at the DNA company have gotten pretty close now to looking at somebody and phenotypically being able to give a rough estimate of what their hormones probably exude from a genomic perspective. For example, we’re all wearing our heart on our proverbial sleeve here, I’m an estrogenized guy. I’m probably going to have a full head of hair until my late 80s, as my father and both grandfathers did. So that’s just one phenotype. Obviously, the challenge, in my instance, is retaining muscle mass as one additional phenotype. It’s hard for me, so I have to work extra hard. Then you’ll have the guys in the gym and they take one or two days out of the week, and they do half an hour and they’re ripped, and they’re bald. And guess what, they might have that advantage, but then certain hormones an androgenized guy has might predispose them further to prostate cancer, or a BPH (benign prostatic hyperplasia) for that matter. This relates to the gut because it could affect the speed at which you produce progesterone into testosterone, testosterone into estrogen. We know too much excessive estrogen is very proinflammatory, particularly in the gut, and then how you take estrogen and the genes that help clear or metabolize estrogen into their end metabolites. So these are known well for their predisposition unto estrogen-related cancers, breast, ovarian, and colon. And then step three, how you detoxify those, and we’ve been through some of that, but we can reiterate them. So obviously, there’s the hormonal influence on gut permeability, we’re coming to know that. So variants, and we’ll come back to CYP19A1, which is how quickly you take androgens and make estrogen, which affects estrogen synthesis. And that might directly actually influence gut barrier function. There’s the stress response. That’s not just an executive function thing. That’s a hormone thing, and integral to the body’s stress response, causing us to, depending on our variations and genetics, be susceptible to irritable bowel syndrome. Genes like CYP17A1, that you mentioned at the top, that starts this whole cascade here, involved in synthesizing stress hormones. You know that plays probably plays a role. And there’s gut motility, like hormones and neurotransmitters of course influence the speed at which our guts move, right? And how transit time works. Inflammation, particularly sex hormones implicated with an inflammatory response in the gut. So variants here, the androgen receptors, the AR gene, and the variations there affects androgen receptor function, of course, but influences inflammation, inflammatory pathways in the gut. There’s the microbiome composition, there’s immune function, nutrient metabolism, of course, detoxification, all of these things are going to have a major influence on gut health. So your CYP17A1, how you take progesterone in the steroidal sex hormone pathway and produce testosterone, you see this red light, that’s you, you’re slow. That’s actually great. I mean, we call it great, because it depends on everything else I see here. But it’s great because it’s slower, or red light, by the way, does not mean somehow you’re stopped, whether you’re not making enough, it’s not a bad thing, it’s the speed at which you’re taking this. So given that you have a yellow or a green light on the CYP19A1 or in this case, taking testosterone making estrogen. This would be your saving grace if you were green, the speed at which estrogen over spills in the body. But if you were an amber light here, or even a green light here on the CYP17A1 is what I’m pointing at. But then you are an amber or red light on the CYP19A1. That’s a different picture. But I’m painting the scenario of one compensating for the other in terms of overspill, in particular as it relates to gut health of estrogen metabolism. So your variation, and we can flip down to those variations, but I know what they are. So I’ll just refer to them in context of this picture here for you, your CYP17A1, you’re an AA. So this is again, responsible for biotransformation of pregnenolone, progesterone to testosterone, and the Cytochrome P450 cascade. So first step in hormone production critical in determining degree with all your hormones, the rest of their influence on your overall health. So you are a slow converter of progesterone to testosterone, the SRD5A2 is your testosterone into the very virulent dihydrotestosterone or DHT. And the speed at which you do that is average, we’re in the middle in between. Now, one of the things, were talking phenotype, might as well bring it up, it’s not so relevant to gut health, but I can tell you, compared to your peers, your counter, your friends, whoever, that they’re complaining, I mentioned the gym that they’re complaining the degree of what it takes them to work out in the gym and have some level of definition or be lean, and somewhat muscular. And then other friends are always complaining about cellulite and fat retention, all these different things. Obviously, I know, you pay close attention to your diet, I don’t know, maybe there was a time that you didn’t. But even in those times, so long as you did exercise somewhat. And if we consider this, the androgen receptor gene here, and the speed at which you clear testosterone, you don’t have to work as hard as the average person to actually retain muscle mass, and you’re not going to be one of those that really notices cellulite. It’s just the phenotype that you have. I mean, feel free to correct me if I’m wrong, but at least your genes.

Lindsey:

No, not wrong.

Bryce Wylde:

Yeah. So SRD5A2, this is the 5-alpha reductase that converts testosterone into dihydrotestosterone. For you there’s moderate enzyme activity. And you know, we call this potential for elevated dihydrotestosterone. It’s worthy of mentioning at this point. These are genes and depending on your environment, your lifestyle, so many other factors. The only thing it’s going to tell you any conclusive evidence of what’s happening at this moment in time right now are laboratory biomarkers, right? So endpoints, you can test for DHT, right, you can test for these things. Depending on where you are in your life. These are just the signals or the genes that dictate the average amount over your life and where you sit there. But at any given time, you can test for all these different things to know where you are. By the way, in menopause, and I’m sorry to take another tangent, but it’s so relevant in so many things. How you come into menopause, is entirely predicted by where you started this cascade. If somebody is very quick to make an abundant amount of testosterone, and by the way, guess where all estrogen comes from? Testosterone. In guys and and females, it comes from testosterone. It’s the CPY19A1 gene that makes it, in what speed, but if you’re greenlit here from progesterone into testosterone, and you’re greenlit from testosterone into estrogen, what do we call that? We call that estrogen dominant, particularly if how you convert into DHT is relatively slow. It’s like a cascade or waterfall. Everything is going into estrogen. And then if you have over here your estrogen metabolites, I’m giving a hypothetical situation, this is not you. If you’re producing very little 2-hydroxy but a ton of 4-hydroxy and 16-hydroxy, well, then we know what the risks are from that in these estrogen scenarios. Now your estrogen dominant plus estrotoxic, right? So these are these sort of scenarios. That’s not you, thankfully, in again with with you the if there’s potential for producing high amounts of DHT. And I just described some of the various phenotypes. We’ve got to be concerned or thinking about things like PCOS when there’s an elevation or retention of DHT. But your CPY19A1 gene is not at all sluggish or too slow. It’s right right there in the middle, which is exactly what you want. So again, just to remind everyone listening, this catalyzes aromatase and this is the very rate limiting step in the conversion of androgens into estrogens both men and women. And of course, you’re this moderate expression with enzyme activity with modestly reduced estrogen and estrogen to androgen ratios. And again, in postmenopausal, here’s my prediction for you ready? I don’t have a crystal ball, but you’re going to have a quite an easy menopause. You know, I can tell you the reality is that the hot flashes are insufferable, and I’ve had to go on hormones.  Oh, you have? Okay, that’s interesting. So the hot flashes may be related to some of those other genes as they pertain to the 9P21 and detox, but, but I would have predicted a relatively easy menopause.

Lindsey:

No other symptoms besides the hot flashes.

Bryce Wylde:

Okay, good. Well, that’s another predictor. By the way, these are all symptoms that the body uses to prepare, inevitably, this shift. So the speed at which you actually go through menopause is another thing, and nothing I can predict through what I’m seeing here. But how quickly obviously, your estrogen supplies dwindle, controlled by other genes, would be would be related in this as well.

Lindsey:

So first question. Is there anything in here that predicts that I’m going to be low on progesterone?

Bryce Wylde:

So we don’t look at the genes that ultimately cascade down from cholesterol, because they’re not as important. Obviously, if you’re on a statin, and certain things suppress cholesterol, or some of the other precursory . . . pregnenolone, and so forth. But what this suggests is the amount of progesterone that is otherwise circulating at any given time, is otherwise average to higher than the average individual. So and that doesn’t mean menopause because those are all going to blink a little bit. But here’s really what I want to drive home depending on what kinds of hormones people are otherwise supplementing, bioidentical hormone replacement therapy, there are certain qualifications we like to look at. And this is relevant to gut health, very relevant to gut health. If you are estrogen dominant, and estrogen toxic by taking progesterone even on its own, what’s it going to do? It’s turning into testosterone into estrogen. It’s not exclusive, you are producing more of that stuff. So if I’m looking at you, and I’m looking to determine a candidacy, if you will, for BioIdentical Hormone Replacement Therapy, or even regular HRT, you’re a great candidate. Anyone looking at this would say, or any of our team anyways, would say yes, she’s actually qualified with the exception. And it’s a mild exception down here. This is what we’re going get into step two here is looking at the degree of metabolite production again, the speed at which you produce these metabolites. In an ideal world, you’d have a green light over here, in an ideal world, and what this is a 2-hydroxy estrogen I’m looking at controlled by the CYP1A1 variant. And the reason I say that in an ideal world is because being slow on the protective 2-hydroxy is to suggest you’re a little more at risk studies show. And then over here, the 4-hydroxy, in an ideal world, it’s fine that it’s this yellow variant that, you know, it would be red and 16 would also be red. So how we work this through though is, and you’re very familiar I’m sure with the research around indole-3-carbinol or diindolylmethane (DIM) and some of these cruciferous family of vegetable extracts, that this helps flip the switch on this helps to slow down the 4OHe and over to the 2-hydroxy estrogen so helps to increase or helps to speed up the metabolism of the estrogen and clear it.

Lindsey:

So eat my broccoli?

Bryce Wylde:

Eat your broccoli. Bowls and bowls of it. So in the gut health circles, depending on your FODMAP assignment or how well you do on some of the insoluble fiber levels and so forth. And obviously that’s a whole different story. But yes, at the very least take an extract and I tend to prefer a diindolylmethane over indole-3-carbinol. I think in these instances, anyways, I don’t think you can eat yourself to a therapeutic range of broccoli.

Lindsey:

I have at various points taken that for various and sundry reasons. So definitely something I can go back on.

Bryce Wylde:

Yeah, I think so. I think it’s indicated for you. So far, I think there’s two things that I would really consider in your daily regime. And that would be the tocotrienols and some indole-3-carbinol, or probably even better, some diindolylmethane (DIM). And then this step here that we’ve already somewhat discussed today at length, glutathionization. We haven’t talked about the detoxification ramifications of catechol-o-methyltransferase, which is also involved in executive function, very important in methylation and converting all the neurotransmitters into active metabolites, etc. But it’s very important here in excreting estrogens. Now, the reason, and I’m just going to highlight this real quick, you’re seeing a red light on GSTs, and our algorithm works in very mysterious ways. Sometimes this is one of them. If your GSTP1, which is true, you have the AG variant, it’s going to show up automatically, even though you have a great GSTT1, two copies and a great GSTM1, two copies, your SOD, you know, hybrid variant AG, and your GSTP1. So that’s why it says considered suboptimal. So the other thing is maybe, again, when we’re talking gut health, I still think one of the best things to consider for folks is upregulating glutathione. And I think, if you do a quick PubMed search, there’s like 32, or four, something like in the realm of low 30 studies have been done on supplemental glutathione. And 30 or more of them have basically resulted in either no effect or very little effect. And I think what the studies show in summary is that yes, the glutathione that you might consume in glutathione format, whether it’s liposomalized or otherwise, reduced, acetyl- or whatever, is probably entering to the system, but it’s not getting into the cell, intracellular, whether it’s the cells of your intestine or into your red blood cells beyond homeostasis. So it’s probably doing some antioxidant good outside of that, but it’s not getting beyond homeostasis into the cell. So we like to recommend precursors.

Lindsey:

Like NAC or glycine?

Bryce Wylde:

You got it. NAC, glycine, exactly. Alpha Lipoic Acid, selenium, a little bit of selenium, or three Brazil nuts a day, non irradiated, organic, if possible, Brazil nuts. But there’s also some interesting ingredients, I think out there worthy of further due diligence by anyone listening to this, and that’s gamma-glutamylcysteine. So some interesting studies out of Australia, taking this gamma-glutamylcysteine, seems to actually upregulate glutathione intracellularly. Beyond homeostasis. So it’s like the direct precursor. Anyways, all of that to say, we’re huge fans of precursors to glutathione. We don’t think glutathione itself is really going to work, it’s probably just going to dissolve in the stomach and in the gut, and not really do. . .

Lindsey:

What about S-acetyl-glutathione?

Bryce Wylde:

Any of those variants, you look at any of those things, and it just doesn’t survive, it just gets taken down.

Lindsey:

Well, it’s a lot more expensive, so certainly easier to get the precursors.

Bryce Wylde:

And there you go, exactly. So in a generalized summary of detoxification and gut health, and methylation and gut health, we’re talking about elimination of toxins, liver-gut axis, microbiome interaction, cellular repair, that’s so huge, immune regulation, all these things factor in neurotransmitter synthesis. We didn’t get into that. But obviously, we look at the whole brain-gut axis and executive function, energy metabolism and methylation. All that plays a role and the interaction between detoxification and methylation oxy toxin elimination, microbiome, I think I mentioned that, hormone balance, we just finished some of that. Both detoxification and methylation influence hormone metabolism and elimination, which can impact various aspects of gut health as well, including motility that we very briefly alluded to, and even immune function. So you’re getting to see how all of these things, you can’t look at any single gene on its own. All of them play a significant interaction, and they need to be looked at in context of pathways. And we’re very proud of that at the DNA company, not just what we look at and how we report on them. But the science that supports these various pathways and pathway interactions, I guess, would be the quick and dirty summary.

Lindsey:

Do you have time for one more question?

Bryce Wylde:

Love it.

Lindsey:

Okay, so this is a little off topic. But one of the reasons I was really excited to have this report done by the DNA company was because in my 23andme results, when I ran them through Genetic Genie, it indicated that I had APOE 4 and 4, which is the worst genotype for the risk of Alzheimer’s. And I recall reading that that meant I had something like an 85% risk of having Alzheimer’s by age 80, but correct me if I’m wrong. So I was waiting for independent confirmation of this. And so I was really relieved when you ran this report, and I saw that I only have APOE 4 and one APOE 3. So can you tell me a bit about this and the degree of difference in risk profiles for 3 versus 4 and what people can do who have the APOE 4 genes and other genes that are relevant to Alzheimer’s?

Bryce Wylde:

Absolutely, yeah. So starting at the top with when we’re thinking about where we’re getting our information from, or that is to say the results of a genetic report, we have to consider where it’s coming from. And ultimately, unfortunately, some of these genetic reporting companies that are involved in looking at a tremendous amount of genes all at once, this is really more of a cost savings iInitiative, or let’s call it a business model. They can’t run small runs of gene sequences. And this gets a little bit complicated, but just save it to say they’re running tens of thousands, so your entire genome essentially, at one time. That’s going to lead to a varying degree of inaccurate reporting. And it’s quite widely available, the literature boils this down, it’s basically 15 to 20% of false positive on the APOE4, so either receiving a 4 or a 3/4 or 4/4 a variation wrong 15-20% of the time. I probably shouldn’t say this, I’ll just use a very famous TV doctor had this done. And we did these genetic tests for that person, very unique, actually, presentation. But I’m saying this because he reported his variations on the air. So but I’m just holding back a little on the story. But at the end of the day, same kinds of situation went down as I’m assuming went down with you is he was falsely reported on. We correctly reported on, and here’s why we’re able to correctly report on these. It’s because we run very small runs, really small batches of genetics at a time, so the chances of making a mistake is very low. When you look at the literature, what you have to understand about these studies, by the way, see, I’m showing you this on p. 4 of the cardiovascular report (p. 45 of the PDF). That’s because we don’t report APOE in context of some kind of dementia report. So we’re not making anything that we can talk about it in context of cognitive decline. Dementia is very relevant to that. But we report first and foremost on this cholesterol carrying capable capability of the apolipoprotein. And that plays a role. But so you look at these populations, and you see, those that have essentially had diagnoses of Alzheimer’s, that were extrapolated, and then looked at, depending on literature, you read, 30 to 40% of those with Alzheimer’s had an assignment of genomic APOE 3/4 and upwards of 70% had 4/4 variants. But you can’t just jump the gun and so quickly reverse engineer that to mean, if I have an APOE 3/4, I have a 30 to 40% increased chance of getting Alzheimer’s. And really, there’s so many different factors involved, as we all know, right? Diet, lifestyle, sleep, can get into so much here. But so there’s a definite association. We don’t report on this as the Alzheimer’s gene. We could talk Alzheimer’s, because having your variation here of a 3/4, there’s implications of again, cardiovascular disease, coronary artery disease, ischemic stroke, and we haven’t talked about the combination. But putting this in combination with the 9P21. It’s definitely a highlight risk for me for you. And it’s something that you want to take away from this report outside of gut health and its implications, is cardiovascular disease. So this is very much an old story of cholesterol being part of it, obviously size, particle size, oxidative cholesterol, how angry it might be and how quickly it might want to deposit within the lumen of the artery lining. But when we combine APOE, as a 3/4 with a 9P21 multiple G, we’re much more concerned about the predisposition of inflammation that warrants the deposition of that cholesterol, right? Does that make sense? So yes, you know that the studies are there. By the way, third ingredient for you, for me, anyway, would be a very bioavailable form of curcumin. And there’s multiple ones out there. I like the liposomal curcumin in this case. It’s all about bioavailability because it doesn’t easily, speaking about the gut, doesn’t easily get through the gut, into the general circulation. So piperine or pepper can help that. But liposomal or micellized. Micellizing is getting it to even smaller, tiny little lipid particle size that can get absorbed easier. So yeah, I’d say with this gene, we like to make these recommendations in combination with other factors, consider that curcumin is advisable for you. But that’s a long way of saying there’s some inaccuracies in certain other companies reporting on this gene. We can’t take it out of context and say it’s a direct upregulation or assignment to getting Alzheimer’s. But at the same time, can you mitigate or do certain things given the rest of the genome pathways that you’re expressing risk. And I think yeah, you can, that’s our whole MO is what can we do through diet, lifestyle and supplementation to tweak or mitigate genetic pathway expression?

Lindsey:

Awesome. Well, this was all super interesting. And I love hearing this about my genes. I wish I could go through the entire report with you, but I will certainly read it more in detail myself. I really appreciate you giving your time to this. And we will include links on how to order your own DNA report from The DNA Company in the show notes.

Bryce Wylde:

I appreciate you having me on.

Lindsey:

Yeah, thank you so much for being here. Any final thoughts?

Bryce Wylde:

I just think understanding our genetics and our gene pathways is an incredibly useful starting point to knowing what more we need to focus on. A lot of people are confused about, if they’re biohacking, or what might be the underlying – we hear this term all the time underlying cause – so you know, obviously genes and environment play a role and how we grew up and all these different things. But I think it’s a great starting point for most people. And if you think about it, it’s a one and done test, which I also love, so you’re spending in, but you never have to do the test again. And it informs on so much more of what you want to put your efforts toward and I think that’s what people are so confused as to where do I start. Well you know, what’s a great place to start the journey, start the process of wellness biohacking. Understanding potentially what other physicians, clinicians, consultants, like yourself, you might want to consider talking to to help you navigate and wade through. There’s so much to know and learn, right, but it’s a great starting point. This is your instruction manual. And if you don’t know it, you’re at a disadvantage.

Lindsey:

Yeah. And I think for people in particular who have very complex health problems that are deep like chronic fatigue or fibromyalgia or some combo of gut issues and mental health issues and something else, that’s the kind of situation where I think that something like this would be useful.

Bryce Wylde:

Can we have time for just a quick anecdote?

Lindsey:

Sure,

Bryce Wylde:

Okay, thank you. So on that note, this is where we see incredible stuff come out of the weeds. So in our clinic and I mentioned this is going back top to the top talking with Dr. Mohammed, I give him such kudos for figuring this out. The light bulb that went off. We had all these young female patients at P3 Health coming in, and you know, what you call out for, what you see more of and do well for, you get more patients, right? So we had all these women come in with chronic fatigue and fibromyalgia and misdiagnosed Lyme and we did well at diagnosing Lyme, still do and couldn’t figure out. It was a huge pool. There was like dozens of these women and again, in their mid to late 20s. Otherwise should be healthy, eating healthy tried everything. Okay. What did they all have in common genomically? I’ll just cut to the chase. They were null variant detoxifiers; they did not have the instructions to properly detoxify. In combination. The two most striking things, there was a third, but it came third, distant third. The second thing, estrogen dominance with estrogen toxicity. So alluded to that a little bit. Third thing, distant third, methylation, poor methylators, but nonetheless poor like terrible detoxification, methyl estrogen dominant, estrogen toxic. This is a story more about what we got them off versus what we gave them. What did we take them off? Birth control pills. They were probably just adding fuel to the fire so they had these predispositions, but they were taking birth control pills, hyper dominant estrogen, not able to clear it. Because that COMT and GSTs are reliant on that information, they’re genetically there to get estrogen out of the body. So just dumping more estrogen, like fuel right onto the fire. So yeah, nine times out of 10, maybe more, taking them off their birth control pill, has solved their chronic fatigue and fibromyalgia.

Lindsey:

Wow. Very interesting. Well thank you so much for your time. This was awesome.

Bryce Wylde:

Thanks, Lindsey. I appreciate it. Thanks for all you do.

If you’re struggling with  bloating, constipation, diarrhea, soft stool, acid reflux, IBS, IBD or any type of chronic disease, etc. and want to get to the bottom of it, that’s what I help my clients with. You’re welcome to set up a free, 30-minute breakthrough session with me (Lindsey). We’ll talk about what you’ve been going through and I’ll tell you about my 3- and 5- appointment health coaching programs 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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