As featured on Feedspot as #18 in gut health blogs!
Adapted from episode 107 of The Perfect Stool podcast hosted by Lindsey Parsons, EdD, Gut Health Coach and edited for readability with Dr. Loredana Shapson, PharmD, FNTP, founder of LifeMod Solutions, a holistic health practice in Newtown, PA.
Lindsey:
So why don’t we start with your gut health story? I know your history involves taking a lot of antibiotics, much like mine and many of my listeners.
Loredana Shapson:
Yeah. Which ended up taking a turn for the worse after that course. So I suffered from constipation for most of my life since I was a teenager. I would only go to the bathroom maybe once or twice a week. If I did, it was not very satisfying. It was small, little pebbles, nothing. Then eventually, as I got older, I started to bloat and it would happen randomly and unpredictably, with certain foods and sometimes not others. Like anybody else, I started to look on the internet. What’s causing my bloating? What could this be? I started putting myself on supplements, and I started working with a couple of gut specialists. Even after working with some of these people, and doing a lot of stool tests, and SIBO tests, and all of that, I still wasn’t getting some of the results that I had desired. But I’d spent a lot of money seeing some of these people.
Eventually I got put on an antibiotic. After I got put on that antibiotic, my gut symptoms actually got worse, not better. So when before I was bloating randomly, it was now happening every single day. When I would wake up in the morning, I would have a flat stomach, and then I would drink water. Then boom, I would look like I was nine months pregnant. It was that drastic. So I had extreme food restrictions, I couldn’t even take a bite of avocado or not even a teaspoon of fermented food, no liquid, nothing. I was so triggered by all that. When I had my bloating, I also had mood issues, like irritability and anxiety and focus issues. I couldn’t sleep very well, I had trouble losing weight. I was just realizing that my gut is connected to my entire body and affects all other parts of my body.
With my background in pharmacy, I eventually researched how to fix gut health. I found some shortcuts. Now I’m using everything that I did with myself with my patients. I’ve been treating patients for about two years now, specifically for gut health and for that particular focus. It’s been really awesome to see the increased healing, the less supplements that are needed, the more food they can bring back in sooner. It’s exciting to be here on this podcast. I’m happy to be on your show today to share some helpful tips for your listeners.
Lindsey:
Yeah, that’s awesome. So did you figure out it was SIBO in your case? Was it methane SIBO? What was going on?
Loredana Shapson:
Yeah, so I did take a SIBO breath test. It was both. I had a mixture of everything. I had four stool tests over the course of two years. And the stool tests didn’t really provide much data for me. I mean, it did show that inflammatory markers were up, but obviously if your gut’s imbalanced, your inflammation is going to be up as well. So it showed dysbiosis. But it didn’t really change the way that my functional medicine doctor at the time was was going to go after helping me. But yeah, it was methane SIBO and I just remember spending a lot of money on supplements. I think at one point I was on like 18 different things. It was crazy.
Lindsey:
I can believe it. So we did agree to focus on bloating in this episode. And that’s, I guess, where you’ve started focusing your practice. So talk to me about the different causes of bloating.
Loredana Shapson:
I like to funnel bloating into two sections. So first and foremost, it is imbalanced gut bacteria, whether that’s an overgrowth of something and not enough of another. We can have SIBO, which you just mentioned, which is the bacterial overgrowth, and then there’s also SIFO, which is fungal overgrowth. I see a ton of that in my office. And then we also have SIPO, which is parasitic overgrowth. So all of these can be imbalanced from one level to another, and they can cause bloating.
The question is, how do we get an imbalanced gut? I’m sure you’ve talked about this on your podcast before, but it’s antibiotics in prescriptions, antibiotics in our foods, and other prescriptions can cause bloating. There’s also things like the pesticides and herbicides, preservatives, all of these things that kill bugs; chlorine in tap water. All of these things are going to create imbalances in our gut. So that’s first and foremost. And then the secondary part of this picture is low digestive enzyme release. So what causes that? Well, first the gut imbalance can lead to that. The secondary thing is stress. I like to funnel stress into three little tubes where first is physical stress. Say you fell, you had a surgery, whatever it is, your body’s in physical stress, and it’s turning on your sympathetic nervous system, which is your fight or flight response. The next is emotional stress. Maybe you have a really big project at work or you’re fighting with your partner, that emotional stress triggers your fight or flight response. Then the next is chemical stress, which is things like pesticides or herbicides, antibiotics. It could even be heavy metals and the things that are in our personal care products that are causing stress on our body.
And the bottom line here is, whenever your stress is on, and your fight or flight is on, your digestive system turns off, which we call your rest and digest nervous system. So when I approach healing my patients, we got to give the patients digestive enzymes now, because they’re not making enough right now, whatever their cause is, it doesn’t matter, we want you to feel good. So digestive enzymes come first. And then we work on imbalance in the gut, which has to do with your diet, supplements, and probiotics, so on and so forth.
Lindsey:
So how do you approach testing in your patients? Are you running stool tests and seeing their enzymes are low?
Loredana Shapson:
No. So I actually don’t run any stool tests on any of my patients, and I’m still getting pretty awesome results. And so the reason why I do that is because the clinical research is showing that, yes, stool tests are great in clinical research because they’re understanding what therapies do and how it affects the gut microbiome. But I want to bring up one particular study, it was a meta analysis. Meta analysis for those of you that don’t know is almost like the second best type of research that you can use to apply to patients compared to randomized clinical controlled trials. There was a study done in 2019. This was a meta analysis that included 11 trials, and it had over 729 patients. And what they wanted to look at was “Do prebiotics help IBS symptoms?” They compared prebiotics users to a placebo group. I know we’re not talking about prebiotics right now, but it was interesting in this study that they looked at stool tests from patients before and after.
When they looked at the study results, prebiotics did not improve GI symptoms, it didn’t improve quality of life, it didn’t improve functional bowel disorders, it didn’t improve bloating, or gas or abdominal pain. What they did see was in the stool tests that the Bifido group did grow. So even though the stool test looked a little bit better from when they got started, it still didn’t equate to the patient feeling better symptomatically. So that’s one study that really stood out to me to say that we need to step away sometimes from taking all of these stool tests, and all of this lab work and focusing on the numbers for patients. What I particularly focus on is how do you feel? Are you getting better? Is your bloating going down? Those are more of what I focus on in a lot of my patients.
There was another study done in SIBO patients where they did a SIBO breath test. They wanted to see if they could use a SIBO test to determine how they would respond to a low FODMAP diet. After this study, what they found was it wasn’t the levels of methane or hydrogen that really determine the response rates. What determined whether somebody was going to do well on a low FODMAP diet was their symptoms at the time that they were started. The more severe symptoms they had, the better that they would respond to a low FODMAP diet. So that was an interesting kind of a study too, because it shows us that the test, even though it’s positive, doesn’t always show that they’re going to feel a certain way.
Lindsey:
What about H. pylori? I mean, that’s one where I really like to know about when I go into working with someone. Without a test you can’t know if they have it or if it’s overgrown.
Loredana Shapson:
So H. pylori is definitely something that I haven’t had to test here in my office. I would like to know if my patients have had the test done with their GI doctors, because that does change things a little bit because H. pylori can cause ulcers. One thing that I ask my patients whenever I think H. pylori is an issue for them is: are you having pain? Is it really harmful? Are you having cramps, and is it really uncomfortable? Another thing that cues me into that is are you taking a Betaine HCl* supplement or an acidic supplement for digestion? If that’s causing you pain when you take it, or even if vinegar bothers your stomach and causes you pain, then maybe you have an ulcer. Maybe that could be from H. Pylori. So that would be a different scenario. I haven’t seen too many H. Pylori patients in my office. But I know that at the end of the day, what we find is that as soon as you come in with the good probiotics, everything starts to rebalance.
Lindsey:
And what about testing for SIBO? And using Organic Acids? Do you do that at all?
Loredana Shapson:
I have. Yeah, that’s probably the test I run the most in my office is the urinary OAT by Great Plains. And I will check that in my patients when they have severe issues if they really want to know. It’s not typically covered by insurance plans, and you’re going to spend at least $300 to $350. So if the patient really wants it at the start, I will give it to them, but otherwise, if we go down this course of taking care of SIFO, usually I’ll pull that urinary test about four to six months in so that we can see how we are doing. Is there still an issue there? We always want those numbers to be in the lower 20th percentile for the markers one through nine.
Lindsey:
So how do you approach treating people with gastrointestinal issues if you’re starting without a test?
Loredana Shapson:
We look at symptoms. I mean, first and foremost, it’s digestive enzymes. That’s key. We start with diet and enzymes to get things moving. So number one, if they’re not pooping, we get them pooping. If they’re having diarrhea, we try to stop their diarrhea because they’re not absorbing their nutrients efficiently. So that’s correction number one is to fix their stool frequency, whether it’s constipation or diarrhea. Usually, once you add a digestive enzyme, it can rebalance on its own. Constipation gets better with digestive enzymes, because you’re breaking down your food better. We find that once you start increasing the acidity of the stomach, that you’re actually already beginning to correct the imbalance of the gut, because stomach acid’s important for killing bad guys that aren’t supposed to be there. It’s why we have stomach acid, because we were bringing in a ton of microbes through our mouth on our food and everything that we’re touching. Once we start increasing the stomach acidity, we’re rebalancing the gut inherently just by doing that. So I usually start with enzymes, and then add either something to help them poop if they’re not pooping, or whatever they need to do to slow down their pooping, if it’s an issue with diarrhea. Once they’re on that for a couple of weeks, then we start thinking about probiotics.
Lindsey:
Are you doing enzymes that have Betaine HCl in them? Or is that separate?
Loredana Shapson:
So we’re doing Betaine HCl separately, and then if they require another enzyme, depending on how severe their bloating is, I’ll add another enzyme that has everything for protein and fats and other carbohydrates and different fibers and cellulose and all those. Generally, I do really well with just a betaine supplement.
Lindsey:
So when you were saying enzymes, really, you’re talking about betaine HCl?
Yeah, generally, betaine is a big fix. If you think about the way the digestive system works, I call it a three legged stool, right? You got your stomach, your pancreas and your gallbladder. And if one of those legs are kicked out, the whole system kind of collapses. But the core of that three legged stool is the stomach, because once you have enough stomach acid, that triggers the pancreas to release appropriately. And then once that happens, the gallbladder releases appropriately as well. So it’s really the stomach acid that determines the next chain of events down below. If you fix stomach acid, you’re automatically going to fix the enzyme release.
Lindsey:
And will you give Betaine HCl to someone who is actively suffering from what seems like reflux?
Loredana Shapson:
Yes, that’s actually what I recommend to patients who have reflux. It’s often a difficult conversation to have, they don’t understand. They’ll say: wait a minute, I have acid reflux, and you want me to add acid? And I say yes. I often tell my patients what you can use in your kitchen is vinegar. I like apple cider vinegar, because it is a probiotic, but any vinegar works, as long as it doesn’t have sugar. Take a tablespoon of vinegar, and one to three ounces of water. Take that down, and then wait at least an hour before you drink any other liquids, because you want that acidity to do its job. But ideally, if you’re feeling acid reflux, you’re not digesting your foods properly and it’s sitting for too long in your belly. It’s pushing that valve open and causing acid reflux and little drops of acid are getting into the esophagus where they shouldn’t be. So you just want to keep things moving downward, which you do with acidity, and, boom, you’re not going to have that problem. So I definitely recommend that to all my patients when they have acid reflux, either use vinegar or betaine, and get rid of it.
Lindsey:
And are you using the vinegar before the meal because you said to not to drink anything else after that?
Loredana Shapson:
Yeah, so you could use vinegar to help with your acid reflux symptoms at that moment. And then also, you can take it at meal time. I’m not particular with taking it at the beginning of the meal, during the meal, or after. As long as it’s with the food, it’s going to do its job. I like to simplify things. One of the things that bothers me about some of the gut health stuff that’s out there is that they make directions very complicated. It has to be an empty stomach, not an empty stomach, before food, one hour before food, an hour after eating. I find that compliance with my patients becomes very difficult at that point. So for me, I don’t care. Take your vinegar before, during or after, either way, the patient always seems to get benefit. And so clinically, I’m seeing that it doesn’t really matter. But obviously everybody’s different. And you have to try for yourself to see what works for you and your patients. I mean, do you notice any patterns or trends in your patients who take vinegar before or during or after?
Lindsey:
I usually don’t know that level of detail with my clients. You know, I say that this is something that you take with a meal. Whether they take it at the beginning or the middle of the meal, I don’t know.
Loredana Shapson:
Yeah, so that’s the thing. I hope people can see that it doesn’t have to be as complicated as everyone makes it out to be.
Lindsey:
I was just curious because you said to not drink anything else after. So you’re basically telling people to eat without drinking?
Loredana Shapson:
Oh, yeah. 100%. You don’t want to drink a lot of liquids with your meals because it’s going to dilute your stomach juices. We want to maintain the acidity in our stomach. The more water you’re adding to it, you’re going to slow digestion down. It’s going to increase your risk for bloat. You’re going to feel full with a distended belly. What I always tell my patients is that hydration has to be between meals with room temperature water, about a half hour before you eat or an hour after you eat.
Lindsey:
I find that very challenging. Personally, I take all my supplements with my meals, so I have to drink as I can’t get them down without it.
Loredana Shapson:
You can certainly sip as needed, but you should not be chugging a full glass of water.
Lindsey:
So is there a particular enzyme product you like?
Loredana Shapson:
I like standard process Zypan* because it has betaine in there, but it also has some pancreatic enzymes. So that’s what the Zypan stands for, Zy for enzyme and pan for pancreas. There’s a little bit of pancreatic enzymes in there. Plus some betaine. And there’s also some organ meat tissue in there too, which is really healing. There’s some spleen tissue, and they all help heal the gut.
Lindsey:
And do you do the betaine with the challenge approach where you start with one pill, then increase?
No, I usually find patients do really well with two pills. If they have severe bloating, we’ll do three with each meal. Two seems to be like the magic number. And then once we get probiotics on board, I find that the Zypan dose ends up coming down to one with each meal, and then only as needed if they have acid reflux. Typically at that point, it’s usually not an issue anymore. And then eventually, once the probiotics are on board for a couple of weeks, Zypan falls off. I think the probiotics start coming in, and they start helping you break down your food, you don’t need the enzymes anymore.
Lindsey:
So what kind of probiotics are you using?
Loredana Shapson:
Oh, my favorite one is Megasporebiotic* by Microbiome Labs. They’re my flagship probiotic, it’s so well tolerated in a lot of my patients, because they’re non-histamine forming probiotics. So that’s the one I always start my patients on. And you know, everybody’s a little bit different on the starting dose. I don’t follow the directions on the bottle. I never do that for any of my gut supplements. I always start at a quarter of the dose that’s recommended on the serving size. Anytime you’re doing anything with the gut, slow and steady. So even if it says two capsules, don’t start there. Maybe do one capsule every other day. You’ll be on that for a week, and then you go to one a day. But I find that slow and steady wins the race here. You’re less likely to have those Herxheimer reactions and those negative, sick reactions that most people hate. You lose a patient quickly if they have a bad reaction.
And so if you see someone with diarrhea that’s not clearing up with enzymes and Megaspore, where do you go from there? So at that point, I go to gut inflammation. Biotics research has a product called GI Resolve*. That one includes gut soothing and healing nutrients with N-acetyl D-glucosamine and aloe vera. You’re basically reducing inflammation. Then another product I will try specifically with my patients who have a lot of immune issues, histamine reactions, Crohn’s, or ulcerative colitis is MegaMucosa* by Microbiome Labs. That’s a great one. But I find that the GI Resolve is my go-to and then MegaMucosa is what I’ll bring in a little later. And that usually repairs the gut, I find that two or three days after starting that, diarrhea goes away, and patients start to have more firm stools. And I see that if they have blood in their stool, that goes away as well. So we’re really healing the gut with those nutrients for sealing it, reducing inflammation. That’s going to help with the bowel so you’re not pushing your stool out so quickly.
Lindsey:
So I’m curious, because I just had someone who told me they started GI Resolve, and then their gut felt like it went on fire. And I thought that was odd, because that product is something that’s supposed to heal and seal. What would you make of that?
Loredana Shapson:
My initial instinct is to say that they need a binder. So whatever healing reaction is occurring, they’re probably releasing a lot of trash. And oftentimes, a binder is going to mop up that stuff. So I like GI Detox* by Bio Botanical Research. That’s a pretty good starter binder that you could add, but obviously you have to leave two hours between taking that and any other supplements or food. But that’s my instinct. If something goes awry, you lower the dose to be extremely slow. I’ll start people on that by taking one teaspoon. I always start low and slow, then increase every week. They’ll be on it for six weeks, which is more than they’ll ever need, but it’s still a good way to do it.
Lindsey:
And how do you approach SIFO or Candida?
Loredana Shapson:
Yeah, so SIFO is interesting. I see a lot of that in my office, unfortunately. So what we do there is basically the same starting approach because as we correct the digestive enzymes and the acidity, you’ll start to rebalance the gut. The next thing is you start getting into probiotics, they’re going to start balancing out the SIFO and the fungal overgrowth. Sometimes in most cases, I do have to add in a fungal product, which is an herbal product that gently gets rid of the Candida and the yeast. So my favorite product to start people on is by Systemic Formulas called Fungdx*. It’s a great product that’s really well tolerated. Systemic Formulas tells you to do two pills in the morning and two at night. I don’t do that dose; it’s too high. I find that people have negative reactions from die off. I start people on one a day.
And what I have found is that SIFO requires a long haul kind of approach. I’ve had to care for patients through SIFO for up to eight months. It takes some time to totally be eliminated, unfortunately. It’s a slow and steady process. So the more herbals that you add, you absolutely have to add binders too because of the die off. The mycotoxins that die off releases, in general, are some of the worst. They can cause so many issues from anxiety to weight gain, irritability, bloating. It can cause a lot of problems. So always paired with SIFO, if I ever put an herbal product on, is a binder for the whole time they’re on an herbal product. I find that when I don’t, the patient has Herxheimer reactions, they have bad reactions from it. So one of my favorite binders is by CellCore. They have a binder called Biotoxin Binder* (purchase using patient direct code: I0rdLMOm). And it’s specifically formulated to catch yeast and mold toxins. And so that one is expensive, but worth every penny.
As a case study, I had a 30 year old female in my office and she had sores all over her body, up and down. They would show up as red inflamed, and they would ooze, then they would heal over and scar. So she was embarrassed. Summertime was coming up. She didn’t want to wear shorts. She’d been to a dermatologist. She had been to doctors, and nobody was able to help her. I uncovered in my office that it was an overgrowth of fungus because she had had so many antibiotics since childhood for sinus infections, that fungus overgrew. As soon as I put the biotoxin binder on, all of her sores, new ones stopped opening up, which was a great sign. They just stopped forming. Unfortunately, the ones that scarred over were still there. But just by adding that binder, we saw a huge shift in the amount of new sores that were coming out. So yeah, I can’t rave about that particular product enough when it comes to SIFO. Have you heard of CellCore before? Have you used their products before?
Lindsey:
I have heard of CellCore, but I don’t generally use it. They’re not available through Fullscript. So it’s like you got to send somebody to it separately. Their products are not cheap, too. So that’s an issue. But yeah, I do have access to them and have used them with some people.
Loredana Shapson:
That’s my limitation too with them. They’re a great product line, but they’re too expensive. I only pull those big guns out when I need to.
Lindsey:
Can you dig in a little bit more about that skin-gut connection? People might be asking why those two parts of the body are connected. Is it literally the yeast coming out of the skin?
Loredana Shapson:
It’s a great question. And so whatever’s happening on your skin is a representation of what’s happening in your gut. And this goes for acne, for eczema, not just sores and all of that. But the gut lining and the skin and even your nasal passages, all those mucous membranes are made up of the same cells. They’re responding to the same influences, which is the fungal infection in the gut. I think it’s just an imbalance in the gut. And then yes, you could be releasing mycotoxins from your skin and it’s just coming out as irritation. Anytime you have a skin thing, always think of the gut and once you start rebalancing the gut, the skin always gets better.
Lindsey:
I have had some people with super persistent skin issues like eczema that just keeps coming back. Even through multiple rounds of every possible probiotic, you can imagine, every possible antifungal, antimicrobial, the condition still just keeps coming back.
Loredana Shapson:
Can I dive in a little more? How long have they been on the probiotics?
Lindsey:
Continuously, for years. Probably for a year.
Loredana Shapson:
Okay. And then what products do you use for fungal?
Lindsey:
So a lot of times, you have clients who go off on their own and get their own products. So this patient was using a variety of products, but there was one in particular that was a combo antifungal that had berberine, caprylic acid, undecylenic acid, and grapefruit seed extract, which I try and avoid because I know that that really decimates the microbiome, but that was something that he decided to take on his own.
Loredana Shapson:
Oh, interesting because I use grapefruit seed extract* in my mold patients, but I’m not getting negative results to their health after using it.
Lindsey:
Well, sure, they make people feel better. I just see on the stool reports that after taking grapefruit seed, then their Akkermansia disappears.
Loredana Shapson:
I would say that one thing to look at if their eczema is still coming back is the type of probiotic that they’re using and the quality of it, and how long they’ve been taking it. So that’s a minimum of three months every single day and they should have a blend of the spore-based probiotics. The Lacto-Bifido is going to be even more important than the spore-based ones. And then you have to rotate your SIFO products every two months. You should always be changing your SIFO herbals because of resistance and that kind of thing.
The other thing to think about is the environment. So are they continually exposed to something where they’re living or where they work that exposes them to mold that they are not aware of? I personally went through a mold infection twice with two different exposures, one at work and one living with my in-laws for a little bit when my house was under construction. I noticed it because my gums were bleeding every morning, and it happened like day two of me moving in. I didn’t understand why. Then I started developing anxiety, and I started to have irritability and I just felt completely off. A couple of months in, I found out they had mold in their basement. I’m like a little mold thermometer now. I was able to help my in-laws with that. It takes a long time. I would say try to have the SIFO products rotating every two months for a minimum of eight months, and then checking their environment.
Lindsey:
And would you continue the SIFO products that long for anybody who’s positive? Or is this more in proportion to the numbers that you’re seeing on the test?
Loredana Shapson:
Yeah, I would say numbers on the test is where I go when deciding the length of treatment. But I have seen that eight months is usually my average. So with patients who are struggling with eczema, do you find that you’ve been on up to eight months worth of SIFO supplements?
Lindsey:
At least three months of Megaspore, two per day, and CanXita Remove for at least six to nine months.
Loredana Shapson:
I find a good combo that I like to use is Candida Complex* by Klaire Labs. I do also use grapefruit seed extract twice a day with Candida Complex. I find that that combo works really well.
Lindsey:
It’s powerful. That’s the dilemma, right?
Loredana Shapson:
Yeah, I think that while Akkermansia goes down, I feel like the short term benefit of getting rid of that yeast and mold is more beneficial than worrying about Akkermansia. Because it’s going to be very easy to bring back Akkermansia after the fungus goes away. So I think that the benefits outweigh the risks in this situation. I would use grapeseed. I’m speaking from my clinical experience, too. I’ve had patients do really well on that. But again, I’m also not pulling stool tests like you are to see the difference. But all I know is my patients are feeling better, their pain is going away, their headaches go away, so I would maybe try something different. Another thing I would think about too is a gut healing nutrient again, like GI Resolve. Any of those products just to seal the gut up again.
Lindsey:
The funny thing in this particular case was the thing that would clear this eczema was doxycycline. The patient would keep going back to the doctor and getting doxycycline. So I’m wondering, is it bacterial? Is it not fungal?
Loredana Shapson:
Yeah, interesting.
Lindsey:
It’s tricky. I’m sure you have tricky cases. Everybody does.
Loredana Shapson:
Doxycycline is such a big gun to use, because it’s a broad spectrum antibiotic. So I feel like in the long run that’s making the SIFO go up. That’s not helping in the long term.
Lindsey:
I certainly tried to get him off it, but it’s the only thing that would clear it, and it’s on his face. So of course he’s worried about that.
Loredana Shapson:
Yeah. Then topically, grassfed tallow* is really soothing for skin stuff. So give that a shot to just keep the issue at bay while you’re working on the underlying stuff.
Lindsey:
I’ve never heard of that. That’s interesting.
Loredana Shapson:
Yeah. You have to go back to animals and animal fats.
Lindsey:
So you mentioned Lacto-Bifido probiotics too, which ones do you like there?
Loredana Shapson:
Yeah, so I like Designs for Health Probiomed 50*. So when it comes to probiotics, I’m glad we’re touching on this. It’s really interesting. The question I get is, oh, my gosh, there’s so many probiotics out there. How much do I take? 10 million, 25 billion, 100 billion, there’s all these doses that are out there? Do I take it on an empty stomach? Should it be refrigerated? It’s become this intimidating thing. And here’s the answer. Here’s the summary. It doesn’t matter what the heck you take, just take it every single day. It doesn’t matter, once a day is all you need. And the clinical research is showing that a lot of these meta analyses, when we pull together these trials where we’re studying 4000 patients, 7000 patients, all of these trials, the average dose is about 25 billion. It’s not that high. But the range is from 10 billion up to 100. You’ll see 100 billion in some of the IBD cases, like Crohn’s and Ulcerative Colitis. But still, the average over all of these is about 25. So what I use in my office at the start is Probiomed 50. That is 50 billion. And I find if I use anything higher than that, they get negative reactions. So I avoid that.
Lindsey:
And that’s a combo Lacto/Bifido, multi-strain kind of affair?
Loredana Shapson:
Yeah.
Lindsey:
And does it have streptococcus strains in there?
Loredana Shapson:
No, I avoid streptococcus and I actually avoid Saccharomyces boulardii as well.
Lindsey:
It’s so funny about this; there’s people who love Saccharomyces boulardii and people who hate it.
Loredana Shapson:
Yeah, yeah, I know. It’s like a catch-22. I don’t like it because of the urinary tests that I’ve run. I’ve also run some food sensitivity panels on some of my patients and a lot of them show antibodies against Saccharomyces. So I try to avoid more fungal stuff; that’s a fungal strain. And so the body doesn’t want fungus right now. And I find that 100% of my patients are overgrown with fungus because of the way we live our lives and the diets that we eat, high in sugar and refined carbs, and antibiotics and environmental exposures as well. So I really just focus on the Bifido and Lacto, and the Bacillus, the spore-based species, and I get really good results. And after that, eventually, a couple months in, we’ll start adding fiber supplements and that’ll help also with the growth of the good bacteria as well.
Lindsey:
Okay, so not prebiotics, but fiber in particular.
Loredana Shapson:
Yeah, like in the beginning, I’ll start with soluble fiber. There are basically two types of prebiotics, there’s the insulin type, which is like your FOS, the fructans and the galactooligosaccharides, the GOS. Those can cause bloating; they’re fermentable. I mean, that’s just what they are. They’re the inulin type. The others are non-inulin types. So these are things like guar gum and pectin, and these are the ones that won’t cause bloating, the 2′-FL.
Lindsey:
The HMOs.
Loredana Shapson:
Yes, exactly. Yep. So the human milk oligosaccharides. And so they’re not fermentable, they don’t cause gas or bloating. So I’ll usually start my patients with fiber like that first, after they’ve been on the two probiotic types for at least a month or two. And then we’ll start bringing in some fiber. And again, that study I brought up earlier in this conversation, that was the study that really was like, wow, prebiotics are not the fix when you try to feel better. Now when it comes to IBS and bloating and abdominal pain.
Lindsey:
Well, yeah no, the last thing you need to do is add more food for . . .
Loredana Shapson:
Yeah, exactly. So we do that later on, once the good guys are back in. So yeah, my favorite product to start, which is really well tolerated, is by Thorne Research, and that one’s Fibermend*. My patients do really well with that at the start. But again, the directions are for one scoop. I never start there, I go to one quarter of it. And then we stay there for a week or two. And then we go up a little bit. Here’s another thing to a lot of the research with prebiotics and fiber; the doses that they’re using, the average dose is about five grams. So when you look at some of these fiber products, one scoop is sometimes 11 grams per serving; that’s too much. So we’re even seeing in clinical research, less is better. It’s a slow and steady thing. So where do you max out then? So that usually I’ll usually keep people at a half a scoop, but I have more people up to one, it takes about a month to get there. But we’ll get to one scoop and we stay there for a little bit. And then eventually I’ll add MegaPre.
Lindsey:
And if they take more, then they end up getting bloated again?
Loredana Shapson:
Yeah, like sometimes they’ll just have a negative reaction. So everyone’s a little bit different with how they respond. But obviously they don’t feel well. So okay, that was too much. Go back to what you were doing. We’re going to stay there for two more weeks, and then we’ll increase after that. Yeah, like think of your gut, like I tell my patients, it’s like you’re working a muscle out at the gym, you’re not going to go into the gym lifting a 50 pound pearl weight right away, you’re going to start at five pounds, you’ll start at 10. And then after a couple of weeks, you go a little more, you go a little more, your gut’s the same exact way.
Lindsey:
So without doing stool testing, how would you approach parasites?
Loredana Shapson:
Parasites, I usually uncover in the other testing that I do in my office, which is the muscle testing.
Lindsey:
Okay, we haven’t talked about it on the show. I’m not big on muscle testing. But go ahead and just tell me what you do to determine if someone has parasites?
Loredana Shapson:
Yeah, sure. So I do something in my office called muscle testing. And it’s taught by chiropractors, the science of Applied Kinesiology. But basically, I put things near your body, and using the strength and the weakness of your muscle, it tells me whether your body likes it, or doesn’t like it. Is it something I want to talk about or not talk about? And so the reason why we’re able to do this is because we have this energy field that comes out around our body. We cannot see it, just like we can’t see our phones talking or the oxygen that we’re breathing. But we know it’s there. It’s this nice big bubble. And you know, people can take a picture of it. Some people call it your aura, whatever you want to call it. That’s in the medical literature. It’s called the biofield or the morphogenic field.
So when I’m putting things near your body, now it’s making an assessment “Do I like this or not”? Or is it significant to me? And so in my office, I have parasite vials and it has the digital imprint of what a parasite’s frequency is, what it vibrates at. So we’re energetic beings. Everything around us is vibrating. Everything in the universe has a unique frequency down to its decimal point, you can actually measure it, just like every human has a unique fingerprint. So aluminum vibrates at a particular frequency, mercury is different. So parasites are also different. They’re their own little living beings. And so in my office, I have parasite vials for flukes, amoebas, egg layers and non egg layers.
Lindsey:
Like live parasites?
Loredana Shapson:
No, it’s just the digital imprints in water. So it’s a vile, they have found that water has a memory, just like a computer system. So it’s for lack of a better word like electrified water, but it’s containing that digital frequency. So when I bring the parasitic frequency into your energy field, your body tells me whether this is significant or not. And if it shows up, then I know that they’re dealing with parasites. And that’s how I start my parasite protocol.
Lindsey:
If they’re weak in response to a parasite, does that mean they’ve got it or if they’re strong?
Loredana Shapson:
Depends on the test that you’re running. Generally, weakness is what is going to say like, yep, this makes me weak right now, this is an issue.
Lindsey:
Yeah, no, that’s something I’ve just sort of stayed away from because I don’t understand or necessarily know about the science behind it. I’m open to anything that’s got peer reviewed research.
Loredana Shapson:
Yes. And this does. I’ve got three studies I can send you about muscle testing. And it’s been paramount in the way that I approach my patients and it reduces Herxheimer reactions and helps me individualize nutritional supplements too.
Lindsey:
We sort of discussed it, but if you wanted to summarize, is there a treatment order you follow in terms of things like parasites, yeast, bacteria, etc.
Loredana Shapson:
When it comes to patients with bloating, I generally start with the enzymes and the probiotics. I used to go right in with an herbal product like Dysbiocide* or FC-Cidal* by Biotics Research and more herbals, and I really stepped away from that, because I went through that. I overdid it myself with herbal products. And what that was doing was tearing down my gut even more; it wasn’t rebuilding it back up. And so I just kept in this cycle of herbals and herbals and herbals, but never building. So I no longer do that approach with my patients, unless I find that when I start adding probiotics and for some reason, I can’t get them to adjust to it. They’re still having negative reactions. And I say, okay, they’re fighting each other too much. Let’s come in with a month of Dysbiocide or FC-Cidal, for the SIBO aspect of people. And then we’ll bring in the probiotic. And actually since I made that switch, I haven’t had to really go back to the Dysbiocide or FC-Cidal, I find that the digestive enzymes, the diet that we recommend, which is usually a paleo diet, and then the probiotics on board, I find that bloating goes away, I don’t need to use herbals and everything’s okay.
When it comes to SIFO, I generally like the Fungdx and the grapefruit seed extract along with a binder like Biotoxin Binder. And then when it comes to parasites, I really use a variety of products. Parasites are tricky, they are smart, they like to hide in biofilms. So especially for egg layers, I’ll do a cycle of 10 days with parasitic stuff, usually at bedtime, because that’s when parasites are the most active is at bedtime and you’ll know that because a lot of people grind their teeth at night. They’re jittery, their nervous system is super activated, they twitch. Those are signs of parasitic infections. And so usually a dose at night, 10 days on and then we stop for four days. And the reason why we stop is because that gives time for more eggs to hatch. And then once more eggs hatch, boom, you come at them again. In 10 days, you take another four days off. And we do that for about nine to 12 cycles. So that ends up being about four to five months.
Products I like to use, I use a variety of stuff because I find that once we get one product on, once that product’s done I have to switch to another one and have to switch to another one. Because each of the herbals can target the flukes or the amoebas or the egg layers. So it’s good to just rotate through them all. But I like Wormwood Complex by Mediherb. It is really great. They’re a part of Standard Process. The other one I like is Systemic Formulas. They actually have some great ones, they’re called VRM: VRM1*, VRM2, 3* and 4*. So 1 and 2 are for egg layers. Three, I can’t remember if they’re for amoebas and 4 are for flukes, but they’re going to cover all the types of parasites. So I usually rotate through those. Sometimes I’ll double up and have like a 1 and a 3 on a board. And then a 2 or 4.
My muscle testing, they usually indicate which ones the body wants at that time. And then sometimes I have to put a binder on for my parasite people. A lot of people don’t realize that the fungus and the parasites, they also bind to chemicals. Fungus in particular is a really great heavy metal chelator. So they’re going to bind to aluminum and mercury and cadmium. And so when you start killing these guys, guess what they’re going to start releasing, chemicals and heavy metals and trash. So binders again, the GI Detox is a really great product. I usually do that if I’m having them do the parasitic protocol at night, then I’ll have them do the GI Detox first thing in the morning. As soon as they wake up on an empty stomach, take two of them. I also liked the binder by Systemic Formulas called Bind*. That one’s really great as well.
Lindsey:
Did you ever use the Para 1*, Para 2* (purchase using patient direct code: I0rdLMOm), by CellCore?
Loredana Shapson:
Yep, I do like that. I find that Para 2 only does really well with Para 1 in my muscle testing. So I usually pair those two together. Or Para 2 paired with one of my VRMs. I usually find that of the ingredients in parasitic stuff, like wormwood, clove, artemisia, those are the ones that are really big guns for parasites.
Lindsey:
And there’s also the Biotonic*.
Loredana Shapson:
I haven’t used Biotonic actually.
Lindsey:
Yeah, well, that’s nice too because it’s got the adrenal stuff in there. So it’s kind of a combo.
Loredana Shapson:
Yeah, I like that, that’s another thing we haven’t talked about is adrenal support through all this.
Lindsey:
Okay, let’s talk about it. What the heck?
Loredana Shapson:
I mean, adrenal support, anything that has to do whenever your body’s under stress, I call the adrenal glands like kicking screaming children, they’re the first ones to fall on the floor and start flailing and going out of whack no matter what you’re going through, so they need support. So I really like ashwagandha and rhodiola as two herbal products that are wonderful for calming the adrenals down.
And then I also really, really like Biotics Research Bio-Glycozyme Forte*. That product is for sugar regulation, but within it, there’s also organ meats like hypothalamus, pituitary, adrenal gland, thyroid; there’s a lot of organ meats in there. And organ meats are paramount in healing; it’s one thing that we lack in our diet. Even if we wanted to get access to these things, it’s hard to find. And if you ask our ancestors, they all ate it, they all prized the organ meats; they ate the brain, they ate the heart, they ate everything. So I find that when you strengthen the organs with organ meats, you’re going to get a better, stronger response, hormonally, and with the adrenals as well. So Bio-Glycozyme Forte, I’d probably say 99% of my patients start on that first at the first visit. And they’re on that one three times a day. Yep. And that’s a wonderful product for blood sugar and adrenals. And then again, ashwagandha and rhodiola are some other ones. I bring in some ginseng too.
Lindsey:
And does that matter to you whether they show signs of adrenal dysfunction? Or that’s just kind of everybody?
Loredana Shapson:
Yeah, everyone’s got blood sugar issues. It’s just our diet and the way that we live our lives being so stressed out, we’re constantly so enzymes and Bio-Glycozyme Forte are my big guns that I always start with.
Lindsey:
I’m not sure that you totally answered the question before in terms of order of operations. So if you find somebody has parasites, if they have fungi, if they have bacteria, is there an order that you address those?
Loredana Shapson:
Yeah, great question. So yeah, I generally always go after parasites and fungus first. In terms of size, when we look at their size, they are the bigger ones that live in the body, and the smaller ones like to hide in the bigger guys. So I’ll usually go after fungus and parasites first or sometimes together. And then I’ll go after the bacteria. And usually once the probiotics come on board, it really balances out the bacteria.
Lindsey:
I mean, there’s a lot of crossover really with herbals of what deals with what, right? Like I mean wormwood addresses bacteria to some extent, too, doesn’t it?
Loredana Shapson:
Yeah, there is crossover with a lot of these, like berberine can do fungus and it can do bacteria. So there is crossover, so you’re going to get benefits on both ends. I find that the ones that work for parasites can also work for fungus. So that’s why you’re going to handle both together anyway.
Lindsey:
Well, that was a lot of really good concrete information. I’m sure people are going to love all the takeaways.
Loredana Shapson:
Yeah, there’s a lot in there.
Lindsey:
And you can find all these products in my Fullscript dispensary.
Loredana Shapson:
Yeah, there is an order for how these things should be added in. I wouldn’t jump on all these things at once. It’s a slow, steady process. That’s what we’re here for. Lindsey and I can help you through when to start what and for how long.
Lindsey:
You can waste a lot of money on supplements trying to figure this out on your own. And I’ve discovered that there is a lot of complexity to this stuff over time and supplements are expensive. And if you take them in the wrong way, they can cause harm or they might not work and then you think okay, I’ve tried that. Unfortunately, then in your head “I’ve tried that” becomes a narrative that you then give to the next person you work with, which puts them at a loss for that thing. Okay, well, if you’ve tried that, and that didn’t work, but you maybe you didn’t try it quite the right way, then I don’t have that tool in my toolbox. Because I think okay, well, they’ve already tried it. So, it is better to get the help of someone. That’s the sad reality of it.
Loredana Shapson:
Absolutely. There’s a lot of individuality here. One final comment on probiotics. A lot of the research is showing peak benefit of probiotic uses at two months and sometimes three months. And there’s some studies showing six months when it comes to eczema and skin to your point with your patient. That study was done in children but still they showed that the longer that they were on at the six month mark, people did better than three months of probiotics. So know that time is a thing. And I find that a lot of people come into my office, “Oh, I tried a probiotic for a couple of weeks and it didn’t work.” And I’m like no, no, you didn’t give it enough time or you were using the wrong one like Saccharomyces boulardii, or you know, one with strep, but I don’t really go to the start.
Lindsey:
So tell me where people can find you. And do you see people who are outside of your area?
Loredana Shapson:
Yeah, I work virtually and in person. I’m in Newtown, Pennsylvania, but I do meetings over Zoom. And for people with bloating, I have a freebie on my website, you can go to my website and get my belly bloating fixer elixir tea, and you drink that every morning and that’s going to start fixing the underlying reason for low digestive enzyme release, part of your bloating problem. So I find that people who start that, their bloating reduces or distension comes down. Some people have lost weight in the first week – two pounds – acid reflux goes away. So really great things using stuff in your kitchen. So get your hands on that recipe for free on my website.
And then I also just released a two-week online gut course, also on my website. And I basically structure everything that I do with my patients and the protocol that I use with my patients in this two week program with education and access to all the supplements that we just talked about today and when to use them and why. And it also gives them direct contact with me, so that’s right on my homepage. It’s called “Bye Bye Bloat: Eliminate Bloat in Two Weeks for Good,” so check that out. I specialize in women so I mean, anyone can really do that program to be honest with you, but women is who I typically work with in my office, and I have a YouTube page. I’ve got free health tips there. You can also find me on my Instagram and Facebook.
And 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.
