The Dr. Hyman Show - Do You Need To Take Probiotics?
Episode Date: June 27, 2022This episode is brought to you by Gut Food, Rupa Health, Athletic Greens, and InsideTracker. Probiotics are critical to protecting and rebuilding the gut. They compete with bad gut bugs and yeast, ...modulate intestinal function, and are essential to changing and improving immune function. They are also anti-inflammatory, they help us break down food, and they build nutrients. In this episode of my Masterclass series, the second in a series on gut health, I am interviewed by my good friend and podcast host, Dhru Purohit, about how probiotics work in the gut, the best fermented foods to eat, and much more. Dhru Purohit is a podcast host, serial entrepreneur, and investor in the health and wellness industry. His podcast, The Dhru Purohit Podcast, is a top 50 global health podcast with over 30 million unique downloads. His interviews focus on the inner workings of the brain and the body and feature the brightest minds in wellness, medicine, and mindset. This episode is brought to you by Gut Food, Rupa Health, Athletic Greens, and InsideTracker. Check out Gut Food at gutfood.com. Check out a free, live demo with a Q&A or create an account at RupaHealth.com. When you purchase AG1 from Athletic Greens, you will receive 10 FREE travel packs with your first purchase by visiting athleticgreens.com/hyman. InsideTracker is offering my community 20% off at insidetracker.com/drhyman. In this episode, we discuss (audio version / Apple Subscriber version): Why we need probiotics (5:32 / 1:52) Top insults to our gut (7:04 / 3:25) Evaluating store-bought probiotics, including kombucha (8:08 / 4:26) What probiotics do (10:06 / 6:28) Different strains for different symptoms (14:43 / 10:50) The top fermented foods (18:34 / 14:46) Bacteria in the gut and your immune system (24:05 / 18:51) Who shouldn’t eat fermented foods (26:25 / 20:18) Steps to shape up our guts (28:48 / 23:46) The downside of antibiotics and supporting the gut (34:15 / 28:57) Products and Research Studies Mentioned in This Episode Disclaimer: This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. You should always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal, or homeopathic supplement, or adopting any treatment for a health problem. The use of Gut Food or any other products or services purchased by you as a result of this podcast does not create a doctor-patient relationship between you and any of the physicians affiliated with this podcast. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.
Transcript
Discussion (0)
Coming up on this episode of The Doctor's Pharmacy.
We live in a gut-busting world.
I mean, our hybridized, processed, high-sugar, high-starch diet, low-fiber, low-polyphenol
diet is a disaster for the gut.
The health of your entire body is rooted in the health of your gut.
Hippocrates said, disease begins in the gut, and so does health.
Over the last decade, research on the importance of the gut microbiome has exploded, which led me to ask the question, is there a simple daily way to
transform your gut microbiome? Turns out there is. With the help of a few experts and years of
research, I've created the ultimate multivitamin for your microbiome and it's called gut food.
Gut food uses the power of three critical gut supporting components,
prebiotics, probiotics, and polyphenols and five ingredients at clinically validated dosages to
help reduce inflammation, support the growth of beneficial gut bacteria, improve digestion and
bloating, and support mood and energy. I created this product because it's what I wanted and I
wanted to offer to all my patients because nurturing your gut health can literally transform your life.
I'm so excited about gut food and I know you're going to love it.
Check it out at gutfood.com.
As a busy doctor with multiple jobs, I'm all about help almost all my patients. I was really excited to learn about Rupa Health. Hormones, organic acids, nutrient levels, inflammatory factors, and gut bacteria are
just some of the many things I look at to find the most effective path to optimal health
for my patients.
But that means I'm placing orders through multiple labs, which is just an overall pain.
And it also makes keeping track of results more difficult for me and my patients and
other doctors.
Rupa Health has totally changed that.
They've made functional medicine testing simpler and more convenient than ever
so that practitioners like me can focus on helping their patients.
With Rupa Health, functional medicine practitioners can access more than 2,000 specialty lab tests
from over 20 labs like Dutch, Vibrant America, Genova, Great Plains, and more.
It's 90%
faster, letting you simplify the process of getting the functional tests you need and providing a
noticeably better patient experience. This is really a very much needed option in the functional
medicine space that I'm so excited about. You can check out a free live demo and a Q&A or create an
account at rupahealth.com. That's R-U-P-A health.com. I'm all about streamlining my daily health routine
to be as powerful and yet simple as possible.
And that's why I love AG1 from Athletic Greens.
Because when it comes to my health, I want it all.
I want my gut to function great, my brain to feel sharp,
my immune system to be strong,
my body to feel energized and able.
And being in my line of work,
I know that means I need optimal levels of nutrients.
Which is one scoop of AG1.
I get 75 high-quality vitamins, minerals, whole food source superfoods, probiotics,
and adaptogens to support my entire body.
Even with a really healthy diet, it's hard to hit the mark for all our nutrient needs.
So I feel better knowing that I have some extra help from AG1.
Unlike other supplements and powders out there, AG1 is third-party tested
and made without GMOs, nasty chemicals, or artificial anything, and it tastes great,
kind of like a tropical green drink. I like it on its own mixed with water, but it also works
really well in most smoothies. If you're curious about trying AG1 from Athletic Greens for yourself
right now, they're offering my community 10 free travel packs with your first purchase. All you
have to do is visit athleticgreens.com forward slash Hyman. Again, that's athleticgreens.com
forward slash Hyman to take ownership over your health and pick up the ultimate daily
nutritional insurance. Now let's get back to this week's episode of The Doctor's Pharmacy.
Hey everybody, it's Dr. Hyman.
Welcome to another episode of The Doctor's Pharmacy.
And this is a special one because it's a masterclass where we dive deep into popular health topics,
including inflammation, autoimmune disease,
brain health, sleep, gut, and more.
And today, my friend, my business partner,
my podcast host, Drew Prowett,
and I are going
to be diving deep into part two of our gut health series.
Today, we're talking about probiotics.
Now, unless you're living under a rock, you've definitely heard of these before.
They're pretty famous and for a good reason.
When our team decided to create a multivitamin for the gut, we knew that probiotics were
going to be an essential part of the formula.
Drew, really excited to have you back doing this with me. And I'm excited for
this conversation about probiotics. Take us down that road. Yeah, Mark. Well, I'm actually going
to ask you to take us down that road. Okay. You know, you're the expert over here and it's a
topic that a lot of people have questions about. And we're very lucky that there are actually,
you know, there are a lot of really great companies
doing very great things. Sure, there's some poor stuff that's out on the market too, but there's
been so much awareness. Generally speaking, most people have heard of the term probiotic.
There's still a lot of confusion that's there. And that's what hopefully this episode can get
a chance to get into. But yes, on the topic of what we've been up to with our product Gut Food, go to gutfood.com and learn a little bit more about it and join the wait list.
We thought a deep dive into the topic of probiotics would be a fantastic fit for not
just talking about our product, but answering people's questions. So Mark, I'm going to take
you big picture and just say like, why do we need probiotics in the first place? And when was the first time that
you encountered in your journey and even had heard the term probiotic?
Oh, wow. I mean, first of all, probiotics are exactly what they sound like. They're pro
biotics as opposed to antibiotics. They help produce a healthier gut by giving the gut the good bugs in it that it needs to thrive.
And I first discovered them probably back in, God, the beginning of my career as a doctor and began to know about them through learning about nutrition and the role of the gut way
back 30 plus years ago.
And studying functional medicine, they became just
very obvious to me that they were critical components of rebuilding gut and rebuilding
health for so many patients. So I've been using them and experimenting with different probiotics
over decades and decades. And I've learned so much about what they do, their role, why they're
important, how they work, how they don't work, which ones are good, which ones are bad. And it's
just a, it's a little bit overwhelming out there for people to figure out what do I take and which one do I take?
And if is it cold or in the fridge, can it be on the shelf? Does it, what do I take for this
condition, for that condition? And, and they're varied because there's literally thousands of
different microbes and they all have different roles. They all do different things and they all
have different benefits. So it's really about customizing and personalizing, but there are
some basic ones that have really important functions and we're going to talk about
that. And you went through the whole backstory in the last masterclass that we did on polyphenols,
but just high level, what are the top insults that are going on in this world that we live in today
that are destroying the microbiome and putting us in a place where we even need to be thinking
about probiotics? Yeah. I mean, just briefly, we live in a gut-busting world. I mean, our hybridized,
processed, high-sugar, high-starch diet, low-fiber, low-polyphenol diet is a disaster for the gut. So
it's a perfect storm for creating bad bugs. Second, we know we're born by C-sections. We
don't breastfeed as much. We get early antibiotics. We use all kinds of drugs that screw up the gut
from acid blockers to anti-inflammatories to the pill or birth control. And all that is a perfect storm. On top of that,
you've got all the ingredients in processed food like carrageenan and gums and emulsifiers that
further damage the gut and cause leaky gut. And if that weren't enough, our food is often filled
with pesticides and herbicides, glyphosate, for example, which is a microbiome destroyer.
So we basically live in a gut-busting world and we have to be very vigilant about keeping
our gut healthy, even if we don't have gut symptoms.
So one of the first questions that people had, Mark, on this topic of probiotics is
store-bought probiotics and things like kombucha and probiotic beverages, are they actually
healthy and can they be beneficial to people?
Yeah, so let's just take kombucha because that's the kind of big craze
and I'll go down to the other ones.
I mean, kombucha is great for a lot of people.
It can be fine.
It's a bubbly drink.
It tastes good.
It actually has probiotics in it.
It can be beneficial.
But a lot of them also are loaded with sugar.
Most of them.
Yeah.
So, I mean, without them, they taste pretty bad.
Without sugar, it tastes pretty bad.
So I'm kind of not a huge fan.
I think for the right person, it can be fine.
And if your gut's pretty healthy, it can be fine.
But if you are struggling with weight, if you have blood sugar issues or a lot of overgrowth or yeast problems, it can be problematic.
Because the sugar is going to feed the bad bacteria.
Yes. And on top of that, liquid calories are some of the most destructive, it can be problematic. Because the sugar is going to feed the bad bacteria.
Yes. And on top of that, liquid calories are some of the most destructive when it comes to metabolic
health.
Sure.
Right.
So you don't want to drink your calories.
And as far as probiotic beverages, they're little kind of bottles of probiotics.
They can be very good and helpful.
And I think they're not bad to try and take.
And there's a lot of probiotics in the refrigerated sections
of a lot of health food stores and grocery stores. And there's a lot to choose from. And people are
kind of confused about which one should I take for what. There are also probiotics that are
ones that are in pharmacies like Lactobacillus GG or Align that are more kind of commercially
available probiotics that have been well studied for treating different conditions.
So there's a lot out there.
I think, you know, we have to look carefully at what's in them.
Are there a lot of sugar?
How long have they been there?
What does it say on the bottle?
A lot of times, you know, you look at the bottle and it says, you know, 50 billion,
you know, colony forming units. But then when you actually do look at it, they're not, they degrade very fast.
They may not have what is in there.
So quality matters.
Brand matters.
How it's stored matters.
And I think that's a little bit of a kind of crapshoot when you go trying to look for
this stuff in the store.
So Mark, take us a little bit deeper, really on the topic of like, why do we need probiotics?
And how can they be beneficial?
Like, what are actually the things that they make a difference on when it comes to our
health?
Yeah.
So thank God we're in this era of microbiome research because we know now from many, many
studies, from many different strains of probiotics, all the beneficial effects that they have.
And we're still learning more and how to develop more and better probiotics.
So we're growing fast in this knowledge base.
But probiotics essentially are modulators of intestinal function.
So they will change the immune function.
They'll change the cell signaling communications.
They'll compete with other bacteria that are bad bugs and get rid of those.
They'll compete with yeast and help reduce those by actually helping promote more of the good bugs.
They tend to be tourists.
They don't exactly colonize most of the time, although they can. So they don't stay forever. But as long as you're
taking them, they do their work. And then they have all these inflammatory things that they do
that are anti-inflammatory. They actually help you build digestive components that actually help
creating vitamin K and biotin and other nutrients that
your body needs. They're helping break down foods that you can absorb. They're helping
create short-chain fatty acids. So they really change the whole ecosystem of the gut. And it's
so important because if your inner garden is unhealthy, for most of us it is, then you're
more likely to get not only digestive symptoms like irritable bowel and reflux and inflammatory
bowel disease, but you're more likely to gain weight, get diabetes, have allergies, have asthma,
have autoimmune diseases, have depression, anxiety, ADD, dementia, and a lot of other things when your
gut's not working. So, you know, we do all the things that are really bad for our gut. And even
our stress is bad for our gut. Alcohol is bad for our gut. All these drugs that we take are bad for our gut. And so we live in a culture where we need to double down on focusing on gut health. And to date,
we really haven't had a way to do that. I mean, yes, take this probiotic or this probiotic,
but we've created a multivitamin for the gut, which really puts together all the key components,
prebiotics, probiotics, and polyphenols that the gut needs to create a healthy inner garden. And I think when we get off of the processed food, when we get off of the gut-busting
drugs, when we start to take probiotics, when we start to take gut healing compounds that are in
gut food and are a multivitamin for the gut, we can really start to help rejuvenate and rebuild
the gut, which then has all these downstream consequences of improving your immune system,
improving your mood, improving your metabolism, reducing inflammation of the body.
It's really what we want to be doing. And when you look at some of the data, and we have really good data on the product that's in our formula called Lactospore. Lactospore is a spore-based
probiotic. And when they did clinical trials, a pilot study, but it was a randomized control trial,
they found a 42% reduction in bloating in the internal bowel, a 47% reduction in vomiting,
a 43% reduction in diarrhea, and a 68% reduction in pain.
And even more remarkably, they looked at what happened to the brain.
Because how is the gut and the brain connected?
Well, they are very connected through the gut-brain connection. And depression went down 57%. Sleep got better, 58%. Dementia symptoms
went down 26%. Quality of life went up 47%, along with GI discomfort going down by 62%.
That's amazing just from a probiotic, right? So, you know, there are a lot of ones on the market
out there. This is shelf-stable, so you don't have to refrigerate it, which is a big deal, building travel with it. And two,
it's one that is a very unique form called Bacillus coagulans that has all these benefits.
Not all probiotics are the same and not all have these benefits, but this one is really well
studied and actually has these incredible benefits. Yeah. And what's great about the
formula is that it's the levels shown in the clinical trial, which we'll have the links to
those below, that is the same level that's placed inside the formula. Now, we're not just here to
talk about the new formula that you put together, gut food. You've been using probiotics as part of
your protocols that you've written in your book for a really long time. And one of the great things
is that there's a lot of really great companies. you know, a lot of, we call them the doctor's brands, right? Metagenics, Designs for Health,
Thorne, Claire Labs, you know, I'm leaving out a few, Pure Encapsulations.
They have been some of the most incredible brands and many others in that ecosystem
that have really touted the benefits and educated many practitioners like yourself about
how different
strains of probiotics could be used to deal with patients who are struggling with various sorts of
things. Is there an example, you know, not that you have to mention a particular product, but
is there an example sometimes where you might bring in a particular strain of a probiotic
because it's been shown to do really well for a patient that has a specific condition?
I mean, one I like to use is really great. It's called Saccharomyces blyardi, which is not actually a bacteria.
It's a yeast.
But it's called often yeast against yeast.
But it has profound effects in regulating not only the biofilm in your gut, controlling
yeast overgrowth, but also helping with the deal with chronic gut issues like clostridia
like I had.
So it's shown that if
you take this particular strain it helps reduce the symptoms or even get rid of clostridial bacteria
which is really great so i really am very focused on which ones do what um some of them by the way
if you go to pub med and you type in saccharomyces boulardii there's a ton of research on also
diarrhea yeah diarrhea right people who get to go to India and they get like
deli belly or they go to Mexico and they get Montezuma's revenge or whatever, you know,
people are calling it. Saccharomyces is one of the things that people are given to help them
deal with some of the stomach upset that comes from just being introduced to bacteria that they
may not typically be introduced to. Absolutely. And then there's, you know, there's different
bacteria for different things. For example, for babies,
often there's a particular bacteria
called Bifidobacterium infantis
that's really important for immune development.
And it's absent in most babies
because the mothers have had an antibiotic
sometime in their life and wiped that out
or they're born by C-section.
And the 25% of calories that's in breast milk
that's not digestible by babies is there to feed
this particular bacteria and others called Bifidobacterium infantis. And if you have low
levels, it's a big problem. So you can actually give the baby probiotics when they're born in the
first hundred days to help them colonize with Bifidobacterium infantis and avoid the autoimmunity,
the allergy, the eczema, and all these other downstream things that are going to happen
if you don't have this important bacteria.
So that's just another example of how different strains do different things.
Yeah, and just a little shout out.
They were on your podcast previously, the name of the company that is-
Evivo.
Evivo.
Yeah, they're doing some new game-changing stuff in the space.
And there's plenty of others.
There's our friends Kieran at Microbiome Labs.
There's some friends that you're connected with at Seed that are also doing some amazing things.
It really does feel like we're in this sort of golden age of people really starting to put the emphasis on probiotics.
And it's less about the competition between all these different people and more about the awareness.
Because we need a lot of different solutions for people at different levels.
And we may be getting to a point soon where we get personalized probiotics where-
I'd be very excited.
We look at your microbiome and we look at what's there, what's not there. And I do this now. I say,
oh, you don't have enough of this or that, so I'm going to fix this or that. So I do that.
But we're going to be more sophisticated about it and be able to make custom probiotics for people.
And you talked about this a little bit before, but there's so many Instagram ads and TikTok ads
that I get, which are like, hey, we'll tell you exactly the diet and the probiotics to take based on your stool.
So send in your stool and let's tell us. You chatted a little bit about this in the past,
but just talk about how we're getting there, but maybe we're not exactly there.
Yeah, we're getting there. I think there's sometimes overreach and over-promising and
under-delivering on some of these tests. And they don't take into context the patient's
overall health, the other parts of their digestive function.
They just look at the actual bacteria
and they make all these conclusions based on the science.
But that can be a lot of noise too
and not actually helpful for people.
So I think it's important to learn about yourself,
to do the testing, but take it with a grain of salt.
A lot of the recommendations that are happening now,
you want to try stuff and see how it works,
but you don't want to think of it as the gospel. So one of the things we want to chat about when
it comes to eating probiotic rich foods, which also includes some prebiotics in there as well,
and we'll do a whole nother episode on prebiotics. So the research shows that eating a high fermented
food diet increases diversity in the microbiome and decreases inflammatory markers. So the question
is, what are some examples of some of the
top fermented foods that many people can include on a daily basis to tap into some of these benefits
that the research is showing? Yeah, absolutely. I think, you know, historically, we didn't have
refrigerators. And as a species, we really got good at preserving food. And we did that through making cheese or through drying meat or through creating fermented foods.
And these cultures have had these for thousands of years.
Which, by the way, is another form of cooking.
Yeah, exactly.
So sauerkraut, kimchi, pickles, miso, natto, tempeh, kefir, yogurt. These are all forms of bacterially generated
food substances that actually are full of these beneficial compounds. And there's a great study,
I love this one study, it was looking at Polish women. So they eat about 30 pounds of sauerkraut
a year, which is like about almost a pound a week, right?
It's a lot of sauerkraut.
And what's amazing is when they move from Poland to America and they eat the American diet, their risk of breast cancer goes way up.
Whereas with the sauerkraut eating in Poland, they have very low rates of breast cancer.
Interesting.
Correlation study.
Yes.
But still, important to pay attention.
The same is true when you look across the board at longevity zones. When people leave those longevity zones, like in Japan, they come
to America, they get the same rates of disease as Americans. So it's really, it's not so much
your genes as the environment. And so fermented foods play a big role in our keeping a microbiome
healthy and regulating all sorts of things from cancer to heart disease to obesity to diabetes
to mood disorders. It's kind of cool. So I think if you can tolerate them, it's fine. If you have,
for example, histamine problems or if you have a tiny yeast overgrowth or really bad dysbiosis,
it can be a little bit challenging to eat those foods. But I would include those on a regular
basis. Hey, everyone. It's Dr. Mark. If I've learned one thing during my two decades in
functional medicine, it's that we're all unique. No two people are alike, which means we can all
benefit from personalized medicine. But for most of the history of medicine, individualized healthcare
just was not possible. We couldn't look inside the body and see what was really going on. But now,
thanks to advances in technology, that is changing for the better, and it's doing so in some amazing ways. And I've got a great example of amazing healthcare
technology that I'm excited to tell you about. It's called InsideTracker, a wellness tracker
that uses science and technology to deliver ultra-personalized healthcare guidance.
It can analyze your blood, your DNA, your lifestyle habits, and then give you actionable
recommendations to help you meet your health and wellness goals. InsideTracker provides you with the information you need to make powerful
health decisions. It gives you a customized dashboard to help you track and reach your goals.
And the numbers are calibrated to your body, as opposed to just listening to the normal ranges
that your doctor might tell you. It also helps you understand those numbers and take action on them.
If you're curious about getting your own health program dialed in to meet your unique needs,
I highly recommend checking out InsideTracker.
Right now, they're offering my community 20% off at InsideTracker.com forward slash Dr. Hyman.
That's D-R-H-Y-M-A-N.
That's InsideTracker, I-N-S-I-D-E-T-R-A-C-K-E-R.com slash Dr. Hyman, D-R-H-Y-M-A-N.
And you'll see the discount code in your cart.
Which ones do you include on a regular basis when it comes to those fermented foods?
Oh, I like miso.
I like sauerkraut.
I like tempeh.
And those are my favorites.
Do you do any kefir or anything like that?
I like sheep or goat yogurt, but I don't eat it that much.
And is it in the yogurt form?
Because when you go to like Whole Foods, for example, they'll have like goat and sheep yogurt.
And then they'll also separately in these larger bottles have like goat kefir.
So there's yogurt and then there's kefir.
Do you choose one over the other?
I like yogurt.
Kefir is liquidy.
I mean, they're both fine.
Okay.
There's a brand that I've been eating a lot.
No affiliation with them.
It's called Redwood Hill Farm.
And I do not consume dairy on a regular basis because I always have dairy and I break out.
I break out and it's just a mealy.
But I've been having this Redwood Hill Farm goat milk kefir.
They have Whole Foods, other places.
It's great.
Get the one that's unsweetened.
And the goat milk is important because it's A2
casein, which is what's not causing all the inflammation. The A1 casein is what's causing
your pimples. Totally. And I don't break out. I feel good. I feel like my gut health is stronger
than ever before. So just an example of, you know, we'll be writing a newsletter on this whole topic.
So typically, Mark, people are not making these products, although you could.
My daughter makes them. I wonder how she had a whole thing of kimchi being made.
Well, maybe we could all buy from her, but she's too busy being in medical school.
So I don't think she'll have time for that.
But typically, people are not going to make them and they're going to get them from the store.
Just a couple of odds and ends that you want to make sure, just like the kombucha.
What do you want to make sure that people are looking out for when they're buying some of these things? I mean, I wouldn't, if they're buying fermenters, I would stick with
really traditionally made fermented foods, pickles, sauerkraut, miso, kimchi, things that
have been around and been done for thousands of years. Tempeh, natto, all those are really
wonderful to include in your diet and see what you like and what you enjoy. So Mark, another thing
that I found super fascinating about fermented foods that I have
inside of my show notes here is that fermented foods are shown to reduce markers like interleukin-6,
which is an inflammatory cytokine. So break that down. What are inflammatory cytokines and how is
it and what mechanisms that you could guess that fermented foods would play in that would reduce
the overall inflammation of the body? Yeah, yeah. So first of all, cytokines, we've heard about in the face of COVID and the cytokine
storm, which kills people. Essentially, it's a flood of these inflammatory molecules. And
cytokines are the messenger molecules of your immune system. And they have all kinds of names.
One of the class of them are called interleukins. And there's many, many different kinds. Some are
anti-inflammatory, some are inflammatory.
Interleukin 6 particularly is a very common one.
It's very high in belly fat and visceral fat, abdominal fat.
It's highly correlated with heart disease, dementia, cancer, obesity, diabetes, and it's
really driven off of a state of low-grade inflammation that comes from this visceral or belly fat on fire.
The beautiful thing about our understanding about the relationship between the microbiome
and our belly fat and our metabolism is that it's mediated through changes in the microbiome
that drive inflammation.
We talked about earlier the metabolic endotoxemia,
the basic toxins in your gut that leak across and start to trigger immune responses. And the
immune responses then generate a cascade of responses that increases certain cytokines
like interleukin-6. So if you have a bad gut, if you have a leaky gut, if you're eating the wrong
foods, you're going to get higher interleukin-6, which is going to create more insulin resistance, create more weight gain, create more belly fat, and a vicious cycle.
So the beautiful thing about fermented foods is that they can help reduce
this process by normalizing gut function, by optimizing the gut in different ways,
through optimizing healthy bacteria, reducing the bad bugs, which then reduces the leakiness
of the gut, which then further limits the inflammatory cascade that results as a result of a leaky gut.
So it's really, you know, kind of a beautiful story about how your microbiome plays a role
in your immune system, plays a role in your weight, and how that all connects to eating
the right foods and not eating the wrong foods.
If somebody's struggling with things like yeast overgrowth or histamine intolerance,
are those two examples and are there any others of where fermented foods – because we read the articles or we read the headlines and we say like, okay, this food is good for everybody.
But if somebody's reacting to fermented foods, one, what could that possibly be an indication of?
And number two, is there anything they should be thinking about doing?
Yeah.
So certainly fermented foods and their stomachs just go crazy and blow up and they feel horrible. And that's because there's something going wrong in there. Something's
rotten in Denmark, as Shakespeare used to say. So we have often bad bugs growing in there,
yeast overgrowth. We have something called SIFO or small intestinal fungal overgrowth or SIBO,
small intestinal bacterial overgrowth. And that means that these
bugs have migrated into small intestine. You started putting foods in there and it starts
battling. You start a war with the good bugs and the bad bugs and you get all this dangerous things
that start to happen, which is more bloating, more gas production, more discomfort, more GI symptoms.
So while fermented foods are good, they're good in the right person. Because if your gut's not sorted, and I call it the weeding, seeding, and feeding program.
If you haven't done the weeding and you got a lot of bad bugs in there, you start eating fermented foods, you're going to be in problem.
So, you have yeast overgrowth.
If you have small intestinal bacterial overgrowth.
If you have histamine intolerance, you should be very careful.
So, if you don't react well to fermented foods, it doesn't mean fermented foods are bad for you.
It means there's something wrong with your gut. Find it and fix it. And can you still take a probiotic,
for instance, and get the benefits? Because it's not exactly like there's a clear test to say,
like you have to go and do the weeding first, unless sometimes you're working with a functional
medicine doctor, they can help you interpret it. Sure. So in that instance, can you still
take, right, if you want to get some of the benefits, can you take things like probiotics?
And that could be one way if you're reacting to fermented foods to still get the
benefits of the bacteria that you'd be introducing in your system. Yes. I mean, you have to be
careful. If you have a tremendous amount of bacterial overgrowth and you take probiotics,
you can get worse, just like with fermented foods. But the thing is, beautiful, you can start slowly
and then build up and it's sort of kind of win the war over time. I typically like to do this to weeding first, but you can actually start to seed and see how that
works in a way that actually is a low dose initially. And then you start to build up on
the dose and people can generally tolerate it. But it's often important to treat the underlying
issues first. So Mark, whether we're introducing fermented foods or not, and I hope that a lot of
people are, right? Because it's a smaller part of the population that's going to have reactions to fermented foods and needs to go
on a little bit more of aggressive protocol, maybe with a practitioner. But whether we're
about to introduce more fermented foods or start to have them on a more frequent basis, or we're
getting ready to include like a probiotic, a high quality probiotic into our diet, there are things
that we can do to get our body and our gut, especially in the best shape, to benefit from
those things. So what are some of those lifestyle recommendations?
Well, when you plant the soil, to plant a seed in the soil, you want to prepare the
soil, unless you're using tons of fertilizer and pesticides and chemicals that you don't
want to do.
So how do you prepare the soil to plant the seed?
So you have to do the same thing for your gut.
Just as you're going to start your garden, you get rid of all the weeds and you dig it up and you make the soil nice, you have to do the same thing for your gut. Just as you're going to start your garden, you get rid of all the weeds and you dig it
up and you make the soil nice, you have to do the same with your gut.
And that can be done through herbs or some medications.
If you have bacterial overgrowth, fungal overgrowth, parasites, that's what we call the weeding
phase.
The other part of the weeding phase is weeding out foods that cause problems.
Because if you're taking probiotics but you're still eating a ton of junk food and sugar
and drinking sodas and having lots of gluten and your gut's a mess, it's not going to work as well. So the key is to do a gut-healthy diet, which is essentially
the Pegan diet or the 10-day detox diet, things I've written a lot about.
Then actually you can start to add these foods in because your diet's going to start to change
the garden very quickly. It's going to start to get rid of the bad bugs,
fertilize the good bugs, and then the probiotics tend to work better.
So it's much better to actually take the probiotics in the context of a healthy diet than to try to make up for a healthy diet by eating probiotics.
Yeah, because sometimes the approach with the modern world of supplementation, this always happens, is that there's this feeling that, oh, this is just going to fix everything and I can just go and continue to live the lifestyle that I was living previously.
But your food is always so much more of an impact than anything else that's out there.
So cleaning it up over a period of time is so key. So Mark, when it comes to shopping for
probiotics, what are some of the things that people can be looking for when choosing the
right probiotic? I mean, it's difficult because it's kind of the wild west out there and the
regulations are really on not matching the need.
And so the bottle might say 50 billion units, but there might be five.
Or it might say there's these strains of bacteria, but they might have put them in the manufacturing, but by the time they get on the shelf, they're not there.
Or the cold chain might be broken, so the probiotics that are kept cold aren't cold and they degrade over time
so you got to really be careful and then you ought to know which probiotics so there's a bit of a
science to it with that said there are some really good companies out there that are pretty reliable
that test their products aggressively we mentioned a bunch of the encapsulations metagenics there's
others um that are quite good uh zymogen there's a lot of good products that we use in the medical space. So I tend to focus on those. And I think that when people are choosing, they should really
be looking at, you know, where is it coming from? Who's the manufacturer? What's the process?
What's their quality control measures? Do they test and how do they maintain shelf stability?
If it's a shelf stable product, if it's frozen, what was the cold chain like? So you got to kind
of do a little bit of due diligence. And I think then you can kind of come
up with, you know, probiotics that are for different things. Like I said, it's not like
there's, it's not like just one size fits all. So different probiotics have different benefits
for different people at different times, just like different drugs. So it's going to be that
personalized. So there are some general probiotics you take like lactobacillus and bifidobacterium and others, but there's a lot of strains and things that are now coming out that are
a more research-based strain. So it depends on what you're dealing with. If you're dealing with
immune issues or hormonal issues or brain issues, I mean, there's probiotics for depression now,
for blood sugar, for all kinds of stuff. I just literally, I'm going to be doing an Instagram
live with a famous actress who had
diabetes and started taking a particular probiotic that helped balance her blood sugar.
And I've seen this in other patients.
When they get the gut healthy, their blood sugar gets better.
So there's really very much a future of customized and personalized probiotics.
No, absolutely.
There's a ton of great companies that are doing stuff in the space.
And I think through education and digging in a little bit and asking the companies how they approach it, that's a big part of the process.
Talk a little bit more about lactospore, which is the probiotic that you put in your formula.
Yeah. I mean, the reason we picked this is because of the level of data on this. This is a
probiotic that's been well-researched in randomized clinical trials,
looking at its efficacy across a broad range of health issues, digestive symptoms, mood issues,
and more. And it's quite amazing when you look at it. It's a spore-based probiotic,
which is quite different. It's shelf-stable, so you don't have to worry about keeping it in the
fridge. And the data actually is quite amazing because it shows that it has dramatic reductions
in GI symptoms. So for example, the lactob spore cuts down on irritable bowel symptoms by 42%, bloating by 47%,
vomiting by 47%, diarrhea by 43%, overall GI pain by 68%. But it also deals with other
physiologic problems like depression and mood issues, like reduction in depression by 57%
and improvement in quality of life scores by 47%. These are quite amazing data, sleep improvements by 58%.
So we've got data showing that these kinds of probiotics work.
And I tend to rely more on the ones that are research-based, that are used in the clinical
studies that I can rely on and I know the manufacturer.
So that's why we tend to pick these probiotics for our formula as opposed to just some random
product.
So a couple last things on the topics of probiotics. Almost everybody in the world
has taken an antibiotic at some point in time and people are always curious about that.
On one extreme, there's this deep, deep, deep fear that, oh my gosh, I've heard so much about
the gut microbiome from functional medicine doctors and experts like yourself and I'm just
worried to take an antibiotic ever. And on the other side, it's like the data is way overblown. We don't, you know,
we're fine. Antibiotics, the body's resilient. Tell us where you lie on that spectrum of things.
I mean, look, antibiotics have been a huge benefit to humankind, for sure. And for that,
that many of us would be dead right now. No question about it.
But there's a downside, which is they wipe out a lot of keystone species in our gut,
in our microbiome, that leads me to kind of wonder about how we can actually kind of reset our system after antibiotics.
So I'm very aggressive with my patients if they've
taken antibiotics to rebuild their gut after. I always put them on the Saccharomyces while
they're on antibiotics because that helps prevent antibiotic-associated diarrhea and also changes.
And then afterwards, I make sure they take a good three, four months of a good multi-complex
probiotic after. And it's really important because if you don't, you're just kind of going back to,
you know, having these altered microbiomes that never reset. And you want to reset them. And you
also want to use diet to reset them too. That's really important. So the diet is the best way to
create a sustained change in the population of your microbiome. And the probiotics really help
regulate your immune system and leaky gut all along the way. All right, Mark. Well, we talked
about a bunch of companies that you love and use and trust on a regular basis. We'll have a link to those.
We're all about lifting everybody up and highlighting and putting the spotlight on
companies that you love and that you use in your clinic and they use at the Cleveland Clinic as
well too in some cases. So we'll have a lot of link to those in the show notes as well as some
of the studies that we mentioned. We'll put those in the show notes as well. And with that, I think we can go ahead and conclude today's episode.
Well, thanks, Drew. It's been a fun class. I think we really always have more to learn about
the microbiome, about probiotics, about how to fix the gut. And the exciting part about this
era is we're learning more every day. And I'm learning more every day. And I've been doing
this for 30 years. So it's pretty exciting. So if you like what you heard on this podcast and you want to learn more about our new multivitamin for your gut called
Gut Food, just visit gutfood.com to sign up for the wait list and be sure to share this
podcast with your friends and family and we'll see you next week on The Doctor's Pharmacy.
I hope you enjoyed this episode of The Doctor's Pharmacy.
Make sure to check out Gut Food and learn more at gutfood.com.
I hope you're loving this podcast.
It's one of my favorite things to do and introduce to you all the experts that I know and I love and that I've learned so much from.
And I want to tell you about something else I'm doing, which is called Mark's Picks.
It's my weekly newsletter.
And in it, I share my favorite stuff from foods to supplements
to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team
uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter.
I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up.
That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter and I'll share
with you my favorite stuff that I use to enhance my health and get healthier and better and
live younger longer.
Hi, everyone.
I hope you enjoyed this week's episode.
Just a reminder that this podcast is
for educational purposes only. This podcast is not a substitute for professional care by a doctor or
other qualified medical professional. This podcast is provided on the understanding that it does not
constitute medical or other professional advice or services. If you're looking for help in your
journey, seek out a qualified medical practitioner. If you're looking for a functional medicine
practitioner, you can visit ifm.org and search their find a practitioner database.
It's important that you have someone in your corner who's trained, who's a licensed healthcare
practitioner, and can help you make changes, especially when it comes to your health.