The Dr. Hyman Show - How To Improve Your Health With Probiotics

Episode Date: October 3, 2022

This episode is brought to you by Rupa Health, Paleovalley, and InsideTracker.   Your gut is your inner garden—the more good bugs you have in it the more likely it is to flourish. Our gut bacteria regulate many of our bodily functions, from creating vitamins to controlling our immune system, our brain function, and, of course, our metabolism and weight. They are critical to our long-term health. But even if you’re eating the right things, you may need some outside assistance maintaining plentiful and diverse gut bacteria. Probiotics help populate your gut with beneficial bacteria, improving your sleep, daily elimination, brain health, and so much more.  In today’s episode, I talk with Dhru Purohit, Dr. Tracy Shafizadeh, and Dr. Elizabeth Boham about probiotics, the importance of the gut microbiome starting in infancy, and why you should work with a skilled practitioner to choose the right probiotic for you.   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. Dr. Tracy Shafizadeh is leading the work in understanding the infant microbiome. She is a nutritional scientist who helps new and expectant moms learn about creating healthy gut bugs in their babies. Dr. Shafizadeh received her Ph.D. in nutritional biology from the University of California, Davis, and spends her free time "loving the guts" out of her two boys.   Dr. Elizabeth Boham is a physician and nutritionist who practices Functional Medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing. This episode is brought to you by Rupa Health, Paleovalley, and InsideTracker. Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, and Great Plains. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com. Paleovalley is offering my listeners 15% off their entire first order. Just go to paleovalley.com/hyman to check out all their clean Paleo products and take advantage of this deal. InsideTracker is a personalized health and wellness platform like no other. Right now they’re offering my community 20% off at insidetracker.com/drhyman. Full-length episodes of these interviews can be found here: Dhru Purohit Dr. Tracy Shafizadeh Dr. Elizabeth Boham

Coming up on this episode of The Doctor's Pharmacy. You're more likely to get not only digestive symptoms like irritable bowel and reflux, 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. Hey everyone, it's Dr. Mark. I know a lot of you out there are practitioners like me, helping patients heal using real food and functional medicine as your framework for getting to the root cause. What's critical to understanding

what each individual person and body needs is testing, which is why I'm excited to tell you about Rupa Health. Looking at hormones, organic acids, nutrient levels, inflammatory factors, gut bacteria, and so many other internal variables can help us find the most effective path to optimize health and reverse disease. But up till now, that meant you are usually ordering tests for one patient from multiple labs. And I'm sure many of you can relate how time-consuming this process was, and then it could all feel like a lot of work to keep track of. Now there's Rupa Health, a place for functional medicine practitioners to access more than 2,000 specialty labs from over 20 labs like Dutch, Fibrin America, Genova,

Great Plains, and more. Rupa Health helps provide a significantly better patient experience and it's 90% faster, letting you simplify the entire process of getting the functional medicine lab tests you need and giving you more time to focus on patients. This is really a much needed option in functional medicine space. And I'm so excited about it. It means better service for you and your patients. You can check it out and look at a free live demo with a Q&A or create an account at rupahealth.com.

That's R-U-P-A health.com. If you've been following me for a while, you know that I often talk about how eating organ meats is so good for your health. Now, I know it can be hard to work them into your diet, but when we don't eat things like liver, kidney, and heart regularly, we're missing out on wonderful sources of essential nutrients. Organ meats are nature's multivitamins and the richest sources of natural vitamin A, B

vitamins, and minerals that we have. But liver isn't everyone's first choice for a delicious meal, which is why my friends at Paleo Valley created their Grass-Fed Organ Complex supplement. Paleo Valley Grass-Fed Organ Complex contains three different organs from healthy grass-fed pasture-raised cows. So you're getting a wide array of nutrients and each ingredient is sourced from a family-run farm in the U.S. It's been gently freeze-dried in order to preserve as many of the nutrients as possible. The end result is an odorless, tasteless, burpless supplement that offers all the benefits of organ meats

in an easy-to-swallow capsule form. If you're struggling with brain fog, low energy levels, or if you just want to optimize your health and vitality, try Paleo Valley Grass-Fed Organ Complex. And right now, Paleo Valley is offering my listeners 15% off their entire first order. Just go to paleovalley.com slash hymen to check out all their clean paleo

products and take advantage of this deal. And now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Theon, one of the producers of The Doctor's Pharmacy podcast. Our gut and the tons of bacteria that reside within it regulate many of our bodily functions from creating vitamins to controlling our immune system, our brain function, and of course our metabolism and weight. The health of the community of microbes living in and on our bodies is a top priority for overall wellness. In many cases, probiotics can be a great way to encourage a healthy gut microbiome and therefore a healthy body. In today's episode, we feature three conversations from the doctor's

pharmacy on why our guts are so imbalanced and how we can repair them using probiotics. Dr. Hyman speaks with Drew Pruitt on the vital gut-brain connection and sources of probiotic foods, with Dr. Tracy Shafazada on why gut health is important during pregnancy and what probiotics to give to babies, and with Dr. Elizabeth Boehm on the importance of working with a skilled practitioner to determine if probiotics are right for you. Let's jump in. 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 for 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 were 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 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. 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 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, 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 and there's 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 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 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 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 and we start to take gut healing compounds that are in gut food in our 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 and irritable 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 one's 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 quagulans that has all these

benefits. Not all probiotics are the same and not all have these benefits, but this one is really well studied. It 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.

A lot of we call them the doctor's brands, right? Metagenics, Designs for Health, Thorne, Claire Labs. 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, not that you have to mention a particular product, but is there an example of 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, it's really great, is 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. Some of them are- And by the way, if you go to PubMed 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 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 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 100 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 really 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 we look at your microbiome and we look at what's there and 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 other 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 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 sauerkra 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 was looking at polish women so they eat about 30 pounds of sauerkraut a year which is like about a pound was 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, 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. 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 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. Which ones do you include on a regular basis when it comes to those fermented foods? Yeah. Oh, I like miso. I like sauerkraut. I like tempeh. And those are my favorites. Do you do any kefir or things 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 Whole Foods, for example, they'll have goat and sheep yogurt. And then they'll also separately in these larger bottles have 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 we'll be writing a newsletter on this whole topic. So typically, Mark, people are not making these products, although you could there's a 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 you know what do you want to make sure that people are looking out for when they're buying some of these things in the store? I mean, 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 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. 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. 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, you know, 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 the articles or we read the headlines yeah sure okay this food is good for everybody yeah 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 the Shakespeare used to say. So we have often

bad bugs growing in there, yeast overgrowth. We have something called CFO, or small intestinal fungal overgrowth, or CBO, 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 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, put 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 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 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've 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 in the beginning. Like Pure Encapsulations, Metagenics, there's others that are quite good. 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 where is it coming from, who's the manufacturer, what's the process, what's their quality control 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 more research-based strains. 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. As a nutritional scientist, I think that this part of the research and part of the story is Davis and a team of researchers that were using human milk as an example of food that in its perfect form, because if you think about it, human breast milk has not been impacted by mass industrialization and we haven't really toyed with it too much. It's

actually the pressure on human milk is actually from human evolution. And it really, the body is constantly dialing in human breast milk to be exactly what the baby needs to thrive and grow in the first six months of life. So this team of researchers at UC Davis at the Foods for Health Institute said, well, let's dissect and analyze every aspect of human milk and let's see what's there. And we'll use that as a template for what babies are supposed to be consuming. And everything was there that you would expect the lipids, the protein, the lactose, the water, the micronutrients, the macronutrients were there. What was really fascinating. And you

touched upon it is 15% of the nutrients in breast milk were these complex carbohydrates called human milk oligosaccharides or HMOs for short, that were completely indigestible by the baby, which makes absolutely no sense that human milk, which is very metabolically taxing for the mom to make would have 15% of nutrients that completely were not used, utilizable or indigestible by the baby until they figured out that it's food for B. Infantis in the baby's intestine.

So then you go back to kind of our day in the life of a baby. It's a, it's a rough 24 hours, but they, you know, they, they get through it and the baby is born. They're exposed to mom's gut microbes. B. Infantis hopefully sets up camp in baby's intestine and it needs food too. So human milk starts coming in to the intestine and it feeds the baby and it feeds B. Infantis. And then all of a sudden, those 15% of nutrients in human milk are no longer locked up in these complex carbohydrates. The infantis is utilizing them for fuel and turning them into

something that the baby can actually use. And that's the short chain fatty acids called lactate and acetate and others. And those are actually signaling molecules. They're actually a fuel for the growing colonocytes, the intestinal cells as the baby is rapidly developing. They are, they are changing the pH of the baby's intestine so that pathogenic or bad bacteria can't thrive. They're creating this protective environment in the, in the infant's gut. It's such a beautiful story that nature has designed. And so when baby has B. Infantis in their gut and they're consuming HMOs, preferably from breast milk, then it sets up a protective environment where pathogens can't grow. B. Infantis is getting

everything it needs. Baby's getting 100% of the nutrients in breast milk. And it's a, it's a, a very, um, calm, low inflammation, protective environment in baby's gut. Now, if you can imagine the opposite scenario, which B. Infantis is not in baby's gut, HMOs are coming in through the diet, completely locked up and not utilizable by the baby. Instead pathogens are growing because the pH of the colon is in their perfect zone, which is not, um, hasn't been curated by B infantis. And those HMOs are actually being excreted in large amounts in baby stool. So what we see is we see babies that are missing B. infantis with eight five to five to eight to ten watery stools per day those are they're just wow about HMOs wow and if you think about it that's what pediatricians have been telling us moms for a long time if you have a breastfed baby expect

five to ten watery stools per day but I'm not sure that that is actually what we're striving for because in our clinical studies that we've been at that we've conducted. We see that when babies do have B infanthus and they are utilizing HMOs, they stop pooping them out, dumping them out into the stool. They're no longer in the diaper and babies are accessing 100% of the nutrients and benefits of breast milk. Now you asked me about formula. All babies need to be fed, all babies. And if you, and if a baby is not getting breast milk, formula is the next best option.

And we are big advocates of fed is best. However, we know from a nutritional composition perspective, there are big differences between breast milk and formula and formula companies are working very hard to try to get formula as close to breast milk as possible. Yeah. There are, there's a long way to go.

There's a long way to go. And the HMOs in formula, although they do have them on some of the labels contains HMOs, they are not nearly at the, at the concentration of breast milk, nor are they at the composition of what's in breast milk. So it is a hat tip to the idea that there are HMOs in formula. It's like window dressing. It's good marketing. It is it indeed. Yeah. So I would say that babies, um, exposed to antibiotics, babies born by C-section and babies that are receiving formula, they're not going to create this high B infantis protective environment

in their gut. And they will, that is where we start to see the high levels of inflammation in the gut. And then the longer term effects, negative health effects as baby grows. Absolutely. Because, you know, the baby's immune system when it's born is not developed. And the first year is critical for its development. And it develops the immune system by sampling in the environment through the food it's eating and through the microbes that are in there. And when those microbes are off or out of balance, it's going to drive lifelong changes that are often challenging.

And as a functional medicine doctor, I see this very often, you know, what's the story? Baby born by C-section, given antibiotics in the first years of life, lots of ear infections, sore throats, maybe then they get some eczema and diaper rash and they get asthma and then they get allergies and they get autoimmunity. And it just, you see this pattern over and over and you start to pay attention to it. So when I take a patient's history, I start with the mother's health before birth. And I go all the way through to the timeline of what's going on. The study I read that was so striking to me that just put this in bold relief was a study where they compared the microbiome and the short chain fatty acids

that are produced with babies who are breastfed versus formula fed. Now you mentioned a few of them, but one of the most critical short-chain fats is something called butyrate and it regulates immunity, cancer, it feeds the colon. It's so critical. It's anti-inflammatory. It's used to treat colitis. I mean, it's quite an amazing molecule and it's produced by the bacteria, the right bacteria, digesting the starch, the fiber, right? And in this study, they looked at the kinds of short-chain fatty acids that are produced depending on what you're eating, if it's formula or breast milk. The breast milk babies all had high levels of butyrate, which is what you want. The formula-fed babies had high levels of another short-chain fat called propionic acid. Now it's a

big medical word. What does it mean? It's one of the short chain fats, but it turns out that this is very neuroactive in a bad way. So they are able to induce autism in animal models by giving them propionic acid. And guess what? It's also used for? It's a preservative used in flour. So anybody eating wheat in this country, unless you know for sure that the company is organic and this and that, and doesn't put anything in it, they put propionic acid in, which leads to behavioral issues and mood issues, attention issues. And like I said, in animal studies, it can induce autism. That's terrifying to me. And so I really think that, you know, we should be looking at children's microbiomes. We should be looking at their poop. We can measure, I do this every day in my practice.

I measure short chain fatty acids. I look at the types of them. I look at the kinds of bacteria there. And it's quite, it's quite amazing to see how many people have disordered gut microbiomes. And we don't even think about it. As physicians, we basically treat the downstream problems and not the gut. What you're talking about is going way upstream, way back to day one of a baby's life. And maybe even, I mean, I read a study years ago where they gave the mothers a probiotic and then the babies, and they gave the mothers a probiotic, helped the baby actually have less asthma and eczema and allergies. Essentially essentially, if you don't have this as a mother in your system and you don't pass it on to your baby, the baby doesn't

have it, the baby doesn't get the ability even to use the oligosaccharides, ends up with all these problems, it creates a pretty bad situation long-term for the baby. So instead what's growing there are, we call them potentially pathogenic bacteria. It's not like getting E. coli or salmonella or shigella. It's not these horrible, but it's this imbalance in things like Klebsiella and Pseudomonas and Enterococcus and all these weird bugs that can be potentially infectious that are irritating. And they're critical to get rid of or to change the environment in there because it will program the body for life so talk about how important it is to to have this early in life and what the consequences of not having it are

when these other bugs tend to overgrow and lead to all these secondary problems down the road, not just colic and diaper rash and fussiness and a little diarrhea as a baby. Who cares? Okay. The baby's miserable. You're miserable for the first year. It'll get better. That's not the real problem. The real problem is what I started out this webinar with, which is talking about this pandemic of inflammatory adult diseases that start in childhood, in infancy. So can you talk a little bit about that and what happens with all these bad bugs and what do they do? Yes. So one thing that is paramount to us here at the Avivo team is that we insist that science leads the way for what we do here and where we go and what we publish and what we bring forth for people to be able to use and the products that we make. I would say that the vast majority of the probiotic industry kind of glosses over the rigorous clinical science that needs to take place in order to really be able to say, we understand what's happening in the gut microbiome. Here's a probiotic product that's going to actually address that problem. And here are the clinical outcomes

that are, um, that you can expect that that is a, um, the, the rigor that is required, I think is lost in the majority of probiotic products that are out on the market today, our group, our team, which is, as I mentioned, a spin out from UC Davis and the foods for health Institute, we set out to say, let's let science drive the direction that we're going to go. And let's look systematically at what do babies look like if we don't do anything. And we just look at a population of babies born today in the Davis, California area, breastfed babies. What does it look like if we actually give B. infantis back to them, feed them Avivo every day? And what does that do not only to the amount of B. infantis in the baby's intestine, but to the abundance of the other pathogenic bacteria that were there in the absence of B. Infantis. So that is what over the last five years,

close to 20 different clinical publications that we've been able to publish in peer reviewed journals have shown that when a baby is missing B. Infantis in their intestine, whether that's because of antibiotics or C-section, whatever reason, there is instead an almost full composition of what you mentioned as potentially pathogenic bacteria. And to your point, I want to make sure that we're clear, that doesn't mean overt infection. That means kind of a quiet, but abundant composition of the infant gut microbiome that you can't really see from the outside of pathogenic bacteria setting up shop in the baby's gut microbiome, including staph, strep, klebsiella, clostridia, as you were mentioning.

And they are causing inflammation in the infant gut. What we don't want to do is jump on the bandwagon, the microbiome probiotic bandwagon and over interpret or hype over, over hype any data that we have so far and say, um, just spend a lot of money on probiotics and you'll be fine. We will not do that as a team and as a, as a company. So what we've done is we've gone through and said, not only can you restore B. Infantis back to the infant gut through feeding Avivo to babies, we were able to answer that definitively in one of our early publications where we showed a complete restoration of B. Infantis to babies who are fed Avivo. But then we looked at the composition of the infant gut and can we reduce those pathogenic bacteria? Yes, we can to up to, uh, up to 80% reduction of those pathogenic

bacteria. Then if you do that, can we see a reduction in the inflammation markers of inflammation? Can we see a reduction in antibiotic resistant genes? Can we see a reduction in many other of the, of the markers that show that a baby is either on a path toward autoimmune and auto-inflammatory diseases or not. And that's really what we are. We are still on this journey. I would say collectively, not just the Avivo team, but the field of microbiome science, you have to be able to follow those kids out and do the clinical studies to be able to definitively show that you get prevention or treatment of any of those diseases that you mentioned.

We're not there yet, but we have many very large clinical studies ongoing right now because there is enough early data. There's enough early basic science that shows we believe that this is exactly what's happening. We're reducing the inflammation. We're reducing those pathogenic bacteria by feeding Avivo. And now we're going to systematically go through and say, what conditions can we prevent in those babies going forward? But we do know from the field and the science in general, that if you've lacked this bacteria, you're more likely to have allergies, type one diabetes, obesity. We know that you literally can transplant the poop out of a thin mouse into a fat mouse and the fat mouse will lose weight independent of its calorie intake.

Like that should shock you. I wrote about that in a book I wrote a number of years ago. I think the blood sugar solution, we've known this for a long time. Like this is not a new news. And yet it just has not reached medical practice. And to me, it seems like the better part of our judgment should be to give every baby this probiotic at birth, because if 90% are deficient, I mean, yes, we can test everybody, but it's benign. It's safe. There's really no downside except the cost. And it seems like something that would pay for itself in spades in terms of the reduction in all these secondary conditions later on, such as obesity-related conditions, allergies, autoimmunity, and so forth. It just seems like a no-brainer to me. I don't know why we're not doing that, but hopefully you guys can get the research and we

can get this reimbursed by insurance and we can actually drive the changes that need to happen because, you know, as a doctor, the pandemic of diseases in kids, it's just scary to me, like with obesity issues, the allergies, the asthma, the autoimmunity, the ADD, the autism. I mean, these are diseases of inflammation that often start in the gut. So how do they actually work? Because, you know, when we think about probiotics as an adult probiotic doctor, I treat a lot of kids too, but we really understand that these probiotics don't take up residence, that they don't colonize, that they're sort of like tourists. They travel through, they change the economy down there, they have an influence on what's happening. But like if you take some probiotic that you get in the store, even if it's a good one,

it doesn't necessarily stay. So you have to keep taking it. Tell us about how unique this particular probiotic is in its ability to colonize the infant gut, which is really remarkable to me. It is remarkable. And I think to your point, the majority of the research and the focus and the effort and the dollars on microbiome research has been focused on adults to date. Babies are so unique. And if you think about the lifespan or the life cycle, there's only a very, very small period of time where we have a single food source. Because as soon as you turn four to six months, people are giving little bites of everything on

the adult's plate to the baby. And that's great. That's important. That's a, that's part of this weaning process. And for the rest of your life, you have a varied diet with tons of different plant fibers, tons of different fiber coming from all different sources. But in that first, I'd say, let's call it four months. When you have a single food source, you have a single fiber source as well. So as we mentioned, the human breast milk, the human milk, oligosaccharides, let's think of those as the fiber in breast milk. And they are very specific to, uh, B. Infantis. So B. Infantis is the only bacteria that's been found to be able to digest all of the HMOs in babies and sorry, in, in breast milk. So I agree with you

that the studies that have been published on adults and probiotics have shown that it's very transient, that they are, they are tourists. They usually, they may show some benefit while you're taking them. But as soon as you stop taking them, your body kind of reverts back to its steady state where it likes to be, which probably isn't the best state of the microbiome. What we found in our studies is that babies who were fed B. infantis in form of Avivo along with breast milk for 21 days in that first month of life, as long as they continue to consume breast milk, B. infantis remained high in their gut microbiome until almost a year. You just give it for three weeks and then it lasts the whole year. It's never been shown before in any other population to be able to feed a probiotic for a short amount of time and then be able to track it and see that it's steady and it colonizes, it stays steady. And we believe

that's because B. Infantis, as long as it's getting the food source that it needs, which is human milk, then it's going to continue to populate and, um, and proliferate and set and colonize the infant gut. So what we also saw in that same study is when babies switched over to formula or cow's milk, you could see the levels of B infantis slowly diminishing, which is exactly what we want to happen. We want when babies start eating plant fibers for other bacteria to come in and say, I can do that really well. I can digest plant fibers. That's my jam. And so we let them take over. But in the beginning, when HMOs are present in high abundance, B infantis must be there to be able to digest them for babies.

Amazing. And does it work if you have formula and for some reason you can't breastfeed to take it as well? And do you have to supplement with HMOs? Okay. So I know we started this conversation saying that there's very stark differences between human milk and formula and formula is part of the reason we believe that there's been a disruption in the infant gut. But I also said with passion that you have to feed your baby. And if breast milk is not available, you have to be able to feed your baby. And so for those babies that are consuming

formula, they have to have B. Infantis in their intestine as well, or else we've lost half the population in terms of being able to bring them the benefit of B. Infantis. So what we did is we looked at babies who were consuming formula and the ability of B. Infantis to digest formula. And it is able to utilize some of the nutrients in formula, not exactly the same mechanism as it does in breast milk, but it is able to digest some of the, some of the components of a formula. I would say to any mom or dad out there who's, who has a formula fed baby, some B. Infantis colonization in your baby's gut is better than none.

So even though you're not gonna see the same benefits that we've published with breastfed babies, it is important to get some levels of B. infantis and increase the amount of bifidobacterium in your baby's gut, even if you can't reach the same abundance as if your baby was consuming breast milk. So I would say yes to both formula and breastfed babies.

And is there a way to get HMOs as a supplement to give along with the probiotic? Maybe. Because as an adult, we do give prebiotic fibers, right? So we do give that to supplement with probiotics. I'm going to say maybe only because even if I could give you a source for where to get them, we haven't looked at the ability of those exogenous HMOs to recreate what we can see

when baby is consuming breast milk. You know, one of the things that came up for me as well was the idea that, that women should take it while they're pregnant. And it's one study that looked at, it was lactobacillus GG. It was a different probiotic, but it helped. So do you see there's a role for taking B. infantis as a mother? So I'm going to answer this question, not as a researcher. I'm going to answer this question as just Tracy talking to Mark. If I were pregnant, I would want to have to ensure that B. Infantis was in my gut microbiome so that when I delivered my baby, it had the best chance of getting B. Infantis from me. However, we have not, we have not conducted those studies. And if you're treated for a group B strep with antibiotics, then it doesn't matter what

you took during pregnancy because those antibiotics wipe it out. And if baby is born by C-section, it doesn't matter what you have in your gut microbiome, baby doesn't get it from you. So that's the only reason why we are very focused on getting it into baby with the idea that in a future state, we would love to be able to supplement moms or feed moms in vivo and see benefits for moms as well. Probiotics, you know, can be problematic. If, you know, a lot of people are there to bow, they go, oh, I'm going to take probiotics. And they go to the drug store and they go to the health food store and they get the probiotics and they take them and often they get worse. Yes. So, you know, explain that there's an important order to doing things and that what would be beneficial at one point might be harmful at another point. I think that's absolutely true. You know,

order is really important. And, you know, if, if somebody does have an overgrowth of, of bacteria in the wrong place, sometimes probiotics make that worse, you know, and you can get, um, if you take a probiotic and feel more bloated or your digestion doesn't feel, it feels worse, not better, then that's the wrong probiotic or the, or, or could be the right probiotic, but at the wrong time. So it's really important that, um, um, that you're either working with somebody who knows what to, how to recommend, what order things to do it in, or just knowing that if it doesn't feel right to you, put it on hold. There's lots of different brands of probiotics out there and quality of probiotics out there. Some probiotics have dairy in them. And so for people who are dairy sensitive,

they don't work. Other ones don't. There are also some strains of probiotics that can, and of themselves, depending on the milieu, increase the amount of bloating for certain people. So it's hard to give a general recommendation. It's hard for me to say, well, take this one because it doesn't work for everyone, but just know that if you try one and it makes you feel worse, put it aside. And it may be that it's just not the right one for you, or it's one to try at a later date after you've gotten rid of the dysbiotic bacteria.

Some people get the, get a probiotic and they feel better right away. And then that's, that's great. I hope you enjoyed today's episode. One of the best ways you can support this podcast is by leaving us a rating and review below. Until next time, thanks for tuning in. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. 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. 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.