The Dr. Hyman Show - What's Driving Your IBS And Gut Issues?

Episode Date: August 12, 2022

This episode is brought to you by ButcherBox and Athletic Greens.   Our gut is a powerful control center, due to its bidirectional communication with the brain, which we call the gut-brain axis. This links the emotional and cognitive centers of the brain with intestinal function. Certain conditions, such as irritable bowel syndrome (IBS), are tied to imbalances in the gut-brain axis and can benefit from taking a systems approach in healing, which includes looking at diet, the microbiome, stress management, and more.   In today’s episode, I talk with Dr. Todd LePine, Dr. Emeran Mayer, and Dr. George Papanicolaou about various root causes of irritable bowel syndrome, including microbiome imbalance, parasites, and stress.   Dr. Todd LePine graduated from Dartmouth Medical School and is board certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine certified practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine’s focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders, and the neurobiology of mood and cognitive disorders.   Dr. Emeran Mayer is the author of The Gut-Immune Connection as well as The Mind-Gut Connection. He has studied brain-body interactions for the last 40 years, is the executive director of the G. Oppenheimer Center for Neurobiology of Stress and Resilience, and is the founding director of the UCLA Brain Gut Microbiome Center at the University of California at Los Angeles. His research has been supported by the National Institutes of Health for the past 25 years, and he is considered a pioneer and world leader in the area of brain-gut microbiome interactions and its clinical implications.⁣   Dr. George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is board certified in Family Medicine from Abington Memorial Hospital. He is also an Institute for Functional Medicine practitioner. He worked on the Navajo reservation for four years at the Chinle Comprehensive Medical Facility, where he served as the Outpatient Department Coordinator. In 2000, he founded Cornerstone Family Practice in Rowley, MA. In 2015, he established Cornerstone Personal Health, a practice dedicated entirely to Functional Medicine. Dr. Papanicolaou joined The UltraWellness Center in 2017.   This episode is brought to you by ButcherBox and Athletic Greens.   If you sign up today, ButcherBox will give you two ribeye steaks for free in your first box. Just go to butcherbox.com/farmacy to claim this deal.   Right now, when you purchase AG1 from Athletic Greens, you will receive 10 FREE travel packs with your first purchase by visiting athleticgreens.com/hyman.   Full-length episodes of these interviews can be found here: Dr. Todd LePine Dr. Emeran Mayer Dr. George Papanicolaou

Coming up on this episode of The Doctor's Pharmacy. Traditional medicine is naming and blaming. You name the disease and you blame the name for the problem. Oh, I know why your stomach hurts. You have irritable bowel syndrome. No, that's just the name of the problem. Hey everyone, it's Dr. Mark here. This episode is sponsored by ButcherBox.

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vitality by trying AG1. Right now, they are going to give you 10 free travel plaques with your first purchase. All you have to do is visit athleticgreens.com forward slash hymen. Again, that's athleticgreens.com forward slash hymen. And now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Fee and one of the producers of the Doctors Pharmacy podcast. IBS or irritable bowel syndrome is a common gut problem that affects millions, resulting in miserable, often debilitating symptoms like bloating, cramps, diarrhea, constipation, and pain. IBS can be caused by a range of factors, which is why it's so important to personalize treatment based on the unique circumstances that exist for each person.

In today's episode, we feature three conversations from the doctor's pharmacy on the range of factors behind irritable bowel syndrome and how to resolve this condition. Dr. Hyman speaks with Dr. Todd Lapine on the various root causes of IBS, with Dr. Emron Mayer on the role of the microbiome when it comes to gut health, and with Dr. George Papanikolaou on when parasites are the cause of IBS. Let's jump in. So let's talk about this thing called irritable bowel syndrome. What did we learn about it in medical school?

Not much. I mean, I think we basically learned that it was one of those conditions where you sort of treat the patient and it's not serious. You're not going to die from it. And I can remember actually at Dartmouth, we had Dr. Almey, and he was an expert in irritable bowel. And back then, it was felt to be more of a sort of neurologic, sort of like stress-related thing.

Psychoemotional. Psychoemotional. And actually, I'll tell you, this is an interesting side story. He did a test where he took some medical students and was measuring the manometry of them. And while he was doing the sigmoidoscopy, he was measuring the tension in the colon. And then he, while doing the, you can only do this to medical students, and this is back in the 50s. And he told them, he goes, I think I see cancer. All of a sudden, there was a spasm of the colon oh yeah and it was and it was like he wanted to evoke to see what it was what was going on with the irritable bowel and they thought it was a lot of those nervous related

and which there is a stress component and uh so back then the concept of irritable bowel was that it was all sort of in your head it's all sort of like we had a very uh fancy word for it in medical school we called it super tentorial which is a doctor's way of saying it's of in your head. It's all sort of like in your head. We had a very fancy word for it in medical school. We called it super tentorial, which is a doctor's way of saying it's all in your head. It's all in your head. A tentorium is that thing that kind of separates your top of your brain from the lower brain.

It was a joke, but it was very pejorative. And we often thought that these patients were malingers. It was called functional bowel disease. Yeah, he did a lot of terms. There was no real cause for it it was more psychological yeah and maybe stress related and these people are all emotional and upset turns out it's not so right and we and we call it syndrome right syndrome so what when we say syndrome in medicine what do we mean it's a constellation of various symptoms and you know we

we now we don't know what the hell's going on we don't know what it's like yeah it's like it's like you know chronic fatigue syndrome you know it's like you know, we, we now, we don't know what the hell's going on. We don't know what it's like. Yeah. It's like, it's like, you know, chronic fatigue syndrome, you know, it's like, you know, how many different things can cause chronic fatigue? It's like, there's 23 flavors or how many flavors of Baskin Robbins ice cream. Same thing with 31. I used to scoop Baskin Robbins ice cream as a moment of my jobs. Right. Right. And then that'll probably cause irritable bowel. Probably. About those artificial, artificial flavorings and sugar. So, yeah. So, you know, nowadays we sort of classify irritable bowel into irritable bowel with constipation, irritable bowel with diarrhea, and then mixed irritable bowel.

That's how we're sort of, you know, putting an ICD-10 code on it. And that's a way of conceptualizing it. But there are lots of different things that play a role. Without question, I think stress does play a role with irritable bowel. And I think that, you know, stress can manifest in the body in so many different ways. We've talked about this when we talk about autoimmune conditions, because oftentimes when we have a patient and some stressful event happens, it triggers a host of things and sort of like a ripple effect that goes on in the body. And without question,

there is a stress component to some irritable bowel. Well, yeah. I mean, you've got your second brain in your gut. There's more serotonin in your gut than in your brain. You've got this whole nervous system that connects the two that is extraordinary complex and feeds back both ways. So from the top down and bottom up. So irritable bowel can cause irritable brain and irritable brain causes irritable bowel. It goes back and forth and forth right and you want to have a happy bowel happy brain that's that's you know that's sounds like the key to a happy life happy happy bowels happy brain exactly exactly and then yeah and there is that it's an interesting thing that you're talking about because you have that gut brain connection and it's like a two-way highway and they're they're basically communicating

the brain's talking to the gut and the gut's talking to the brain and then you also have the enteric nervous system and and some people sort of forget about the enteric nervous system. And that's the intrinsic nervous system to the gut. So literally, if you sever the spinal column and there is no connection to the gut and the brain, the gut still works. You can still poop fine if you sever the spinal column. It's got a mind of its own, is what you're saying. It's got a mind of its own, exactly. Right. But, you know, Todd, I want to come back to what you said, which is really important. You said, you know, we categorize irritable bowel with constipation or diarrhea or whatever, and there's a whole classification system that is

driven off of symptoms. Yeah. And the difference between functional medicine and conventional medicine thinking about any disease is that it's not focused on the symptoms, it's focused on the causes. So just saying people have irritable bowel doesn't tell you anything about the cause. It tells you they feel uncomfortable, they're bloated, they have diarrhea, their bowels are weird, they're uncomfortable, cramping, whatever the symptoms are, is irrelevant when it comes to trying to figure out the cause. I mean, yeah, okay, you have irritable bowel, but that's when you start to think about the problem. In traditional medicine, you name the disease, you stop thinking.

You know, and our colleague, Sid Baker, always had this great term. He says, you know, traditional medicine is naming and blaming. You name the disease and then you blame the name for the problem. Oh, I know why your stomach hurts. You have irritable bowel syndrome. No, that's just the name of the problem. But he talks about thinking and linking, which is functional medicine, right? You think about the problem and the cause once you get the diagnosis and you link everything together to see what the factors are. And there's no such thing as irritable bowel syndrome. There's irritable bowel syndromes. Like you said, there's

31 flavors and each one is different and each one needs to be treated differently. Exactly. Exactly. Yeah. That's, that's, uh, it's, it's, it's so, so, so true. And there is this, you know, this web-like interaction in the body and it's, it's very important to understand, uh, the whole inter, uh, connectedness of it. It's very, very important. So, so typically go to the doctor and you have irritable bowel. Um, what do the, what do they tell you to do? Well, you know, they, they, you know, they'll, they'll often tell you, you know, take some Metamucil and I'll see you later. That's, eat more fiber, drink more water. Yeah. That's, that's the same. Learn to live with it. And that's essentially what they're dealing with stress. Yeah. That deal with stress. Yeah. And

they'll, they'll, the interesting thing, this is, I had a patient just the other day who I was seeing for GI symptoms. It wasn't specifically irritable bowel. And the patient's GI doctor said, diet has nothing to do with your symptoms. I mean, it was unbelievable that a GI doctor told her diet makes no difference. I couldn't believe it i i just i like actually actually i was on the console with a patient yesterday and she said i went to my gastroenterologist and i i wanted to show my stool test he's oh gastroenterologist don't look at stool i'm like well then who does if you're a doctor and i'm like you, that just doesn't make sense. You don't look at what goes in and you don't look at what comes out. How are you supposed to know what's going on in there, right? And that's the difference in functional medicine. Yeah, exactly. Yeah. It's

sort of, it's a little bit mind blowing. And yeah, you know, you talk about like, you know, going back to Sid Baker and sort of name it and claim it kind of a thing. Blame it. Yeah, name it, name it and blame it. Is that, you know know and then tame it with a drug right and then i i always i always tell my patients you know i went from being a medical student to a student in medicine i'm sorry i'd like to always learn about things i love that and yeah and it's a very important thing that you have to remain open-minded and i think you also have to remain curious because every patient's different that's you know that's actually the joy of actually practicing functional medicine is it's not boring by any means. It's, it's, it's, you're, you're constantly growing and learning and helping patients with the latest diagnostics, the latest therapeutics to, to personalize their

treatment. And that's the fun part. I mean, doing functional medicine is a wonderful profession, as opposed to regular mainstream medicine where most doctors are burned out. You know, they really are. They're just, they're unhappy. They're burned out. They're doing rubber stamp medicine. You know, I'll see you.

Here's your proton pump inhibitor. Next, next patient. That's it. That's it. So, you know, doctor sees you, you have irritable bowel, they give you metamucil. What else can they do sometimes? Well, sometimes they'll give prescription medications. I think one of the older ones that they used to do for ibs was zelnorm remember that one yeah they took it off the market because it was like really hurting

people i think people were getting librium was the other one remember that that was that was like a valium which is basically taking value is it valium for the gut yeah yeah and they're actually in certain patients uh there were some benefits from that because it did sort of calm down uh the nervous system i think uh sure anybody anybody taking valium yeah you're gonna feel i feel good a couple shots of tequila a little i feel good right but that's really not what we do with medicine you're you know you were talking before about how you never know what the issue is when someone comes in. I was thinking about it.

It's much like Forrest Gump medicine. Forrest Gump has a box of chocolates. Life is like a box of chocolates. You never know which one you're going to get. I think in traditional medicine, you got irritable bowel. It's a thing. You treat it all the same. Functional medicine is not like that.

We see something with irritable bowel and then we go, wait a minute. What is the cause of their irritable bowel? Like you were saying before, it's very personalized. How do we start to think about identifying what their particular issues are? Because before we can even treat it, we have to understand the why. And that is what I always say. Functional medicine is the medicine of why, and regular medicine is the medicine of what? What disease and what drug? And I think the big thing is time, taking the time to talk to a patient. What? Talk to a patient? you know what talk to a patient actually and listen to the patient that's wow listen to the patient that's that's actually you

know that actually sometimes the less i talk during a uh an interview and uh you know evaluation of a patient the better i do because you know oftentimes we want to jump in and ask this question they'll say something and we ask a question you know know, I think in the average doctor's office, a patient speaks for like 30 seconds, the doctor interrupts them. Yeah, no, actually, there was a study published years ago in JAMA. It was 18 seconds. 18 seconds, 20 seconds. Before the doctor interrupts. Exactly. Because, you know, we're trained to like, you know, probe the questions and, you know, they have their own sort of path of thinking going down that. But I think the big thing is,

you know, we spend a lot of time listening to the patients and getting a history and a story. And, you know, an important thing is an interesting thing in terms of IBS patients is that babies who have colic, and they've actually looked at what is it that causes colic in babies, you know, you know, the latest evidence is that babies that have colic have high levels of Klebsiella. Klebsiella is a bacteria. And we know that Klebsiella is actually associated with other inflammatory conditions and autoimmune conditions.

So Klebsiella excess in the gut is actually associated with ankylosing spondylitis, which is inflammatory bowel disease, which manifests systemically with arthritic symptoms. So getting a history of colic is important. Listening to the history of, you know, were they vaginally birthed? Were they breastfed? What type of diet did they have as a kid? And when did they get food introduced? Yeah, and all those things can play a role in terms of...

Like early gluten. Yeah, exactly. Early dairy. Yeah, exactly. Trigger leaky gut. Exactly. And just there's really, you know, listening to the patient. Antibiotic use.

Did they have a lot of ear infections? Did they have a lot of strep throat? Did they get a lot of antibiotics? What's going on in the family? Did anybody else in the family have any digestive issues? So just taking the time to get that history allows you to sort of play detective and try to figure out, okay, what are the things that are potentially playing a role in driving this and what might have triggered it. And then personalizing, you know, diagnostics and treatment and everything else. It's all about personalization.

I think it's very, very different what you're saying. This approach really is being a medical detective. Absolutely. And it is relevant whether you're breastfed or, for example, or vaginally birthed because that affects your gut flora and the development for your whole life. I mean, I recently read a study that showed bottle-fed babies have a high levels of what we call a short-chain fat, which is made by the good bacteria. This one is called propionic acid. Now, this is not such a good one and it's been shown to induce autism in animal studies and has been associated with autism and ADD, that is increased when you're bottle feeding. When you breastfeed, you get increased in butyrate, which is the

beneficial short-chain fat that actually heals the gut and reduces inflammation. There's all sorts of good things. So we think, oh, it's the difference, bottle fed, breastfed. That's not to make people feel guilty if they have to bottle feed. You have to do it sometimes. But you can fix that by making sure they have the right prebiotics and the right probiotics. Because breast milk has undigestible fibers that are prebiotics and sugars that are prebiotics for the good bugs that aren't actually digested by humans. So breast milk knows that. Exactly. And the other interesting thing about breast milk, I mean, if we could sort of bottle breast milk, it's very, very powerful stuff. There's a thing in breast milk called milk oligosaccharides.

And these are very, very complex sugar moieties, sugar chemicals. And they're actually so complex that for a long time, science didn't even study them because they were too complex. It was like this, you know, a Lego set that was this incredible building blocks. And what they've done now, there's a couple of companies, one company in specific out of Europe has actually synthesized one of the oligosaccharides in milk. And there are actually hundreds of them. And these act like fertilizer for the good bacteria. So these things that are found in breast milk are very, very powerful things. Yeah.

Yeah. So powerful. And so we dig down into the story and figure out when did it start and what's connected to it. Did you have foreign travel? Because people often have post-infectious irritable bowel syndrome. People can get it after antibiotics. People can get it after any kind of stress or trauma. And people don't realize that it's connected to so many different things. So let's talk about what are the causes, and then we'll go into sort of a case of how

we would deal with this. So what are the top causes that you found in functional medicine that are driving irritable bowel syndrome for people? Well, a lot of irritable bowel also is probably misdiagnosed I think is sort of SIBO. I think a large number of, and SIBO is this diagnosis of you know small intestinal bacterial overgrowth. So a bunch of people, they're about to have SIBO. Exactly. Or bad bugs growing where they shouldn't be in the small intestine. Exactly, yeah.

And I think that we're sort of finding that a lot of these people that we're diagnosing with this catch-all term, they're really having potentially small intestinal bacterial overgrowth. There are tests that you can do for that. We do the- That's also known as a food baby. When you eat food and you get a big bloated tummy right after, and as a food baby, that's what SIBO is. Right. Because what's

happening is we have bacteria on our skin, we have bacteria in our mouth, we have bacteria in our stomach, the small intestine, large intestine, most of them sort of live in the colon. But there are times when the colonic bacteria start migrating upwards and they go higher up. And it's sort of like invading a neighborhood. It's mostly sterile up there. Yeah. I think it's not necessarily that we've always thought it was sterile, but even the stomach has bacteria. But it's just much less. And there are all different kinds of bacteria. So the lower bacteria are more fermenters. They ferment things. And that's where we get, I think I have talked about that,

and I've seen this a couple of times, the auto brewery syndrome, where patients, in fact, I just recently had a patient, a fantastic case, and he actually heard me on one of the podcasts where I was talking about auto brewery syndrome. So I did a consult with him, and he ended up going was talking about auto brewery syndrome. So I did a consult with him and he ended up going and buying a breathalyzer. Yeah. And he confirmed that he has auto brewery syndrome because he was producing alcohol. He was driving over the limit. He was just short of the limit. Saves you money on beer for sure. It was actually quite interesting because

he actually was doing a very strict low carbcarb, no-sugar diet. And even with a really good diet, he was pushing making alcohol. It's really quite interesting. So yeah. But anyway, so talking about how do we diagnose this? So you can do stool testing. I like the GI map test where you can do quantitative PCR for bacteria, yeast, fungi. So that's looking for the genetic material of the different bugs. Yeah, it's like CSI. Yeah, CSI. I find it to be a very helpful tool. You can also do the hydrogen methane breath test.

Although the thing about the hydrogen methane breath test is that I've had some patients who have significant irritable bowel SIBO-type symptoms. They're bloating. And they're negative. And they're negative. And they're negative. And I think, based upon my reading of the literature, is that they're probably producing hydrogen sulfide. Yeah.

And I think that when you just sort of get a history of, you know, they pass very foul-smelling gas, it smells like rotten eggs, that's usually the people that are producing hydrogen sulfide. Yeah. People don't realize it, but, you know, cows just don't produce methane. Humans can produce methane. Exactly. If you have this. And we measure that coming out but cows just don't produce methane. Humans can produce methane if you have this. And we measure that coming out in your breath. We measure hydrogen. We

have to take this drink. And that's really a clue that there may be these bugs growing in there. And they have to be treated directly. And that can really help a lot of people. Oh, huge, huge amounts. Yeah. And it's often missed. It's very much missed. And you also have to do the test properly because everybody produces small amounts of hydrogen and methane. It's just that you want it lower down in the colon. It really doesn't become as much of a clinical issue. The other thing is to also think about in those types of patients is to make sure that they have sufficient amounts of stomach acid. Stomach

acid is very, very important at helping with the proper digestion. So you can actually do testing for gastrin levels. And I've been surprised at how many people have high gastrin levels. So when you don't have enough stomach acid, your body produces more gastrin, which is the hormone to pump out more hydrochloric acid. It's like flogging a dead horse. Exactly. Absolutely. And I would venture to say that most people's issues are not high acid in the stomach, it's low acid. It's low acid. And we're taking more of these acid blockers, which by the way, also cause irritable bowel. So they help your heartburn, but they cause trouble bowel. And now there is a role for short-term use of these acid blockers, like in the ICU,

the studies have been shown they've been very helpful to prevent stress-induced ulcers and a hospital-acquired pneumonia. But they're really to be used short-term. And when you start using them long-term, they are very toxic. They are very toxic. They produce increased intestinal permeability. They cause malabsorption of nutrients, vitamin B12, iron, other trace minerals. Magnesium, zinc, yeah.

Yeah. And they cause bacterial overgrowth. And they cause osteoporosis and pneumonia. Absolutely. Oh, yeah. Huge. Huge. Huge.

And I actually, I am really surprised that these things are over the counter. They really should not be over the counter. Yeah, no, I remember. I've talked about this before, but I remember when I was in medical school, the rep, these just came out and the drug rep was like, these are super powerful drugs. You never want to give them more than six weeks. They're designed to treat ulcers. After six weeks, you got to stop them.

Don't take them long term. And now people eat them like candy all day long, every day. And I'm like, this is not good. And we see so many complications from that. So if your irritable bowel is there and you have these acid blockers that you're taking, there might be a correlation. So we talked about SIBO and we can talk about how to treat that, but essentially it's killing the bad bugs and reseeding the gut. And what other things are driving your bowel besides that?

Well, also you can also potentially have problems with part of the intestine that causes peristalsis. So normally you think of the gut as like this conveyor belt. It's always moving things through. So you eat and within about 24 hours, everything should sort of move through. And there are some patients, especially with the patients who have problems with constipation that will have problems with motility or really motility disorders. And there's a test. Maybe just not moving down. Not moving down. And there's a part of the intestines, which is called a migrating motor complex. And you can actually test for antibodies against the migrating motor complex. It's called IBSure test. And I'll do that. It sounds like an autoimmune thing. Yeah. It's a

little bit like a paralysis, if you will, or a weakening of the gut. And we talked about that earlier, how in some cases, you'll have patients who have Lyme disease. I actually had a very good integrative gastroenterologist who brought my attention to this, is that he had a lot of patients who had refractory SIBO. So SIBO was one of those things where it sometimes can come back and oftentimes does come back. And what he was finding is that some of the more difficult patients with refractory SIBO actually had underlying Lyme disease. And Lyme disease affects the nervous system. He tied the two together because there is a paper, it's called Bell's palsy of the gut. And in fact, Bell's palsy is where you get facial paralysis. And I'll never forget this. When I was in my private practice, the first time I saw a

real acute case of Lyme disease, the patient presented with Bell's palsy. So her face was paralyzed and I did testing on her and the patient had acute Lyme disease. And that is one of the known complications. And it's thought that also that Lyme disease can actually affect the gut and you get paralysis and decreased motility of the gut. Yeah. So, so that is a very important point because, important point because there are the typical things that go on, food sensitivity, gluten, dairy. Some people react to the chemicals in food that are food additives. Food additives, food colorings. Food colorings, sugar alcohols. Emulsifiers. Emulsifiers. All these things that are in our junk and processed food do have a huge impact on

people. There's obviously the SIBO. Some of the people get parasites. Yeah. Little, little microscopic hitchhikers. Yeah. And there's, there's one called blastocystis, which is really common. It doesn't, it doesn't cause a horrible disease, but it can cause irritable bowel in about 30% of people with IBS. Oh yeah. I want to, I want to venture to say that I have picked up a lot of these, I call them little microscopic hitchhikers.

And when you actually look in the, in the mainstream literature, they, you know, they, they basically say that, you know, that a lot of these you don't need to treat it. So there are times when somebody can, they have dientamoeba, histolytica, and blastocystis, and sometimes endolimax, nana. And sometimes people will have these and they'll have a small amount of them, and they may not cause any symptoms whatsoever. But if I find them in the stool test and patients are having symptoms, I treat them. Yeah, absolutely. And then there's also other things. People have like enzyme deficiencies we can see on stool tests, they're not digesting their food well. And also, you know, for me, I had terrible irritable bowel, you know, almost 30 years ago.

It was from mercury poisoning because mercury affects all your enzymes. It basically interrupts the enzyme function of many different enzymes throughout your body, including your enzymes. It basically interrupts the enzyme function of many different enzymes throughout your body, including your gut. And until I got rid of the mercury, my irritable bowel wouldn't go away no matter what I did. I just ate turkey and broccoli and brown rice for six months and nothing worked. And so you have to keep being a detective and thinking about what are all the variable causes. And we look at the stool testing. We look at breath testing for bacterial overgrowth. We look at organic acid urine testing to see if there's markers of bugs in there. And we sometimes dig down deeper to look at things like metals or Lyme or other tick infections.

So there is a real deep thinking about what is going on with this person. And it's guided by their history, right? Exactly, yeah. And it's personalized. It really is. It's totally personalized, and it takes history, right? Exactly. Yeah. It's, it's, and it's, it's personalized. It really is. It's, it's, you know, it's, it's totally personalized and it takes time to figure that out. Yeah.

So diet plays a huge role in regulating what bugs are growing or not growing and how they affect everything from our mood to our weight and our cognitive function. But it was fascinating is that the other direction also affects us. In other words, our thoughts and feelings and emotions and stress actually create a feedback loop to the gut that can actually cause damage to the gut, alter the bacteria, create a leaky gut, create inflammation that actually is almost the same as eating a bad diet.

Can you explain that? Yeah, so this is the intriguing thing. So you asked me earlier, you know, why are we – and how do we end up where we are today? One is the diet, but the other one is the top-down influence of our minds and our chronically stressed brains. Our brains did not develop for that, so we developed very effective acute stress response systems that saved us human species from extinction many times. But these systems were not designed as adapted for chronic ongoing stress, which we experienced, obviously, since the last year. We've seen the impact of that on people's lives. And the chronic stress will not go away now that the pandemic will be ending. There's enough other factors.

So what the brain does, and I like to call it the brain-gut microbiome system rather than an axis because it is a bidirectional system. Brain talking to the gut, gut talking back to the brain-gut microbiome system rather than an axis because it is a bidirectional system, brain talking to the gut, gut talking back to the brain. And the signals that the brain sends via like the sympathetic nervous system can talk directly to the microbes and make them more aggressive, changes their gene expression patterns and the way they interact with us as the host. But they also indirectly change the microbial abundances by changing the peristalsis and the motility and the transit, the secretion of fluids into the gut. So when you're stressed, your microbes live in a totally different world than if you're in a relaxed state.

And what has been repeatedly, you know, long before the diet-related leaky gut syndrome came, you know, appeared is that both severe acute stress and chronic stress can increase the permeability of the gut, decrease the mucus layer, and lead to a low-grade immune activation at the gut level. So now imagine in our world an unhealthy diet that does exactly the same thing together with its brain influences. It's the worst thing that we can do to our gut health. And since gut health doesn't stand up you know it goes very well so i think that's really that yeah i think that's so key i mean everything we do affects this inner garden and we just thought it was just inert waste material

that now we're recognizing is regulating almost everything in our body and that the key to health and longevity is to optimize our inner garden and to figure out how to do that. And the fascinating thing to me was when I saw in my practice, and this was decades ago, how the gut microbiome, we didn't even have the word microbiome back then, but the gut flora affected the cognitive, emotional functioning of my patients. And I have story after story of cases of, you know, ADD or behavioral problems or depression or neurodegenerative diseases. When you fix the gut, which we did as sort of a matter of course in functional medicine to address physical problems, that the mental or cognitive problems would get better. And sometimes in striking ways. And we wouldn't be able to measure the imbalances in race flora or the overgrowth of certain bacteria, the overgrowth of fungal components and how those had huge implications for their cognitive function. And by treating them, people would get better. So what are you seeing in terms of the therapeutic strategies we need to be using now for chronic

disease? Because when you go to the cardiologist or you go to the rheumatologist or you go to the psychiatrist, they're not saying, can I please have a stool sample? I want to analyze your microbiome and tell you what you need to do to make it right. They're like giving you the regular medication for their particular disease.

How do we get past that hump in medicine and start to really have doctors and the system as a whole start to take this into account? And what are these ways in which the microbiome specifically is affecting the brain? You mentioned tryptophan, but I think there are others. Yeah, I mean, there's many other of these so-called neuroactive metabolites, for example.

You know, they're being generated by the microbes, and the relative abundances of this, it's a combinatorial system. The relative abundances of these microbes determine ultimately what the output to the brain or to, you know, I mean, it's not only the brain. It's other organs as well. But having been interested in IBS, you know, for a long part of my career, now this has expanded to cognitive decline and to psychiatric disorders. I've seen the same thing as you do. And I have to say the experience that I had being in the middle of the conventional medicine world at a university was ignorance and total rejection at meetings. So the whole brain system was something that people either were not interested in

or put away as psychological, hysterical stuff. I have a quote from a very prominent colleague who called this the disease of neurotic housewives. Irritable bowel, you mean. Yeah. So that's what we learned in medical school. It was just people who had it anxious and crazy, and it wasn't really because of anything physical. It was functional.

But it turns out we were just not very good at looking, right? So it's like saying, well, you know, like we won't be able to see bacteria until we had a microscope, right? So now we have a different kind of lens to look at all these conditions, and we see these connections that we didn't before. But, you know, I think I give you in functional medicine a lot of credit here because the emergence of that type of medicine, I mean, not that I agree with everything, you know, being a skeptical scientist.

I still have some. I don't agree with everything either. If I can't, there's a certain area. But on the other hand, I think it has another tremendous influence because all of our patients have already been to a functional medicine doctor, you know, and they come with these concepts. And if we are open-minded at university, you would actually learn a lot. So, for example, the leaky gut, I learned from my patients, learned it from physicians like yourself long before this became an accepted term.

I think that the system will gradually change. I mean, there's now, like at UCLA or other places, like GI wellness programs that deal with, you know, relaxation, mindfulness-based stress reduction, diet, sleep. They really look at the whole human being rather than just the organ or the ulcer or whatever. In psychiatry, I think you will be slower. I think most psychiatrists are still very skeptical that this plays a big role. And I think we need to find, we need to get examples of, and unfortunately, this will

take well-controlled, randomized controlled studies to convince much of the medical world that this is actually happening. I mean, I can already hear it now. People say, oh, there was all this excitement, like when you wrote your book about the mind-God connection. But I haven't heard anything about this. Is that really true or was this just a fad? Yeah, no. So there's still this skepticism by the traditional medical establishment

that this is not something important. We should also keep in mind, you know, many of the medications that are being used, for example, in psychiatry are also metabolized by the microbes. So, what we ultimately, what our brain sees is partially influenced by what the microbes so what we ultimately what our brain sees is partially influenced by what the microbes do with it and that again determines is determined by what microbes you have and what diet you're on so you know it's this link I think what's going to be easier and I see that trend already there's a field now called nutritional psychiatry that is gaining ground. And I think it's going to be easier through the dietary path,

and there's physicians that are being trained in this, whereas I had maybe one hour of education in nutrition in my career. It's not much better now. But I think this – yeah, it's not much better now. But I think this will be changing. I've seen trends that just go in this direction. Younger physicians, they come to us and do research with us in our center. They're extremely interested in that and really want to pursue those kind of avenues. But I mean,

I should say another thing, you know, what will slow this process, you make a lot more money with the traditional, with the conventional medicine, with the procedures. So for example, as a gastroenterologist, so we now know that, now know that people get colon cancer earlier and earlier age. And so the way the medical system has responded to this, so let's move colon cancer screening guidelines to start at 40 instead of 50. So probably in 10 years, we're going to move it to 30 years of age. And when somebody gave a lecture about this a few years ago in our division, I was asking, do you guys do any dietary assessment of these people

that develop colon cancer at age 40? And they said, well, that's actually a good idea. We should look into this. What a concept. It was amazing to me. But that shows what a concept, yeah. When you think about it, you put pounds of food every day in your gut. But you make more money doing colon cancer.

Right? Yeah, that's true. You make more money. But you put pounds of food in your gut every day. How do gastroenterologists not think that food has anything to do with digestive disorders? It's amazing to me, actually. Oh, you need more fiber if you're constipated or avoid these foods if you have reflux. But it's very limited and superficial.

So if you had patients coming to you with mood disorders or neurodegenerative disorders, how would you approach treating them through the gut? Yeah, so I, first of all, I start to explain to them this concept of the brain-gut microbiome system and how it's influenced by both the brain and the gut and the diet. I present them with a very holistic model of treatment that we want to target all the parts of this brain-gut microbiome system at the same time, that I don't think a single approach, just limiting to diet will be sufficient. So there's know the regular moderate exercise i mean like all the things that we know are beneficial looking at the sleep stress reduction i with depression it depends on the amount of anxiety and depression that's actually there i almost always now that we have these simpler versions, for example, of cognitive behavioral

therapy, the online systems that are coming, you know, rapidly becoming available, anybody can do from their home in 10 sessions. So I recommend all these things plus the diet. And from a dietary standpoint, I mean, obviously this is a minefield, you know, as you know better than anybody else. I've come to this conclusion and pushes in my book that if you eat the things that are best for the health of your microbial system, you will automatically do the best for your health and for preventing or slowing cognitive decline and treating your depression. Depression, if you have a severe form of major depressive disorder, I don't think diet alone will do it. I think you will have to combine it with medication, at least initially. And then if you get into remission, it's a maintenance.

You can rely on your diet part. Yeah. But I always look at this, you know, these multiple channels that we have to access to bring up microbiome access. So it's our diet. Yeah, the microbiome-tarome targeted diet makes it easy. You don't have to argue how many grams of protein are best for you and how many grams of carbs, what percentage. I think it becomes very simple. Micro microbes love complex carbohydrates that they break down into health-promoting molecules such as short-chain fatty acids.

So it's very simple. So I don't know, you know, how this is going to be perceived, that recommendation, once the book comes out. But I certainly have thought about this a lot and could get a philosophical twist to that as well, that microbes are the most abundant and ancient life form on this planet. So they know exactly what's best for the planet and the creatures that live in it. So providing them with the healthiest food will take care of us too

and the environment. As we know from a largely plant-based diet being beneficial for environmental reasons. So, you know, I want to just sort of summarize a little bit here, because what you're saying essentially is that we can treat a whole host of chronic diseases that are in origin inflammatory, including all the brain diseases, including depression, which is inflammatory, as autism, and ADD, and Alzheimer's, these are all brain inflammation diseases. So what you're saying is we can alter the course of these conditions by changing our microbiome. And a lot of it has

to do with our diet, with exercise, stress reduction, sleep, and maybe some other things that we haven't really talked about, such as whether there's probiotics or prebiotics or things that can help fix the gut. So talk about how we sort of need to sort of eat differently specifically for the microbiome. You mentioned plant, I like to call it plant-rich diet, but how do we design a way of eating that facilitates a similar kind of microbiome, for example, as the hunter-gatherers? Do we all need to be paleo, as we call it, or what should we be doing? Yeah, I would say, you know, I mean, I stay away from these categories like paleo or keto because I think they're so contaminated

by political and strong personal feelings that, you know, I actually went to get a blurb from a book from a prominent person in this diet field. And he didn't like that in my book there was one sentence about eating fish and chicken. And he said he cannot write a blurb for a book if it has that sentence, if I would change it. And I said, well, I'm not going to change it. But this is the kind of world I think that we have gotten into, that people are so fanatic about certain types of diets. So I would say, I mean, the things you want to do is you want to create as many different microbes or nurture

as many different microbes as possible. And since they're all specialized in different types of fibers and different types of polyphenols the greater variety of the food the more we force the system to diversify and and that's really the whole goal in it and then continuing this just doesn't help just to do it once you have to you have to really change your lifestyle. This has to become a permanent way of eating. Then you nurture the richness and the abundance of this expanded ecosystem. We know we can't go back to the ones or the hunter-gatherers or some people, the hot star in East Africa.

Because some of them, sadly, some of these microbes have actually disappeared or extinct. Just like, you know, we can't bring back, you know, the animals that have gone extinct. Even though, yeah, kinetic engineering and CRISPR may make that possible again. But we can bring back about, I think we can reach about 80% of these kind of systems if we stick to a diet like this. And I would say in addition to the variety, different types of fiber, plants, fruits, and vegetables, it's also you know external microbes so you mentioned probiotics i personally would recommend if you have access to natural and if you like the taste of natural probiotics and fermented vegetable or dairy products go with that if you don't have access you know take um

take a supplement which is often a challenge because there's not enough controlled trials that would actually show you this one is better than this one you know and so the way people have dealt with it you mix a whole bunch of them together in very high concentrations. We don't know if that mix is actually better than if you had a couple that made the big difference. But if you look at countries like Korea that consume a vast amount of fermented products from child, from infancy on, I would love to do a study on these chronic diseases if there's actually an impact on that but this study has not happened so far to my knowledge

but this is what i would recommend you know yeah and there's there's also one thing that you know i think it is really important to mention. It's not just what we eat, but also when we eat it. So there's always three things that I think. What we eat, when we eat it, and where does it come from? Those are the three main criteria I think you should make. When we eat, as you know, and as the audience knows, there's a lot of these intermittent fasting strategies, beautiful results in animal models, me being the big skeptic of animal models from my own personal negative experience.

You know, the human studies are not as convincing because they're more difficult to do. They have started now now randomized controlled trials. Of all these strategies, I personally like the time-restricted eating because I think it's the most realistic. There are studies now on the microbiome that actually that positively affects the microbiomes that, you know, mice that are on time-restricted eating can actually eat what's called a cafeteria diet,

a very unhealthy diet, without developing metabolic syndrome. So just... But it works better when you eat healthy, though. Yeah, it definitely works better, yeah. So, and this goes sort of into this whole concept of the keto diet so you're in a ketogenic state for 18 or 16 hours um if your first meal of the day is is at noontime and it's without um any carbs and sugar you can extend this ketogenic period even longer um and so you you get multiple benefits And so we've started this during the pandemic in our family and actually works really well. It's feasible. I'm not sure if I could fast two days a week on a regular basis, even if I wanted to do it. But the time-restricted eating, I think, is something. So combining that kind of microbiome-targeted

diet, largely plant-based, with the compression of the time when you eat it, I think right now, in my opinion, is sort of the optimal way of influencing your metabolic health. Yeah. And in your book, The Gut-Immune Connection, how understanding why we're sick can help us regain our health, you talk about something called a gut microbiome diet, which is rather than focusing on the traditional macronutrients, you're talking about how do we eat holistically in a way that feeds our inner garden. And that's a very different paradigm. And really, in functional medicine, the way we start almost all our patients is by getting their gut right. And we try in functional medicine, the way we start almost all our patients is by getting their gut right. And we try to do that through food and through the right

lifestyle factors, supplements, sometimes resetting their gut through cleaning out the bad bugs. But it's an interesting idea that we have, if we focus on a way of eating that facilitates a healthy microbiome, we can address a whole host of downstream chronic inflammatory diseases. Which is, in some ways, I mean, it sounds simplistic. It almost sounds like the, you know, the string theory of chronic diseases. But I've spent a lot of time thinking about this, and I think it makes a lot of sense, you know. um now the unfortunate thing is not everybody can do this so this we haven't talked about this i mean like we've seen covid epidemic you know the the racial and socio-economic disparities um that a lot of people don't have access to that diet or it's a lot more expensive than buying the hamburgers um you know two for one two for one hamburgers, two-for-one hamburgers for $2.50, which is a completely ridiculous price.

But that, unfortunately, becomes the diet of a lot of people that can't afford the other one. They certainly don't have the money to buy supplements. So this is a whole other question. And unfortunately, it's this part of the population that is most severely affected by these chronic diseases, you know, and COVID as well. So how to deal with that issue is another whole other challenge. Yeah. You know, we often are very sort of human-centric in our thinking. And what you bring up in the book is a different way of thinking about a relationship to our environment, that our own microbiome is connected to the microbiome of the

soil, that what we eat, how we grow our food, how that impacts the environment, how that impacts the planet, all are related, and that we can't treat one without the other. And a lot of the podcasts I've had and the work I've done in my food fix book has really been focusing on the bigger ecosystem of our food system and how it's creating the food that we're eating in a way that's damaging the soil microbiome, that's damaging our own microbiome. I mean, even glyphosate, which we use, for example, in massive amounts and which we have discussed on this podcast, destroys the microbiome of the soil and our own microbiome. And it's prevalent. It's on everything.

So help us connect the dots between the soil microbiome, our microbiome, and the overall health of the plant and the planet. Yeah, I mean, I should say, you know, one insight I also gained is the interactions of our gut microbiome with our gut is in many ways very similar to the interactions of the soil microbiome with their root system when they're in trouble, which attracts the microbes to gobble down the liver of this. Just like in our gut, there's microbes living that can live off the mucus layer, which is also a carbohydrate, a sugar layer. layer, you know. And just that concept that plants depend on the microbiome to, for many functions on the soil microbiome, but mainly to defend against disease and stress. UV light, drought, pests, insects, a whole range of diseases.

The plants send down these distress molecules through their root system and attract the microbes from the environment that then form very close interactions and stimulate the plant to produce polyphenols, these same molecules that we now know are so healthy for us. And then these polyphenols go back up in the plant to the leaves and to the seeds and to the fruit to protect those assets of the plant. I just found it absolutely amazing that these same molecules that, you know, the microbes stimulate in the plants to help the plant health

are re-ingesting. And we're dependent on the microbes to break them down into smaller molecules that can then do the same thing in our system. They can be absorbed and go to our distressed organs, including our brain. And, you know, it's beautiful how nature has done that. So it's a design principle, I think, that works so well for the plants that evolution decided let's stick with it. It works for humans as well. Ear and bowel is so prevalent, and it's such a big problem for people. Yeah.

And there's many causes of it, but sometimes it is a parasite. I had a patient recently who was a very famous lady and she was really struggling with chronic gut issues and we treat a parasite and boom, she was instantly better. Yeah. So yeah. So again,

Plasticis histominus, which is a parasite and another one called Entamoeba histolytica, they've both been implicated in IBS as triggers for IBS. Cerebral bowel, yeah. Yeah. So if you can't find a reason for somebody's IBS and triggers for IBS. Herbal bowel, yeah. Yeah.

So if you can't find a reason for somebody's IBS, you should be looking for one. Because IBS is just not the diagnosis, there's a trigger for it. You should, and you haven't been able to get to the bottom of it, you should be looking for those two parasites. Unbelievable. So we're treating, I will start with herbal therapies, and then I will advance to using pharmaceutical agents if necessary. But then I want to make sure the rest of their gut is working. So we look at their digestive processes.

And oftentimes, why do we have the parasite? Because their digestive processes aren't working well. They're not making enough HCL in their stomach because they're under chronic stress. They might not be producing enough pancreatic enzymes. They may have some issues with their gallbladder that's limiting, and their liver that is limiting their production of bile or release of bile. So we want to make sure they have all their digestive enzymes. We want to make sure that their immune system is working well. So we want to make sure they have all their digestive enzymes. We want to make sure that their gut immune system is working well. So we want to create that environment.

Besides treating, I'm going to want to make sure that they're getting the types of foods and supplements in their diet that will support a healthy gut microbiome. Good prebiotic foods, the cruciferous vegetables uh i want them to make sure they're getting things like uh broccoli and uh asparagus and brussels sprouts and dandelions my dad was greek and you know we lived in a suburban community and in the springtime my dad would go around the yard and he'd get all the dandelions and he'd bring them in the house and he'd steam them up and boil them. And he'd mix them up with garlic and oregano and garlic and oregano and dandelions, right? What are we doing? We're giving our gut great prebiotics to feed the good bacteria and giving natural herbs and botanicals to make sure that we keep a healthy gut microbiome. So dandelion's really good,

artichoke's really good, konjac root with glucomannan is really good prebiotic. So I want to not just treat the organism, I want to create a really healthy gut microbiome that has a healthy immune system that will prevent further disease down the road. Yeah. So really it's about not only killing the bug, because I've been in traditional medicine, where like, kill the bug, okay, see you later. Carpet vomit, and let's move on. Forget it, and the problem is that most people's gut don't get back to normal on their own.

And I often see this even with celiac patients. They will be told, oh, you have celiac, don't eat gluten, but they still struggle for years with all kinds of digestive issues that they cannot handle certain foods, or they have bloating or gas. And it's even after they've eliminated gluten. So you really have to go through this whole gut restoration program. We talk a lot about it on the podcast, but it's such a key part of functional medicine.

This five-hour program where we get rid of the bad stuff, foods, bugs, whatever. And then we kind of put in the good stuff and help the body kind of repair and heal. So that's really an incredible approach. And we've seen patient after patient who've had amazing, and I've seen, I've come across really crazy things. I've seen people with schistosomiasis from Africa, and I've seen people with endometriosis, and I've seen a lot of parasites.

Blastocystis is one of the most common ones. And it's often thought to be not a pathogenic one, so it's not bad. Yeah. But it often does cause symptoms. And if people have symptoms and they have blastocystis and they have irritable bowel. So let's sort of jump to this final topic because I think that it's such an interesting topic. Right. And it has to do with worms.

Yeah. So like, look, we all co-evolve with living with all these bugs. Yeah. And we had them and they lived with us. What's interesting is that, you know, in the advent of sort of modern civilization, we've become over-sanitized and we've lost the contact with the natural world. And I, you know, I think we've seen this uptick in allergies,

in asthma, in autoimmune diseases, in inflammatory diseases. MS, rheumatoid arthritis. MS, yeah. Psoriatic arthritis. And all these diseases. and the question is why? Because when you go to the developing world, you go to a hunter-gatherer culture, they don't have them.

No. There's just no allergies, no asthma. Now I was thinking about the other day, I grew up every summer spending three months on a ranch with horses and poop and outside and being dirty all the time. Absolutely. Dirt and sleeping outside. Couldn't wait.

And, you know, like being outside. And I don't have a single allergy or anything. And I think, you know, there's this whole phenomena where you see kids who grew up on farms don't get allergies and autoimmunity. Oh, man. If mothers today saw what you and I were doing when we were kids, mucking around in creeks, holding on to salamanders, feeding. We had a horse farm near us and I would feed the horses apples through the fence and they're

licking my hand. Yeah. Yeah, mothers today would be like freaked. Right, exactly. So we've sort of over sanitized ourselves and there's a number of books like the Epidemic of Absence we mentioned, it really talks about this and there's a there's a really good science behind using worms reintroducing worms yeah into the body and when you look at the part of the immune system that has us deal with worms it's the same part of the immune system that helps us deal with allergy

or asthma which is fascinating to me because it's like, oh, it has nothing better to do because it's supposed to be fighting the worms all the time and keeping everything under control, but if you don't have the worms to fight, all of a sudden the directin gets turned on you and your body starts dealing with attacking. Exactly.

Becoming more allergic or autoimmune related. So there's an interesting observation. There's an observational study that looked at people with autoimmune diseases in sub-Saharan Africa and underdeveloped countries. And they looked at those in regards to the severity of disease, progression of disease, and response to treatment compared to developed countries like the US. And they found that those patients in sub-Saharan, and they compared it along the lines of like the load of parasites. And they found that the patients in sub-Saharan Africa, and the hypothesis is that

it's because of the parasites, they have their disease, their rheumatoid arthritis is less severe. It progresses more slowly and it responds better to therapy versus developed countries where there's less parasites. And we, you know, we have this, you know, this, you know, the operation of the hygiene hypothesis where we just live in too sterile of an environment that our immune systems just are, like you said, are going to get confused and they're more likely to have an autoimmune response in response to something that's coming through the system that they maybe should not even respond to. That's coming through the system that they maybe should not even respond to.

That's called immune tolerance. Your body actually has to have immune tolerance. You have to tolerate your own antigens, but you have to tolerate the antigens of other organisms. Because if you're responding to everything that comes through your body, then you're gonna be constantly inflamed. So your immune system has to have a mechanism by which it can appropriately tolerate organisms.

And in that particular setting, those organisms that are being tolerated may be doing something good for us. So if we're having immune tolerance for a parasite that isn't harming us it's getting some benefit but it's creating compounds that actually modulate and balance our immune system that's a win-win yeah so i know this sounds completely wacky right but it's true uh dr hyman and dr george are giving patients worms well you know what they quacks or what's going on here i will bring in a patient and she will sit here and tell you that she is a believer in Helman therapy because she had severe psoriatic arthritis and we worked on everything.

And her goal was to be able to either come off of or greatly reduce her need for her immunosuppressive Humira. When she came to see me, aches and pains in all of her joints, tired, fatigued, really having difficulties. And I did all of the things that we do and we've talked about on this podcast in functional medicine. But one thing I brought up, you know, I put her on a lot of things that could impact your immune system, Helman therapy.

So I started her on Helman therapy a year and a half ago. And she was in the worst, well, she was actually getting better from her pain, but she could not get beyond two and a half weeks without needing her next Humira. Started on Helmin therapy, helping her to get to that goal. She's now, she can go every six weeks before she needs a Humira shot.

And that started once she started the Helmin therapy. That's incredible. So she's getting parasites, she's getting Helmin, she's getting these worms, she takes them in capsules. We get them from a really high level company and it really does work. It does. I would say I've been shocked and i use it very selectively and i have patients who are really struggling and the usual functional medicine stuff doesn't work and i

think that i've been shocked at some of the things i've seen i had this one kid who was on the autistic spectrum yeah but he was also extremely allergic and he had really high levels of ige which is the antibody against sort of allergens when you have allergies like asthma allergies and I'm like I told them I said look I don't know this is gonna work I think the risk is very low we use rat tapeworms which sounds gross but they don't actually get take up residence and they don't actually cause any real problems long term they just pass through but they can help regulate immunity on the way in you want to try them it's like she's like sure was it really a miracle this kid not only had reduction all the symptoms and allergies and

everything but his ige levels which normally should be like under a hundred were a thousand and it came down to normal wow on this therapy wow and i've had other people that are autoimmune diseases uh kids it's really quite striking so there's something to it you have to pick the right patient absolutely uh and we'll figure it out but um i just think that in medicine, the idea is that it's not like we just decide, oh, you know what, there's nothing else to do. Let's just, oh, I heard about witch doctors in Africa using helmets. I think I'll try that. There's a lot of research.

I think we pride ourselves here at the Ultra Wellness Center in getting to the root cause, but really combing the literature for real data that says it helps us find new therapies that are going to be beneficial. And so we do that. And there is a lot of studies that support Helman therapy in reducing the severity of symptoms in response to medication in people with rheumatoid arthritis, psoriatic arthritis, MS, and asthma. Pretty amazing, right? Yeah, it is.

So it's, you know, this is. And it's actually in the mainstream medical literature. It's mainstream literature. And yet doctors are really not doing it. And we're a little kind of on the leading edge here at the Center for Functional Medicine, I mean at the Ultra Wellness Center. And we're really focusing on

what's gonna work for the patients. And we're really focusing on what's going to work for the patients. And we use criteria like, you know, is there scientific evidence? Yes. Is it safe? And if, you know, yes. Does it have bad side effects? Hopefully not. Is it reasonably priced?

Okay. And if it meets those things, you know, we find a great therapy, but it's a million dollars a dose. And it's a million dollars a dose and it's invasive or it doesn't work but so we really try things that are potentially helpful and we work with our patients in ways that i think are pretty unique and inspiring and allows us to really see remarkable miracles where we often don't so if you're listening to this podcast and you've struggled with gut issues if if you have autoimmune issues, if you have allergies, if you have cystic acne, if you have who knows what, you got to start with the gut. 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.