SIBO vs IBS vs Leaky Gut: Tests, Treatments, and How to Heal Fast | Dr. Carolina Gonzalez

[00:00:00] Up to 70% of patients that are diagnosed with IBS actually have sibo. If you have leaky gut, you probably aren't absorbing your nutrients as well. Most of the supplements that are being promoted as parasite cleanses are actually laxatives. Anti-parasitics can be incredibly toxic. We live kind of in a world where antibiotics are given pretty freely.

Now you have a cold. You go in and you get an antibiotic. Chemicals that are introduced into our environment, it is always deemed safe because there's lack of evidence, and then it takes generations until finally we look back and say, oh, that was a bad idea. You wanna make sure that you're raising the good bacteria because they're actually really important for modulating your immune system to not just let's wipe out all of the bacteria.

That should never be the goal. Dr. Carolina Gonzalez is a gut health powerhouse who knows how to turn constant bloating, discomfort, and confusion into real answers and relief 

with her expertise in the microbiome. And as the founder of Good Gut Doc Supplements, she's here to show [00:01:00] you how to finally fix your gut and feel your best.

The goal is never, I think to restrict the diet and have that be the answer. It's to get to the root. And the root could definitely be, what if they have celiac disease and you're chasing this parasite cleanse? To be honest, if you have had longstanding digestive symptoms and now you're worried about everything you eat, like food fear, it's common for those patients to fear that they're going to welcome to the Dr.

Brighton Show, where we burn the BS in women's health to the ground. I'm your host, Dr. Jolene Brighton, and if you've ever been dismissed, told your symptoms are normal or just in your head or been told just to deal with it, this show is for you. And if while listening to this, you decide you like this kind of content, I invite you to head over to dr brighton.com where you'll find free guides, twice weekly podcast releases, and a ton of resources to support you on your journey.

Let's dive in. I wanna go through, worth it or not, [00:02:00] yes or no answers. Lactose breath test for sibo? Yes. Stool cultures? Yes. Food sensitivity testing? No. Okay. Elimination diets? Yes. Parasite cleanses like we see on social media? No. Okay. We're gonna get into all of this today and a whole lot more, but I wanna ask you first, what are three surprising habits that are quietly wrecking people's gut, quietly wrecking people's guts?

Well, we know of the obvious poor diet, alcohol, those sort of things, but quietly wrecking people's guts. I would have to say definitely. Uh, eating too quickly or in a rush and caffeine on an empty stomach. Mm. Why caffeine on an empty stomach? So caffeine is, uh, a laxative, first of all. Um, and it's an irritant to the gut lining, so, mm-hmm.

If you don't have something already in your stomach before you drink that coffee, it's gonna kind of go right through you. Especially if you're someone that's prone to IBSD or diarrhea, that's gonna just go right through you. So it's best to have something in your stomach before does the quality of the [00:03:00] coffee matter.

For sure. I mean, we always wanna have better quality, um, organic, you know, mold free, but, um, in general, like it still has caffeine. Mm-hmm. And so if you're someone that has a little bit more of a sensitive gut, you should still try to have something in your stomach. Yeah. For drinking, I'm a sensitive stomach kind of person, but I'm someone that, um, so for instance, I was just at a hotel yesterday and the coffee was like, not.

Good quality at all. Mm-hmm. I took the first sip and I could just, the acid hit me and I was like, Nope. Uh, if I drink this, I'm gonna be erected. Right. And so I find that there is a difference with the quality of coffee. And I also think how you're consuming your coffee. Like is there milk in it? Is there collagen in it?

Definitely. Like are you doing more with it? Right. But I agree with you, food first is always gonna be better. Yeah. I'm from, I'm like from a hormonal perspective, cortisol, if you're hitting Yeah. Coffee first. Mm-hmm. Then your cortisol response in the morning is, is gonna be less than desirable. Mm-hmm. So, um, when it comes to stress, so that's something you brought up and you had talked in the context [00:04:00] as well of like making sure you're chewing your food.

Mm-hmm. Like slowing down. What does it do when people are like eating at their desk, working, uh, eating while they're driving a car? Yes. So there are two states we could be in with our nervous system. You can either be in fight or flight or rest and digest mode. A lot of us tend to be in the fight or flight mode because we're working, we are trying to meet deadlines, we're texting, trying to, you know, figure everything out.

And we're rarely getting into that rest and digest mode. So if you're not making that intentional transition from work, work, work, to now it's time to relax, sit down and eat. Your body's not gonna get the cue that, uh, it's time to eat. So essentially your stomach is not gonna put out the right digest amount of digestive enzymes.

Your gut motility is not gonna be working efficiently. Um, so you're not gonna be. You know, ultimately digesting your food as well as you should be. Um, and so that's an instant where, um, either the food can either go right through you, you don't absorb the nutrients. Um, it can, you know, over time lead to [00:05:00] something called SIBO or small intestine bacterial for growth, which I'm sure we're gonna get into.

Oh, yes. So, um, yeah, very important to try to make that intentional switch to, uh, rest and digest. But when you're eating and I'm, I'm sure we'll talk about some of the ways to do that as well. Yeah, totally. And it's something that I think with moms, it's pretty insidious. Insidious because, you know, they'll be like doing the dishes and they're feeding their kids and then they're just grabbing things and eating them.

Yeah. Um, I think, so when we talk about this, people often think of like. Oh, like, this is like, don't eat at my desk. But there's a lot of other ways that we cannot be prioritizing our food. Sure. I mean, it's something, um, I have a toddler who right now likes to do like, I want to eat and walk around and I'm like, when we eat mm-hmm.

We sit, there's a reason for this. Um, I used to have a professor that always say. The only food you ever eat, uh, standing is a super ripe summer. Ripe summer fruit. And you eat that over the sink. Like that's a situation maybe. Yes. But outside of [00:06:00] that, we, we really gotta carve out time for our food. Yes. Now, another really common stressor that.

People have, and I don't think they necessarily see it as a stressor, is poor quality sleep. Yes. How is that impacting people's digestion? Yes. So in a couple ways. So definitely it's impacting your behavior the next day because if you're not getting good quality sleep, so well, let's define what poor sleep is.

So, uh, when you're getting on average less than six hours of sleep, when your sleep schedule is erratic, you're not gonna bed the same time, you know, on average. Um, that's gonna affect your behavior the next day. So you're gonna make poor choices when it comes to your diet. You're gonna probably be reaching for things to give you that burst of energy.

So carbs, sugar, and so that's gonna negatively impact your gut health. Right. Um, and also a, a poor sleep actually can. Cause, uh, increase in cortisol as well. And that increase in cortisol is affecting your physiology. It's affecting your microbiome by depleting the good bacteria. Mm-hmm. And also worsening leaky gut, actually.

[00:07:00] Um, there's actually an interesting study that was done on rats where they were sleep deprived and they saw an increase in pro-inflammatory substances in their gut as well. So, um, yeah, it's affecting your ability to make good choices the next day and also your microbiome. Yeah. And you know, to dovetail on the, what you were saying about the cortisol is cortisol disrupting gut health.

That can lead to inflammation. Then the inflammation rises, then the cortisol's gotta rise again, and you can get in this real loop. And so I wanna talk about actual, actual things today, right? Like things that people can be doing to help support their gut. But I do wanna go back to what you just said about sugar.

Mm-hmm. This is a big debate out there, right? Because there's the anti-D diet, culture movement, which is like all food is food and safe. And it's like, well, as someone who has a food science and nutrition degree, let me let you know, I also have a chemistry degree. All food isn't actually food. Yes. Things that you can put in your mouth.

They're like designed in a lab and [00:08:00] while they have calories, they don't really have the benefits. But when it comes to sugar, there's this idea then. If you're restricting sugar, you're trying to push a diet. Mm-hmm. But I wanna talk about sugar from the perspective of what can I be doing to the microbiome and people's gut health overall.

Yeah. So I mean, foods that are usually higher in sugar are typically lower in fiber. Mm-hmm. And so that's one. So when you have a diet that's generally lower in fiber, you're not feeding the good guys or the good bacteria. So then you're basically creating an environment where you, you have less of the good bacteria around and then that sugar tends to favor or feed the pathogenic or opportunistic bacteria, which are generally more pro-inflammatory.

Mm-hmm. So it's depleting the good bacteria by not giving them the fiber and then increasing the pathogenic or more, you know, likely to be inflammatory bacteria as well. Yeah. Mm-hmm. No, that's, um, I think a really important thing to understand, uh, as of right now, do you know how many people in the US are actually meeting their fiber goals every [00:09:00] day?

Probably none, to be honest. I know. I don't always get there. We don't always hit it every day. Yeah. But it is something that I, uh, I actually was just with a group of doctors and I was talking about like, when I travel, it's always like protein and fiber. Yes. These are surgeons. They're like, what do you mean fiber?

Like, how are you just like focusing on fiber? Like that's your goal. Mm-hmm. And I'm like, mm-hmm. I'm looking at exactly what I can be eating to get 25 to 30 grams of fiber. Yeah. Because especially when you travel cortisol disruption, propensity for estrogen issues to arise and like, but, and, and how many people get constipate, we're gonna talk about some travel tips today, but so common to get constipated while you're traveling.

Oh yeah. So I'm like, it's one of the big things I look at is getting enough fiber. We do know it's a very, very small percentage mm-hmm. Of adults in the United States, let alone children who are actually hitting their fibro goals. Yeah. And what's interesting, there's a lot of talk about neurodivergence and diet becoming really in the [00:10:00] mainstream conversation.

And I've been going through all these studies about A DHD and diet and the, um, the, you know, the people with A DHD, their microbiome is in some ways a poor quality microbiome. Mm-hmm. In terms of not enough of the good guys growing, not enough diversity. Mm-hmm. But the underlying thing that I keep, just like every single study I read, I'm like.

This is fiber and resistant starch issues like over and over again. I'm like, it just really underscores how important fiber is. Totally. Yeah. And I think sometimes with, with, uh, like the SIBO diets and like IBS diets, like it, it does limit fiber because you're trying to limit how much you're feeding. You know, there's already bacteria, overgrows.

You're trying to limit how much bacteria you're feeding, but you can get stuck in that low fodmap, low fiber. Cycle. And then what's going on is now you've dealt with the sibo, but now you're depleting the good bacteria. And that is actually just as important at tempering the microbiome as it is, you know, getting rid [00:11:00] of the, the overgrowth.

Mm-hmm. You wanna make sure that you're raising the good bacteria because they're actually really important for modulating your immune system, modulating inflammation, maintaining the integrity of your gut lining. So it's not just let's wipe out all of the bacteria that's, that should never be the goal.

Yeah. Which is, uh, sometimes the case that happens with antibiotics. Right. But sometimes antibiotics have a time and a place. Sure. So I'm gonna wanna talk, um, definitely more about treatments, but I wanna know from your opinion. If somebody starts getting diarrhea after they eat a meal, like every time they eat, they're having loose stools.

Mm-hmm. Liquid stools. What are some of the first things that they should rule out? Definitely a food allergy or food intolerance. Mm-hmm. Uh, definitely I would begin with maybe looking at dairy, I mean. One out of two people are lactose intolerance in, in North America. So maybe trying a, a dairy free trial or uh, a food elimination in that instance.

So you can try, you know, first dairy and then maybe limiting gluten and then maybe eggs or corn. [00:12:00] Um, you know, do one at a time because if you remove them all, you're gonna drive yourself crazy. So I would start there maybe investigating that. Um, I had a patient actually who, um, that was the case. Like they would eat and immediately have to go to the bathroom.

And for her it actually ended up being a food allergy instead of a food sensitivity. Yeah. So an allergy is actually, uh, when your body's just releasing a lot of histamine in response to that specific food that you're eating. And that was the case for her. She ended up be having allergies to eggs and milk.

Mm. And so after removing those, she was completely fine and she was like the happiest person alive. Um, so that would be one. The second one is actually one that. Probably is not as common, but that's something called bile acid diarrhea. Mm-hmm. So sometimes after getting a gall, your gallbladder removed, you have what's called dumping syndrome, which is basically there's nowhere for the bile to be stored.

So after eating that bile is just kind of irritating your gut. It's going right through you. And so is the food. So if you've had your gallbladder removed and you're still having diarrhea after meals, definitely look into [00:13:00] that. And then the last one probably would be anxiety, to be honest. Mm-hmm. If you have had longstanding digestive symptoms and now you're worried about everything you eat, like you're talking about like food fear, um, it's common for those PE patients to, you know, fear that they're going to get sick after eating.

And sometimes that can present with loose stool or diarrhea right after eating. Mm-hmm. So food sensitivity testing, you were like, no. Yes. Let's talk about why No to food sensitivity testing and then food allergy testing. Mm-hmm. Which is different. Sure. So, um, the gold standard for determining food intolerances is actually doing a food elimination, which is not fun, but it does give you, you know, immediately, you know, are you intolerant to this food or not, just by removing it and then reintroducing it in your diet.

Um, the food sensitivity testing, I believe they've come a long way from when they first started, but I still think that there are some flaws with that. Um, [00:14:00] especially if you have leaky gut, um, based, everything that you're eating essentially is going to show up on that food sensitivity test as. Positive or that you're sensitive to it.

Um, so it's really hard to say, is it, is it the food that's the issue? Or is it that you have leaky gut or some other imbalance that's driving that food sensitivity. And oftentimes that can cause more food. Fear, it can cause really restrictive, unnecessarily restrictive dieting. Um, and oftentimes patients, when they get the results back, they will tell me, I eat this food every day and this food is not an issue for me.

Or vice versa. I never eat this food. Why is this coming up flagged as high? There's been instances too where we've actually submitted two of the same tests from the same person, same time, and gotten drastically different results. Yeah. So it's hard to trust the results. That's why it's best to just do a food elimination diet and then, you know, if that's inconclusive, maybe then we can order a food sensitivity test.

But that generally tends to be my last resort versus some practitioners that tends to be their first go-to. Mm-hmm. I'd much rather start with a [00:15:00] food elimination diet and then see what other imbalances there are, um, you know, sibo, sifo, leaky Gut, that sort of thing. Mm-hmm. Yeah, I had a food sensitivity test.

A long time ago while I was on birth control, I was on the pill and it came back and it was pretty much every single food. So it's on like a 96 food panel. Yeah. And it was like 94 foods. And I was like, what? And that was my first experience where I was like, okay, this is intestinal permeability, like gone wrong, which is what people call leaky gut.

Mm-hmm. Um, and yeah, you look at something like that and I'm like, yeah, a pa, it's so easy for patients to be like, oh, I have to cut all these out. No, yeah, you are having this IgG response because your gut is leaking. As you said, particles are getting through, your immune system is lighting up to that. Talk about how that differs from food allergies because people often get these things confused.

Right. So food allergies can definitely be exacerbated by a leaky gut, but [00:16:00] you don't have to have leaky gut to have food allergies. So food allergies is basically a totally different immune response. Um, that's based on more in IgE. So that's allergy. And then the sensitivity, we're looking at IgG or IgG four.

Mm-hmm. So if you have a food allergy, first of all, the symptoms are gonna be much more acute. So right after you eat that food, you're gonna get symptoms, whether that's, like I said, the, the immediate urgency, the diarrhea. Um, but typically you're also getting things like hives or itching in your throat.

Maybe some kind of swelling, um, or anaphylaxis if it's really bad. Um, so the testing, um, you know, there, there could be some allergy testing that's done through the serum or blood, but typically you wanna be doing, you know, the skin prick testing with an allergist. So you're in a controlled environment.

God forbid if you have some kind of, you know, reaction, you're there with an allergist. So that actually is a gold standard for food allergies, um, versus doing it through the blood or serum like you would with food sensitivities. Mm-hmm. You can reintroduce with food sensitivities that too, but [00:17:00] what about allergies?

What should people know? Um, I would be very careful. Um, I would definitely do a lot of work first on your microbiome, on healing your gut, you know, gut lining. Um, and I would be very careful. I would tread very lightly with that. Most times you're not able to introduce a food allergy if it's a very mild allergy, where, you know, maybe you're getting a little bit itching, you know, a little bit of the tingling.

Um, and it's something that you're wanting to deal with and still have that food in, in moderation, that's okay. But in general, I would stay far away from food allergies. Mm-hmm. Yeah, I think it's really important to parse those out because it, it can be really confusing. We've used the term leaky gut, I said an intestinal hyperpermeability before.

For people who are not familiar with that, what does that mean? Leaky gut. Mm-hmm. So yeah, essentially, um, our gut is a tube and it's sealed off to the rest of the body, to the immune system, to your bloodstream, everything else. Um, and leaky gut actually is occurring in the small intestine, not in the large intestine.

Um, [00:18:00] because that is basically where we have the most surface area to absorb our nutrients. Mm-hmm. And so with leaky gut, what's happening is you have, uh, almost like holes in that tube of the small intestine where it's allowing food particles to get through bacteria, toxins, different products to get through and come into immediate contact with your immune system into your bloodstream.

And then that can, you know, lead to something called endotoxemia, which is basically, you know, you're getting inflammation now el elsewhere in your body, not just in your gut. And so that's when you can see some systemic symptoms arise, whether it's brain fog, fatigue, mood issues. Skin issues, allergy sensitivities.

So, um, so yeah, so with leaky gut, we're looking, when we're testing for leaky gut, we're looking at something called zonulin, which is the protein that actually holds the cells of the line, the small intestinal lining together. And we're looking that at either stool or in the blood. And if you have a high level of zonulin, well then you're spilling too much of those proteins that are meant to hold the, uh, the lining together into your stool.

And so [00:19:00] that's how we can detect leaky gut. But I don't always test for it, honestly, because I'm able to just know, based off the symptoms. Like definitely if they've had longstanding digestive symptoms, they probably have leaky gut, just clinical picture. Um, and also other symptoms that they have. Do you always have to have gut symptoms?

Actually, not always. Mm-hmm. No. I've definitely ordered tests on patients, um, when I suspected it, but I wasn't sure, especially if they were having like acne or eczema or fatigue. Brain fog, nutrient deficiencies is another big one. Um, because if you have leaky gut, you probably aren't absorbing your nutrients as well.

So that's where we see things like iron deficiency, B12 deficiency, that sort of thing. What are common triggers of leaky gut? So, uh, definitely poor diet, processed foods. Um, unfortunately not eating organic foods. So when you're consuming a lot of foods that aren't organic, they probably are leading with pesticides, with Roundup, and those are chemical irritants for your gut lining.

Uh, medications. [00:20:00] So we know birth control. Can we know, uh, definitely antibiotics. Uh, long use of NSAID use. So aspirin, ibuprofen, alcohol for sure. Caffeine on an empty stomach possibly. And, uh, stress actually, so that high cortisol can also contribute. Mm-hmm. Yeah. Uh, it sounds like a lot of stuff I think people kinda get and sibo.

Yeah. And then there's sibo, which we're definitely gonna talk about today. How can people start to identify, like, what might be the cause of their gut dysfunction? Like when we're talking about diet and lifestyle, I think it's really important to try to work with a naturopath or functional medicine doctor because it can be so hard.

Um, so that's where you go and give your entire history, your life and your whole life. Like how was, how was your mom's pregnancy? Totally. Yeah. So, 'cause it's really hard to figure that out on your own. And so it's really important just to give it to a professional and like lay it out for them and then they can start to put, put the pieces together.

But essentially I would. Begin with the [00:21:00] basics, honestly. Like how's your diet? Are you primarily following a Whole Foods, you know, limited processed food diet? Um, how's your stress level? How's your sleep? You know, your hydration. Are you limiting alcohol consumption and said, use that sort of thing. Mm-hmm.

And if the answer is um, no to one of those and you know, do you need to work on that? Um, if you have still symptoms, you know, lingering after you're trying to follow all of those recommendations, then you might wanna look into some other type of testing, SIBO tests, GI map, stool tests, that sort of thing.

Mm-hmm. So you said eating non-organic food, a lot of people push back. The biggest argument I always hear is that there's no nutrient differences. And I'm always like, well, that's not the primary reason why we opt for organic is to have a more nutrient dense. Bell pepper, for example, but it's pretty controversial.

I don't know understand why, but I want you to talk a little bit about the science behind, like what we understand about what some of these, like conventional [00:22:00] used pesticides, especially in the wake that we just saw, um, our government just. Silently, like slipped into a bill to be like, let the, let the pesticides rain free.

Like, why are we gonna check these anymore? Yeah. So I mean, they're definitely, you know, more pro-inflammatory. So that's an instance where we are seeing, we're seeing of leaky gut. Um, it's definitely depleting the good bacteria as well, causing, and then inflammation just allows for opportunistic bacteria to thrive as well.

Mm-hmm. And these are compounds that are not easily, uh, detoxed from our body, so they tend to actually even be stored in our tissue much longer than, than other things. So, um, because they're inorganic, so they just tend to, you know, build up in our tissue so hard to detox and, you know, we're not even talking about what it's doing to our fertility, to our hormones neurologically.

So it's just bad all around and. Honestly, it, it's really discouraging because like what you said, with that rule being passed or put into effect, we don't know how much our organic farms are being [00:23:00] protected from all of that. Mm-hmm. Off gassing from other, you know, inorganic farms. So, yeah. Um, you just gotta try your best, um, maybe move to another country, just okay.

Yeah. Well, and that's the thing. I appreciate you bringing that up because just because it's organic doesn't mean it doesn't have any pesticides. It also, you know, matters. So. I went to an ag school, I grew up in California, and you would see, uh, a non-organic farm right across the highway from an organic farm.

And as I was driving to school and you'd see them spraying and I'm like, how much of that is getting over? So we, I say this because I think it's important for people to understand. You cannot control everything. You can't, and as you were saying, it can be harder to detoxify from some of these environmental pollutants.

Mm-hmm. And we do know that many of them are endocrine disruptors. So. Or hormone mimickers. Mm-hmm. And they can be disruptive. I mean, this is my problem with the whole conversation [00:24:00] around chemicals that are introduced into our environment is that it is always deemed safe because there's lack of evidence, because there's been no studies done, and then it takes generations has study after study after study coming out.

Mm-hmm. Until finally we look back and say, oh, that was a bad idea. Mm-hmm. Really, the, the burden lies on the consumer and it never should. The average individual. Shouldn't have to navigate the grocery store with apps, trying to figure out what is the safest thing. Right. Or feeling like they have to have a PhD in just understanding the food supply to make better choices.

We should have those protections in place and chemical companies should have to prove without a shadow of a doubt, this is safe before it's ever introduced in the environment. Because the reality is it's not just the humans you are impacting. Yeah. It's not just the people. And this is my other beef.

It's not just the people who eat the produce, it's the people who work in the fields. Oh my gosh. And so many people are like, it doesn't matter if you eat organic or [00:25:00] not. And I'm like, it. It is so unethical to me, so unethical to say that when we know that many people, central Valley of California, for example, really high rates, thyroid, cancer, other cancers, why is that pesticide exposure?

Mm-hmm. We know where that's coming from and, but you act like, well, because you are not getting exposed to it in Apple. We are globally a community. Mm-hmm. And we are also com in community with these microorganisms that inhabit the earth, the microbiome of the earth, like Right. And the animals of the earth.

So anyhow, that's my, like environmental and I think about, I think about like antibiotic resistance, but what's happening to the pesticide resistance. Yeah. Like, that's also something to be worried about as well. Mm-hmm. Yeah. So would you say that people need to be choosing a hundred percent organic or is there like a, a middle ground here?

Yeah. So I mean, uh, try your best, you know, honestly, and I know the cost comes into, uh, as a factor as well. Mm-hmm. Um, [00:26:00] you can always try to follow the Clean 15 Dirty Dozen, which basically shows you, uh, which foods are likely safer to consume if they're not organic. And usually those are the foods that have a thicker peel, bananas, avocados, uh, cantaloupe, those sort of food fruits.

Mm-hmm. Um, versus other ones that, you know, have a thinner skin. Berries. Right. Those generally are more, uh, toxic, have toxic, more toxic levels of pesticides. So, um, try to follow that list as best as you can or just kind of, you know, use your judgment when you go. Try to go to farmer's markets when possible.

They're typically not using pesticides. I hope. Um, you never know. So just try your best and maybe try to opt for the organic foods that, um, have the thinner skins or they don't have peels. Mm-hmm. Yeah. The, uh, what you, what you said about the farmer's market, usually farmer's markets are small farmers and so they don't have, I wanna say this.

Anytime we scale food [00:27:00] production, we compromise the integrity of the entire process. Yes. So if we look at why do we opt, what, say opt for grass fed beef? Yeah. There's, like, it is better quality for sure, but it's also smaller production compared to something. And we'll call out Hearst Ranch 'cause I just think they're the worst huge feedlots where you just see cows for miles.

Mm-hmm. And miles and miles like. You're not only treating the animal bad, that's problematic, but the way you're treating the animal is impacting the quality of that animal. A hundred percent. Yes. And what we're consuming, and so that's why I'm always like dollar vote for the small guys. Mm-hmm. Because they, they, it is just inherently.

Often going to have better quality because it's not being scaled to a level where they're compromising and cutting corners and doing things like what we call poor husbandry practices. Correct? Yeah. You are what you eat, I tell patients, so, yeah. Or what you absorb. Or what you absorb. Yes. Yeah. So I wanna ask [00:28:00] you, if somebody is waking up, they're feeling gassy, they're feeling bloated first thing in the morning, what's something that can help them with those symptoms, but also what should they be thinking about on a deeper level?

Yeah. So if you're waking up gassy and bloated, I would definitely say put more time between your last meal of the day, the night before. Mm-hmm. And the time that you go to sleep. So generally, we wanna stop eating three hours before bedtime to allow your body to fully digest that meal before you lay down, you're in a supine position.

Um, so yes. Try to not eat too close to bedtime. I would say, um, after that, you know, start your day with a glass of warm water, maybe a little bit of lemon, a little bit of apple cider vinegar. Mm-hmm. Um, drink that, because actually that's a great way to wake up your digestive system, get the digestive, uh, juices flowing and that can maybe help digest any food from the night prior if you ate too late, too close to bed.

Um, but if that's going on consistently, I would definitely ask yourself, um, you know, are you not eating too close to bedtime? Right. [00:29:00] And then if, if you're not and you're still getting these symptoms, that's when you wanna be looking into some other causes. Right. So, um, yeah, that would be, those would be my suggestions for that.

You're a Latina. I'm curious, does your family eat really lace? They do. And I yell at them. Yes. Yeah. So it's like lunch around like, I don't know, one, two, and then, you know, our last meal, Lana is not until like. Nine or 10:00 PM sometimes. Yeah. And I yell at them. I'm like, guys, like how, how are you doing this?

Because it's also affecting your sleep, your sleep quality. Right. And like your blood sugar and all these things. So, but they've been doing it for so long, they're probably resistant to that. Yeah. I blame it on Spain. I'm like, I really feel like it was Spanish influence. 'cause I don't know if you've been to Spain, but it's wonderful there, but I just can't hang with like, restaurants not opening.

Mm-hmm. Until eight people eat, like, it's like 10 o'clock people are starting their meals. I'm like, it's 10 o'clock and I'm already out. I'm sleeping. But it is the thing that, like with, with all of my Mexican friends, like they'll, they'll dock on me sometimes 'cause they're [00:30:00] like, oh, I'm making dinner reservations for nine.

I'm like, I what dinner like earlier. And they're just like, you're a Latina. Like what's your problem? Like, why are you eating so early? I'm like, science. Yeah. Right. Yeah. So I had to ask that. 'cause uh, it is very much a cultural thing. Mm-hmm. So we have to also be, um. I think aware of that. Tell me where Yeah.

As we make recommendations, right? Sure. Of like, well, culturally that can be difficult. Mm-hmm. So what can someone do if, like, if they're, if, if they get invited, uh, you know, out with big Hispanic community and against dinner at nine, what are some things maybe you can do if you are having late dinner to try to safeguard against that morning bloat?

Yeah. That's where, uh, digestive enzymes mm-hmm. And even bitters can be helpful. So bitters are bitter herbs that you take usually in the form of drops before your meal. And that can again, simulate your vagus nerve, stimulate digestive juices to help you digest that meal better. And then after that, I would also take a digestive enzyme, honestly.

Mm-hmm. A good comprehensive one to help digest protein, [00:31:00] carbs, and fats. Um, 'cause that's gonna make sure that you are digesting a little bit better before again, you go lay down unless you're gonna be up, you know, mariachi with your family until like two in the morning. Um, so that would be helpful. And then, you know, drink some water and, you know, hope for the best.

Yeah. Uh, what should people look for with a digestive enzyme? So a good quality digestive enzyme. Uh, well let's start with what's a good supplement, right? A good supplement one is one that is being third party tested by an external lab that has no interest in the profits or gain of that supplement.

'cause supplements aren't regulated, so you want to make sure it's a good quality supplement. But beyond that, a good enzyme is one that has a good array of different enzymes to digest proteins, carbs, and fats. So hopefully it has things like amylase, lipase, protease. Um, you know, there's a question of should it have HCL or hydrochloric acid or not?

If you're someone that doesn't suffer from gastritis or really bad heart or reflux, generally I would say try to get one that has HCL or hydrochloric acid in it [00:32:00] just to help further help digest that protein. But if you're someone that's a little bit more sensitive, try to get one that doesn't have it.

Mm-hmm. Um, so yeah, one that has a good quality, a good different amount of digestive enzymes in there. Yeah. Yeah. Well, that's fantastic. Mm-hmm. I appreciate you sharing that with people. How can someone quickly calm a gut flare after eating something that doesn't agree with them? Fast. Fast. Okay. As long as possible if you're able to, if it's safe for you to do so.

Um, try not to eat anything until your stomach is, has gone back to baseline, is feeling better. Um, I'm such a fan of fasting. I think it, it's good for so many things. It's definitely good for a digestive flare. So if your flare happened, you know, around, you know, four to 5:00 PM try not to eat anything until the next day if possible.

Drink a lot of water. Hydrate. Well, electrolytes. Tea is great as well because tea contains tannins which help bind toxins. So if you happen to eat something that, you know, had some bacteria, um, it will be helpful for that. But in general, try to [00:33:00] fast and, you know, if you can't fast, just try to eat very blandly.

Mm-hmm. Um, try to eat low fiber. Low residue, so soups, broths, white, uh, white rice, chicken, that sort of thing. Mm-hmm. Yeah. Yeah. I recently, I just had like food poisoning literally like five days ago. I got a smoothie somewhere and I think like, uh, at first I started bloating and I will do that sometimes with pea protein.

I joke that I'm like, I, I think, I think vegan protein should be illegal, but that's just because with my gut, if somebody loads me up on like a ton of like. Tea protein. Mm-hmm. And it's just like, I think it's more about how it's processed as well. Sure. Um, but I bloated initially and I was like, oh man, it must have been pre pea protein.

I thought it was whey. Mm-hmm. And then the symptoms came on and I was like, what do I have in the house? I was like, I have my women's probiotic. I sacrificed these ardi. And then I was like, I have berberine in the house. Mm-hmm. And like, hit that. And we were going on a trip the next day we to be up at 3:00 AM My husband's like, you're never gonna make it like you're so sick.

Like you're [00:34:00] never gonna make it. I'm like, watch me. Mm-hmm. Watch me. Um, but I'm totally with you because outside the supplements mm-hmm. I was like just drinking, um, clear fluids, like just trying to like, give my gut the rest that it needed. Rest. Yes. So I wanna, I wanna switch gears to parasite cleanses.

'cause this is like. You see? Eye roll everybody. Eye roll. Okay, here we go. Do most people really need a parasite cleanse or is this an influencer trend? So if we're talking about our side of the world, the western side mm-hmm. The Americas, um, generally, no. We tend to live in a pretty sterile environment. Um, unless you're someone that's eating like a ton of raw, uh, fish, uh, sushi or you're someone that works a lot with like animals on a farm, then yes, I might think more about parasites in that instant.

But I can tell you I've done hundreds of stool analysis and out of all of them, maybe a. 5% came back positive for intestinal parasites. Mm-hmm. So, yes, they are hard to detect, but the type of stool testing I'm doing is [00:35:00] actually looking at DNA level of the, of the parasites. So if we're not seeing any DNA level, then you don't have a parasite.

Mm-hmm. And the reason why this is all a rave is because, um, most of the supplements that are being promoted as parasite cleanses are actually number one laxatives. And so if you're flushing out your gut, you're gonna think it's doing something for you. And you might feel good, especially if you've been backed up for a while.

So you might think it's doing something for you, but really it's just flushing you out and further depleting your good bacteria. Um, so I would say no. Most cases it's not necessary unless you're showing obvious signs of, of a parasite infection. Mm-hmm. Or like I said, context. Right. So Well, and some of these supplements are irritants as well.

Mm-hmm. And people pass mucus. I don't know if you've had patients. Oh yeah. Patients take photos and they're like, look at this parasite. I'm like, that's mucus. That's mucus. Yeah, that's mucus. Um, and that's supposed to be there protecting your gut lining. Right? Like and so you just stripped your [00:36:00] defense.

Mm-hmm. And so I think that's another thing that, um, you know, people are, and it's the people who are promoting these, uh, supplement kids. I'm always like of the opinion of like, adults get to make their own choices. You can educate people. Mm-hmm. If they choose to do it, that's their life. I take issue with the kids when people are like, yeah, giving some of these supplements, because there's people who I believe they actually do know this and they're from a marketing perspective saying it's natural.

Mm-hmm. So it's safe. Antiparasitics can be incredibly toxic. Mm-hmm. If at high doses, like not every herb is safe. Right. And so that's another concern I have is that you have a small human, I'm also like, what if this, this child actually has something else going on? Mm-hmm. What if they have celiac disease?

Right. And you're chasing this parasite cleanse. And often I ha I think that as doctors, it's really easy for us to like judge the individual. We always have to like go back at like the root cause. Right. Why [00:37:00] are they doing that? Because they probably went to a doctor who didn't listen. Yeah. They probably went to a doctor who dismissed them and they were like, well, I'm, I'm desperate.

I'm gonna try this other thing that I see working for other people on the internet. Yeah, definitely. And some of the herbs, if you are doing an herbal antiparasitic, um, like, uh, warm wood for example mm-hmm. At, you know, higher doses, it's actually pretty toxic to your liver. Yeah. And so it's very important to be careful with that, especially when dealing with children.

Yeah. Yeah. And acute hepatic failure is nothing to mess around with. No. So what are the actual signs of the true parasite infection, um, so that people can understand? Because really, I mean, I have people when I talk about my endometriosis and they're like, you have parasites. That's what's going on. I'm like, mm-hmm.

Well, the predominant theory right now is that. This actually happened in embryonic development, right. Like in utero. They're like, then your mom had parasites. I'm like, cute. Okay. [00:38:00] Right. Yeah. So actual signs. So they're pretty vague and nonspecific and there's a lot of overlap with other functional digestive disorders like sibo.

So it's hard to really parse out, you know, is this a parasite? Is it sibo, is it something else? But in general, um, that's why it's important to get a good intake from the patient and, you know, see the context of everything. Um, but other signs and symptoms other than digestive symptoms, bloat to diarrhea, cramping, you usually see weight loss.

Mm-hmm. Especially if it's a worm. A warm is gonna be eating up your nutrients, you know, all of that. So we tend to see weight loss. Sometimes we can see a fatigue, we can see brain fog. But again, these can also point to sibo. Right? Yeah. Um, so other signs could be, actually a funny one is rectal or anal itching.

Mm-hmm. Um, especially one that tends to wax and wane with the moon cycle. It kind of goes in accordance with the feeding of the parasite. So that would be another telltale sign of something that makes me wanna, uh, look more into parasites. Mm-hmm. Yeah. And if you have [00:39:00] rectal, anal itching, there's a little scotch tape test that you can do.

Really fun. But we have people do this with their kids and we'll. See the eggs from the, like, this happens with pinworms. Mm-hmm. Um, yeah. It, it is. I want people to understand. I think that like there, we all have our things in medicine that we like absolutely hate and parasites are one of those that I'm like, yes, if you have one, we definitely, we definitely wanna make it gone.

Yeah. I wanna say, I appreciate you bringing up that, you know, if you're eating sushi, you're eating undercooked meats. Mm-hmm. If you are living in certain countries or traveling to those countries. I was actually just with a Brazilian doctor and we were talking about the internet trend of parasite cleanses, and he's like, yeah, like when I was growing up as a kid, we had parasite treatments every six months.

Right. Because of where we were at. He's like, is that what people are doing? I'm like, no, they're getting like boxes of like herbs and all this stuff. And he's like, what? Like, like they were taking like what? Ivermectin or Albendazole? Yes. Like some medication. Yeah. Yeah. Yeah. And that's pretty common because if you're in an area where, you know, there is a [00:40:00] lot of farmland, right?

There's runoff, you're coming in contact with animals, maybe the meat isn't the highest quality. Mm-hmm. There are definitely considerations. I don't want people to think that parasites are not a thing and they're not something that has to be, uh, considered. But I am curious. These, what we're talking about is these influencer driven parasite cleanses, um, these supplement kits and boxes.

I'm sure you've seen them. Mm-hmm. Are they doing more harm than good for gut health? I wouldn't say necessarily they're doing more harm than good. I just think they're not doing anything for the person. I think it's delaying proper treatment, uh, actually figuring out what's going on with the, with the person rather than just kind of flushing them out and giving them random herbs and laxatives.

Um, but if they're doing that consecutively or, you know, weekly even then yes, they're irritating their gut lining, they're depleting their good bacteria. And again, sub supplements aren't regulated, so we don't actually know the quality of the herbs of supplements. So some of them actually can be doing more harm in that case.

Right. If they are laden with, [00:41:00] um, toxic heavy metals or if anything like that, they're not being tested for purity. So, yeah, just be careful with what you're getting out there. You wanna make sure you're getting supplements from a trusted, reputable company or from a practitioner. Okay. So in context of this conversation, do you eat sushi?

Sometimes? Yes. Pretty much like every podcast guest, I'll give 'em a list of places they wanna go and it's always the sushi restaurant that they pick. But yeah, I'm super. Picky about my sushi, and I have like, one of my kids is always like, I love sushi. We'll be like at a gas station. Oh no. Can we get sushi?

I'm like, no, not from here. No. I'm like, no, no, no. I'm like, I always tell my kid like, food poisonings a really dumb way to die. Like it's a, it's a really dumb way to die. Yeah. When you are in a developed country and you have the ability to avoid those things, like don't, don't mess around. Yeah. With it. Yeah.

That would be such an ironic way for me to die. No, thank you. Yeah. Well, it's like, you know, something of like, you know, and because I, this happens to everyone every now and again. Like, you [00:42:00] make something like soup gets left out mm-hmm. Uh, overnight and that, I remember my husband when we were first dating and he's like, oh, should we just like put this away and, and eat it tomorrow?

I'm like, do not know about bots. Like, what? No, that's trash. And he's like, we spent till this time making it. And I'm like, yeah. And we messed up like. That's a bummer. So you wanna talk about like if someone suspects they have a parasite, maybe they're like, listen, I'm listening to these influencers online, they're making sense.

What can they do to test? What's the proper type of testing? Yeah. To actually catch a parasite because the one and done stool culture. You're never gonna see a parasite. You might, but you are probably not. Yeah. It's really hard to detect parasites, especially if they're hiding out somewhere. But that's why I prefer doing something like a PCR Microbiome Stool Analysis, which is looking at the DNA components of the of said parasite.

So if you're suspicious of that, try to get in contact with a naturopath or a functional medicine doctor that can order this test for [00:43:00] you. Um, because that's gonna be probably the most effective way to try to detect a parasite. Mm-hmm. Especially if it's a more chronic one. Uh, like you said, a lot of the ones that we're doing at Quest or LabCorp, they're just looking for the presence of the actual parasite in the stool.

But if it's not coming up in that stool sample, it's very easy to miss. Um, so again, if you, if you are having acute symptoms and you think you have food poisoning or a possible parasite, definitely go, go see a doctor right away. And, you know, they might give you antibiotics or anti-parasitics. Um, but if it's something that's been more chronic, low grade, long standing, A PCR, uh, DNA stool analysis is what I would recommend.

And the other thing, you know, you, you, you've said, see a doctor a few times, I think it's important for people to understand is it's not enough to treat. The organism. Mm-hmm. There's also a healing phase that has to happen afterwards. And in the case of parasites, certain parasites, they can trigger autoimmune disease.

You wanna make sure you're not missing that. Yeah. They can also lead to nutrient depletion. Sure. If you [00:44:00] are like, oh, I'm fatigued, and I think it's just 'cause of the parasite, well, we wanna also get a CBC like mm-hmm. At least a cbc, and make sure you don't have a iron deficiency anemia. So there's no one ever says you get to have just one thing.

And in fact, most people do not have just one thing. And there are consequences of having infections that you also wanna make sure are dealt with properly because. Just eradicating the organism is often not enough for people to truly feel better. Mm-hmm. So instead of going and buying an expensive parasite cleansing kit, what is an actual evidence-based way to treat parasites?

Yes. So if it turns out you actually have a parasite, you've done the test, you come back positive for a parasite, definitely work with a naturopath or gastroenterologist, depending on the severity, you might need a prescription. Mm-hmm. You might need albendazole or meb isol I ivermectin, depending on the type of parasite it is.

Mm-hmm. If it's not to that level, you can definitely work with a naturopath to get on a good anti-parasitic [00:45:00] regimen where you're taking anti-parasitic herbs, um, along with, uh, modifying your diet. So parasites do thrive off processed foods and sugars. So you wanna make sure that you're limiting that and focusing mostly on a whole foods based diet.

Yeah. And that you're seeing the treatment through, because sometimes the parasites can be shed in phases, um, depending if they're actively feeding or if they're dormant. So you might have to do a couple of weeks on of treatment, weeks off, weeks on like that. Um, depending on how severe the infection is.

Do you not typically prescribe these medications? I can't prescribe in my state. Oh. 'cause I'm in Connecticut. Oh, okay. So I don't prescribe prescription medications. Yeah. But if it's a very severe parasitic, then I'm in, I'm referring to infectious disease. Mm-hmm. Or a gastroenterologist. Yeah. Mm-hmm. And that's, I think, important for people to understand because there's different formulary scopes or practice, which means prescription rights.

Mm-hmm. That's what I didn't, I didn't realize you were in Connecticut. I'm licensed in Oregon. Mm-hmm. I've got a full formulary. Um, and people, patients will come to me [00:46:00] and they're like, wait, you're gonna, you're gonna prescribe a pharmaceutical? I thought you were like, Antip Pharmaceuticals. Mm-hmm. And I'm like, oh baby.

I'm all about like, how do we get you feeling better? Better as soon as possible? Because I have been there with things where I've been, you know, I, I, I have a history of h pylori and, um, that was something that I'm like, oh yeah, I gotta, like, I've gotta get rid of this. As you, we were talking off camera.

I've had SIBO a couple of times. One time I, um, used herbal treatment totally fine. Another time I landed in the ER because the pain was so bad and the pain I was having was so severe that I was like, it's rifaximin. Yeah. Like, I can't, I can't go through my days, so I have to have something. And that's what I really appreciate in this conversation of what you're saying is that it's not an either or.

Right. There's, there's always this division of, um. Happening where people are like, no, you have to do everything, all natural, or only pharmaceuticals actually work. And really it's about looking at what is best for the individual in that moment. Yeah. What do they need? Exactly. [00:47:00] Yeah. Yeah. So when a parasite treatment is medically necessary.

When someone's like, okay, I'm gonna pursue this. Why should they know about treating parasites? Because it's, it's not one of these things that when you start treatment, you just start feeling better overnight. Mm-hmm. Yeah. So you can definitely get a, her primary reaction or what's called a die off or a healing crisis.

Mm-hmm. Which is basically where you feel worse before you feel better. And so you can see a heightening of your symptoms usually when, within the first couple of days or first week of starting the treatment. Um, that's typically when you're gonna see die off, if you're gonna have die off. Mm-hmm. Some people don't have to die off, and that doesn't necessarily mean the treatment isn't working, but I always do, uh, prime my patients with the expectation that that may happen.

And if it does, as long as it's not too uncomfortable, you know, I try to get through it. We support them symptomatically through that. Um, but if it's something that's lasting, you know, weeks on, then um, we kind of just, you know, turn down the volume on the treatment and maybe [00:48:00] support another ways. Well, you have prefaced this many times saying like, working with a licensed healthcare professional is important.

But with that in mind, are there herbs and foods that do help with parasites? I know there's, um, there's certain smoothies that I do well, depending on where we're traveling. Yeah. So, uh, garlic, I mean, as long, if you don't have sibo, garlic is a great one. Yeah. Because it has a lot of anti parasitic antimicrobial effects.

Um, but it's high in fodmap, so if you have sibo, you don't wanna be eating a lot of garlic. Mm-hmm. Um, other ones would be spices. So things like thyme, rosemary, so using a lot of the spices in your cooking. Um, papaya seeds actually are also anti-parasitic. And, um, those are a couple ones that I can think of off the top of my head.

What's in your smoothie? I'm curious. It's papaya seeds. Yeah. Yeah. And I just think papaya is like the nastiest fruit to ever exist. It, um, I'm, it's very interesting 'cause I had said that about papaya and people are huge, just haven't had the right papaya. Mm-hmm. Like I. Tried papaya there. People were [00:49:00] like, you know, you need to have a Mexican papaya.

I'm like, said from Mexico, I hate papaya. Turns out that, um, just like some people have cilantro issues. Some people have papaya issues. They're chasing factors. I still make myself eat it. I still am. Like I am like, it's so good for you. Yeah. Like I get in the mix, but the seeds themselves, that with um, like pumpkin seeds.

Yeah. Pumpkin seeds. I will put in there, I will grate turmeric, ginger in there, try to put in, uh, so looking at polyphenols and bringing that in. Yeah. Which is what you were talking about with this, the spices, the herbs. Mm-hmm. Um, you know, thyme, rosemary, those are also rich in polyphenols. Mm-hmm. Which we know are absolutely essential for, um, your gut microbiome.

I'm also gonna link to the episode. Do you know Dr. Care if it's geral? Heard of her. Yeah, yeah, yeah. I think her clinic is in, uh, Connecticut. Yeah. She's a researcher as well though. Um, they did fantastic research. We did a whole episode together about polyphenols in the diet and, uh, her diet. They did a study in eight [00:50:00] weeks, was able to like, reduce people's, um, biological age by about like four years.

Wow. Yeah. And a lot of it comes down to the microbiome. Yeah. So for everyone listening, like take care of your gut mm-hmm. Because it literally can take years off of your life. Yes. In either direction, right off of your biological age, which we want to be younger or, or years off of your life because you're not having the nutrients that you need and you're having this chronic inflammation.

Yes. We've talked a lot about SIBO and IBS you have said. Anyone before they get diagnosed with IBS should be worked up with SI for SIBO first? Correct. What is SIBO and why is that your stance? Yes. So SIBO stands for small intestinal bacteria overgrowth and the name describes what it is. So you have too much bacteria in your small intestine where it should be relatively sterile compared to your large intestine, which is where your microbiome actually resides.

So, so I think up to 70% of patients that are diagnosed with IBS actually have sibo. Mm-hmm. [00:51:00] Which, like we were talking about, it's a very treatable condition and so why wouldn't we want to rule that out right before diagnosing someone with IBS, which is basically just a collection of different digestive symptoms, an umbrella term, if you will.

Um, when we don't really know what the cause is or the cause is not known, but if there is a cause that can be, uh, tested for and treated, I think. Everybody should be, should have that, you know, before just being diagnosed with IBS and essentially IBS, then that's a chronic condition that is gonna be managed with either medication, uh, lifelong by the way, and, and diet changes.

Um, but if you, if you can treat it, then you can definitely put your symptoms into remission by 90% or more. Mm-hmm. And feel better. Yeah. So 90% is, uh, no joke. Yeah. So why is it so often that. There's this misdiagnosis, people are told they have IBS when in fact it's sibo. Yeah, I think it's, [00:52:00] it has, it comes down to the provider that you're working with.

Mm-hmm. So some gastroenterologists, they're not looking for it. Maybe they haven't been trained in that. Um, there's also testing availability. So if you only have one SIBO machine per hospital, you might have to wait three plus months to, to have access to that test. Mm-hmm. But practitioners can actually, you know, sign up with other companies to actually drop ship SIBO test to the patient directly.

Yeah. So they don't have to wait so long, you know, to test and then treat for it. So I think it comes down to knowledge and then testing availability. Mm-hmm. So, with, uh, IBS, we see this is common. I think it's like the gut, the gut diagnosis that's synonymous to anxiety in women. Mm-hmm. Right. We see a lot of women get handed that diagnosis outside of.

Sibo, what may also be looking a lot like IBS, but it's not actually IBS. Yeah. I mean, so anxiety for sure. And it's interesting because it's not just anxiety, [00:53:00] like fix your anxiety and you're done. Because if you've been anxious and you've been in this fight or flight, like we were talking about earlier for a long time, that can actually alter your microbiome to the point where now you're getting sibo.

So anxiety can definitely be a cause even of sibo. Um, but then there's also something called sifo, or what we used to call just candida or candida overgrowth. Mm-hmm. But that candida is also occurring in the small intestine. In fact, 20% of patients that have SIBO also have SIFO along with that. Yeah. And so.

Um, I can get into the testing for that if you'd like. So, with SIFO it's not, the testing isn't as promising or as telling as the SIBO test. The SIBO test has high accuracy, um, and specificity versus a Candida or SIFO test. There isn't. Mm-hmm. So what I tend to do for patients is I order something called Candida Immune Complex in the blood, and it's basically an aggregate of antibodies.

And if it comes back high or positive, then you're more likely to have sifo. Mm-hmm. Um, you can also order arabinose in the urine, which is not one I do readily. That's. [00:54:00] Often seen in an oat test. Mm-hmm. Um, but oat tests are, are costly and I'm not ordering them on, on every patient. So I'll do the candida immune complex and I'll also look at the other symptoms that the patient is showing up with.

There's a lot of overlap with sibo, uh, with sifo, but typically they're also showing signs of, um, oral thrush, of hives, of itching, chronic vaginal yeast infections, dandruff. Mm-hmm. Um, also recent or frequent use of antibiotics is another telling sign that they might have sifo. Mm-hmm. So I'm screening for both at the same exact time for patients.

And if they have both, I'm typically treating both at the same time. What is making people susceptible to developing these? So, um, definitely stress, unfortunately, is a very common cause because again, it does deplete, um, your stomach acid, which is an antimicrobial peptide against bacteria overgrowth. So then you're getting that bacteria, you know, uh, translocating into your small intestine.

Mm-hmm. Um, it's also slowing your gut motility so food isn't moving as efficiently as it should down your digestive track, [00:55:00] allowing bacteria to come in and feed off of that. So, stress, um, medications, antacid. So I can't tell you how many of my patients come to me that have SIBO that have been on PPIs or, uh, H two blockers for decades.

Right. Yeah. And so that's, that's bad. Um, anything that slows gut motility, honestly. Um, we talked about stress, but also things like hypothyroidism. Mm-hmm. Diabetes, Lyme disease, anything that's affecting the neurological wiring of your small intestine to slow things down. And, um. Antibiotics, um, birth control, antidepressants, all these medications, obviously don't stop them if you think you have si.

Work with a, with a doctor on that. Yeah. Um, poor diet, you know, excess consumption of alcohol. Mm-hmm. Caffeine. So Yeah. And we know food poisoning can be a big Oh yeah. As well. Totally. Yeah. So that's when you get something called post-infectious IBS, which basically it ends up. Turning into almost an autoimmune condition where your body creates antibodies to try to, you know, fight off [00:56:00] the infection.

Mm-hmm. But those antibodies actually affect your gut motility as well. And so, um, as you can see, there's primary and secondary causes. Si. Mm-hmm. Um, and so that would be a primary cause, right? Um, the secondary cause would be that it's slowing down your gut motility. Yeah. So, um. And, and that's actually really hard to treat because those antibodies, we don't know how long they're gonna hang around for.

And so in those instances, we're really doing a lot of work with patients to enhance their gut motility. Um, so yeah, whether it's herbal or uh, prescription based. Mm-hmm. Now, uh, we started this podcast and you said lactulose breath test. Worth it? Yes. Explain what this test is and why you feel like it's worth it for sibo.

Sure. So the lactose breast test is a test we use to test for sibo. So lactose is a non-labor sugar, so it doesn't get absorbed, but it does feed bacteria that may be lingering or small intestine. What will then happen is bacteria will feed off that substrate and then release gases, either hydrogen gas, methane gas, [00:57:00] or even hydrogen sulfide gas.

And basically the way that we're detecting that is you're blowing after drinking the lactose, you're blowing into a bag every 30 minutes for three hours. Mm-hmm. So it takes three hours because that's how long it takes that substrate ideally to get, you know, from drinking it all the way down through your digestive tract.

So within 90 to 120 minutes, if you're having elevated, um, hydrogen gas or methane gas, then you are positive for sibo. And, um, the lactoses breath test is ideal because we're able to see which gas are you. Uh, testing positive for 'cause that will actually determine which treatment we do for you. Mm-hmm.

When the very first time that I self-diagnose sibo, 'cause I did a lactose breath test. Mm-hmm. I, my husband, I was like, you have sibo, I know it. You need to do the test. He's like, I'll do it if you do it. I'm like, fine. Okay. We're gonna do this home test. I'm be for three hours. I was so bloated during the test that I was like, okay, I definitely have seen, I habit it.

Yeah. And then I was aggravated, like I, it was, it was so aggravated. I was like, I can't wait for [00:58:00] the test results. I need to treat this now. Mm-hmm. Um, and I think that's important for people to understand is that this test could definitely make symptoms worse, but also that I had no symptoms. Mm-hmm. I was like, no, I have no gut symptoms.

Mm-hmm. Um, and then it turned out that it was positive. Right. So. Whether it's hydrogen or methane, what is your approach to resolving sibo? Yeah, so again, because I work in a state where I can't prescribe, unfortunately, um, I tend to work with herbal antimicrobials, whether that's burberine, oregano, uh, thyme, rosemary, different formulas of different herbals along with the low FODMAP diet, and a lot of patient education around meal hygiene.

So slowing down when you're eating, chewing your food thoroughly. Mm-hmm. Trying to get in that calm, restful state when you're eating, and also spacing out your meals. Four to five hours in between is really ideal for enhancing your gut motility as well as not eating too close to bedtime. Mm-hmm. So that's typically my approach.

And I do that anywhere from four to six weeks for one [00:59:00] round. Um, and then we kind of reassess and see how the patient is feeling. My goal for the patient is for them to be feeling 90% or better mm-hmm. At the end of the treatment. If they're not, we go ahead and do another round of the treatment. Um, another option would be something like the Elemental Diet.

So the Elemental Diet is a meal replacement, liquid only shake diet that you do and it's completely SIBO safe, a hypoallergenic, but you only drink this shake every day for two weeks on end. And, and then we kind of reassess and either repeat the SIBO test or see how you're feeling. So that elemental diet is meant to starve off any bacteria in your small intestine while feeding you and giving you the calories and nutrients that you need during that time.

And so that's typically where I start. And if patients typically don't respond to that treatment, then I'm referring them to Xifaxan or Neomycin with that. Um, luckily I do work in an integrative practice where we have prescribers on our team. Mm-hmm. So in that case, I would refer them to, to them if they're not responding to the herbal or natural treatments.

And what are you [01:00:00] using for motility support? So I'm using a combination of, uh, ginger five HTP, artichoke root. Mm-hmm. Um, so that would be, you know, there's, I don't know if I can say brands, but, um, there's like, yeah, a motility, activator, modal pro are common ones. Mm-hmm. Um, gut motivator, um, using that. Um, in severe cases, if patients actually have been diagnosed with like gastroparesis, then they have to go on a prescription.

I also, um, have been using LDN often as well with patients low dose naltrexone because it is a nice, gentle anti-inflammatory, but it's also a great gut motility agent as well. Mm-hmm. And are you leveraging the low FOD month diet at all? Yes. So we're doing a low FODMAP diet during the herbal treatment.

Mm-hmm. Not during the antibiotic treatment. So it's not necessary to do it during the antibiotic because you do want the bacteria feeding around for the, um, antibiotic to be more effective. Mm-hmm. But the herbal antimicrobials are not as strong as Xifaxan. So in that case, I do recommend low FODMAP diet.

Mm-hmm. And I [01:01:00] recommend it even after, uh, finishing the treatment. Um, I recommend it up to upwards to a month after finishing the herbal antimicrobials elemental diet or the antibiotics, because when you stop the treatment, you're feeling amazing. But right after is when you're the most vulnerable for a relapse.

You're actually most vulnerable for SIBO relapse four to six months after treating it. Um, but we don't wanna keep you on lo fodmap that long. We wanna, during that time, we wanna continue supporting your gut motility, your digestion, your eating habits, and then going in and healing your gut lining, and then reintroducing the beneficial bacteria again.

Mm-hmm. How long does it typically take for someone to heal from sibo? Uh, typically, uh, weeks to months. Mm-hmm. Yes. I've had, had chronic patients where it's been more difficult, um, and it's taken longer. It's taken up to six months. Sometimes patients don't fully heal, but they're a lot better than when they first started, and they're usually happy with that.

Mm-hmm. Um, and if they're, if they're not and they wanna keep investigating, honestly, that's when I would bring in, um, maybe a [01:02:00] parasitic cleanse, anti-parasitic cleanse, um, because it, it could be something that we're missing or that we're not detecting. Um, so yeah, weeks to months. When it comes to SIFO compared to sibo, how does the treatment approach differ?

Yes, so definitely the diet. Um, you know, it's focused on limiting processed foods, limiting sugar, refined carbs anyway, which is what we wanna be doing with Candida. Uh, I don't always have people go to strict with taking out. All sugars. Like fruits, yeah. Because then it's, it gets really, really strict and impossible to follow.

But I'm also adding in things like, um, antifungal herbs such as monolaurin or caprylic acid. Um, in some instances I'm giving them liquid nystatin, which is an antifungal. Mm-hmm. So it is a prescription, but we coordinate care with our prescribers, um, because it just works so well and it gets people feeling better, much quicker than, than some of the herbal antifungals.

What are some of the mistakes people make when they're trying to treat sifo? Eating too much sugar, not watching their [01:03:00] sugar consumption, um, not treating long enough and not taking probiotics during that time. Mm-hmm. And so, I know I mentioned that I treat both SIBO and SIFO at the same time. Uh, the probiotic that I I give is Sacro Croce Bullard because it's actually a yeast based, uh, probiotic.

So it's not likely to aggravate if you have sibo like other probiotics would. Yeah. So with, with sibo, we're not giving probiotics or prebiotics during the treatment that comes after we treat it. Yeah. And you know, for people listening, we started talking about parasite cleanses. Those are the thing that's the current trend right now.

Several years ago, it was anti candida diets. Everybody had candida. Mm-hmm. Everybody had fungal issues. That was, that was the trend in things. And, uh, you know, as we're talking about this, we're talking a lot about what does the individual have and what is the best treatment for them. And I think that's important, just to underscore and highlight here for people, is that it is possible that you have a candida.

The problem is, is there's no difference between a [01:04:00] doctor who's, like, it's IBS, it's IBS, it's IBS and everyone and the influencer that it's like, it's parasites. It's parasites, it's parasites in everyone. Mm-hmm. That's the same methodology. Mm-hmm. And that is not the bio individualized care that patients need to actually get better.

Right. So, I just, as you're saying all of this, I'm like, I just really wanna highlight that because you can have any of these things. Mm-hmm. But, uh, you know, as, and I know I've, I've, I'm older than you. Been around a lot longer than you and I just watched these trends and I'm telling you, 10 years it's gonna be, candida is back again.

Mm-hmm. Like that's, that's what people are saying again. And so it's really important to work with a provider to understand these things. Now you have been exploring peptides for gut health. Yes. And I think that's a really, in. Avenue for treatment. What are some of like the highlights of what you've been discovering in clinical care and in the research?

Yes. So, uh, peptides are basically sequences of amino [01:05:00] acids that are strung together that are meant to, uh, elicit healing. Mm-hmm. And so the one that I've been working a lot with patients, it's called BPC 1 57, and that one has been shown to actually stimulate healing and regeneration of the cells in the small intestinal lining, which actually is really great for healing leaky gut.

Mm-hmm. Um, so I give it to patients, uh, orally. Okay. Because right now I think the FDA has has done, uh, pushback on the injections of B BPC 1 57. So the oral BPC 1 57, I'm finding is really helpful. We are seeing zonulin come down and symptoms improve drastically. It is a little bit more costly because it's still, I think, something that's newer on the market.

But yeah, hopefully over time, you know, it will, it will come down a little bit. So, um, yeah, these peptides are incredible, but you wanna be careful because. Because it has the ability to regenerate the cells of the, the lining. It does so via angiogenesis. Mm-hmm. And so if you have, you know, any cancer cells or if you have a diagnosis of cancer, you wanna be [01:06:00] very careful because mm-hmm.

That can potentially increase, uh, the cancer or the spread of it. So, um, I'm, I'm very careful with who I'm giving it to. I'm doing a lot of screening with the patient, so it's not something you wanna just kind of pick up off the market and try yourself. You wanna make sure that you're doing your due diligence.

Yeah. Mm-hmm. And that goes for a lot of these peptides Sure. That are being used. I mean, I don't think peptides have really become that mainstream as of yet. Um, they show a lot of promise and you're seeing a lot of people using them in the anti-aging community. But that sometimes gets translated to like, again, it's natural, it's safe, just.

Just go for it. Mm-hmm. Like just use it. Right. Um, and I think that you're right to caution people of like proper screening. And also it's when these things are are costly, you wanna make sure that it's the right thing for you. Yeah. Yeah. And so that's just one thing that I'm using to heal the gut lining.

Other things I like. Collagen is a very, uh, mm-hmm. Effective one that a lot of people can have access to and it's generally safe. Um, [01:07:00] glutamine is also really effective. So glutamine, we normally think of taking that for our muscles for muscle recovery. Mm-hmm. But also great for, uh, it's a fuel source for the cells of the small intestine, so that one is great.

Uh, bone broth, aloe vera demulcent, herbal teas like licorice root, marshmallow root. These are all great things that help heal the gut lining as well. Yeah. Um, BPC is just one of our stronger hitters, but we are also using the other things as well. Mm-hmm. You brought up bone broth. It makes me think of histamine and everybody who, so histamine intolerance is, is a, a big topic and it is, a lot of people are impacted by it.

Not everyone. Yeah. Like the being touted online. So bone broth can be definitely a trigger for people with Sure. Histamine. Often people think like, okay, the only thing I can do is go on a low histamine diet, start restricting. But we know. Many of the histamine problems actually originate in the gut.

Totally. Can you speak to that? Yeah. And so going on a low histamine diet can help if you have histamine [01:08:00] axis in your gut. But why all of a sudden are so many people histamine intolerant or have MCAS or mast cell, um, activation syndrome? It's because of the dysbiosis we have. There are bacteria in the gut that can either directly, um, activate mast cells to secrete histamine or they themselves secrete histamine.

Mm-hmm. And so if you have an overgrowth of these bacteria, well then sure. You're gonna have histamine access. So, yeah. Um, the, the goal is not, is never, I think to restrict the diet and have that be the answer. It's to get to the root. And the root could definitely be that bacterial overgrowth. Mm-hmm.

Mm-hmm. I was recently reading a study, so for years we've heard moms say the food dies affect my children's behavior. Mm-hmm. And I was recently reading a study. Where they did genetic testing regarding genes that help with clearing histamine. Mm-hmm. Uh, because we do know so often when we talk about this food die conversation, it's again, very split of like mm-hmm.

Everybody has behavioral issues with food dies, every child will have problems or [01:09:00] nobody. Right. And it tends to be the more conventionally minded doctors who are always like in the nobody camp, they're wrong. So often, um, when they take that stance, I think about how like, right. Nobody has sibo, nobody has sifo, nobody has leaky gut.

That's not a thing. And nobody has HPA dysregulation. And then we have just like, mountains of studies down and I'm like, yeah, it's, it's always better to be like. Let's be curious. Mm-hmm. Why would a patient say this? But this study actually showed that, um, there's several food dyes, one being the red 40 everyone talks about.

Mm-hmm. That NA actually caused the immune system to release histamine. Mm-hmm. And in the population that has this genetic polymorphism mm-hmm. They're not clearing that histamine. And they did in fact see behavioral changes. Wow. And so it's even, you know, even really another point of saying what you've been saying all along of like this ultra processed food, like paying attention to that if you're someone with histamine issues, certainly if you can afford to get genetic testing and then you [01:10:00] know, like, yes, it's me.

Mm-hmm. But I think paying attention, as you were saying with food sensitivities as well. You eat something you don't feel right that might be true for you. Bring that data to a clinician who's willing to be curious and not just shut you down because they haven't happened to read the one study that is existed at this time.

That so, you know, pulled together the aggregate of other studies saying there's something to this. We need to dig deeper. Mm-hmm. Yeah. And I would say it's not just bacteria overgrowth, it could also be not enough of the good bacteria. Mm-hmm. Because the bacteria also play a role in degrading histamine, specifically bifido bacterium.

Mm-hmm. And that's the one that we see tank the most in the setting of antibiotics. Right. And so we, we live kind of in a world where antibiotics. Given pretty freely. Now you have a cold, you go in and you get an antibiotic, and so the good bacteria will suffer as a result. And then they're not around to help degrade the histamine.

And then you have the other bad bacteria that are just spewing histamine. Um, and sure some people can have an issue [01:11:00] breaking down histamine and they can take enzymes to help with that. But generally, um, that tends to be more on the rare side, it's usually more an imbalance in their microbiome. Mm-hmm.

I'm seeing. Yeah. And this is something that, um, so I've worked with a lot of PMDD patients over the years. I personally struggled with PMDD and I find so often that in addressing the gut mm-hmm. We can get symptoms better. For myself personally, I was able to resolve them all. I never like to make promises of like, we just have to fix your gut and we'll fix everything because we're complex and that's not always the case.

But it is something that as we look at more of the research coming out with some of these issues that women struggle with, we know that with neurodivergent women there could be more histamine issues. Those with PMDD, we also see it with endometriosis as well. And so I think this conversation around the gut is really important.

I would love for you to share with listeners how do you approach someone when they're dealing with histamine intolerance? Yeah, so you can temporarily go on a low histamine diet. [01:12:00] Mm-hmm. And so let's talk about what that would look like. So definitely limiting anything that's fermented, that's aged, aged cheeses or meats, anything like that.

Anything canned, honestly. And leftovers are big ones as well. Yeah. So like you're not a fan of leftovers and it's also, it's not great if you have histamine intolerance. Mm-hmm. Because the longer foods are left out, the more they tend to build up the histamine. So yeah, I think temporary low histamine diet can be helpful.

Um, obviously while you're getting to the root of that. Um, but then you can always take, uh, things to help degrade histamine a little bit more. There are enzymes specific for that. Mm-hmm. Natural antihistamines can be helpful. Things like quercetin, vitamin C, stinging nettle. So just kind of to helping your body clear the deck of any histamine as much as possible, um, would be my advice.

Yeah. And for people listening, I find with, I'm not a fan of doing low, uh, histamine diets overall, um, because I just find that. People who are struggling with histamine, they're struggling with like mood dysregulation, nervous system dysregulation. Mm-hmm. Overall, like they're, [01:13:00] it's one more thing to do, one more thing that can feel really, really overwhelming.

But I do find sometimes that. So in cases of PMDD, if we do that, if we are like, okay, not doing leftovers the week before your period. Mm-hmm. Like, we're gonna start modifying some things while we're also, you know, working on the underlying issues, bringing up the vitamin C uh, you mentioned some great.

Herbs as well. I think those drinking netty is like definitely in, we wanna be doing that. Um, but the other thing with pmm GD is actually using, uh, H one and H two. So we're gonna use something like, uh, Loraine, Claritin and yeah. Pepcid and doing that. Um, typically I'm doing Claritin like 10 milligrams twice a day and then Pepcid once a day.

Um, you always wanna check with your doctor if that's right with you Of course. Because even though these are over the counter, that doesn't mean they don't interact with other medications. They can't have side effects mm-hmm. That they're not right for you. Right. But this is where it's that integrative approach [01:14:00] of like, how do we get you feeling better as soon as possible?

Mm-hmm. And in some people though, a low histamine diet is gonna be the way to go for a period of time. Yeah. I just think that. You know, as much as, as you were saying as well, uh, you know, the, the low fat mat diet, like we just have to be cautious of like mm-hmm. Taking too much away because food, uh, I think very much within North America, people are like, food is just fuel, it's just nutrients, it's just information.

But we come from a culture where food is pleasure, food is community. Mm-hmm. Food is how you connect. And so we have to be really aware of how we're approaching these things in people because being super restrictive and robbing someone of the joy of their life is gonna cause gut dysfunction. If you're miserable every time you eat and you're like, I hate this so much, or as you said, you're afraid every time we're gonna have issues, you can literally make issues in your mind that can happen.

That is a real phenomenon. Yes. Um, I'm always cautious in saying that though, because I just. Feel like [01:15:00] some male practitioners run with that In women. Yeah. And they're just like, oh, you just, you just manifest this with your brain, like your pretty little head caused all your problems. Mm-hmm. And it's like, like it can happen.

Mm-hmm. But. I see that more as often a manifestation of influence, outside influence, teaching people to be afraid of food. Yeah, for sure. And that's why I'm not a fan of keeping patients on restrictive diets, low FODMAP diet for more than six months. Mm-hmm. That's like the absolute max. And then we take a break from treatment.

Yeah. You know, like, let's, let's chill out. Like let's take a break. Um, and I say the same thing, you know, we do wanna, I say these foods are good. Mm-hmm. They're great for our, our microbiome, our good bacteria. We've dealt with the sibo. The SIBO is gone now we wanna reintroduce the good foods that are gonna maintain the good bacteria to keep SIBO at bay.

Mm-hmm. So I try to frame it in a way that is more of a positive and we're we introducing for a reason so that patients aren't so scared and they, they see that it's necessary to bring these foods back in and not stay off them. I mean, I have patients that come in on low [01:16:00] FODMAP for years. They've gone out for years and sure enough we do a microbiome test.

Their good bacteria is nowhere to be found. Yeah. And that's what's keeping them from getting better. Mm-hmm. You mentioned the vagus nerve earlier on. What is that for people who are not familiar with it? Yeah. And why does it matter for gut health? So the vagus nerve is the 10th cranial nerve, and it's a direct communication between your brain and your gut.

Um, so actually 80% of the fibers in your vagus nerve are actually going from your gut back to your brain. Mm-hmm. So we're constantly getting signaling from our brain to our gut and our gut to our brain. That's what's responsible or comprises the gut brain access. So the vagus nerve is responsible for getting us in that rest and digest mode.

And there are ways to activate the vagus nerve, um, such as deep diaphragmatic diaphragmatic breathing. Mm-hmm. Um, humming, gargling. Singing anything that causes vibration here, because that's where the vagus nerve travels over, will help to activate that vagus nerve. And so it's good to be doing these exercises in the morning when you're getting [01:17:00] ready for work in the car, on your way to work, um, or just whenever you want.

And definitely before meals, we wanna be making sure that we're activating this nerve because it's responsible for, uh, the secretion of your digestive juices. Mm-hmm. For your saliva. Right. Your saliva actually contains enzymes that help you digest your food as well. Um, and it's also really important for peristalsis or the contractions of your esophagus, your sum, your stomach, and your small intestine.

Mm-hmm. And so we wanna be optimizing how much, uh, we're actually activating that nerve while we're eating. And thereafter, what do we know about the neurotransmitters that the gut produces? You mentioned the gut brain access. Mm-hmm. We often hear people say, your gut makes the majority of your serotonin.

Mm-hmm. So if your gut's not happy, then your brain's not gonna be happy. But what do we actually know about what's going on there with neurotransmitters? Yeah. So bacteria actually help make neurotransmitters. Mm-hmm. Not just serotonin, but think, think like GABA as well. And so if you don't have the bacteria around to help create gaba, which [01:18:00] is a neuro inhibitory neurotransmitters, so it helps, um, decrease excitatory, um, uh, neurotransmitters, which make you more anxious.

Mm-hmm. Then you're gonna probably be feeling more anxious, have trouble falling asleep. And so, um, that's, this is not a case where you would wanna just take gaba, you would wanna replete the good bacteria specific, specifically bifido bacterium. Mm-hmm. That one is my favorite guy because it plays such a role, again in the breaking down a histamine, but also in the production of gaba.

So there, it's cool because there are some probiotics that target the gut-brain axis, I believe it's called gut-brain axis, which contains predominantly bifidobacterium species to help create more of the gaba, the probiotics. Called Gut brainin access, I believe. Yeah. Yeah. I like very literal talk. Me too.

Yeah. Whenever we're like, it may, we're like formulating a new, um, supplement now. Yeah. And I'm just like, why can't we just call it focus in Mood? Yeah. And I and the team, we came up with Radiant Mind. They're like, no, it has to be something that like, people are like, oh, like it feels, uh, good, but I'm just like, just [01:19:00] like it's for focus and mood though.

Like that's what we're doing here. Right. Um, so I am like, I very much appreciate that naming invention. Mm-hmm. Do those neurotransmitters cross the blood-brain barrier though? Um, yes. So there is controversy with that. Mm-hmm. Um, does the serotonin made in your gut actually make it to your brain? I think so.

Um, again, I, I don't know exactly, but I wanna say yes because I, I, I can tell you that when my patient's gut is functioning more optimally, they're feeling better, they're less anxious, they're maybe less depressed, they have less brain fog. So my assumption is that they are, um, and same with the GABA patients, when they have optimal flora, they're feeling less anxious.

They're able to sleep. Their sleep is better. So my assumption would be, yes. Some of them are maybe not all, but Yeah. Well, and we also know that serotonin that's being produced there, that's why you use five HGP for motility. Mm-hmm. Because that helps with gut motility as well. And what I've seen, uh, in terms of the research is that it may be the neurotransmitters interfacing with the vagus nerve mm-hmm.[01:20:00] 

That actually then is helping modulate how the brain is functioning and responding. Sure, sure, sure. And we also know that, you know, there's been research to show, like when there's intestinal permeability, there can be a leakiness of the brain barrier. Mm-hmm. And then we're having the same kind of inflammatory response happening as well.

Right. Right. Yeah. And then we didn't get into Postbiotics, but I actually did a gut hormone episode and I'll link to that. And I talked a lot about postbiotics from the concept of how they impact your hormones. But let's talk about post, well first tell people what postbiotics are. Mm-hmm. And how do they actually help keep your gut healthy?

Sure. So postbiotics are substrates that are made by bacteria and they serve a roll. Um, so these postbiotics can include things like butyrate. Acetate, even bile acid. Um, things that can break down the bile acid postbiotics are substances that are made by bacteria that help actually. Um, they play a role, they play a role with our immune system, with maintaining the integrity of the gut [01:21:00] lining with feeding beneficial bacteria.

So some of these postbiotics include butyrate acetate substances that actually help break down bio acid as well, or bio acid producers. Um, so they play a really important role. So the, some of the postbiotics actually feed more of the beneficial bacteria. They play a role in regulating inflammation and also maintaining the integrity and health of your gut lining.

Mm-hmm. So as you can see, it's really important to have, um, good bacteria around and some bacteria also produce nutrients, um, predominantly vitamin K and some other B vitamins as well. How can people ensure that their gut bacteria are working for them in making this postbiotics? So you can always do testing for this.

There are special tests like the Biome FX test, which actually does test for prebiotic amounts, so you can always do a test. Um, but generally I treat the patient, not the test. So as long as they're feeling well, they're having regular bowel movements, brown forms not floating, they have good [01:22:00] energy levels, good mood, no uncomfortable symptoms, then that's, that's great.

That's good for me that those are all good signs that your gut is working, uh, optimally. Mm-hmm. Mm-hmm. And are there certain foods that people can be consuming that will help promote the post biotic production? Um, well, any fiber or prebiotic rich foods mm-hmm. Will feed the good bacteria, which will then allow them to help create, um, those substances.

But, um, I'm actually a big fan of green tea, to be honest. Green tea. Yeah. They're polyphenol and all polyphenol. Yes. And it helps actually, uh, feed bifidobacteria and other species to help produce those postbiotics. So green tea is a great one. Um, black carrot, cacao, like all the polyphenols we think of, uh, cherries, pomegranates, dragon fruit.

Mm-hmm. Um, anything that's richly pigmented. Purples, uh, reds, pinks, that sort of thing. Not red wine. Everyone. Sorry. So, uh, when it comes to fiber, what are some of your fiber rich foods that you are [01:23:00] incorporating on a daily basis? Yeah, so a variety. The key is variety and diversity in your diet. You don't wanna always be eating the same fruits and vegetables every day or every week.

You wanna change it up and it's best to eat in season when possible. But, uh, right now I'm really enjoying, um, I'm in Mexico, so I'm enjoying a lot of the fresh fruits here. The mango, the papaya, uh, kiwi, definitely fruits and berries. The tropical fruits, right. Um, and then beyond that, uh, quinoa, sweet potatoes, regular potatoes, brown rice.

So I always tell patients, try to steer clear of any white foods. 'cause they're typically void of fiber. So you wanna, maybe instead of white rice, opt for brown rice or quinoa, um, brown, yeah, any, any brown, uh, rich whole wheat is what we wanna be aiming for, for getting more fiber. Mm-hmm. Oats as well. Um.

Yeah. What are some of your favorites? So I actually, um, I have a toddler who just loves to just keep me on my toes with food. Um, but he's like a chocoholic. Mm-hmm. That kid will [01:24:00] always eat chocolate. And I made this pudding and his cottage cheese that I whipped up with, um, uh, cheese seeds in it. And then I used cacao powder, um, and like a little bit, I think I either honey or maple syrup.

Mm-hmm. And then I just put like some chocolate chips on top of it and he's been eating that. That's been like a little, like hidden fiber. Mm-hmm. Um, the other thing is that, um, he went on just like, I'm only gonna eat p butter sandwiches for, there was like a week for that. Um, and so, uh, I would grind up chia seeds, uh, a little bit of cilium husk.

I like cilium husk. I just think you shouldn't overdo cilium husk. 'cause sometimes it cannot Heavy metal contamination. Yeah. Which is like a lot of our food supply. Mm-hmm. Which is why, another reason why variety is important. So I'll mix like, uh, sometimes flax seeds in there and I mix it with like the, the peanut butter, the almond butter, whatever butter we're using.

Um, and then I will actually, uh, make like, I have to make like a little pocket sandwich, just like a whole thing. Mm-hmm. To get this kid to eat. So, um, [01:25:00] there's a lot of like stealth ways, uh, that I have been experimenting with, inputting, um, fiber into my toddler that I think also works well for people when they're like, oh, I'm having a smoothie.

Mm-hmm. Also this like, chocolate, I should write down this recipe actually. 'cause it was so good. We were, um, eating it and like the whole family was like, this is so good. I'm like, so much protein and fiber. You're like, you guys don't even know it. Mama. Got you. Again. Um, but I think like, thinking of ways that you can incorporate fiber.

Um, I'm a big fan this, like right now raspberries are in season. Mm-hmm. And artichokes. I need my protein, but I could literally just eat three artichokes for dinner and just be like, so happy. Mm-hmm. Um, that, you know, I love the idea of like pursuing what's in season and then I have this thing that I say to patients, I say to a lot of people is, uh, microdose your microbiome.

Mm-hmm. So when we have really picky eaters, or even we're the picky eater, uh, especially like a lot of the neurodivergent communities like, EW, artichokes don't wanna eat that, I don't [01:26:00] like the fill of it on my teeth. Or, you know, there's certain things that they're like, no, I'm adverse to that. I talk about microdosing your microbiome.

So if you're like a. Yuck. I don't want to eat that like mushrooms are, right? Mm-hmm. Right. Can you just have like, can you just have this much like the tip of your finger? Yeah. Can you just have that much, you can swallow it hole if you have to. Yeah. Um, if it's a ti you cut it up like super, super tiny. You just wanna swallow it hole.

But like, uh, I love this concept because your gut will see it. And we often think like, oh, if I'm going to eat chia seeds, it's gonna have to be like a tablespoon or two of chia seeds. Mm-hmm. Well, what if it's just a pinch? Yeah. Could you just do a pinch and like put a little bit in there? And so in this concept of getting variety.

Can we just do it in a way where maybe you're adverse to that food? Mm-hmm. But it's always like, the way I always gamify my brain is like, I can do anything for five minutes. I actually just said to my husband when we were picking the world's worst flights of getting up at 3:00 AM and then coming back home at 1:00 AM within two days, I'm like, [01:27:00] I can do anything for two days.

And then was complaining about it. He's like, you're the one that was okay with it. You said like, I can do anything for two days. And I was like, oh, that is something I say like, but that is something with like the approach to the microbiome, like anyone can do a pinch. Mm-hmm. Anyone can do it. Yeah. And if you give yourself that permission, it's a way to start diversifying what's coming into your microbiome.

Mm-hmm. And then start building up your tolerance to something. We all like to act like we were once toddlers, and then we're never toddlers again, but we're perpetual toddlers for life. Right? Yeah, for sure. And just like with adults, when we, when we tell them like, Hey. I like to go to markets and pick up the weirdest roots I can find where I'm like, I don't even know what this is.

Mm-hmm. I don't know what to do with it. I'm like, gonna Google it, like figure it out. Um, but you know, sometimes, you know, so with that, if I bring that home for my kids, I'm gonna have to show my youngest that like 20 times before he is gonna eat it. That might be true for you as well as an adult. Yeah.

Sometimes you just have to eat the little tiny bits at a time. Maybe you stick it in your freezer for later. Um mm-hmm. And then, you [01:28:00] know, move forward, uh, and yeah. And try to actually bring those foods in. The other thing I would say that, um, you were saying. The getting the whole grains, the high fibers.

If you are somebody who's like, especially like within the Asian community, and you're like, but I love my white rice. Mm-hmm. Put it in the fridge and eat it the next day. Yeah. We can start getting some resistant starch. Yes. So there's ways that we can also, uh, gamier our food. And the other is, you brought up butyrate.

Mm-hmm. I love ghee. I, so I feel like every time I read a study about butyrate, I'm like, we need to be cooking with ghee more. Um, so for people listening, that's a source of butyrate. You, it's the only, you're only gonna get it from dairy. Or your gut is gonna make it, but beauty rate is like such an unsung hero.

Yeah, definitely. That one is, is like fuel basically for the good bacteria. And it's also really important for, um, maintaining that integrity, right. Of the gut lining. So that one is really important and really helpful too, if you're battling with constipation. Sometimes I just get patients with a little bit of butrin [01:29:00] and, um, they're, they're more regular with that too.

Mm-hmm. So, yeah. And the anti-inflammatory effects can be really beneficial if you're somebody, I think especially in cases mm-hmm. Of like endometriosis, PCOS, um, autoimmune disease. When you, your baseline is like, we wanna be inflamed, like your immune system's. Like yeah, let's be inflamed like you're having butyrate.

Mm-hmm. Um, and it, of course, we always wanna work through the gut first when possible, but sometimes supplementation can be just really lovely for people as well. Yeah. Definitely, especially the pickier eaters. Yeah. Mm-hmm. And going back to like the microdosing of the pre and probiotics, think about when you're taking a probiotic, it's mostly bacteria, but it's in a prebiotic base, but it's a tiny, tiny amount.

Mm-hmm. And that tiny amount is, is information for the good back and feel for the good bacteria as well. So, yeah. Yeah. I don't think you have to go out, eat in like crazy amounts of prebiotics or fermented foods even. Mm-hmm. I, I can't stand fermented foods. I'm not a fan really. I'm not a fan. Not fan. I know, I know [01:30:00] I need to eat more.

Um, but I, I'd rather get my, my fiber in other ways. 'cause that's als that's good enough for me to feed my good bacteria. Yeah. Mm-hmm. Fermented pickles are always the ones I recommend when people are like, I hate fermented foods. Mm-hmm. And I'm like, most people are like, can't it? You don't like fermented pickles to there?

I can't, I, I hate the vinegar. That's what it is. Like the vinegar base. Yeah. The small amounts. Maybe we all have our thing. Yeah. Like I can't eat teriyaki or any sweet food. Mm-hmm. Um, I was out with friends recently and I don't know what they did to the steak, but it was sweet and I was like, mm-hmm. Oh, I don't, yeah.

I don't like sweet food at all. Eat food. So for you as vinegar for me it is, is like, or my yogurt too. I could do yogurt. Yeah. Yeah. There you go. You can do, uh, yogurt as well. Mm-hmm. And I think that's actually a lot of people are gonna be comforted hearing that. But that's another thing with like, um, you know, I'll have people like salmon salad.

I'm like, can you, if it's not fermented pickles, can you just do a. Pinch of like red cabbage. Mm-hmm. Um, in there, which that one tends to go over well with kids when it's like, I, my kids are really into [01:31:00] Halloween, so we're doing like spooky stuff where I'm just like, Ooh, this is like bloody guts. And they're like, Ooh, okay.

I'm going to eat these fermented beets, mom. I'm like, yeah, okay. Just don't make a mess. Mm-hmm. Um, but I think it's, it's comforting for people to hear that. 'cause there's people who don't like fermented foods. Yeah. And, um, yeah. Find what works for you, like what you can, 'cause there's so much, like there's, there's a lot of different variety and it doesn't have to be just one thing or the other, or, or all of it.

Mm-hmm. Like, pick what works for you and stick with that. Yeah. Mm-hmm. Well, this has been a wonderful conversation. Yeah. I really appreciate you taking the time to chat with us today. Of course. Thank you so much for having me on. It's been an honor. Yeah. Thank you. Thank you so much for joining the conversation.

 

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