25: Healing Your Gut with the 5R Program: A Functional Medicine Guide with Dr. Aaron & Becky Hartman

Everybody wants to go to fancy lab tests, the gold standard. However, the elimination diet is still the gold standard. What that tells me is even with all this technology, ultimately this best test tube is not outside your body, it's still inside your body. And so which people don't want to hear that. They want to find out the fancy tests they can do. Welcome back once again, everybody. We talked about your gut, we've talked about inflammation, a bunch of things the last couple episodes. So what, like, great, you've learned a lot of these cool things. How do you fix it? That's what today is going to be about. And the five hour program as a time tested true. It's actually the one of the first things I learned in functional medicine when I started my training, I don't know, over a decade ago, a long time ago. So that's what we're going to talk about today and go through that. So the goal, today's episodes, by the end of it, you'll know how for yourself. How can you start working on repairing your gut, restoring your gut at home without any fancy kind of stuff? If you want more a deeper dive into it, we have a lot of resources on our website, lots of books, actually, podcasts, blogs, as well as a whole course we've actually created on this whole topic. But the reality is 80% of this you can do at home just by following this simple 5R program. So with that, all right, so there.

Are five Rs which would be five words that start with R if I'm not mistaken. Am I correct about that?

You are correct about that, yes.

All right, R number one, remove. What are the most common irritants in the gut? And like, how do we identify them? Like, how do we.

The most common irritants are the things people eat the most of is typically gluten, dairy, soy, sugar, corn. Chemicals in our food system you can get a little more nuanced. Nuts, seeds, legumes, things like that. But if you look at the biggest food irritants in the American diet, it's going to be gluten, dairy, soy, sugar, corn, in that order. And then I like to put into that, which is a part of the whole thing, when you do a elimination diet is the chemicals and foods. For example, great example, since you asked, bread. Bread seems like a simple thing to eat, but they actually put emulsifiers in bread to make it go through the machines really easy so it doesn't stick to machines. And they put conditioners in bread so that every loaf of bread looks the exact same Right. Those things actually dissolve the mucus lying in your GI tract and increase leaky gut. So all of a sudden, removing these food chemicals that are ubiquitous in our food system will help lower inflammation in your GI tract.

That's super unfortunate. Okay, so you mentioned some things that are like food sensitivities already. What about like infections and toxins and how do those impact gut health?

So our, our gut microbiome there, and depending on what you read, you get a different number. I just finished doing a course about a week ago and got a whole different set of numbers, but I'm gonna stick with the original numbers I learned, which is you have about a hundred trillion bacteria in and on your body, which is about 10 times more cells in your body. You have about a hundred, about 10 to 20 trillion cells in your body. And these, these bacteria create chemicals, they create compounds, they create short chain fatty acids. They, they create pseudo neurotransmitters, which are things that act like neurotransmitters. But if you have healthy bacteria, you feed them healthy food, they actually will create these amazing health compounds. You have to realize that fungi and bacteria in nature break things down. They break down things that die and go in the soil. I mean, you can take a massive tree and it's gone in a couple years. You can take bones from dead animals and they're gone in a couple years. So if you get that in your gut, all of a sudden there's bad bacteria, they can do bad things to your gut. So part of the remove is not just removing inflammatory foods and chemicals, it's also removing bad bugs.

What tools can help pinpoint what needs to be removed?

Everybody wants to go to fancy lab tests, whether it's an IGG or IGE based food sensitivity test. I'm using a newer test these days, my clinic, that actually looks at all the different kind of IGG markers. There's antibody related testing. You can now do DNA testing. The gold standard, however, for figuring out this is if you go to an allergist and you've got, or if you've got EoE, which is a eosinophilic esophagitis, which is this thing where you react with foods and get reflux and swallowing difficulties. The elimination diet is still the gold standard. And when that, what that tells me is even with all this technology, ultimately the best test tube is not outside your body, it's still inside your body. And so which people don't want to hear that, they want to find out the fancy tests they can do. And when you really get into the weeds with this Dr. Vojdani, who actually discovered and developed the first IGG food testing back, like, I think it was 1984. He is so in the weeds that he's like, he has a food antibody test for cooked eggs and uncooked eggs and egg whites and egg yolks. So all of a sudden an egg, you've got five different things, and that's not counting in chemicals. And then he has sensitivity testing for heavy metals that bind to your cells and chemicals that bind to your cells. And, and so the point is that there's, there's really cool testing out there, but ultimately just removing the food is this simpler, cheaper way to do this. I know, by the way, because everybody's got different bacteria in their gut. Everybody's going to react with food differently. And so in all these tests take into account your gut microbiome, your digestive enzyme levels. If you have low stomach acid, high stomach acid, there's, there's no test that, that's gonna take all that into account. So all of a sudden, just doing a basic elimination diet is the most powerful tool. And then as you add things back in, in about three or four weeks, you can see what your immune system does, because you've given your immune system four weeks to rest, to relax you. Actually there's things called immune complexes which can overwhelm your system. And what happens over time, your immune response goes down, inflammation goes up, your immune response goes down. So you don't feel like I ate diagnostic this thing. I feel, I felt bad the next day or two there, I felt bad. You don't like eat it and feel sick. Like within five or ten minutes, that acute response goes down, but the overall inflammation goes up. When you get more these immune complexes, when you remove the food, your body will clear off. These immune complexes will remove. About the half life of these things is about 28 days. So within 28 days you'll remove over half of them. But it clears your immune system up enough so that when you reintroduce it in four weeks, bam. I ache, I hurt, I'm nauseated, I'm not sleeping well. You, you know that you're having some kind of immunologic inflammatory response to that food. And many times the gut microbiome, the bacteria gut, which are unique for you, that's 60% of what just said at birth. No test can account for that.

So when I've done elimination diets in the past, I actually, they're not fun. I wouldn't say like you're giving, you're taking things out of your diet that it's easier to eat, whether it's, it isn't necessarily cravings or that you miss stuff. It's just easier to not have restrictions around what you're eating. Like, that's just reality and that's, I think it's okay to say that. I feel like where I always struggled was the putting back in because it's like you remove it. That's not, it's not, it's simple. It's not easy, but it's simple. It's like take the food out and then you just put everything back in. Like, you're like, okay, day 29, like, I'm just gonna eat the things and yeah, can we talk about that for a second? Like, does everybody make that mistake? Like, what, what's your experience been what people think?

Well, that's the reason why I, I, we give people in our office a, a formal elimination food plan that's like 28 or 30 pages. Our connected cleanse we put together is a modified elimination diet that's available through our website. The as well it instructs you. Okay, great. Add pick your favorite food you want. What have you been missing the most? Maybe it's your milk, maybe it's your cheese, maybe it's your, your eggs for breakfast in the morning. You put that thing in first and you eat it daily for three days and see what happens. And then if you have no response, you go to the next thing. And there's also gradations within elimination diet because if you have more aches and pains and more pain, ish, joint issues, you also remove add to a typical elimination diet, removing nightshades, which are like peppers and tomatoes and potatoes. If you have a lot of like reactivities, sinus allergic kind of stuff, or even food sensitivities which could be related to histamines. You, you remove foods that are high in histamine. So there's different gradations in that as well. And the most significant elimination diet is autoimmune Paleo, which is geared towards people with autoimmune diseases. But we're just focusing on the basic elimination diet here. But you want just add one thing in at a time. Give it three days. If you just throw everything back in, then you will not feel good. You'll probably feel really miserable and feel defeated because you'll be like, that was all for nothing. I didn't figure anything out. This is supposed, this is whenever you do anything, you always, it's Always good to journal because ultimately this is this discovery. What is your body doing? How's your body responding to stuff? And if you don't do it in a. In a measured, gradable, measurable, checkable fashion, then you won't really learn anything from the experience. Besides, you felt better on the elimination diet. And the goal is to find out what foods you're reacting with and what you react with this season. This time of year might not be what you react with a different size season of the year next year. That's something else to keep in mind.

Interesting. Okay, so the second R is we've removed and now we're talking about replacing, which isn't putting the foods back in. It's actually like addressing things like digestive factors like digestive enzymes. How important or why is it important to like, add. Replace those, like, put those in?

Well, part of what happens when your gut's inflamed and you have a lot of bad bacteria growing and inflammation is it blunts your. Your body's response to food. So you. About 20, 20, 25% of all digestive enzymes of pancreas juice stuff comes out just from smelling food. You sit down at the table, give thanks, smell the. Whatever you're smelling that smells yummy, and you're already releasing digestive enzymes. If you have a state of inflammation or stress or whatever, you're not releasing that. So all of a sudden, your digestion is being impacted just by eating quickly, just by not enjoying the moment. And so one of the ways we can, we can fix that is by give you digestive enzymes directly, like pancreas enzymes, which is the, the most basic one that we've used for decades, going back into the 1930s and 40s, actually in Germany, they were using organ extracts. Actually in the 30s and 40s, things they've been doing in Switzerland and France, they've been using bitters for, I don't know, maybe thousands of years, I don't know, a long time. And those are things. They can be turmeric extracts. They can be like the bitter things. They're bitter and you can get tinctures of those. Those will actually activate dandelion extract. Those things actually activate your liver to make bile and release bile. That helps with digestion. And so if you have digestive issues, gas and bloating with eating, part of that could be overgrowth of bacteria, which actually can be abated simply by removing inflammatory foods. And then if you're not making enough digestive enzymes, just putting something in, and I really like bitters because they're. Again, back to the herb thing we talked about an episode or two ago where we talked about how herbs are just amazing because they're anti inflammatory, they help with, with micro, with biofilms. They also have chemicals that feed healthy bacteria. All of a sudden bitters are doing all of that. And they're actually relatively inexpensive. And there's some really good manufacturers that make really good, I kind of like guy herbs and herb pharma, two good manufacturers, make really good extracts and do a really good job of it. And all of a sudden you're helping your gut digest better, you're addressing some inflammation and you're helping with things like biofilms. If you don't know what biofilms are. Every chronic infection lives in a biofilm, which is the analogy I give patients. If you leave a wash rag in your kitchen and it sits around for like a week, it gets kind of slimy. That's a biofilm. And anywhere you have bacteria living and surviving, they're living in this biofilm environment. And there's good biofilms and bad biofilms. And so unfortunately, when you get, your gut gets messed up, you're. It's riddled with these bad biofilms. And again, herbs are a great way to address those.

What about supplements like hydrochloric acid, bile salts, like, what role do those have in this replacing stage? Or like, is that, are those things that you recommend?

Like, how do you definitely recommend those in the right situation? So let's start with hydrochloric acid. Usually use a thing called betaine hydrochloride. I like to do some. A lot of people have this thing called hypochlorohydria, which is you just don't make enough stomach acid. And, and those people you kind of know, you eat a meal and you get bloated within like 30 minutes of eating a meal. And that's because stuff is in your stomach, it's not digesting and you get kind of bloated versus getting bloated like the two hours later tends to be more related to pancreatic stuff or bacteria stuff a little downstream. So. Or when people eat a meal and they say like, particularly women will be like, hey, I feel like I'm pregnant. It's like, hmm, you probably have low stomach acid potentially. And there's a thing called a betane hydrochloride challenge test where you just take these basically acid capsules and you slowly increase that one at a time until you get a little bit of heartburn with whatever you're eating. And I've had patients take 10, 12, 13 of those capsules before they get heartburn. And it's like, whoa, like you, you're not making any stomach acid. There's another test, which is a bicarb test. We take baking soda and swallow it. And you measure how long it takes for you to burp. And if you're mixed acid and bicarb, it fizzes up. Well, if you swallow, doesn't fizz up and you're not burping in 30 seconds, if it takes 2 minutes, 3 minutes, 5 minutes, then you, you probably don't have any acid in your stomach. And all of a sudden, for those people taking betaine is super important for bile salts and bile. It's, that's a really. I love bile acids because they have so many health benefits. There's all this literature on tadka and ursodiol helping with nerve function as neural anti inflammatories. But, but some people, because of the gut microbiome, the bacteria can't tolerate those. So you gotta be careful with that. In general, I like them, but I do have a significant number of patients who, when they take ox bile or tudka, more ox bile than tudka, strange enough, don't, don't do as well with it. But that's a, it's a pretty inexpensive supplement. It's fairly safe. And then pancreatic enzymes and, and there are, there are kind of catchalls that are like a little bit of pancreatic enzyme, a little bit of ox bile and a little bit of betaine. They're kind of like a shotgun approach. But that's sometimes where, you know, if you're not quite sure and you can't figure it out, sometimes I'm doing like a gut test to look at pancreas enzyme levels. It can be helpful to find out if your pancreas is secreting enough. And then the betaine. There are more advanced tests like a Heidelberg capsule test, which here in central Virginia, Richmond. I don't know of anybody doing that test. You have to go to, like, Hopkins to get it done. So I tend not to even mess with ordering that because people aren't going to drive two hours away to get that test done when they can just do a simpler test.

So I don't want to go too far down any rabbit trails. But I am kind of curious why so many people would have low stomach acid. Like, do we know what that's about? Like, what's going on there?

That's a great Great question. The digestive enzymes and stuff that are secreted in your GI tract is controlled by your autonomic nervous system. And so if you're in a chronic state of stress, poor sleep, you've got trauma in your life, which, depending on what number you read, 20, 25% of women have had some kind of bad thing happen to them. 10% of men have in the childhood. All of a sudden we. The pandemic life. All of a sudden we've got high cortisol, which is going to suppress all this whole. This whole process. And also sibo, small intestinal bacterial overgrowth and dysbiosis have been associated. Actually, it's one interesting. One of my patients is a vet, and in their world, they have this syndrome that's well known of low stomach acid. Built the b. The gallbladder, not working with sibo. And it's funny, when I learned that, I started looking for it in patients, and it's like, how many patients have gut issues whose gallbladder is not working, who've had it taken out before it's not working, who have low stomach acid? And the answer is a lot. I've never read that in the human literature. I'm not sure if the literature is out there in humans, but it's in the vet world. And so it just makes me wonder how many people feel low stomach acid has actually been driven, being driven by bad bacteria in your gut.

All right, the third R is re. Inoculate. So then we're beginning to talk about putting things in back in. So, like, we've heard about probiotics, and prebiotics are getting talked about more. How do they work to rebuild a healthy microbiome? And then another word that's coming up more and more recently is postbiotics. I feel like even at Target now you can go and there's things like talking about postbiotics.

So, like, at Target, really?

Yeah. Some of the supplements are getting popular everywhere.

It's a big business.

So how do those work to rebuild a healthy microbiome?

So there's pre, pro and postbiotics. So the prebiotics are fiber. Prebiotics are the food that bacteria need. So that's the reason why you said you mentioned before you love fiber. Fiber is great. Or you couldn't get enough fiber. Fiber is the new superfood. It's just amazing how just getting adequate fiber in your diet in countries, like in population, sub Saharan African populations consume 80 to 100, which these numbers are crazy grams of fiber a day. They have no autoimmune diseases, almost no heart disease and cancer. Now we're realizing that all the things your gut makes, you have to have the, the fuel. And that is fibers, healthy, real fiber. And there's soluble and insoluble, which I don't want to get in the weeds with that. But that's the prebiotic, the probiotic. Well, great, you got, you got the fuel, but you need the bacteria. So probiotics are the bacteria, the beneficial bacteria, which you can get those from fermented foods, the acidic flavor, and I'll get to that in a second. So you get that through fermented foods. Whether it's fermented vegetables, sauerkraut, kimchi, pickled onions, kvass, which is a fermented beet, fermented like yogurt, kefir lassa, which is a Indian fermented dairy. These are all sources, historically used sources of healthy bacteria. These, the ideal thing would be to consume fermented food with every meal, which they kind of do that actually in South Korea. But for many Americans, that's just not doable or it's hard whatnot. So that's where probiotics come into play, because you can get those healthy bacteria not in the same diversity as you get them in a fermented food, but something's better than nothing, right? And then the postbiocs of this brand new world that has just literally come on the scene the last three or four years, it's come to public consciousness in the last year. And these are all the things that the bacteria make in your, your gut. When you feed the bacteria in your gut healthy fiber or whatever they're eating. And this also includes these polyphenols, which are those colors we talked about an episode or two ago. They create all the stuff. They create vitamins, B vitamins, they create short chain fatty acids, butyrate, acetate, propionic acid. We now know these short chain fatty acids actually repair leaky gut, repair leaky brain. They're actually neuroprotective against toxins to your brain. When people talk about ketogenic diets and all the benefits from like ketosis and stuff like that, literally the fermentation, you're making these short chain fatty acids, butyrate. Beta hydroxybutyrate is a ketone that's made in ketosis. Well, butyric acid is also made by bacteria in your gut fermenting. So all of a sudden now your, your gut is as metabolically active as your liver. If I took your liver out, you would be dead in A week. The micro in animal models, we know that if you sterilize the gut and mice models, for example, they'll get all kinds of weird autoimmune issues and cancers and stuff. And now we're just learning that the bacteria in our gut are a metabolic powerhouse. And you need healthy bacteria making all these postbiotic short chain fatty acids. There's one interesting study that was looking at fecal fecal microbial transplants or stool transplants, which are something new happening now. And it was actually looking at that some way they were able to filter out the bacteria from the stool transplant. Only we're left with these postbiotic things. And they had the same outcomes in stool transplants as those who had stool transplants with the bacteria. So the question is, whoa, whoa, whoa. Is, are the bacteria the magic sauce or is it the cell walls of the bacteria break down that modulate our immune system, which is how mushrooms work? Is it all the chemicals they're making that actually have positive impact on our metabolism? So that's a little bit probably more than you're looking for. But that's like some of the magic that happens your gut with fermented foods and pro box and all kind of stuff.

So is. Is it like, just take probiotics and you're good to go? Like, what's the difference between doing that and actually reinoculating your gut?

Well, the idea is to take something that will reinoculate your gut and people will go right to probiotics as the way to do that. But the thing with probiotics is if you stop taking them, they will just pass through. And so. And that's one of the tricks is how to keep on doing that. Fermented foods are a great way to do it to re. Not get your gut as well, because they're coming with fermented foods, come with the. There's some pre box stuff still left there. They've got the bacteria and they got the postbios. And so kraut shots. We've been learning about the. The juice from sauerkraut has a lot of glutamine. Glutamine helps repair leaky gut. So the reinoculation thing is, I hear what you're saying. It's. It's a. Something you got to keep on doing on a daily basis. It's not just you take a pro box for a couple weeks to stop. Fermented foods are the better way to do it. Per box are the easier way to do it.

Okay, you started to talk a little bit about some of the things in the next section, which is repair, which. So what nutrients are most effective in repairing the gut lining? So like glutamine, zinc, collagen, what is most effective for. To repair the gut lining? We talked about glutamine already, but.

Well, glutamine's like the most important one. Consuming from three to five grams up to three times, three to four times a day. It actually helps repair the leaky gut. Zinc carnosine, which actually over in Europe is a medication to treat reflux the Z. Carnosine. Carnosine is an amino acid. It's actually a chelate form of zinc. And zinc actually helps barriers, whether it's skin, face, mouth, gut to repair. So you've got your glutamine, zinc, carnosine, and then you have a bunch of these things called demulcents, which are things that help with that, that, that, that slimy, mucusy kind of biofilm layer. This actually comes in some of the renoculation. You have to have really good mucus and so things like aloe vera, things like marshmallow root, deglycerized licorice. These are all things that are great for actually that, that gut lining. So again, when you're looking at the gut, the three things healing the, the skin, the lining that's broken down, the glutamine, helping the tight junctions come together, which are the stickiness of the cells, which is using carnosine. And then that healthy mucus layer are your demulcents, which are things like deglycerized licorice, aloe, marshmallow root, things like that.

So this might be a little bit of overlap, but are there specific diets or I guess foods that help accelerate the repair phase? You mentioned fermented foods. Already have.

Fermented foods are great.

Pretty.

If I was to pick two foods, postbiotic fermented foods and bone broth. Bone broth is. There's so many superfoods, it's another powerhouse. Bone broth. It's like it's an extract, a bone extract that has collagen, it has these rare earth minerals. There's so many things that are required for connective tissue to be formed. And your entire gut is a big connective tissue tube. So collagen collagen has become really popular using different kind of collagen supplement products. But if you want the kind of collagen that's going to help with your gut and come along with all these trace minerals, then bone broth is your thing you want to do. So if I was to pick two super foods that would go along with this diet wise to help prepare your gut. It's going to be feminine foods and bone broth.

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Okay, and then finally, we have rebalance. So how do lifestyle factors fit into all of this, like sleep, stress, exercise, and movement? How do those things, like, support gut health?

So, you know, whenever you talk about something like your hormones or your thyroid or your gut, none of these exist by themselves in solidarity. It's the whole system. Like, without. It's like a female comes in and like, I think I. Thyroid issues is like, well, you're okay, but you also have ovaries. You also have an adrenal gland. You're making hormones in your gut. You have to look at the entire, entire picture. And that's the same thing with using lifestyle rebalance. Sleep is when your body heals. Sleep is when your neurotransmitters, again, of which you have just as many, most neurotransmitters actually are being made in your GI tract when you have as many neurons in your gut, it's called the enteric nervous system, as your spinal cord. So when the nerve cells take the trash out when you're in deep sleep. So if you're not getting deep sleep, then guess what? You're not getting the maximum amount of clearance repair. There's a cell cycle that happens when you sleep where your. Your cells go through this. They've been working all day, and they relax, they kind of recycle themselves, take the trash out. And if you're not getting quality sleep, that's not going to happen. You're a level up on the food chain. Your autonomic nervous system that I mentioned before rebalances itself into a rest and digest parasympathetic state. You need that for sleep. Less sleep is directly correlated with an increased level of cortisol and, and cortisol by itself being high can cause leaky gut. You know when I was early on in my training it was a common thing. People get stress ulcers for just being from hospitalized. You're sick, you're, you're in the ICU unit. People just get stress ulcers because being sick in the hospital means you're usually really really stressed. And so we prophylactically give them medications to stop stress ulcers. If you don't deal with your cortisol throughout the day with appropriate sleep self regulatory processes, you will get the gut all over again. And this high cortisol also affects the bacteria that grow in your gut. So you're in a high cortisol state which is drives people towards insulin resistance. You'll get more yeast, you'll get more strep, you'll get more staph growing in your GI tract. So all of a sudden if you're not getting adequate sleep, if you're not working on some kind of self regulatory practice to lower your cortisol levels, what was the other one that will, that your gut will go back to the way it was. Exercise is interesting. Anybody who has a pet. Our, our, our beloved Griff is. It's been very quiet sitting here while we're talking back and forth. He's been really good actually. You let your dog outside, what do they do? They run around circles. They have bowel movement like humans we, we need movement for our bowels to work appropriately. And so if you're sitting all day long and not moving, you know it's going to affect how things go through your bowels. And an interesting thing is that actually this is thing called the minderic motor complex which is a muscle contraction that goes all the way down your GI tract that works best and actually clears out dead cells. It actually removes bad bacteria. It moves the best and swiftest on times when your gut's not full of food and with move with physical activity. So all of a sudden physical activity and having times when you're not eating which goes like interval fasting stuff, those small things can massive impact on maintaining the gains you've gotten with this whole five hour program.

Do you have any stories of someone who has like followed this type of program and had like a big exciting outcome from it.

So exciting outcome. I had, I saw one patient eight or 10 years ago. This is when I was still doing. I was still working in the primary care office. So I was trying. I was straddling the world of primary care and functional medicine. He came to see me and he had inflammatory bowel disease and he couldn't afford a lot of supplements. He was like a local, local pastor at a church. Couldn't afford supplements, couldn't afford a lot of stuff. And his, his bowel function like natively impacted him being inflammatory bowel disease. I think it ulcerative colitis. I can't remember if it was ulcer Crohn's. And he did like a more, more severe elimination diet which is that he actually did. He didn't do a fodmaps, he did autoimmune paleo diet and literally all the symptoms went away. Just the diet alone, without doing the advanced testing, without doing a GI mapper, GI effects or CDSA or whatever fancy testing I was doing at that point in time, just simply by eating real food and removing fake stuff, Aluminum, Paleo. He saw massive improvement. I have another patient who I've been working with for years, still working with now, who with inflammatory bowel disease as well, significant disease. And he was, at one point in time he was actually on I believe Remicade, which is a biologic pretty hard, pretty big, big medication. And he's been off of that now for maybe two or three years. He's controlling it almost entirely with diet. So everybody wants the fancy new supplement, the new, what's the newest, greatest pro pre postbiotic ldn, which I use lots of that as well. It's a great, great thing. But ultimately food is your biggest leverage. You can use, you can literally use food like a drug.

What's the biggest, what would you say is the biggest misconception people have about fixing their gut health?

Well, maybe I would say that maybe the mix biggest misconception is they're already eating a good diet. Like I'm already doing this, I've already removed this. I'm already eating. I've tried that, I've tried that before. I've done that. And then it's like you see them eating their snack wells or whatever the, the, the, the health snack thing is and it's like, are you really eating real food? Have you really removed everything that can cause issues? I had one patient, one time. This is actually, this is interesting story. I have no idea how she figured this out. Again, this Mom's doing primary care still and she had really bad asthma, horrible asthma. And so I gave her a try elimination diet. And I don't know how she did this, but she figured out that cucumbers were her trigger. I don't know how she did it, but removed it, got off all her inhalers. So yeah, really, really intriguing.

I didn't even know cucumbers were one of the things you have to remove out of elimination.

I don't know how she figured that one out. That was just. That was. Maybe she listens to her body. I don't know.

Are there like simple actionable steps like anyone who's listening could do immediately? You've kind of mentioned some things, but let's just cover it again so. Because it's always good to hear things more than once. Yeah.

Simple steps would be remove the big three gluten, dairy, soy, and add on the infamous fourth, which is removing sugar. If you can do that, I feel like that's achievable to most people. The next thing is look at your lifestyle. Are you getting adequate sleep when you eat? Are you chewing 20 to 30 times? I mean that sounds really basic, but so many people just chew a couple times a swallow. Are you having a moment before you eat? Are you just looking at your food and being thankful, being grateful for the fact that wow, I live in an amazing place where I can actually have three meals a day when most of the world. That's not still not reality. Being grateful, eating with that, that state of mind affects your whole entire digestive process. So remove the b. The infamous three plus the fourth, gluten, dairy, soy, sugar, the way in which you eat, accurate sleep and then just stress reduction, which can be something simple as breath work. Like if you do those things, probably 70 ish percent of people will know significant changes in their gut health just from that. And then you can start adding on other cool fancy things. Cool. Testing supplements, supports.

What are the best resources to guide someone through this program?

We actually put the whole entire. A whole thing called the connective Cleanse, which is, is us trying to make this whole thing actionable and achievable to people. So I, I'm. Do I. Sorry. Yes, we, we've done that lots of things but. And it's us kind of guiding people through this process with supports. There's a little small quiz that walk people through and you can help figure out do you have gut, immune, brain kind of issues, whatnot's going on. But that's something we put together to make this Accessible, achievable and actionable for people. Because if it's not accessible, people aren't going to do it if you don't give them achievable goals. You don't start off with a, with a fodmaps diet or a MAPS diet or a album Paleo diet. That's not achievable for the vast majority of people. If you can do something achievable, actionable, achievable and most other available like we put that data for people, so that's available on our website and probably will be wherever this is posted in the notes below or something like that.

I have a little insider knowledge here, so I'm also going to ask you. So you mentioned figuring out which system is out of balance. That sounds like it goes a little beyond the scope of elimination diet. Is that accurate like it is?

Yeah. So, yeah, there's different systems in our body. There's our, our survival hormone system and our sex hormone system. The survival hormone system is your cortisol, thyroid and insulin. Your sex hormone is estrogen, progesterone, testosterone. There's your gut immune brain system, which is how your gut interacts with the immune system in your brain. Trying to figure out an easier name for the other system. The, the system three, it's cardiopulmonary, neurovascular. It's basically your heart, your, your heart, brain vascular system. And then the fourth, the fourth system is your detoxification system. So what we do is kind of walk people through because some people will be like your gut, gut, gut, gut, gut, gut. Right. Some people will be like your gut cortisol detox. And so we kind of give people a test or quiz to take that kind of walks them through what systems are off and then they can focus on. Why would you want to focus on your. This happens with a lot of women particularly. They're like, oh, my hormones are off. Gotta fix my hormones. And it's like you're 30, you're 28, you're, you're, you're not even your hormones are. What's off is not. You know, unless you have some weird autoimmune issue. It's actually probably your, your adrenal glands off, it's your thyroids off, it's you have insulin resistance, it's your guts a wreck or you're toxic. A lot, a lot of young ladies don't realize that all these chemicals in our environment are neuroendocrine disruptors. They're chemicals that act like estrogen, that mess your system up. And so the fix is not giving a 20 or 30 year old estrogen. And even if their testosterone or progesterone are low, which unfortunately is happening more these days, the fix for them might not be to give them testosterone and progesterone, it might be to use progesterone activating herbs. Sure, in orals like evening primrose, oral testosterone activating herbs, but more importantly, which system is off? Because if you address that, all of a sudden your body wants to do what it's made to do, wants to self heal and self repair. And so if you can just remove the roadblocks in your body's natural healing process and get what's lacking, it just will do what it's made to do. And the younger you are, the more prone it is to do that. When you get older is when you're like if you're 60, you know what, your body's not really making as much hormones anymore. So yeah, probably hormones are on the docket at some point in time after we've done this. And so the systems analysis allows you to figure out which, which is your major leverage, leverage point. And if you get the major leverage points and if you buy enough, enough margin, it'll actually take care of the rest for you.

Very cool. So can you wrap up like a summary of the 5r?

So the 5r is remove, remove inflammatory toxic foods. Replace what you're lacking, typically with some kind of herbal potential. Enzymes reinoculate, give your body healthy bacteria so your gut can do what it's made to do. Rebalance, repulse, repair, repair, repair. I love bone broth for this, I love fermented foods for this. Those are super easy things to do. And then rebalance is like life is stressful. The world's a crazy place if you're not in balance at home, if you're fighting with your spouse, you're fighting with your kids. If you, if you're, if you're don't like your job, you're not sleeping well, if you don't have a sense of meaning and purpose in life, it's gonna affect your entire physiology. So the rebalance is, it could be simply find your meaning and purpose in life. But if you walk through these, it's amazing what your body will do. And the younger you are. I've had many, many patients with inflammatory bowel disease, teenage, early 20s who've walked through this with some supports and their, their disease have gone remission. So your body has this amazing capability. The older you get, the more support you need, but it's really kind of cool what the body does when you kind of let it do what it was made to do.

Awesome. Thank you.

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