The Gut Health Revolution: Mental Health, Immunity, and Disease Prevention with Dr. Bishara

Welcome back everybody. Once again, I'm super excited to have a colleague, Christine Bishara. She is a physician up in New York area and we're going to talk about a lot of great things, including your gut microbiome. Some interesting things she's learned as well as a book of hers coming out. So after our introduction, we'll dive right into the conversation. Christine Peschara is the founder from Within Medical. It's a medical wellness practice that places emphasis on the mind, body and the gut brain access to prevent and manage disease. And all my people are very, very familiar with those, those key aspects. She has over 20 years of clinical experience and time and time again Dr. Bashar has discovered that the connection between these systems plays a significant role in disease prevention and management if it's not adequately addressed. She's also the author of the book the Gut Revolution, which explores the relationship between gut health and overall health, including mental health. Dr. Bashar, I'm super excited to have you here for our conversation.

I've been looking forward to it because I know we're very similarly aligned with, with our philosophies even though we're traditionally trained. So it'll be really, really looking forward to this too.

Yeah. One thing I do, I first was introduced to you during the pandemic because I was on social, talking about stuff. I was actually involved with the COVID in many, many different ways. But you actually had an article that came out talking about Bifidobacter and some bacteria related to Covid and the labs. We'll get in that a little later on. But that was when I first was introduced to you and your work. But why don't you walk us through your personal story, your journey. How'd you go? How did you get into medicine? What got you there? What was your process? And how did you get to where you're at today, which is off the beaten path? How does someone arrive where you're at from a document?

Yeah, it's interesting because I think we all become passionate about subjects that we've either had personal experience with or a family member that's had experience, experience. So that's my belief anyway. So for me it was an obese, obese teenager just struggling to lose weight, struggling to be accepted. And it was just trial and error of different things that I tried nutrition wise. And what worked for me was something that kind of ignited this passion. And then when I went to medical school, studying all those biochemical pathways and understanding what was going on in my body when I lost the weight made me Even more passionate to really help others understand. Because I think so many people see the body as complex. And while it is complex, I also think it's very simple. And healing, it is also much simpler than we've been told. So that's my passion, that's my goal in life, is to really teach people about how their body works and letting them understand that, yes, this is a process, but it's actually a lot simpler than you think it is.

Understood. Yeah. Now, as far as your journey to where you're at today, you know, during the pandemic, et cetera, what was the most challenging part of your transition from a traditional, you know, mainstream physician? I'm traditionally trained, you know, at the Medical College of Virginia. You know, how do you go from doing what the standard of care and what you read in your journal articles to actually thinking outside the box and expanding your knowledge? It's really just expanding your knowledge base and practicing not just evidence based medicine, but the most up to date medicine that is based on evidence. How do you. What was that most. The most difficult part of that journey?

Yeah, it's interesting because as you are, we are traditionally trained. And as much as I wanted to teach my patients about nutrition and I worked in traditional medicine for over 20 years, we never have enough time, Right. To discuss with them nutrition and all of that. And so that was always something on the back burner. And then during the pandemic, it was odd because it was kind of literally thrown in my lap. And I think if it wasn't for my passion for nutrition, my interest for understanding how the body heals, I probably wouldn't have published the research that we did. But it was really from the fact that my husband, who works in critical care, kind of was seeing all these patients with COVID really sick patients. They weren't the typical ICU patients that we were seeing on a regular basis. They were patients who were younger than the typical ICU patients, but also just a BMI that was high, no comorbid conditions. So it started kind of getting me to wonder what's going on with certain individuals where they're at such high risk of developing severity of COVID And this is where we kind of stumbled into looking at the gut and it was looking at children, comparing children and why they weren't really getting sick to others. And I guess my love of the gut kind of gave me this inkling that the answer might be in the gut. And so this is where we started doing research. And it kind of every. Like every time we would research Something which would fall into our lap. That led us to bifidobacterium as the probable cause for protection in children because they have so much of it and the probable cause of severity in adults that did poorly with COVID because they're deficient in it. So, yeah, it's all based on just this series of events that happened to just fall in my lap during the pandemic. And the odd thing is, a lot of us, our offices were shut down, so we had more work to. More time, I mean, to do. To do research, because I'm not a researcher. It was my first and only study. But yeah, it's an interesting situation that happened. So.

And that was interesting because my. We. We actually, our. My previous office I was at, we were open seven days a week and we actually never closed throughout the pandemic. So we were open the entire time. And so one of our goals was to keep people out of the hospital and out of the er. That was one of our things. And it was just interesting to see how that was navigated by bigger systems. And I was a little frustrated. It took us two weeks to transition to doing virtual visits. And then by. By the time we got done, I looked around. It almost took two months for the local hospitals and healthcare system to actually be doing the same thing that as a small clinic, it took us two weeks to figure out. So it was a very interesting time for development for a lot of doctors and practitioners.

Did you have a certain protocol that you were using early on that you felt was effective with your.

Well, early on, before we actually had stuff published for Covid is like, look back at the past. We knew stuff about MERS. We knew stuff about SARS, COV1. We had data about that. We also had data about other viruses that are similar, other coronaviruses. And that was where all the vitamin D stuff came into play. There was some gut microbiome stuff in there. I was actually. I actually published in a trial in Atlanta back in 2012 using an anti parasitic for. As an antiviral. And it actually was sponsored by the nih, strangely enough. And so that was. So I knew then that there were anti parasitics that actually had antiviral activity against Hep C, hep B, a whole host of things. So it was one of those things, you know, first and foremost, do no harm, you know. But what could be helpful, you know, in the integrative world. We've been using hydroxychloroquine for Lyme patients as well in the rheumatologic world. For people with mixed connective tissue disorders. So it wasn't a big jump to say, hey, viruses cause immune dysregulation. All the vitamin C literature, the zinc literature, um, I've been seeing mast cell activation patients for years. And so there's a lot of stuff with that. So some of the initial stuff was just what worked with old things. Let's try these. And then, you know, nac and there's a whole host of things. But then as we started getting stuff published, you know, this, the study comes out of Spain. You know, they're using IV vitamin D in this hospital. It's 80 patients, no one dies, right? You're like, oh cool, what are they using? 150,000 units. Oh, wow. Let me push the, push the border a little bit. So all of a sudden as stuff was coming out, so it was informed by history, but as, as data started coming out and I was like, okay, cool, I'm already doing that. I'm already doing that. Well, I'm not doing methylene blue, I'm not doing led, ldn. So all of a sudden you start filling in some of the gaps. But I think that's where, because I was already kind of in the world, it wasn't a big jump to start integrating new stuff. And that was where I think a lot of physicians were stuck because they were not in that world. And so like vitamin D, what it's like, I mean, yeah, that's like you.

And I know that. And it's interesting that you mentioned hydroxychloroquine because when we were researching bifidobacterium, you know, with COVID causing just a hyper immune and inflammatory response, one of the main inflammatory modulators being interleukin 6. And I remember when we were doing research on our study, we came across hydroxychloroquine and how it lowers Interleukin 6. So we were like, okay, maybe this is how it works. But then interestingly enough, a GI doctor who actually does a lot of work on the microbiome, Dr. Sabine Hazen, I don't know if you know her, she published a study on ivermectin's mechanism of action because again, it's an anti parasitic, as you mentioned, they do have antiviral properties. But interestingly enough, she found that it actually increases bifidobacterium levels as one of its mechanisms of action. So it's kind of an indirect thing with the gut. But yeah, it's interesting that you say that about vitamin D. I mean, again, I think we were both immersed in the natural world prior to this, so we had a little bit of an inkling. But yeah, it was, it was hard getting it to mainstream doctors. And I think a lot of people were starting to question my, I guess my, my research and just kind of call me a quack or whatever, but it's all right.

Well, it's kind of interesting because back in 2007 when I joined my previous practice, I was already checking D levels back then, and one of the older physicians in the practice was like, oh, that's just the newest fad. That'll go away. And when we transitioned to electronic medical record in 2012, so I could actually go back and see people's D levels go up over years. So some of my patients, it took them with seven or eight years to get them in above 50. Well, as you know, if your vitamin D level is over 50, you have like less than a 0.005% chance of dying from COVID And I had the fortune none of my patients actually passed away from it. Personal patients. And so my question, the kind of joke kind of story is was I prepping my patients over the last five to 10 years, getting their D levels up, getting them on some probiotics, was I prepping them for this? You know, and that's, I think in the integrative world, we're all the gut. Brain access is always a big part of your entire immune system. Which kind of goes to my first question actually here. Can you explain the fundamental connection between gut health and overall health? Because that's a part of your book and that's a part of Bifidobacterium. What's the connection between our gut and our brain, our immune system? Viral infections. Is this WHO E medicine or is this actually a tradition that goes back 4,000 years ago?

Right. And I say this all the time. I think they knew medicine better than we do now thousands of years ago, because they probably didn't have an overload of information. Right. And so, yes, we have these trillions of organisms, as you already know, living inside of us that modulate our immune system. Some are good, some are bad. And we know that some of the good ones actually regulate a lot of important immune pathways. So some are regulating a lot of anti inflammatory pathways and decreasing inflammation, and some are modulating things that are helping us make neurotransmitters. And unfortunately, as a result of the diets that we're consuming, we're losing a lot of these beneficial bacteria in our gut. And this is where the Harmful ones start to take over and then they cause havoc. So my goal is to really teach people that you do have these things inside of you. They're controlling a lot of what's going on with your brain, a lot of what's going on within your immune system. And they eat so certain things they like to eat certain things that we might not necessarily like to eat, but we kind of have to feed them what they like. And I say feed them a lot of what they like and a little bit of what you like. But that's exactly what's going on, is you have, for example, acetylcholine, which is a neurotransmitter that helps with the speed of neuronal activity in our brain. So impulses that travel need acetylcholine as part of the impulse and the speed of which they travel. But choline, which is part of that acetylcholine molecule, is made from a fatty membrane. It's a fatty membrane. We need certain foods to help us make enough choline. And if we're not eating certain foods, then we're going to start becoming deficient in acetylcholine. And the signs of deficiency of acetylcholine are the opposite of its function. So if you're making enough acetylcholine, you're, you know, your brain's functioning well, you're thinking well, you're on your feet, you're, you're a quick thinker. If you're not, you're going to start experiencing symptoms like brain fog, just memory loss, a lot of this. And we have all these neurotransmitters that we're making. And a lot of them come from precursors of food that we eat. Some of them have to come from food like tryptophan, which makes serotonin. We can't even make tryptophan in our body. We actually have to eat it and certain foods to get it. So I tell people that yes, you are eating for you, but you're actually eating more for them. And they like vegetables, they like plant based fibers. That's what they feed on. And so it's okay to eat what you like, but really feed them first.

I think it's really interesting you mentioned choline acetylcholine. I love phosphatidylcholine. I use it so much in my practice. And it's interesting how it through activating acetylcholine actually increases parasympathetic nervous system activation. It's also interesting how phosphatidylcholine is like the primary phospholipid in our biofilms, in our gut, mucus. And so all of a sudden, if you have inadequate amounts of that, you're not just impacting nervous system stuff, you're actually affecting biofilms, which are a big, big thing. People don't even think about biofilms in your GI tract, in your mouth, your skin, how those play a role, and not just the population of your GI tract, but also they serve as a space between your gut and your lining, and actually almost like an insulator, but they also trap healthy bacteria in there. So it's really interesting how something like choline phosphatidylcholine does a single thing, does so many different things.

Right. And that's the amazing thing about our bodies are little things like that, like vitamin D again, or phosphatidylcholine or tryptophan. So many little things that work so well if we're eating foods that enrich them. But, yeah, unfortunately, the diets that we're eating nowadays is not really helping that. And that's where I think. That's where I think we really need to make the change. Right. Where people understand it is that you're eating foods that actually are killing off these guys that are helping make things for you, so you have to really enrich them. And you're right about biofilm. I think it's a huge. Plays a huge role in inflammation and starts in the mouth.

Yeah. So one. One thing you'd mentioned before, mood, et cetera, et cetera. I know when I got coveted, I got horrible anxiety for about six weeks and took me about six weeks to kind of break that. How. How does the gut health? What's the role with that, with cognition, mood, emotions, that kind of stuff? Because you kind of alluded to it with tryptophan, basically. How does. Can you get a little deeper with, like, pseudo neurotransmitters? Neurotransmitters. How is the GI tract actually impact your emotions, your mood, cognition, thinking, things like that.

You know, we have the communication system right, between the gut and the brain. They're constantly communicating through the vagus nerve. And they've done studies on this where they've taken mice and they've severed the connection between the gut and the brain, but not the brain to the gut. And when they did that, so they cut the connection between what the gut sends to the brain. They found that a lot of these mice stopped experiencing anxiety, which is interesting. Right. So a lot of times you have this alarm system in your gut that kind of alerts your brain. That's one thing. But then again, we go back to neurotransmitters and we talk about so many of them. We already discussed acetylcholine, which helps with speed of neurons. But then, you know, another one is serotonin. If you're not eating enough tryptophan, it's a precursor of serotonin, you're not going to make it, and then you're not going to have your mood as uplifted as it should. Tryptophan also helps with melatonin. So if you're not eating enough tryptophan, you're going to have difficulty with falling asleep. Another one is gaba, which is our calming and relaxing neurotransmitter. And that one requires the production of based on foods rich in glutamic acid. So if you're not eating foods rich in glutamic acid, guess what? You're not going to be able to make enough gaba and you're going to start feeling symptoms of and anxiety and just not yourself. And we don't know, right? We're just eating whatever we find. And we're not realizing that there are certain foods that we need to eat to enrich all of the production of these. So it's really an intricate system between the foods that we eat and the anxiety prevention and depression that so many of us have right now. And unfortunately, that's what's going on with so many of us. We're giving these medications, right, to help keep serotonin around longer, but we're then causing a negative feedback to our body. So it's not going to produce enough serotonin because we're taking medications that keep it around longer. Right. So it's always like that with everything in medicine. If you give something to your body that prohibits the production of it, but keeps whatever it is that you want around longer by taking medication that prevents the breakdown, your body's going to say, well, I don't really need to make as much. So I'm not going to make as much because it's staying around longer. And that's where we get into these problems long term, I think.

Yeah. And I deal with a lot of people with chronic health issues. And it's amazing how many of those people, when they get on SSRIs, like, you know, Prozac, Solo, Paxil, whatnot, that they're so hard to get off, there's a significant serotonin withdrawal syndrome and that's not really talked about a lot that actually you can give you all these weird symptoms. Buzzing, tingling, electrical zap feelings. Unfortunately, the people I deal with a lot of sick chronically ill patients and they're more susceptible to that. And something that's not talked about, like, oh, you can get off it whenever you want. It's like, well, actually some of these individuals, that's really hard. And you have to wean people like ridiculously slow. And it's. I had some people to stop a cold turkey and have the whole underlying illness just flare because they were just doing that too quickly. So that's one interesting thing. Now, as far as the weight loss stuff you'd mentioned with Bifidobacterium, could you talk to us a little bit like GLP1? GLP1s are all the rage right now. Right. Glucagon, like peptide, you know, and it's interesting how certain probiotics like Akkermans and Mucinophylla actually increase your GI tract, making your own GLP1. So could you talk about Probox and the role and actually making our body make this thing that we're now into ourselves?

Exactly. So Akkermansia is great, but I think there can be too much of a good thing. So I'm not crazy about single strain Akkermansia for prolonged periods, but they do produce these postbiotics, which you probably know. Butyrate is a big one, like propionate acetate, which also work on glucose control. Butyrate is a really big one that's been studied and they call it a postbiotic because it's a, it's what bifidobacteria makes and Akkermansia make. And butyrate actually affects those GLP receptors that a lot of people are utilizing with the injectables. So GLPs help to suppress the appetite. They also help to slow down the motility in the GI tract. And so you're not as hungry because the food's not passing through as quickly. But when you feed your good guys vegetables full of inulin and resistant starch, which are fibers present in these vegetables that we can't digest, but they can, they produce the same products, which is butyrate. And butyrate works on those GLP receptors. Butyrate also works on pyy, which is a pathway system that affects our brain directly, our satiety center. So not only are they affecting the GLPs, but they're also affecting this, this system, this pathway that goes to our brains to signify that we're full. So I say when they're full, you'll feel full too. So yes, we have these natural ozempic effects in our body, but we don't need enough food to feed those guys to make enough of those products to cause that food feedback loop.

So yeah, well there's the fiber numbers are kind of mind boggling. And when you read literature you get numbers that vary a little bit, but the average American eats like 12 grams of fiber a day, some ridiculously small amount and yet we need like 40 to 60 grams a day. It's just kind amazing how much. And then there's cultures in Africa where they're eating 80 to 100 grams a day, you know, so what do you, what do you think? Like what's, what's too much fiber? Because I personally supplement, I eat food, I'm like barely squeaking out 40 to 50 grams a day, like, you know.

Yeah, well, I mean you mentioned the African tribes. You're talking about the Hadza tribe. Do you know them?

That's one of them. Yeah.

They have no access to any medical care at all. I mean they're like a hunter, gatherer tribe. And we should really look at Africa as a great example of the fact that you don't need all these high tech and, you know, amazing things to be healthy. The Hadza tribe is a perfect example. The continent of Africa, and I say this sub Saharan Africa, excluding South Africa, but that part of Africa has the lowest colon cancer incidence, has the lowest IBD incidence. And so you have to wonder what's going on with them. Number one, they are eating a lot of tuber fibers, literally eating enough fiber to prevent colon cancer. But I think another big factor is vitamin D. They have the sun, right, and they're exposed to vitamin D. So they have a lot less vitamin D deficiency than we do in terms of fiber. I mean this is part of why I wrote the book because I wanted people to understand. Like, yes, everybody knows we're supposed to eat a lot of vegetables, right? But my intention in the book was to really allow you to the reader to visualize, to have this mental picture of what's going on inside your gut. And you literally have these guys working really hard and they're feeding and they're working and making these products and if you're not feeding them properly, they're just not going to be able to make the products that we need. And so, yeah, I mean you don't need that much fiber. Some people do, it depends. But I think 40 to 50 is a really good meeting point. And I tell my patients all the time, just start slow. I mean you can't go from zero to 360. Right. So if you're eating, you know, one fruit or vegetable a day, work up to two and then three and then slowly increase because yeah, I think your body also needs time to adjust. Right. So I meet everybody where they are. You can't expect someone who's not eating any vegetables to go to seven servings. So. And I even, I mean I'm my own pilot case study because I over the past few years have mentally in my head kind of imagine what's going on in my gut and whenever I'm tempted to eat something that's probably not so good. And I'm not saying I'm a perfect eater, but I do have this mental picture where I say, you know what, no, I need to feed them first and then I'll have whatever I want after. And then you're usually full. Believe it or not, when you eat all that plant based fiber, you're like, okay, I'm not really interested in other stuff anymore.

So. Yeah, yeah, it's really, really interesting the, the concept, what you mentioned about like sub Saharan Africa. Like, you know, if you're familiar with the Nigerian paradox where it's a whole country that has tons of people with APOE 4, which is the gene associated with heart disease and dementia and they have no increased risk in that whole population. It just makes you wonder what are they doing there that's so radically different that literally the gene for Alzheimer's and inflammation is not expressed in that population. And I remember reading this one article one time about kids in, in Africa and I was saying like in the summertime their vitamin D levels get up to 300. It just made me kind of think like, okay, is why are we freaking out when someone comes in the d level of 120.

Yeah.

Or 100. You know, obviously you want to watch calciums and make sure we don't, you know, suppress PTHs and give people hypercalcemia and kidney stones and stuff. But I feel like maybe, just maybe you know, being happy with 30 or 40, these numbers are way too, way too low for an essential hormone that modulates actually controls our body. The transition from the innate to the adaptive immune system of making antibodies. If your D level is low, you're going to be sluggish. Making antibodies to fight off a new how many.

If you were to kind of just quantify percentage how much of your patients that are coming in to see you like new patients would you say just on a first time checking their vitamin D are low? I, I find it's extremely high.

I must say there are some that's. Nor actually the only person it's going, I'm going to say 90 because it's really high. The only person I've checked, a person of skin of color or a person I've checked off the bat not supplementing with a normal D level was actually my son and he's got brown skin. And it's funny because I was like, why is like he doesn't take any supplements? Like why is his D level amazing? Right? And I was thinking about a little bit and my brain pulled this article up that I was reading one time talking about how fats sebum in your skin are important part of the whole when the radiation hits your skin that are needed to make vitamin D. And if you wash, you strip off that sebum with soaps, you actually greatly limit your skin's ability to make vitamin D. And I'm like, my son takes a shower like once every week. He's better now. He's 13. He's better now. He's better now. But when I did this on him like a year and a half ago, he literally would shower a couple times a month. And it's kind of like, you know. I know, I know that's an anecdotal, but made me think, huh, I got an example of someone who knows not.

Okay, let me ask another question. Does he spend a lot of time in outdoors or do you travel to warm climates?

He said he's outside all the time. Yeah, we're on a farm out here and we have a farm outside. We have cows and stuff. And so he's outside in the summertime, he just goes out there and he's outside all the time and gets a really beautiful chocolate tan.

Case studies, right?

It would be, it's really. I mean he's taking showers most days now, so it's kind of, you know, but, but just one of those things where, you know, something as basic as how we clean ourselves can affect because there's literature on that, how you know, the orals in your skin are necessary for the UV radiation hit that get a conformational change, yada yada, yad. And it's really interesting how everything works magically together in a very symphony.

And you're saying this and I'm thinking about babies when they're born and we bathe them immediately. And now studies are showing that maybe we should delay their baths for 24 hours because they have all these amazing bacteria and organisms from mom's vaginal tract that they are baptized with, and they're actually good for them. So, you know, that might be something that we really need to kind of work on, is really. I think we're a country of like, too, too good of hygiene where maybe we need to. And maybe we need to work on not being so clean. Right.

Well, the skin microbiome just. There's a gut microbiome, there's a dental microbiome, there's a skin microbiome, there's a science. There's a vaginal microbiome. Like, my medical college actually was part of the human microbiome. And they're genetically mapping the female vaginal microbiome. But they were like, we're given that part. And so it's. It's interesting how the different composition of sebum hair, sun exposure, moisture, it changes the microbiome in different parts of your body. And, you know, having, you know, your staph in your nose actually is. Is a common colonizer, but you don't want too much staph worse in your skin because you get boils. Right. It's interesting how something that is good in one location you put somewhere else, and it causes problems. And so it's really kind of. It's miraculously complex.

Yeah. And that goes kind of towards the gut, too. Like Akkermansia, like, a little bit is good, but obviously, like a severe deficiency is not good. A little amount is good, and too much is not good either. And then the same goes for fusobacterium, which we've seen high levels of, can increase risk of colon cancer, but small amounts are actually okay. So there's such a fine line. I want to go back to the vitamin D for a second because I wanted to ask your opinion on this. So I've read studies that African Americans living in, or anyone really with dark skin living in colder climates actually are not able to absorb vitamin D. Well, and so that might be another reason why we see vitamin D deficiency and maybe increase colon cancer risk in patients who are darker living in colder climates, like the US for example. Have you seen that at all or heard of that study?

I've never heard that one particular one, Rob. Read more. Is talking about, you know, the, the like, for example, United States, if you live north of Atlanta, you don't make vitamin D in your. In your skin in the wintertime. And so this is this aspect of. Of like, you know, up north, there's Just less sun exposure. Also us. Also certain populations of people with white skin actually have a gene defect that actually it's a filagrant gene mutation, and it sets you up for eczema and warmer environments. But actually at northern environments, you actually make vitamin D easier in your skin. So there's so many different factors that kind of play into it, you know? Yeah, I read this one article, actually. I was talking about the black skin versus white skin. And it showed if you gave it the same amount of sun exposure, you didn't see a significant difference in vitamin D and that particular one off study. So it's kind of hard to place it. I just know my population. I feel like everybody's got, you know.

Yeah. And where are you?

Okay, I'm in Richmond.

You're kind of not super warm, but not super cold either. Yeah, yeah. And New York, literally, I would say nine out of 10 people that are not supplementing are deficient, so.

Yeah, absolutely. Yeah. Now, I want to say a little riff on one thing you mentioned about butyrate, about the postbiotics. You know, I love food, and. And I. Let's talk about spices a little bit after this because, you know, I love spices, but it's really interesting how, you know, you eat fiber, it may butyrate in your gut, but then butyrate, interesting enough, actually protects white matter in your brain against endotoxins. And so one of the issues with leaky gut and kids with autism is they actually get white matter edema driven by endotoxins. And there's a spice that has this thing called desmos, oxy curcumin, turmeric, that actually acts like butyrate in the brain to protect the brain from endotoxins. And so all of a sudden, now something in certain cultures where they use lots of spices, they see lower incidence of Alzheimer's, for example, and things like that. Could you talk to us about spices and their impact on.

Yeah, I mean, I don't know as much about spices specifically on butyrate, but we do know that curcumin, the. The potent derivative of turmeric can decrease inflammation everywhere, not even just our brain. I mean, people use it for their joints. It's really good. But I think the bottom line, if we want to just simplify everything, is. Is really the core of all this, is to diminish inflammation. Right. And you said endotoxins that are being deposited in the brain, but where are they coming? They're coming from the gut. They're being transported from the inflammation in the gut traveling systemically, depositing in the brain. And we see this with Alzheimer's, right? The amyloid plaques that are significant for Alzheimer's and prevent the, the neuronal communication systems from working as well. They are now seeing that they come from an inflammation in the gut that travels. Right. So I think the bottom line is really prevent the inflammation. And I think preventing the inflammation is kind of going back to eating the way our ancestors ate, which is not completely high fat, high protein, which, you know. Yes, a lot of people are into keto and I love ketosis, but I think a very high carnivore diet is probably better than their current processed diet. But it's not necessarily what our ancestors ate. People think like that's all they date, like they hunted all day and that's what they ate. But they didn't, right? They, they mainly ate plants. I mean they weren't hunting and catching every single day and eating it. They were hunting periodically and eating that catch periodically. So I think we really kind of just need to go back to the core. There are a few spices and herbs that are really good that we know. Saffron is another one that has a lot of anti inflammatory benefits. Even foods like honey, right? Honey has antiviral, antibacterial, anti inflammatory. And honey never, I didn't even know this until recently. Honey never expires, it never goes bad. Which is crazy if you think about it, right?

So yeah, when I was in, I was at a mission hospital in Honduras and we had a lot of diabetics down there. One person actually came in with a really bad diabetic foot ulcer and down there it's like you cut stuff off, you know. And we actually used honey on the diabetic wound as an antimicrobial. It actually kept it from getting infected. It was such an amazing medicinal that was used locally down there. Like yeah, here, here we would have actually amputated some of these extremities and people come in, they put honey on. They'd actually, if they had, if they had actually worms in the dead tissue, they just leave it alone and they'd remove the dead tissue, then put honey on. So it's interesting how, and here these are people that we were 100 have amputated these people's extremities and down there, because they didn't have access to simple surgery, they're actually getting better outcomes using, you know, natural stuff. And now we're actually, you know, there's, you can get medicinal worms now you're actually using and honey for stuff. It's just not commonly used.

It's like necessity is a mother of invention. Right? Like, you need this treatment, but you don't have the option, so you kind of have to use what you have. Another one that. I'm Egyptian, and I remember when I was younger, I would see, like, people put Betadine or like a lugal ziodine on everything, like wounds. And iodine is another one that's really important and an amazing healer and antibacterial. But, yeah, I think we need to really go back to the root. We as. We as Americans are just, I guess, been told that quick fixes are the easy. Are the easy thing, and we really need to go back to root cause. Right. This root.

Root, yeah. So can you share a couple examples of some patients that you've worked with? Like, they can't come in with xyz, some basic interventions you've done with them and how, like, you know, maybe a case example of someone and how you used food like a drug, how you worked on their gut and how they.

You know, I've got a couple. I'll tell you this one, which is interesting since you were talking about the. The vaginal flora. I had a patient that had. She was getting these recurrent yeast infections, and she was. She didn't live in New York, so I saw her for, like, a telehealth visit outside of New York. So she had her own primary, and the primary kept giving her antifungals. And then we did a gut analysis, and she was very low in lactobacillus. And we know that lactobacillus is a common vaginal floor. And when you're low in it, you're. You're more likely to get opportunistic infections with yeast infections. So we started this diet where she was eating. She got her own yogurt machine. She was making yogurt, and she was starting to eat a lot of yogurt. And she said, you know, I'm not really having these issues anymore. It's completely resolved. And that's a perfect example of how the body heals on its own. We just have to learn a little bit of what's going on. But that's one. I mean, there's so many others. I had another teenager that had all this acne. He was bodybuilding, and he was taking whey protein because he wanted to build. And whey is okay. It's good. It helps to increase glutathione levels. But too much of it causes acne in certain people. And we couldn't pinpoint it for a long time. He was doing everything, and then finally he's like, oh, you know, I'm using whey protein. And I'm like, oh, that might be it. So we stopped that. And then his acne improved. So that. Those are a couple of examples. Or like, another patient that I had who had a family history of Crohn's, and she was starting to develop symptoms of IBD but hadn't yet gotten a colonoscopy. And. And then I put her on the. Have you heard of the specific carbohydrate diet at all? Yeah, yeah, I put her on that. She was a vegan. And she's like, no, I can't do this. This is completely the opposite. I'm like, well, what vegan are you eating? What kind of vegan? I'm like, unfortunately, this might not be good for you. And I'm not saying vegan is bad for everybody, but for her, it just wasn't working. And so she went on the specific carbohydrate diet, and within two months, she's like, this is unbelievable. I feel so much better. I've never felt better. Better. So those are just a few examples of, you know, how holistic measures really can impact our health.

Yeah, yeah. Unfortunately, you know, I've seen a lot of previous vegans come in to see me with chronic health issues, and it just seems like, at least in America, vegan means you eat a lot of processed rice products and other really horrible food products, and it just, you know, maybe. Maybe. Maybe there's some way you can do it healthy. But I just. In my clinic, when someone comes in, they tell me they're vegan. It's like, you ask them what they're eating, it's like lots of Ross Cakes, lots of processed grains, and they usually don't get enough protein. And, you know, and women, we're learning now, women need way more protein than we've been recommending for the last 20, 30 years just for hormone balance.

It's like, yeah, no, I agree with you. I'm not opposed to vegan. I think. I would say 10% of vegans are doing it right, where they're really eating nutritiously and they know to prevent certain vitamin deficiencies, which can happen. But like you said, I think the majority of people who go vegan don't really do it properly. And I think all the processed foods and the increase in the rice and refined carbs is not really helping them. So.

So in your book, the Gut Revolution, could you walk us through, like, what's. What's the basic outline of the approach you kind of put out in your book as far as, hey, I want to maximize my health. I've got, you know, well, inflammation. But I feel like we're all inflamed these days. Right. What's. How would you feel to, like, you know, simplify that down? How would you. How would you describe your basic.

Yeah, I mean, and this is kind of just based on practicing medicine and knowing how people respond. First you have to convince somebody, Right. That they need to change. And the only way to convince people is to really educate them. And so I think this is what my goal was with the book is. I start off simply just explaining what's actually going on in your gut. And then I have, like, that's the first chapter. I go into real basics. And then we build upon that by explaining the immune system also in a simplified manner so that people can understand. And then we build on it. So then I have each chapter on different things of how the gut affects people, our body. We have a covet chapter, which we talked about a little bit, but then we have another chapter on the gut and weight, the gut and your brain. And I think when people finish reading the book, they realize, wow, the gut really is the source of all evil or all pleasure. Right. Because there's so many things that are linked to the gut. So that was my. My intention is to really teach people and to have such a vivid mental image of what's going on inside you that you want to improve your health. Because we can talk all day, and if they're not convinced by what's going on, they're not going to change. So it's really about just building that mental picture where you can visualize what's going on and really work on that.

Yeah, I mean, I've read different articles about things, and it's like 80% of chronic health problems in our country today can be directly attributed eating processed foods. And so just telling people, like, just eat real food. What does that look like for you? In New York vs California vs Texas? It looks radically different. But just people finding what they can do, what they can afford. But also just when you have a choice, make it real, don't make it processed. Ultra processed. It's just amazing to think that 80% of what we deal with in our clinics is related.

It's so true. And most people don't even realize that the food that they're eating is fake. They think they're eating healthy. They don't realize, oh, I have a bowl of cereal every morning.

It's Raisin Bran. It's really good for me. I had one patient. I had one patient who was giving her. Her child Cheerios, right? Cheerios. And the child had some autistic and sensory issues. The. The kid's urinary glyphosate level was off the charts.

And.

And glyphosate just totally messes up our gut microbiome. There's all kinds of bad things, and it was just from something healthy like Cheerios. And so it's. To your point. She was doing something she thought was healthy. Her kid had a problem. She was smart enough to figure some things out. And it's just like. It's almost, like, scary how easy it is to try to do healthy stuff, and you're actually not.

That's a perfect example. Cereal. Cereal has been. We've been lied to. We've been told that cereal is healthy first thing in the morning. And it's just, you're starting your. Your day off with a sugary, horrible food that has so much glyphosate in it. And, you know, people. People who eat strictly organic even have glyphosate in their urine. So can you imagine people who don't. It's. It's. It's. It's a really. It's an epidemic, and we need to really focus on whole foods. And I think we're starting to wake up, or maybe just you and I are immersed in that community and we think. But I really do feel like we're at least starting to wake up a little bit, or people are starting to realize that they need to eat a little bit. Help.

I mean, it took us.

Me.

How long did it take for us to accept the fact that smoking was bad for us? Right? I mean, that was. It was like 50 ish years. Right? 7000 research articles before the surgeon general said smoking causes lung cancer. And so, you know, it's one of those things. We're fighting against advertising, we're fighting against tv, we're fighting against social media. We're fighting against, you know, all these healthy things. And it's like really, education, you know, getting. Putting good information out there, giving people the opportunity to learn. And then people, you know, have to realize, hey, why. Why is it that my kids are chronically ill? We adopt all of our kids. I tell my patients a story. We adopt all of our kids. They all came from crazy situations. Oldest one was actually exposed to crystal meth their entire pregnancy. Okay, so these are pretty crazy situations. And she's never had a cavity in her life. She's 18 now, she's at antibox once in her life. Mother two have never had antibiotics in her life. And it's like, I can't say they came from amazing. Like we got them. My son, we got him, he had horrible eczema and asthma when he was eight months old and now he doesn't. And it's the, we did a lot of things, we changed and got them, we did a lot of stuff. But one of the biggest interventions was clean food, clean air, clean environment, you know, and just letting our kids bodies do what they're made to do, which is self heal and self repair. And it's a crazy, crazy powerful tool. If people just treat it like a drug and treat their environment and the air they breathe and the food they eat and even the people they surround themselves with like this, is this helping.

My health or my. I think my kids may be the same. I think they've gone antibiotics once. They're all, you know, 18 and above now. But I remember when they were younger everyone was like all the other kids their age were getting ear infections all the time. And I don't think, I don't think one of my kids ever got an ear infection when they were younger. And I really do think it had to do with the diet that they were eating. And it is again, it's just the simple things that, that we need to teach. First we need to teach and then once we learn, we implement. But we can't implement without teaching. So that has to be that middle ground that we need to deal with. And again, this is really why I wrote the book is just to teach, but also to teach in a simplified manner because nobody wants the doctor talking to them complex terms and they're like, I don't know what you're talking about.

So Christina, people want to learn more about you, more about what you're doing. How can people learn more about you? Your book you mentioned a couple times, you know, tell us how to. If people want to learn more about you, where your book is, where can they.

Yeah, the book is the Gut Revolution. It's on Amazon and as you and I I think are connected on Instagram. I have an Instagram which is a hustle on its own, right, Just to post. I try to post educational videos. So those are the two main things. They can go to my website too from withinmedical.com but I really, you know, I try to make as much of the information accessible to people so that they're able to really learn for free. Because we need to. We need to really start healing. Thank you for having me too.

Yeah. Great. Well, this conversation was great. Really enjoyed talking with you. Your book is out. I, you know, we follow each other on Instagram as well, so there's a lot of great information out there. And hope this information was helpful to everybody and we'll be sending out some information as well. People want to follow all this stuff.

Thank you so much.

Take care.