Brain Fog, Bloating, & Microbiome Health: Evidence-Based Fixes with Dr. Will Bulsiewicz

Doctor Will Bolshowitz, we are going to dive into all things gut health today. You are an award winning gastroenterologist. You have studied at impressive places like Vanderbilt, Georgetown, Northwestern, unc. You're a New York Times bestselling author of Fiber Fueleds, and you've published more than 25 peer reviewed papers. So I would love for you to help us by understanding what is the gut microbiome. Why are you so passionate about it? And why do you feel like it is the epicenter of our health?

The gut microbiome is transforming medicine as we speak. And this was something that when I went through medical school 20 years ago, we knew nothing about this because we frankly didn't have the laboratory technology or honestly the computer power in order to study it. There's so much information that exists within our gut microbiome. What is it? This is a part of our body that involves microscopic bacteria and fungi. And they're, they're just everywhere. They cover us from the head of the top of our head to the tip of our toes, but they're most concentrated within the large intestine, our colon. And we call that the gut microbiome. And Bridget, to contextualize this, we believe that in the gut microbiome there are 38 trillion living microorganisms. They're not a part of our body and they actually outnumber our human cells. So we have about 30 trillion human cells. So without a doubt, we are less than 50% human. And they are not just passersby. They're not just hanging out. They are there with a purpose.

They're running the show.

In many ways, I think in many ways they are. I mean, I don't want to go so far as to make the claim that we're just zombies marching around doing the orders of our bacterial overlords. But they are, they, they have a lot of power. And it's a power that influences our physiology. And we classically think of them with digestion. That's why I became interested in them as a gastroenterologist. But that path, once you start walking down that path, you discover the connections between the gut microbiome and our metabolism and our immune system, which is inflammation and our hormones and our mood and our brain health and even the way in which we express our genetic code. And these microbes are playing a role. So I have just listed things and it may take a second to process all of that. And what I would say is take a step back and consider that from my perspective as a medical doctor, I have just told you that these microbes are connected to everything that matters for human health, and that's why they're the Epia center for Human Health.

I love that explanation. Also, I could not agree more. I feel like, literally it was like 2015 that I was lecturing to different physician groups at the Cleveland Clinic saying, like, once you understand the full capabilities of the gut microbiome, you will no longer be able to ignore the role of nutrition because of how much, I mean, would you say that nutrition is the most important determinant of our overall gut health?

Yes. And in fact, the. It's so, it's so cool that you were making that argument to the Cleveland Clinic because I at the same time was talking to the leaders of inflammatory bowel disease research who even they, Bridget, didn't believe that nutrition really matters. Even they felt, hey, just take your medicine. Which I don't buy that argument. And I would say to them, do you believe that the gut microbiome is a role of inflammatory. Has a role in the development of inflammatory bowel disease? I knew what they were going to say, because inflammatory bowel disease, ulcerative colitis, and Crohn's disease, those are literally diseases of the gut microbiome. They're not even autoimmune, they're microbiome based diseases. So I knew that they would agree and they would say yes. And then I could say to them, well, if you believe that, then you have to believe in nutrition.

So I feel like of all of the professions, of course, you know, physicians as a whole, it can be very frustrating when nutrition is ignored or denied as far as the importance of it. But I feel like of all of these specialist groups that gastroenterologists are particularly frustrating because of the upright denial that they have around nutrition like we have. So I couldn't even start to tell you all the stories that I have of people that have gone to their doctor, even like one in particular that has so many financial resources, she has Crohn's disease. She has gone to like 10 of the leading gastroenterologists in the entire United States and then is like, should I go gluten free? Should I do this? Should I eat? You know, should I change my diet in any way? And she's like, every single one of them said, no, just continue like injecting yourself every. I don't know the exact frequency of the protocol. And she's like, then within 30 days of changing my diet, after a decade of going to all these doctors, like, so many of my symptoms improved. Why do you think it is that that happens so frequently to people or that that is like so much still the mainstream thought within the field, specifically of gastroenterology?

You know, there's a lot to unpack here. And let me start with some defensive doctors because I do believe that, like, let me say this, people who have gone to medical school in the United States, they could have been investment bankers. Like with total clarity, they could have been investment bankers. So if their total focus was making money, they should have done that. And I want to believe that with few exceptions. Of course there's exceptions to everything, but with few exceptions, I want to believe that these are people that had such commitment to the purpose of wanting to help others and the compassion for others, it led them into medicine. The problem is that you ultimately end up on the front lines of a war that's happening in healthcare and you have no control over the system. That is forcing you into a position that you're uncomfortable with. Right? Which is that every single year they tell us medical doctors that they're going to pay us less. The cost of living is going up. Your employees deserve a raise. They need that in order to maintain with the cost of living. The cost of your rent goes up, the cost of your equipment and your medical devices and your tools goes up, but they pay you less. So a doctor is forced into a position of spending less time because you have no choice in order to make the same margins. And we can unpack that further, but I think that we have to start by acknowledging that the challenges that exist within a system where doctors can be very well intended and they're just not able to provide care in the way that they want to. And when we take what used to be a 30 minute visit and we distill it down to 10 minutes because we have to see three times as many patients in order to reach the same end point that we were reaching 20 years ago. When you get to that place of 10 minutes, you don't have time for nutrition anymore. So it's a very inconvenient thing. And now should a doctor say nutrition has nothing to do with it? No, that is not the right way to handle that. We need to teach and empower our medical doctors to handle that conversation in a better way. And to me, it would be like building a team where you essentially have a registered dietitian or a person that you trust as your team member and partner who is the expert when it comes to these things, that knows things that you don't know as a medical doctor. Like you. And we refer that patient to that person and we allow that person to like, basically pass the baton and take it from there. But I think that the crux of it is that doctors haven't been taught in medical school about the importance of nutrition. I could tell you how much I had in my medical education at Georgetown. It's a great school. I got two weeks in four years.

And in the two weeks, explain the type of nutrition training you got. Like, what they were teaching.

Yeah. What they were teaching was not how do you talk to a patient who has like even basic questions about nutrition. What they taught was, if you have a vitamin B6 deficiency, what are the manifestations? Tell me the five manifestations of a vitamin B6 deficiency. And it's like, that's so meaningless from a practical perspective. You're just like testing my ability to memorize something and it has no relevance to my ability to later on sit in a clinic with a patient and give them good nutrition advice. So we don't have it as a part of our education. There's no such thing as a drug rep who comes in the door to educate doctors. They're educating on drugs, they're not educating on nutrition. It's not a powerful part of the meetings that we attend, because those meetings are sponsored by drug companies.

Right. There's no money in the nutrition.

There's nothing there. And if you make the choice, because I have made the choice. So I made the choice going back to roughly 2014, that to me, the delivery of healthcare is about the patient and ultimately guiding them to great outcomes. And when I discovered in my own personal health journey that nutrition was essential, that lifestyle elements were essential, once I had that light bulb moment that I wasn't provided as a part of all of my education at Georgetown, Northwestern, unc, et cetera, I had no choice.

But why do other doctors. I know that there's a huge movement, so I'm not trying to make blanket statements and saying that this is the case for all doctors. It just still is so pervasive and stories and that I'm hearing from friends and family members and personal experiences and of the, you know, thousands of people that have come into our nutrition programs that it's like, it's still so pervasive. So like you said, doctors are so smart. So how is it that these light bulb moments are not happening? When you see, let's say, you know, 50 patients within two day period of time, and you're hearing from at least 10 of the 50, like, oh, I made these changes to my diet and it actually helped my symptoms. Like, for me as a clinician, I feel like I've become a better clinician by listening to what has worked for other people. Where I'm like, oh, okay, maybe what we thought was true about this, you know, like, way of thinking that every single person needs to have three cups of dairy a day. Like, maybe that actually isn't true. If it's not working for you, why do you think that doesn't happen to everyone?

Because they don't have time to breathe. I think, like, honestly, I think that they don't have time to breathe, they don't have time to think, and they don't have time to educate themselves on things. I had to do crazy things in order to put myself into a position to learn about everything that we're discussing today. Because I had to basically work 80 to 100 hours a week and then still have the enthusiasm and motivation that at 9 o' clock at night, after I put my kids to sleep, I'm staying up late to read papers and study.

And so what sparks that curiosity for you? Can you think of a defining moment that you were like, oh, this is why I need to spend so much extra time, like, learning about this?

I think there's a couple of different elements that for me, create that. So part of it is that I think that I'm here on this planet to be a medical doctor. Like, I think that's like, embedded in my soul. And I've felt that way for a very long time. And I now find myself doing things that are a little bit outside the box of the traditional role. And that's okay because it's the exact same mission, which is to impact people and improve their lives. So I think it starts, it starts with that I'm a goal oriented person. I've always been that way. You can go to other. You can ask my unc, who knew me when I was a child, whether he thought that I would be a goal oriented person as an adult. He will tell you the answer is yes. He tells it to me all the time. And I think that the last thing is that I had an experience myself where, like, I started, you know, in 2012, I was in the midst of a health crisis and I felt miserable and horrible and there were so many facets of my life that were dark and needed to be lifted up. And in that moment where I'm the one who needed the help, did I reach for prescriptions? No. Did I want traditional healthcare deployed the way that, like, I had been Trained myself to administer? No, I sought other answers because I actually, in myself, wanted to understand and address the root of the issue. And it led me down a path where I tried different things and ultimately stumbled into nutrition and, like, frankly, started with smoothies, and it changed my life. And when that happens, because of the first two things that I told you about, particularly the element of, like, I can't change the fact that this is who I am. I'm a medical doctor, and I want to help people. Then when I discovered that, it set off this wild fire inside of me, not only to deliver that to my patients in their own way, because it's not the same when you're treating, you know, acid reflux and irritable bowel syndrome and ulcerative colitis. They all deserve their own unique personal approach. But it set off a wildfire inside of me to not only deliver that to my patients, because I knew that that was essential to their healing, but also there was the aspect that I just felt like, I need to catch up and learn more about this. And the more that I started to study, the more that I discovered that what was true in my own body was supported by science. And some of the science was the emerging science of the microbiome that wasn't even available when I was in medical school. So it was this opening up of, like, oh, my gosh, enlightened here. I'm seeing things. I'm connecting dots. I'm now understanding that these people that walk through these doors with acid reflux and ulcerative colitis and irritable bowel syndrome, that's not just a disease. There's a reason for that. And part of the reason for that is their gut microbiome is unhealthy and it needs to be addressed.

Yeah, I love that. I think that it's so common for people to have to go through personal experiences in order to have their eyes open to, like, oh, maybe everything that I was trained to believe isn't what's in the best interest for everyone.

Well, I think there's an expansion. Right. So, like, I'm not. At no point am I a person who has rejected allopathic medicine. And I told this to Gary Bruckco when I was on. On his podcast. Like, it's not a rejection of allopathic medicine. It's more the realization that those are tools that play a specific role, and that's not the entirety of the toolkit, for sure.

Yeah, I could not agree more.

So we have all these other things that address the root of the issue, and that's where we ultimately need to go. Medications don't address the root of the issue. They do play a valuable role within a specific context. So I wouldn't, like, try to go out of my way to avoid them. But I think that, like, what I don't like is the idea, like, for example, a person comes in with acid reflux and you're like, here, take Nexium and take it for the rest of your life. And we have no other plan. And the same would be true. We can talk more about, you know, the person with, for example, inflammatory bowel disease that you were sort of referring to. Like, a lot of doctors say, hey, just take your injection. Okay, there's data, there's a study from Japan where just take your injection. At one year, about 60% of people end up in remission. That's great because those drugs work. But you know what? If you were to combine that with nutrition, you get up to 96%. Like, if you ask me, you know, hey, doc, you could have 16 and 25 chance of being in remission next year or a 24 and 25 chance. I know which one I'm taking. And it's not close.

No, this is a really good point because it's not just about like an and or approach. It's definitely like a complimentary approach to our health care system that I think, like, we don't want to try to go down, like, too much of one extreme or the other in terms of improving because we do have a number of people who I've worked with who are on these, on various drugs that, you know, they aren't able to actually get off of, but their quality of life improves drastically in ways that the drug was only able to do so much of. And outside of ibd, I would say for anxiety, for Hashimoto's, for, I mean, so many different conditions.

Yeah, 100%. I mean, you take these conditions, we could go, I mean, we could line them up one by one and talk about, I mean, if it were, for example, you know, major depression, there's so many things that can be done from a lifestyle perspective particularly, but also from a nutritional perspective that can change a person's mood in a beneficial way. And those medications, I've seen them be life changing for people. I'm not going to sit here and say that there's no role for those medications, but at the same time, like, that's not, in isolation, the solution. So I, I agree with you. And I think that, like, I guess the way that I would frame this is like, I want to understand the problem and address the root of the issue. I know this is the same way that you practice and that involves pulling these levers, using these tools that include nutrition and lifestyle elements. And also to me, high quality supplements are on the table. Like, why would we deny the power of something that, like, you take it, you feel a radical difference. We're not. How can you deny that? And medications are there. And to me though, medications are like clearly the last in line. And that's the opposite of what we're currently practicing in our healthcare system, where they're the first of nine.

Opposite. Yes. I. I could not agree more. Okay, so as far as when we think about root cause, obviously inflammation is one of the largest root causes of all disease. And you just announced. I'm so excited about your new book that's coming out that's available on pre order. Correct?

Correct. Yes.

Plant powered plus activate the power of your gut to tame inflammation and reclaim your health. There it is. I love it. I love the COVID So you're gonna go down the path of explaining the connection between inflammation and the gut microbiome. Correct.

Oh, 100. I think that, like, to me, this is the conversation. I can't believe I get to be the person to write this book. It's a true privilege. Because as I step back and look, this is the most pressing issue of our time from a health perspective is chronic, low grade inflammation. And I understand that the conversation has really focused on, for example, metabolic health in the last two years, and I support that. There is definitely nothing wrong with that, but I would actually play a major.

Role, like with the things that you're doing with Zoe, bringing all this attention to the importance of blood sugar connection in the gut microbiome. Like the work that you've been doing has been so important, addressing the 93% of Americans that have poor metabolic health.

Because they're not separate. Right? Because all these things are. It's one body. You're one person with one body. And these things are interconnected. And we think of them because of the way our brain works, because it's easier to process when you can go down a linear path of discussing just inflammation or just metabolism. And it gets confusing when you weave them together, but they are woven together inside of your body. And we can't separate that, especially given.

That if we talk about the 93% of the population that has poor metabolic health. If you then factor in all the people that have autoimmune diseases and GI disorders and you know, the other ailments that are related to inflammation, like migraines and fatigue, you're left with virtually zero percent of the population that doesn't have some kind of condition or underlying issue that stems from chronic inflammation.

Yeah, I, well, so like the way that you just framed that, I was thinking about that this morning of like what percentage of America would qualify as having chronic low grade inflammation? And it ends up sounding like a hundred percent. And I don't want to, I'm almost reluctant because that sounds like over the top and depressing.

It sounds depressing too.

Well, yeah, and I think statistically there's reasons for that. It can't be that far off. And I want people to understand that inflammation. Mike, as I was writing this book, where I started is really with the individual, right? Which is that like I was in a clinic with people that would come in with these conditions and say, doctor, what do I eat? And I felt that they deserved better for the reasons that you've already laid out in the beginning of this podcast, which is to say that they've been dismissed by their doctors, told that nutrition doesn't matter. They know that's not true because when they eat they don't feel well. So they choose alternative choices because that's all they have. And what the alternative choices often are are like whatever is popular at the time. And I want to shift this into let's get evidence based and tactical about this. And so that's what this book became. And as I was researching it, it took me three years to write this book because I got so deep into the weeds of the immune system, it's highly complicated and I had to eventually surface and make it simple. But in that process I discovered over 130 health conditions that I can point to the study to prove that it's connected to inflammation, and I can point to the study to prove that it's connected to the gut microbiome. So there is a triangle that exists between the gut microbiome and our immune system, meaning inflammation and many of these chronic diseases that we are struggling with in the United States. And that includes autoimmune and allergic, but it also includes so much more. Metabolic, hormonal, mood, cognitive. Many different forms of cancer are associated with inflammation. So it's a laundry list. And this is why I think we need to have this conversation and we need to get stop being passive. Don't let the current just carry us away and instead get smart with the way that we build our day. Because these small choices that we make if we build our day properly, we can build a healthful day that is actually lifting us up and is anti inflammatory. And the anti inflammatory means less risk of disease, longer life expectancy and feeling better, thriving.

Yeah. And I think what motivates most people the most is like feeling better on a day to day basis. Because when you have the experience of all these symptoms like longevity, it seems a little bit like a far fetched thing where for as much as I care about longevity and the longevity, movement and eating until eating as well as you can, it's like what I've seen motivate people the most is like, I feel horrible. I don't feel like how I used to feel 10 years ago or 20 years ago. Like, how do I just get back to being able to function on a day to day basis without the headaches, without the GI issues and constipation or bloating or fatigue or poor sleep or all these things. And I think that what you're pointing to is that most people think about gastroenterologists and gastroenterology as a whole of just being like, you're treating ulcerative colitis and Crohn's disease and irritable bowel syndrome. And what you're trying to say is that we're taking it so much further than just the gut, because we know that the gut imbalances contribute to higher levels of inflammation which is impacting every single system in your body. Where we see the rise of allergies and asthma and autoimmune disease and headaches, and also blood sugar imbalances and menopausal symptoms and hormone issues. And, and I think that the way that you're connecting it all is so incredibly important. Where you're like, this is the evidence that people need. It's an evidence based approach. The research fully substantiates it. It's just that there's not a people talking about it.

Yeah. And. And I come back to like, why are we not talking about this? And because the evidence is overwhelming. And I, I honestly think I've been like, sort of trying to process this. I'm curious what you think. I feel like it's just so complicated, like the immune system. You could be a highly educated medical doctor or an immunologist and you can get so lost in it because it's crazy. And so. And I think people are scared to go and write books about things that they think will make the, the paint on your wall dry, like make you like tear up from boredom. Right. That's what people are afraid to do. And I guess I'm just not afraid because I wrote a book about fiber that everyone told me would be a boring book, and I made fiber sexy. So I'm pretty sure that I can take inflammation in the immune system and accomplish the same. But I think there's a point that you made that's really important, which is that yes, there are these health conditions, but I think how you feel, let's start with that, because I think that's like an essential element. And I say this all the time, that we can talk about all these things and we can get very into wearable technology and heart rate variability and all these different things. But what really matters above all else is how do you feel? And that's something that you express. And I would argue that when people who are dealing with chronic low grade inflammation and they create a plan to address that issue, I would argue that I am extremely confident that they will feel the difference on the other side, as there is improvement of these systems. Because, like, the number one thing with inflammation, from my perspective, there's many symptoms. You mentioned some of them gut symptoms, headaches, menopausal symptoms, you could have joint issues, aches, body aches, so skin breakouts. There's many different manifestations of inflammation, but to me, there's one that stands out from the rest, which is energy. 100% people get fatigue. Chronic inflammation is fatigue. And so. And it's because your immune system is at war. And so allowing the immune system to discontinue the war and get reorganized and at ease allows you to actually thrive and feel the best that you can.

And I think it's. The issues with fatigue are so incredibly. We just did a huge, like, data set of thousands of people that have filled out forms of like, what their primary health issues are. And fatigue and brain fog are number one and number two.

Okay, so brain fog, what is this? So you go to your doctor's office and you say, I feel like I have brain fog. I've. I, like, I can't think straight. And the doctor rolls their eyes because they don't know what to make of that. All right? In the same way that, like, they kind of dismiss fatigue as well. Like, what is that? All right, so we have in our gut a single layer of cells called the gut barrier. And you can think of it like the walls of your castle. All right? That gut barrier is there. And when it is intact, it defends and protects your immune system, which is just on the other side. 70% of the immune system is Lining your gut. So I would actually make the argument, Bridget, that the gut barrier is actually the second of three parts to our defense system. So the immune system is the third part. The gut barrier is the second part. And the first part is actually the gut microbiome. But this wall of the castle, when it starts to break down, which some people call it leaky gut, that's not exactly the language that I prefer. But I understand what they're saying, and it's not inaccurate.

It simplifies it.

Yeah, it simplifies it because basically things are sneaking across, you know.

But what do you prefer? Increase intestinal permeability.

Yeah, but then I sound like a scientific nerd, which I am. But it's fine. Yeah, so I'm fine with leaky gut. I get it. And so when that breakdown, though, occurs, you know, these cells are the most rapidly turning over cells in the entire body. Every three to five days, you have a completely brand new lining to your intestine every three to five days. There's no other part of your body that's even close to that. So you are constantly remodeling, repairing this gut barrier, but when it's broken down, you allow things to sneak across that are going to activate your immune system and create inflammation. So that's sort of the first major step in the development of chronic, low grade inflammation. But then if we extend the war, imagine we have this castle, all right? And you have gotten. You have broken through the castle wall, and the invaders are now fighting the army that lies inside the castle walls. Well, in the center of the castle, you have the citadel, right? And the citadel is where you put your most precious stuff. And so the citadel is actually the brain barrier. The blood brain barrier is made up of the exact same. Most people don't realize this. Even medical doctors don't realize this. It's made up of the exact same cells that are making up the gut barrier. And the blood brain barrier, by the way, is also made up of the exact same proteins that hold the cells together, like cement, called tight junctions. So when you disrupt the gut barrier, which creates inflammation, you are creating an environment that can subsequently disrupt the blood brain barrier. And when you disrupt the blood brain barrier, people find it hard to focus, hard to think this is brain fog. And I would actually argue that's a leaky brain. That's what's happening there.

Oh, I'm so happy that you just went there, because I also think that for people who feel like, oh, it's just fatigue, I actually have so many questions that I want to ask you in this moment in time, so my brain's going in three different directions, but for people who think that it's just like, oh, fatigue, and then they're in their doctor and they're like, oh, it's just because of your age, or it's because you had kids and you're a mom now, or it's because you're stressed or all these things that people are told and then they're like, like, but that doesn't really feel right. And then it seems like it should just be this quick, easy solution. And for as much as I don't want to say that nutrition, like, doing the basic things can make a huge difference. It can be complex to, like, improve if you have, like, a really bad leaky gut situation or issues with your intestinal permeability. Like, it's not the easiest overnight solution. And I feel like sometimes just following generic plans on the Internet will only take you so far, which is where it can then feel frustrating.

But.

But another thing that I just want to acknowledge is right now there's a huge movement with all these OBGYNs and menopause doctors who are recommending, like, it's just hormone replacement therapy that you need. It's because you're in perimenopause or menopause. And I'm totally on board with that. But I feel like it's almost like going to the extreme where it's like, is that like, everything? Because if you just take hormone replacement therapy, like, that's not going to move the needle on your blood brain barrier or the lining of your gut that you're talking about if you're not doing the other things. So I'm interested on your take on that.

Yeah, well, I know that your community is mostly women, and so is mine, by the way. But I think that these are the same issues that are occurring in men's health as well, which is that we have an epidemic of low testosterone. And so is the solution that every guy gets on testosterone replacement therapy, Is that the solution? Are we not going to have a conversation about the opportunities that exist for diet and lifestyle, exercise to improve testosterone levels, make people feel better? And I think that, like, that's a. It's a parallel issue that's taking place and it's convenient and easy to recommend HRT and nothing else? Because, once again, for the same reasons, it doesn't require you to dig into more nuanced, complex conversations about, you know, these other elements. I agree nutrition is complicated, and it's nuanced But I think what we need to start with is this essential basic understanding. What is the goal? Is the goal a healthier, thriving version of yourself that is stronger, fitter, more resilient, and as a result less symptoms? Or is the goal no symptoms and not really a concern for the fitness and the long term because there's a bifurcation that takes place? So I'll give an example, an analogy. If I hurt my knee, I have a choice. If I want to be completely free of symptoms and never feel pain in my knee, I could lay on the couch and never walk for the rest of my life. And that's an absurd choice. No one in their right mind chooses that because we all want to walk. But like, I could do that and my systems will start to fail. The knee will have no pain though. Or alternatively, I can go through a process of rehabilitation. Now, rehabilitation can be nuanced and we acknowledge that, like in that process, we're not trying to create pain, we're not just accepting of pain, but there can be pain. Pain is how you build. But you also do these things in a smart, strategic way and you restore function. And in restoring function, you are able to get up off the couch, walk, get back to playing pickleball or fit or basketball or whatever you enjoy playing. Right? That's where I want to be, that's where everyone else wants to be. But yet when it comes to nutrition, we don't treat the choice the same way, which is that many times we guide ourselves into like symptom oriented approaches, just focused on, I don't want to feel those symptoms. And you end up restricting, restricting, restricting, restricting until there's nothing left. And the alternative is more nuanced, which is we're going to restore fitness. And that requires success through addition, going the opposite direction. And there may be symptoms along the way. And so it requires sort of that nuanced element of figuring that out so that you can restore fitness, so that you end up in a place where in the same way that like the person with the knee they rehabbed and now they're playing pickleball and basketball again, I'm arguing now you're in a position where you're eating whatever food you want, you're not having symptoms, you're thriving and your nutrition is better and your health is better as a result of that. So I think like this is part of the issue that we're talking about here, is that these nuances, the conversations about digging into nutrition, there's effort that's required to do that. And if people are not willing to put the effort in, then they're going to take the. The cheap, quick fix, but you're not really going to get yourself where you want to go.

Yeah, that's a great way of explaining it. So when it comes to leaky gut, how much of disease do you think is actually driven by leaky gut?

I think way more than we realize, because basically what's happening there is the inappropriate activation of our immune system. Now, don't get me wrong, this is not the only thing that matters. There for sure are other elements that include, you know, for example, genetic predisposition. Right. So your genetic code on some level determines, like, what are you more likely to develop, what are you less likely to develop. That being said with, I would make the argument that the mechanism for development of many of these health conditions involves breakdown of the first layer of defense, our gut microbiome. When the gut microbiome is weak, we have to understand it's the gut microbes that are tasked with helping us to maintain the gut barrier. That's not just intrinsic to our body. We need our microbes for that. So when they're not able to fulfill their job, because they're not well, then the gut barrier suffers. And when the gut barrier suffers, then we get the natural permeability, which we call leaky gut, where things like bacterial lipopolysaccharide sneak across and they activate the immune system. So these things that naturally exist, contains within our intestines, contained and managed. When our gut microbiome is healthy, they're allowed to get into places they're not supposed to be. And when you get past the microbes and you get past the gut barrier, then you get to the immune system. And the immune system considers itself the last line of defense for your body. And so that leads to activation of the immune system. And it's very, very clear the impact that lipopolysaccharide has. And we have many different examples of this. I could literally talk all day about all the different examples of proof that what I'm describing is, in fact, true. You could take Covid and talk about COVID and what we've learned from that. You could take ways in which lipopolysaccharide has influenced people's cognitive health, Parkinson's disease. So there's many examples of this to be true.

And really, in the last five years of the research, would you say mostly? Yeah, mostly like the strongest.

Yeah, mostly because we went through a phase, like, basically, I would Describe it as 2006 we first get the laboratory technology. Oh, my goodness, there's like thousands of microbes. What do we, what are we supposed to do with all this information? And so then there was probably a roughly 10 year period of just starting to like, understand the basics. And then roughly 2015, we started to get a little more tricky and nuanced with how we were doing it. And from 2010, it all accelerates and builds upon itself so that by 2020, we're now starting to get into more technical stuff where we can actually use this to really understand disease and simultaneously to create actually avenues for healing. So in the microbiome, there are examples where the microbiome is now mainstream in allopathic medicine and really powerfully influencing health outcomes because they have met a sufficient level of research.

Give us some of those examples, like.

The top ones, melanoma research, immunotherapy, that's being used to treat melanoma. So the idea here, you know, again, let's start with my basic thesis, which is that the gut microbes, the gut barrier and the immune system are interconnected and they rise and they fall together. Okay, that's my basic thesis. So in melanoma research, let me unpack how that is true. Melanoma is, of course, of skin cancer, the most dangerous skin cancer that exists. And they use a new form of treatment. It's like an improvement upon chemo. Chemo is like poison the cells. And the hope is you disproportionately poison the tumor cells, more so than you poison their own cells, but you're poisoning all of them. Immunotherapy is a newer approach where you basically say, I'm going to take their immune system and use their immune system to attack the cancer cells. We have abnormal cells every single day, both you and I, precancerous cells, things that could turn into a problem. Our immune system clears them every single day. That happens. And so the problem is that our immune system has failed on some level when we reach a point of actually having a malignancy. And so what they did is first of all, they noticed that people who were receiving antibiotics were not doing as well with immunotherapy. So the doctors immediately reacted by saying, oh, well, they're just sicker. That's why they're on antibiotics. So they did a randomized control trial. And when they randomized people, so you're taking away the whole they're just sicker idea. They still did very, very poor with antibiotics.

Wow.

Antibiotics destroy the microbes. When you destroy the microbes, the gut Barrier suffers. This is a normal part of taking antibiotics. Our body has to recover from that. We take them for a purpose. And so. And antibiotics have been associated, by the way, with the manifestation of many different inflammatory diseases later on. Okay, so they see this. So the next step is they go, oh, well, if breaking down the microbes is bad, what if we built them up? So they turned to fecal transplant and they took.

I'm obsessed with fecal transplants. I want to talk about fecal transplants too, at some point. Keep going.

Okay. Yeah, so they turned to fecal transplant and they took this group of people, small group. This is like a case series. But I think it, like, serves the purpose of, like, opening up our minds to this possibility. And these are people who had failed immunotherapy. They've already failed. So we're trying to get a different result doing the exact same thing, except this time we give them a fecal transplant. And the majority of people who have this cancer that is threatening their life, the majority of people actually were able to get rid of the cancer after getting fecal transplant and immunotherapy. All right, so the fecal transplant changed the outcome for those specific people. It was life saving.

So with fecal transplants, I was under the impression that the changes only last for a specific period of time, Right. That the changes can only last for like, less than a week. Is that right?

Uh, so it's like a. It's like a gradient. Like, it's not like a hard cliff where like a week later it's gone. It's more. So if you think about it over the course of a month. Right? Cause to me, about four weeks is when big changes occur in the microbiome. So if you think about it over the course of a month, that first week you're gonna get the biggest bang. And then second week lasts, third week lasts, fourth week lasts, and by the time you get to a month, you're almost back to where you started.

Got it. So they used just one round of a fecal transplant to improve the outcomes of these people that had melanoma to the point that they then were cured of melanoma. Is that right?

So these are people that ultimately went into remission from their melanoma. So, like, to the best of our ability to call it a cure. And the thing about it with that is fecal transplant is highly effective when you're talking about an acute issue that you're addressing that can be resolved within that sort of acute time frame. So, for example, C. DIFFICILE infection is the actual classic use of fecal transplant.

Because recurrent, right?

Well, it's intended to be used for recurrent, yes, but that's really just the sort of indication of our process where the first time a person comes in with a C. Diff, you don't necessarily need to put them through a fecal transplant. You could just give them an antibiotic and get rid of it. But the problem is that the manifestation of C. Diff in the first place is the consequence of a weak microbiome. So this entire argument of the microbiome is our first line of protection. The reason people get C. Diff in the first place is typically after antibiotic use, you suppress the regular microbiome. That regular microbiome that used to keep the C. Diff in check is no longer present or not adequate at least. And so now the C. Diff is not in check and it rises and it takes over the colon and it creates this vicious colitis. And then the opposite becomes true. Where then when you restore the architecture of a healthy microbiome through a fecal transplant, the C. Diff goes away because it's being once again suppressed by the microbes. So even though it's an inflammatory infection that manifests with like literally a ragged, bloody colon, it's vicious. Even though all those things are present, the solution is in the microbes. So now the real quick, Bridget, there's a difference. Like this also would work for immunotherapy, because that's a time sensitive thing. You administer the immunotherapy, you administer the fecal transplant. This would be different, though, if we're talking about long term, for example, type 2 diabetes, where that's a chronic health issue and giving a fecal transplant by itself is not enough to get control or like ulcerative colitis. If you want to make fecal transplant therapy for ulcerative colitis one time is not going to cut it. It's going to have to be repeated.

So it's interesting because the reason that I became obsessed with fecal transplants is around 2015, I had a patient that had, I can't remember if she had Crohn's disease or ulcerative colitis. And she was in my office with her husband and telling me how she gives herself a fecal transplant with his stool at home anytime that she's having a flare which keeps her off of the medication. And then of course she uses like nutrition and lifestyle to help to improve her symptoms as a whole, but that she had been able to maintain no medication for 10 years using a fecal transplant from her husband. I'm not like recommending that people do this at home. I know that there's obviously adverse effects of a fetal transplant, fecal transplant, but to me it was like, wow, if you think of the gut microbiome as a rainforest and you're just taking like one probiotic, you're only getting like one, maybe five strains of bacteria. But when you think about the fact that you have 38 trillion bacteria, like, the fecal transplant is basically the rainforest replacing the rainforest for a better rainforest that you can only get so much of. So to me, it's like, besides fecal transplants, nutrition is the most powerful way to change the microbiome. And of course, like, fetal transplants aren't FDA approved for anything outside of recurrent C. Diff. So I don't want to seem like I'm completely like going off track, but I find it so fascinating, like you said, that it's showing the power of the microbiome in like, some of these instances and future benefits that I really believe will happen in medicine. Do you believe that that will happen in medicine where they can, they'll figure out a way to make them safer, that they can be used for more conditions outside of just like jumping to an antibiotic all the time?

The answer is yes, I do believe, and some of these studies are underway. But you have to also bear in mind that unless a pharmaceutical company can figure out a way to make a profit off of these things, then the amount of funding to back them is going to be limited. And so that slows down our process because what we're dealing with is just government grants alone to cover this type of thing. So that's the unfortunate reality by everything that you, you just described and everything that I've described. You know, again, the only FDA approved indication for actually administering a fecal transplant today is a recurrent C. Diff infection. But the point though is that we are first of all demonstrating the mechanisms underpinning these health conditions and the opportunities that exist, whether that's fecal transplant or taking a different approach through diet and lifestyle. And I would actually argue that even with the fecal transplant, it shouldn't be administered by itself. It should be in combination with a dietary overhaul, such in combination with the lifestyle. Right? So. Because that's how we get the healthy microbes to hang around, because you have to feed them. If you don't feed the microbes, if you take a healthy microbiome and then you starve It. It's just going to decay. We shouldn't be surprised by this.

Yeah. So essentially it all comes down to you cannot bypass the nutrition. Whether you're doing a fecal transplant or whether you're doing hormone replacement therapy or whatever it is that you're using. The nutrition has to be a part of everything.

Yeah. And if you. And if we think about it, if you take a step back, I think this is one of the big points that many people are missing, but people that are more holistic, like yourself, get this. If you take a step back, you might be making a dietary intervention for a specific goal. Right. Your goal might be that I want to reverse my insulin resistance and my type 2 diabetes. You can absolutely do that with nutrition. But you also need to realize that because the microbiome is at the center and because your nutrition through the microbiome influences. So because it's going through that lens, what you put into your mouth is ultimately coming into contact with your microbes, and then it's going to ultimately disseminate into your body like a shotgun. And so that combination of nutrition meets microbes ultimately is impacting health throughout your entire body. And the systems that you didn't think were a problem or had no intention of trying to improve, you discover. Oh, my gosh, my skin is clearer. Oh, my gosh, I'm sleeping better. Oh, my gosh, I have way more energy. Oh, my gosh, I can focus better. And that's the power of what we're talking about. That is the opportunity that we're talking about, which is that you might orient towards a specific issue, but you can really improve your global health as a person.

Love. So I want to talk about. Since we're on the topic of leaky gut, I'd like to just talk to get your stance on elimination diets, let's say targeted elimination diets. Do you think that it's possible to heal the lining of the gut without removing any foods?

Yeah. I mean, let's dig into the nuance, right? Because we already acknowledge, both of us, that there's nuance to these topics. And I come across, when I'm speaking on a platform as if I'm anti elimination diet, which actually is not true. My second book, the Fiberfield Cookbook, actually was built on a foundation of elimination diets. It's the implementation, it's the way in which we approach it. So it's not that it's wrong to take one step back, it's that when we take one step back, it's for the purpose of taking two steps forward. And so with these elimination diets, whether it's a fodmap diet or a low histamine diet, the idea is not to say that you're not allowed to restrict, you are allowed to restrict. Again, I've written about this in my books, but it's more so that the restriction is a temporary, intentional approach so that through that process, you're building up the systems, you're addressing the root of the issue that allows you to then turn around and add back in and go beyond. And so I actually see this as like a part of the growth process of like temporary restriction as opposed to where I like take issue is FODMAPs cause symptoms, I get bloated, I'm going to stop eating FODMAPs for the rest of your life. And the data are clear that that causes a negative impact on your microbiome. So without doubt, if you eliminate fodmaps for the rest of your life, you will have a less healthy microbiome, which.

A lot of people, because there's a number of people that are trying to improve their health and then they get symptoms from eating healthy foods, which could be histamines, it could be fodmaps. But we hear all the time, like, especially when people go through the blood sugar reset, which is a program that I run twice a year, where we're substantially increasing their fiber intake. And some people will like, I have more symptoms. And I'm like, this is a sign that your gut is imbalance. And instead of, you know, we'll sometimes see gastroenterologists, like, people will come to us two years into a low fodmap diet. And we're like, why are you eating low fodmap? And they're like, well, no one ever told me like, that you're supposed to eventually get off the elimination diet. Right? That you're like low FODMAP for life, or you're low histamine for life, or you're gluten free, dairy free, grain free, egg free for life. And it's so unfortunate that the message that you're cycling out is that it's like, about taking things back so that then you can broaden, moving forward without symptoms.

Yes. And the problem is that, you know, like, literally as you and I have sat here and covered this probably as succinctly as we possibly can, it still takes us four or five minutes to like, say these basic foundational elements. And a reel on Instagram is 60 seconds. And so this is an inherent flaw of like all of these different systems where information gets like, goes viral and disseminated quickly based upon, eliminate this, you'll feel better, you'll thank me later. And it's like, okay, cool. Like I kind of, when I give people the benefit of the doubt that they're not just trying to get clicks, then at a minimum, like there's more that we need to be discussing.

Well, I also think that for people, I think there is a group of people that are just trying to get clicks, but I also think that there's a large group of people like health coaches and personal trainers who like you said about doctors, are well intentioned people. They just don't have the clinical, clinical experience or the number of reps with the number of like patients and clients that they've seen in order to figure out like, oh, there's so much more to me saying like dairy is inflammatory for everyone or that, you know, like high fiber foods are the cause of your, your bloating and other things like that.

I'm so glad that you brought this up, by the way. I just want to comment real quick that you mentioned the reps and that is why is this so ignored? I don't get that. Because like, if we were trying to create like imagine going to war and your general literally has just studied war and never actually been in battle, right. Would you have respect? Would you trust that that person really understands what you're about to go into? So, and it's like shocking to me how much advice we take from people who don't have a license to do anything and never have. I know, and they read papers and they can point to papers and I appreciate that. But any person who has spent time with patients one on one, you understand that there is a process to all of this and the papers, they inform our general understanding of how we approach these issues. But there's still like this strategic play of finding what works for the individual that isn't necessarily reflected in a randomized controlled trial.

So true. And that is one of the downfalls of just following the evidence, right? Like just following the randomized controlled trials could lead people to a lot of symptoms for the rest of their lives that they're never able to uncover if they're not able to work with a practitioner that can dive deeper into like, okay, let me, let me listen to what you're saying, even though it goes against the randomized control trial and think about mechanistically why that may be and then how we can go in a.

Different direction because there's Personalization, and people don't take that into account. And then we end up in these wars. You know, there's like this tribalism and these wars that are taking place on the Internet. And you have people who. Their entire account is like, just to call out other people and yellow about how their science isn't up to snuff yet. The funny thing about it is that that person whose science may not be up to snuff, part of where they may be coming from. Look, I am 100% behind science. I've studied it my whole life. I have a master's of in clinical investigation from Northwestern. I was on a grant from the NIH. My science, my papers have been cited more than 5,000 times by other scientists. But what I'm saying is that there is more to the story than just, hey, the study said this. Therefore this is true for everyone. That is not, in fact true, because within that, even that randomized control trial, there are people whose response was beneficial to the thing that you just proved on a population basis isn't helpful. Right. So it's like those studies are intended for what occurs on a population basis. But we have to be prepared to accept that. We have individuals. And the individual person, your patient, my patient, the individual person, what they care about is can you make them better? Not what the clinical trial shows. They don't care about that.

Yeah, that at the end of the day, is the most important thing. Okay. I want to make the most of the time that we have left, and I'm trying to think of the best way to do that. Perhaps it would be. Talk about. Can we talk about the work that you've done at Zoe and connecting the gut microbiome to blood sugar? Because what I see is people that come to us on really low carbohydrate diets, or more like carnivore diets or other extremes, and they miss the connection to the gut microbiome. So can you talk about the work that you've been doing at Zoe and what you guys have found in a lot of the research that you've been working on?

Sure. So Zoe is a. A nutrition company that is basically trying to improve the health of millions of people. And where we started is building the world's largest microbiome database. So. And that microbiome database has over 300,000 people where we don't just have their microbiome, but we also have information about their health history. We have CGM data, so continuous glucose monitor where we know what their blood Sugar response was 24 hours a day for two weeks, including, they would log their food. And so, like, you would see, like, they eat this food. This is what happens. And we also have testing, like, related to their. Their blood lipids after our meal. So we would give people a standardized meal. This is like a science play. Most people didn't realize we were doing this, but we would make a science play where we would basically pack in what in the beginning was muffins and later became cookies. And it was standardized so that, Bridget, you could be using the Zoe kit, and I would be using the Zoe kit, and we could compare our results head to head.

I did the muffins.

Yeah. So you were early days. Yeah, you were early days. They switched it over to cookies eventually, so. And they also made them blue. And there's a story behind that too. But so anyway, so this is what we built, and it allows us to take a look at this large Data set of 300,000 people, including their microbiome, and start to understand what's going on and what you see. We published a paper actually, back in 2020, where we break down what are the different factors that influence your blood sugar? What are the different factors that influence your insulin release? What are the different factors that influence your postprandial triglyceride level? Basically, postprandial is minority way of saying after you eat your triglyceride level after a meal. And what we discovered is that the gut microbiome is a crucial part of this entire story. In fact, it's powerfully informing what our triglyceride levels are after a meal, which is connected to our inflammation levels. It's actually extremely connected to insulin release. Let me explain why that's important. Because when you have a diseased microbiome, you are more likely to become insulin resistant. So effectively, that was proving that concept. The microbiome is strongly tied to insulin sensitivity and insulin resistance. Now, that's different than blood sugar. That's not the same. Because blood sugar, the most powerful thing, is not your microbiome, it's what you eat. So if your entire goal is to keep your blood sugar as low as possible, and you don't care about any other thing, you don't care about anything else. Like you don't care about your health, your longevity, inflammation, your microbiome. If the only thing you care about is that blood sugar, which is kind of the approach that a lot of people have taken to this, then you would eliminate carbs. Because if you eliminate carbs, then your blood sugar is not going to go up. As high after a meal.

And when we say carbs, that could also include non starchy vegetables. Because I've worked with people wearing CGMs who literally opt to like remove bell peppers and broccoli from their diet because the bell peppers are sending their blood sugar up 15 points and like, that's too much for them.

So when I say carbs, I'm referring to all carbohydrates. Sometimes when, when people hear carbs, you know, like the word carb is kind of a loaded thing that gets complex because sometimes people think it's like sugar and flour and that's okay. I get where they're coming from. I get where they're coming from. But, but actually, when I say carbohydrates, I'm referring to all carbohydrates, including naturally occurring sugars, including medium chain carbohydrates and also long chain carbohydrates, which by the.

Way are fiber, nutrient dense, whole food carbohydrates.

Yes. And they're predominantly, predominantly, not exclusively, but predominantly found in plant based foods. Right. Whereas in animal based foods, the carbohydrate content of meat is zero. The carbohydrate content of dairy is quite limited. It's lactose. Lactose is the exception. It's the only, it's the only carbohydrate that's in there. So if you, if your argument is that, okay, by going low carbohydrate, I lower my blood sugar, then this is going to naturally guide you towards a lower carbohydrate animal based diet. And the problem is that that completely ignores all the other facets of your health. Health. And it also is quite misinformed because it gives you the impression that blood sugar is bad and the lower the better. And that's not true. Blood sugar is bad when it's excessively.

High and that's when you're insulin resistant.

Which is what happens with insulin resistance. Yeah. It is not bad when it is within a natural range. Our body is designed for that. In fact, the fuel of our brain is sugar. And this is a big part of the reason why. Bridget, you will see if you actually take a step back and view. I try to be as understanding as I can be to the carnivore diet. We can have an open discussion about this, but you're never going to be able to convince me that long term this is the optimal choice for people's health. And this is the reason why we see people who have advocated For a carnivore 100% animal based diet it and they subsequently are forced to reintroduce carbohydrate rich foods. And they might be, and you might call it honey and fruit, but you're adding those things back because you have, you have gone so carbohydrate poor that your glycogen stores, which is your reserve energy source to protect your brain, they get burnt out. So you got no glycogen. So now you're not even adequately fueling your brain anymore. And these people, they have problems with exercise, they have problems with their focus and concentration. Their hormones fall out of whack, especially for women.

This is very important for women, I think, like, even more so than men, because obviously men and women are different. But for me, like when I was eating very low carb in like 2017, I was working on like a keto diet program for type 2 diabetics when, as a shared medical appointment when I was at the Cleveland Clinic, and like, the results were so amazing that I was like, wow, maybe I need to be doing this too. The compromise that it has on your thyroid health and your hormones as a female, like, we need whole food carbohydrates in order to support that process and not overly stress our bodies. And like you're talking about the glycogen source for the brain health. And also from a gut microbiome standpoint, like, there is then no fuel for those microbes to produce the short chain fatty acids, which I'm assuming I haven't read your new book, but I'm assuming a lot of that work is around the research in short chain fatty acids and how they're able to lower inflammation.

Yes. So there's so much to comment on there. I'll just comment on the book real quick.

The book, we should do like 10.

Interviews because I feel like we can definitely do more. We can definitely do more. Especially if your audience lets me know that they appreciate this by sharing to their social media tag. Both of us, if you guys do that, then you're telling us that you want more of this kind of content and then we'll make it happen. All right, perfect. So a quick comment on the book. So the book is called Plant Power plus. Please don't be intimidated by the title of my book, okay? Because this is about finding what works for you. And what you're going to find inside is that I am making an argument that there are many different approaches that can ultimately lead to improved health. But when I say many different approaches, that doesn't mean everything is the same. And there is no difference. My argument is that plant predominant approaches, which could be Mediterranean and could be vegetarian and could be flexitarian or just a balanced omnivorous diet, or it could be a plant based keto, these can all work and you can be healthy and you gotta find what works for you. So these are all on the table and the book gives you the framework to find what works for you. All right, so you mentioned the gut microbiome. Of course I'm concerned about the changes that occur in the microbiome. We have a study actually where they looked at this, where they put people on five days of a completely plant based diet versus five days of a completely animal based diet. And the reason for this, the polarity, is not to like argue vegan versus carnivore. The argument was that we need to prove that what you eat impacts your gut microbiome. And so this was a 2014 study where they chose the opposite diets. But what they found on the animal based diet, five days of a completely 100% animal based diet with zero fiber, was actually quite disturbing because when you go that high in fat, you're going to naturally have bacteria emerge that love bile. So you have something called Bilophila wadsworthia that emerged. And Biophila wadsworthi is an inflammatory bacteria that's been associated with colorectal cancer. We had another one called Allostypes putridenis. This is one that you find in abscesses where like people have an infection that's pocketed off, you find this bacteria there and now it's showing up in their colon because of the dietary choices that they're making. Then you add the emergence of bacteria that have also been associated with different forms of cancer. So the point from my perspective is not to say that like, I guess the way that I would frame this is for the people who have like opted for a carnivore based diet. If you're feeling better, I'm very happy to hear this. But you're also in the most restrictive diet and this is not a solution to long term health. And there are consequences that you will ultimately suffer. And we don't want to wait until then. Let's start to work now on the process of reintroducing foods to bring them back on board. Because your body thrives on varieties of plants, as many different types of plants as possible. Your body thrives on receiving that fiber, those polyphenols, those healthy fats. So those are the things that we want to bring back into the equation. And so my argument is to Say like this is about meeting you where you are. So if I'm meeting a person who has, who's on a carnivore 100% animal based diet, I'm not here to have a conversation about 70% plant based. I'm here to have a conversation of going to 10%. And to be totally honest with you, if we went back in time to 2012, I was in the same place of being like super low fiber, not much plant based food, too much ultra processed, too much junk food. And I think that there's a place that exists where you can have a diet that you love and thrive and enjoy it. And it's not necessarily an all or nothing thing that there's tons of options and you can, you can add to your diet the things that you really enjoy, but we can also build it to be healthy. And that's ultimately where I want to guide people.

And what you said about how quickly the epithelial cells regenerate within the lining of the gut, like, I think that there's a lot of promise for people where even if you have made choices that aren't necessarily in the best interest of your health, that there's so much opportunity to reverse a lot of the damage that's been done and help you really feel good again.

That's right. 100%.

Okay. Amazing. Dr. B, thank you so much for coming on the show. I'd love for you to share where people can preorder the book and all the ways that people can find you and benefit from your work.

I have been working on a lot of exciting stuff behind the scenes and the book is just one of them. So my brand new book is coming out in January. This is called Plant Powered Plus. And I would encourage you to pre order your copy today because what happens when I launched my first book is we sold out and then people couldn't get their hands on it. So it's nice to know that you have your reservation already booked. And so Plant Powered plus to me is like, I'm hoping that this is going to be the book that redefines inflammation, helps you to really understand it, understand the ways in which it uniquely impacts your life. Every person who reads this book is going to read it a little bit different. Different. You're gonna hear it in your own way. And I've created a plan that's flexible, that's meant to grow with you so you can install both diet and lifestyle. Cause we haven't talked about the lifestyle that much, but there's a big part of the book that's about that install those elements to thrive. So I have a website. I would encourage everyone to come to my website, thegut healthmd.com and I have tons of free resources there that are meant to help people. I have a quiz that you can take that like defines your gut type and sort of introduces ideas of how you can approach that. And I have a newsletter which is like basically a substack, but it's free. And then last but not least, I have social media. The Gut HealthMD is where you'll find me on both Instagram and Facebook. The issue is the algorithms don't like to put me in front of you because I don't say things that are crazy controversial. So that's why I like my email list better because then we can just like actually have a conversation for sure.

And get more than 60 second question clips.

And get more than 60 second clips. I started a company that launched in 2024 called 38 Tara, and it's a gut health supplement company. And it was the motivation for me was to create products that really changed the way that people feel. And I felt like the gut health supplement world was not up to snuff in terms of delivering products that really would do that and also to be as transparent as possible people. So anyway, so for those of you who are interested in high quality gut health supplements that are widely third party tested, NSF certified, then come check us out. 38 Tara. You can actually see the package right here if you're on YouTube. 3838 T R A.com you can check that out.

I love it. I love it. You're also doing all this as a father of four of children spanning the ages of one to 11. So that is also unbelievably impressive that you're contributing all these amazing things to the world and that you're also an extremely engaged father of four.

Yeah, we were talking about this a little bit offline and I guess what I would say about this, I love being a dad. And I love being a dad as much or more than I love being a medical doctor. And it's like actually a true privilege to be a part of these people, be a part of their life, my children, as they grow up, up, and to guide them. And it's like, you know, the, the thing about it, Bridget, is that a day will come. Not too soon for me, but nothing too soon for either of us. But a day will come where we retire and we will walk away and people will forget who we were very quickly. But you know who will not forget is our kids. And I teach my kids all the time about my grandparents, their great grandparents who they have never met, because there's an entire family story that exists. So I value, like, the chance to make an impact in the broader world. It's really fun for me to, like, work hard and use my education and my skills to try to help as many people as possible. That's what you have me doing right now. But I also just as much, if not more, love the opportunity to snuggle my one year old and to jump in the pool on a Sunday and to do all these wonderful things with these kids and be a part of their life as they grow up.

Oh, my gosh, that is so sweet. And yeah, that perspective is everything.

It's just a real privilege, honestly. You know, these kids, they are.

Yeah. And the time flies.

It does.

Okay. Thank you so much, Dr. B, for being here. Thank you everyone for listening and we will be back soon.

Thanks, everyone.