The Surprising Link Between Gut Health and Mental Health

I'd like to welcome everybody to today's presentation on gut health and mental health, the impact of the second brain. I'm your host, Dr. Donnelly Snipes. Now, this video is for educational purposes only and not intended to replace medical advice. Always have clients discuss any nutritional changes or supplements with either a registered dietitian or their primary care physician. As you will learn, altering things, even taking probiotics can impact the way that medications work for people. So it is important, if somebody's diabetic, for example, to make sure that you're not telling them to go do something. You're just saying. This is potentially an option that you can discuss with your doctor. In this presentation, we will briefly review the findings from the research. Identifying the connection between the brain and the gut will differentiate gut health from proper nutrition, identify signs and consequences of poor gut health, explore the bidirectional relationship between the brain on your head and the second brain in your gut. And they, they do interact with one another. And we'll identify promising alternative approaches to treating mood and other health disorders. So the gut brain axis, there are different pathways for communication between the gut and the brain. And it's, you used to think, you know, what you ate was broken down to make neurotransmitters or whatever, and everything was just kind of a one way and that's not the way it is. The enteric nervous system actually communicates with your brain. So when you get that feeling in your gut, when that's something stressful, it's communicated via the vagus nerve, the brain. Likewise, when your brain senses something that is stressful, it will communicate that to your gut and your gut will go. So it is bidirectional. When your gut microbiome gets out of whack, that's a stressor and it communicates that to the brain, which will trip off the HPA axis. So we see these two things work in tandem. When one is out of whack and it or stressed out, it communicates that to the other, which becomes stressed, and then it tends to spiral one way or the other downwards or upwards. So how do they communicate? We have neuronal signaling through the vagus nerve. We have endocrine effects through the HPA axis. So when the HPA axis is triggered, we know that it causes your body to secrete a bunch of hormones and neurotransmitters to respond to fight ORF flight. Remember, HPA axis is your fight ORF flight response. Stimulation of systemic inflammation. Well, that's not good in the short term. Inflammation is designed to bring nutrients, if you will, to areas of the body that are injured. Systemic inflammation is registered as an ongoing threat to the body, a systemic threat. So that's going to keep the HPA axis activated. And when the HPA axis is activated, it's going to tell the little workers in the gut we need to produce those stress hormones because there's a threat going on. And a wide range of changes in metabolism can also impact the brain microbiota changes. And when we talk about the gut health, we're talking about the gut microbiome and the little workers in the gut microbiome. The bacteria are the microbiota. Microbiota changes called by, caused by illness, dietary changes, probiotics and antibiotics impact your endocrine and neuroendocrine pathways bottom up the brain, so down here. And then it sends a signal to the brain. Likewise, the brain can send signals down to the gut and alter which workers are called into duty. Based on whether you're resting and digesting or you're stressed or whatever else is going on. It's important to remember that we're going to talk about a lot of correlations today, that when we see this alteration in the microbiome, we tend to see these symptoms, but it doesn't mean causation. We can't say, well, when this happens, then we definitely are going to see symptoms of autism. We can't say that. We can say, in some cases we see that there is a correlation. And a correlation means there's a relationship between X and Y, your gut microbiome composition and particular symptoms a lot of the time, but it's not all the time. So we can't say that X causes Y because there are some people out there that don't react the same way. So there's another factor, C playing in there. Whether it's their health or genetics, their mood, their stress, their environment, their nutrition, all of these can impact the foods that you eat, the nutritional value of the foods you eat, what types of foods you eat. Because a lot of times when we're stressed, we gravitate towards those feel good foods, those comfort foods. And just in general can impact your, your mood and your stress levels. And then there's chicken and bi directionality. You're like chicken, the chicken and the egg dilemma. Did somebody develop depression or addiction and that changed their gut microbiome, or did they have a wonky gut microbiome that led to behaviors that were characterized as depressed or addictive? They don't know the answer to that yet. They do know for. Well, I'm getting ahead of myself. Other examples, not all people develop depression during menopause, but all people experience an alteration of the gut microbiome when their estrogen is reduced. We know that lower levels of estrogen impact the gut microbiome. So why don't some do, some people get depressed and others don't. Don't know. But it's certainly worth considering if you've got a patient who is in menopause or in getting ready to go through menopause and they're having mood swings. Or if you've got somebody with premenstrual dysphoric disorder. It's certainly worth considering whether or how we know it's impacting their gut microbiome as estrogen levels change, but whether those alterations are impacting their mood and whether there's a nutritional component to it. For example, sometimes when people are pmse, if you will, a lot of us, you know, kind of make the joke about having just chocolate and caffeine or something. Well, that's our brain saying we need more dopamine. We need to kind of try to balance the system out. Our cravings are the way our body says something ain't right and we need to try to balance it out. So we, we recognize that the foods we're eating when we are stressed may actually contribute to stress in the gut. And there was another article that I should have linked in here, but I didn't, that actually talks about how when people eat comfort foods, the initial reaction is one of increased dopamine and serotonin, but very quickly afterwards that sugar leaves the system or that those fats leave the system and there is a paradoxical triggering of the stress response. So just like with alcohol, when you drink alcohol initially you may feel okay, but then as it leaves the system, there's a paradoxical anxiety response or stress response because the body can't respond as quickly. And it, it's interesting to recognize, but the take home from that is we can't ignore the gut, we can't ignore nutrition, we can't ignore sleep, and we can't ignore hormones when we are working with somebody who has some sort of mental health or physical health disorder. So let's talk about all the things the gut microbiome influences. And no, we're actually not going to talk about all of them because we'd be here until the cows come home. Addiction Alcohol use impairs the intestinal barrier and causes changes to the intestinal permeability. Leaky gut as well as the Composition of the gut microbiome. When people drink alcohol, it actually increases the bacteria that are associated with increased inflammation and decreases what we'll call the good bacteria or the anti inflammatory bacteria, the bacterial products. So these inflammatory bacteria bacteria produce products that penetrate the impaired intestinal barrier and then it gets out into your system and, and so you have all these toxins flowing through your system that causes systemic inflammation. Beneficial bacteria such as bifidobacteria and lactobacilli improved the levels of liver associated enzymes in patients with mild alcoholic hepatitis and demonstrated beneficial effects on anxiety and depression. So that is a huge win. There's a lot of talk about what are, what else can we do to help people who are in early recovery, who are detoxing, who are going through post acute withdrawal? And I think a novel target really needs to be the gut microbiome. And bifidobacteria and lactobacilli are prevalent in most of your yogurts and your fermented foods. So it's not like you need to go out and buy these random supplements. It's about eating a reasonable and healthy diet. All right. The gut microbiome also influences ADHD symptoms, anxiety. When certain gut bacteria are more prevalent, people tend to have more anxiety than when other gut bacteria are more prevalent. Autism. Children with autism spectrum disorder treated with oral. Oral vancomycin, which is an antibiotic designed to reduce cholestridium, had significant improvement in behavioral, cognitive and GI symptoms. So they speculate in some children with autism spectrum disorder with certain symptoms, it could be due to an overgrowth of the cholestridium. Unfortunately, our antibiotics, right now you've got broad spectrum which just wipes out everything. You've got gram positive and gram negative. So. And that one wipes out half and the other wipes out half. So you're, there's nothing that you can say that's just, let's target this one bacteria, let's target this one thing and decrease that. You're either wiping out the gram negative or the gram positive or everybody. So that's a downside. That is a big downside. And you'll learn in a little while that people who've been on even a short course of antibiotics often tend to have a somewhat disrupted microbiome for up to two years after the antibiotic course. I know, let that sink in. Dementia and Alzheimer's disease is associated with falibacterium, and I'm not even going to try to pronounce the last word, but this is a different bacteria than Your. Normal bacteria that you're going to find in antibiotic or in yogurts and fermented foods. So I'm not saying go and find it and ingest it. No, I'm not saying that. In fact, this particular type of bacterium is not really well suited for exogenous administration. It's better to heal the gut, to eat foods that are high in prebiotics and probiotics and allow the gut to balance itself out. They found that when that particular bacteria was increased, there were improvements in symptoms in people with multiple different types of dementia. And they found that it was associated with these different types. Alzheimer's, frontotemporal dementia, dementia with Lewy bodies, vascular dementia and Parkinson's disease related dementia. Now each of these dementias was impacted by a different bacteria in those families though. So we can't again, we can't just say, well there this is the bad one, we need to knock it out. And we can't just say if somebody has dementia, well then they need to increase this particular microbe in their gut. Can't do that either yet. And I'm hoping that we discover some more information about that in the coming years. Depression is the leading cause of disability in the world, according to the World Health Organization. The effectiveness of the available antidepressant therapies is very limited. And when people take antidepressants, guess what? It alters your gut microbiome. Who knew anything you ingest or inhale or whatever is going to impact your system. Data from the literature suggests that some subtypes of depression may be associated with chronic low grade inflammation. So got people thinking. The role of intestinal microbiota in the development of the immune system and and its bidirectional communication with the brain have led to growing interest on the reciprocal interactions between inflammation microbiota and depression. As the inflammatory microbes take over and we see more systemic inflammation, we see people who have more depression. So what happens if we knock down some of those inflammatory microbes and increase the food and the the environment, improve the environment for the anti inflammatory microbes. They found that there is a lot of evidence that healing the gut microbiome can help with anxiety and depressive symptoms. Likewise, people who are not achieving maximal gains with antidepressants or without antidepressants may also benefit from examining their diet. And not just am I getting enough carbs and protein and fat and vitamins, but am I eating whole foods that actually nurture my gut? As I said earlier, estrogen levels impact the gut microbiome and People who have postpartum depression have an altered gut microbiome that is unique to the postpartum period when all those hormones are going through drastic changes. This is another area that they're examining for novel interventions because there are a lot of women who don't want to take any kind of medication for their postpartum depression if they're breastfeeding and working on healing the gut microbiota. Working on more holistic approaches may be a novel approach for people who are experiencing mild symptoms of postpartum depression. Ptsd. Who knew? The gut microbiome plays a crucial role in the development and function of the central nervous system, the nervous system, complex behaviors and brain circuits, and may contribute to PTSD by influen influencing inflammation, stress responses and neurotransmitter signaling. So let's kind of break that down a little bit based on what we've talked about in the past. Remember, people with PTSD often have a disregulated HPA axis. Hm. So did the HPA axis get disregulated and then cause a disruption or dysbiosis in the gut, or did the stress from whatever happened cause changes in the gut which hyperactivated the HPA axis and caused all those changes? We don't know. But we do know that people who have a dysregulated HPA axis tend to have systemic inflammation and tend to have an altered weight cortisol response and an altered stress response until their HPA axis is able to heal. And one of the key components to healing that HPA axis, as long as the vagus nerve is carrying messages back and forth, if the HPA axis is a nervous nelly, then the gut is going to be balanced toward fight or flight. If the HPA axis or as the HPA axis heals, you'll see a change in the gut microbiota. And they've also found associations between the microbiome and schizophrenia. And I know I haven't gone deep into each one of these because again, we'd be here for hours. But what I want you to understand or see is whatever disorders you're working with, the guts involved, and you can do more research on, on PubMed if you work with particular disorders. So let's talk about some other things that we often see in people who are presenting in our office, because most people don't just come in and have depression, they have other things going on as well. Let's talk about all of those things. The gut microbiome influences the immune system. We already talked about how it was integral in regulating the immune system and immune system development in children. But we also know that in response to stress, it may ultimately start producing more an environment that's more conducive to the inflammatory microbiome. And that inflammatory microbiome can trigger autoimmune disorders or the key or the hallmark of autoimmune disorders is inflammation. What happens if we start addressing the gut microbiome? Now, a lot of people with my autoimmune disorders have concurrent anxiety or depression. So as long as they've got stuff going on up here that's causing them stress, it's going to stress the gut microbiome. So you're going to have to take a concerted two prong approach. You can't just treat one and not treat the other. However, it is an important component to examine. Left to its own devices on the American diet, the gut is going to take a long time to rebalance itself. And we're going to talk about what to do at the end of the presentation. Diabetes severity of gut microbiot microbiota disbiosis or alterations is associated with disease severity and restoration with probiotic administration and animal models and human patients has been associated with an improvement of symptoms and disease progression that is huge. Diabetes impacts so many people and this is type 1 and type 2 diabetes. And I know type 1 is different than type 2, but remember type 1 has a lot of autoimmune disease aspects to it. So if the gut microbiome influences autoimmune disorders, well, there you go. If you're talking about type 2 diabetes, which they're starting to see some autoimmune components into, but that's again a different presentation. Then you can see how addressing the gut microbiome can be helpful and reducing disease progression. Reducing the progression to, you know, needing a pump to peripheral neuropathy to all those other side effects and problems is is huge. My husband's grandfather is 93 years old now and he's been living with diabetes. And it's been a challenge the last few years as he's become more selective in what he eats to help him manage his blood glucose. And his blood sugar has become much more rangy, if you will, since he quit eating as many var as much of a variety of foods, which tells us something's going on and it could be that he's not eating enough fiber. We know this to nurture the healthy gut micro microbiome. The gut microbiome influences your gonadal hormones, estrogen, progesterone, testosterone and estrogen Progesterone and testosterone influence the gut microbiome. It goes both ways. The gut microbiota regulate estrogens. When this process is impaired through dysbiosis, which is again, when the microbiome is out of balance, there is a reduction of circulating estrogens. We know that too little estrogen is associated with symptoms of depression, especially in women, and too much estrogen is associated with symptoms of anxiety. Menopause related gut microbiome changes were associated also with adverse cardiometabolic risk. So we've already talked about how hormone changes can impact the mood, can impact people's moods and their free floating estrogen levels. But we also need to recognize that a lot of these hormones are also involved in our cardiovascular system, and that's important. High blood pressure is associated with the development of dementia. So we need to follow it back and say, okay, what can we do to help control the hypertension? Well, what can we do to help control the diabetes? Well, we're talking about the gut, and it's not a panacea. There's a lot more you need to do than just eat fiber. But it's certainly one aspect of. Many men with a testosterone deficiency also have different gut microbiota compositions. The microbiome also influences hypertension. When we have stress, our blood pressure goes up. If the body's under stress, either due to systemic inflammation or because the gut microbiome is saying stress, stress, stress, for whatever reason, blood pressure is going to tend to go up and it impacts immunity, it imp. Impact, impacts inflammation. We've already talked about those. How many of our clients present with depression or anxiety or addiction and some sort of underlying health condition like fibro or autoimmune disorders, or colitis or Crohn's disease? My point being, there may be an, an underlying pathology or an underlying contributor to those symptoms. Gut microbiome, it isn't going to cause it all on its own, but it certainly could be one of the bad guys in the gang that's working to increase inflammation and systemic dysfunction. Now, serotonin, norepinephrine, dopamine, GABA and glutamate, we've talked about these over the past few weeks. And you know that these are your big, Your main neurotransmitters. Your neurotransmitters are responsible not only for mood, but also for cognition, for attention, for heart rate, for blood pressure. So if the microbiome influences the availability of these things by virtue of altering your neurotransmitters in and of itself could alter your Blood pressure levels. The gut microbiome influences serotonin neurotransmission in the brain by regulating the availability of the 5ht precursor, tryptophan. Remember, what happens in the gut doesn't stay in the gut. It goes somewhere. And through the vagus nerve, it can transfer up to the brain. Several gut microbes are capable of synthesizing neurotransmitters. So they're actually in the gut, they're assembling, they're making these neurotransmitters, including gaba, norepinephrine and dopamine. These neurotransmitters in the gut can act on target cells in the gut and serve as an important avenue of communication. So if the little gut workers are making a bunch of norepinephrine, then that's telling the receptors in the gut, hey, there's a stressor out there. Probably need to alert the big guy if it's making a bunch of gaba. And I'm oversimplifying, I know, but if it's making a bunch of gaba, then that tells the receptors, hey, we can send the all clear to the brain because we're relaxed. Remember, GABA is your main relaxation neurochemical. The gut microbiome influences the development of emotional behavior, stress and pain modulation systems, and brain neurotransmitter systems. That's really important to understand that it's not just chemicals that we're talking about, but it's also our response to those chemicals and how our brain responds. When we feel pain, what does it do when we feel stressed? How much is that HPA axis triggered imbalance in the gut microbiome reduces oxytocin, yet another one of those chemicals we've talked about and impairs. I spelled that wrong, sorry. Social. Social cognition, that's important. So when oxytocin goes down, people have difficulty reading other people and interacting in social situations. I'm going to bring this around to a full point in a second. Even mild stress can change the micro balance in the gut, making the host you more vulnerable to infectious disease and triggering a cascade of reactions that feed back to the central nervous system. Mild stress make you more vulnerable. We know when we're vulnerable, that's a threat. When there's a threat, the stress response, the HPA axis, goes into high gear and puts you into fight or flee. This is not where we want to stay. When you're in fight or flee for too long, we start to see breakdowns in the system. Stress can affect behavior by inducing overeating and consumption of foods that are high in calories, fat or sugar, decreasing physical activity. Do you really want to go to the gym when you're stressed out? Chronic activation of the HPA axis, shortening sleep and directly and indirectly altering the gut microbiome. Directly, brain sends signals to the gut to alter the microbiome. But indirectly, when you don't get enough sleep, when you are not as active, then that tells the brain to send a different signal to the gut. Exposure to chronic stress, especially early life stress. Can you say aces? Adverse childhood experiences, anybody? Exposure to early life stress decreased the relative abundance of bacteriocides and increased the Cholestridium species in the cecum, which is the intestines, and caused activation of the immune system or inflammation. Now go back to that second slide, I think where we talked about. Children who have certain symptoms of autism show an improvement in their symptoms when the level of Cholestridium is knocked down in their system. Hallelujah. So we can see that early life stress is probably, I think we're pretty safe in saying a child with autism is probably exposed to a lot of early life stress when, until they can get their diagnosis because the parent doesn't understand what's going on and as an infant they can't communicate it. So we do see a lot of early life stress which can contribute to the building up of this. But we also know that the same thing is true in adults who are undergoing chronic stress. They're just stressed all the time. And this could be like domestic violence, intense stress, or even just the stress that most people are going through, but they have difficulty managing it and feeling safe in their skin. We see the increase among other bacteria of the. We see an increase in the Colostridium species, acute and chronic stress, which we all have, increased the permeability of the gastrointestinal system and the blood brain barrier. Oh, okay. So now not only do we have the toxins leaking into the system, but we also have the blood brain barrier becoming just open to anybody. So the toxins are more able to get into the brain and cause inflammation in, in your brain. Inflammation of the GI tract places stress on the microbiome through the release of cytokines, inflammatory cytokines and, and neurotransmitters, coupled with the increase in intestinal permeability. These molecules then travel systemically. Elevated levels of cytokines tnf A and MCP or monocyte chemotract, chemo attractant protein increase the permeability of the blood brain barrier, enhancing the effects of these rogue molecules from the permeable gut, their release influences brain function, leading to symptoms of anxiety, depression and memory loss. Different difficulty concentrating. So that's kind of the process that's happening and how it gets from your gut all the way up to your head. The vagus nerve is one of the biggest nerves connecting your gut and brain, and it sends signals in both directions. And we have talked about this in several other videos. A lot of people with anxiety and trauma histories have a vagus nerve that doesn't work very well. We call it low vagal tone. So when the stressor is over, they have a hard time triggering the relaxation response. So the stress response just keeps going. And in people who have weak vagal tone, it becomes more difficult to get the brain to recognize, hey, you can send the all clear to the gut in mice, because we can't do this in humans. In mice, it was found that feeding them a probiotic reduced the amount of cortisol, your main stress hormone, in their blood. However, when their vagus nerve was cut, that probiotic had no effect. So when the vagus nerve is cut, whatever's going on in the gut stays in the gut. We are now starting to see the importance of this vagus nerve and of course, strengthening it. So people with poor vagal tone are going to have more difficulty getting the message to the brain that, hey, we can chillax now. So the brain is going to continue to send stress signals, which leads to inflammation and blah, blah, blah. We need to help people. See, I told you it wasn't a panacea. Not only do we need to improve gut health through nutrition, but we also need to make it a safer environment for the good bacteria by helping strengthen that vagus nerve, by helping people develop the skills to downregulate when they're under stress. Now remember, stress is normal, stress is natural. We all need a little bit of stress. But people who have a dysregulated emotional response often take longer to get back to baseline, and they have a more intense response at the peak. And what we're wanting to do is help retrain that HPA axis by actually implementing strategies like humming, singing, chewing gum, blowing bubbles, even massage when they're under stress and that that stressor has passed. So to help them reduce that stress response faster, help their retrain their vagus nerve to pay attention and recognize when. When it's safe. Factoid research has found that tweaking the balance of gut bacteria can alter an animal's brain chemistry and lead it to become either More bold, anxious or depressed. Now, we're probably not going to see huge changes in humans. What they're doing with mice is just like mega dosing them. But it is interesting to recognize that in mice we are able to see behavioral changes, attitudinal changes when we alter the microbiome. So when you're working with somebody who is timid, who is fearful, what impact might certain probiotics have on them? Not again, not saying to experiment with that, but instead look at healing the microbiome. Now, we've already talked about leaky gut a little, but I'm going to go over it again briefly. Leaky gut is when the cells lining your gut aren't stuck together as tightly as they should be, allowing proteins, viruses, bacteria and more to leak out of the gastrointestinal tract and into the bloodstream. Leaky gut syndrome is often described as an increase in the permeability of the intestinal mucosa, which could allow bacteria, toxic digestive metabolites, bacterial toxins and small molecules to leak into bloodstream. Now your think about your intestine, it's this tube thingy, and inside your intestine you've got the little projections that help the food move along. But we also have a layer, hopefully a thick layer, of intestinal mucosa. And what makes up that intestinal mucosa in large part 5 HT, which is sort of the precursor to serotonin. Oh my goodness. So if somebody isn't doesn't have enough serotonin in their system or their brain is not signaling to send enough serotonin to the gut, then that mucosa can become thinner. So not only are the cells not as tightly packed together, but the mucosa is thinner, so it's easier for bugaboogas to get through. When inflammatory agents leak into the bloodstream, it also increases the permeability of the blood brain barrier via those mast cells, letting potential inflammatory molecules into the brain. Inflammation is associated with major depressive disorder and suicidal behavior. Those with major depressive disorder and a recent suicide attempt had higher levels of gut permeability markers, which is interesting. Now, what do we draw from that? Not really sure. However, remember we just learned about the mice who became more bold when certain microbes were increased. I wonder if it's the gut permeability itself or whether the microbes that were prevalent in that person's system were making them more bold and potentially depressed and the inflammation was enhancing their depression. I don't know. But it is a curious thing to note. And if you're working with somebody who is depressed. You know, obviously we're not going to wait until they're to the point of feeling suicidal to suggest strategies to start helping heal the body from the inside out. Lipopolysaccharide, or lps is an inflammatory toxin made by certain bacteria. TNF alpha is an inflammatory cytokine also made in the gut, which has been linked with depression and a reduction in serotonin production. Now, all of these really technical things, I'm just telling you so you have this information. It's not as much you're not going to be tested on it, but I think it's important to understand kind of what's going on under the hood. Inflammation and high LPS levels in blood have been associated with a number of brain disorders, including severe depression, dementia and schizophrenia. These molecules increase inflammation, which trigger the HPA axis. The HPA axis releases cortisol and suppresses serotonin and sex hormones. So let's look. We're getting ready to get to the solutions in a minute, but I think it's interesting to look at the the symptoms of leaky gut, the symptoms of autoimmune diseases and the symptoms of mood disorders kind of side by side. All the things in bold are symptoms that are common to all three disorders. Under mood disorders, I have GI disturbances, achiness and pain, and sugar and carb cravings with an asterisk because those are not DSM 5 TR symptoms. However, when you're working with people with mood disorders, it is very common to see these symptoms. When people are anxious, stress response says it's not time to rest and digest. Let's get all that stuff out of there. So they tend to have diarrhea, flatulence, which means they're not absorbing the nutrients, which means there's an alteration in the gut microbiome. In autoimmune disorders, you see achy, muscles, fatigue. You also see some low grade fever, maybe some num, numbness and tingling in the hands and feet, that peripheral neuropathy, hair loss, skin rashes, and then in leaky gut, a lot of the same things. But when you're working with clients, think to yourself, is it just a mood disorder or do they also have, and quite honestly, if they've got a mute mood disorder, they probably do have some level of systemic inflammation going on from something we're not exactly sure what. But this could be one potential target. A healthy gut absorbs nutrients sufficiently to support brain health. A healthy gut prevents bacteria and inflammation causing agents to leak into the blood. Bloodstream and a healthy gut can adequately produce neurotransmitters. As a little, another little factoid, gut bacteria manufacture about 95% of the body supply of serotonin. Now remember I said a lot of it's down, down there in the intestines in that 5ht mucosa. But so we also tend to demonize certain bacteria. And, and I've added this in here because it's fascinating that like with most things, too little, not good, too much not good. We want just the right amount. So Lactobacillus and Bifidobacterium synthesize GABA from monosodium glutamate. And most people have been taught that MSG is bad. MSG is bad. Well a certain amount of it may be converted to, to GABA for some people who have a strong reaction to it. Yeah, it's bad. I had a friend of mine who would get incredible migraines anytime he was exposed to msg. So it's not for everybody, but it's kind of interesting. E. Coli, how many times have we heard about spinach or something being recalled because eco it's contaminated with E. Coli? Well yeah, you don't want too much of it. A little bit goes a long way. E. Coli, bacillus and saccharomyces produce norepinephrine. So you do need it in your gut to help produce norepinephrine. Candida, which gets another one that gets a bad rap when it's overpopulated. Then it does cause a lot of health problems. But you need a little bit. Along with streptococcus, your strep bacteria and Asheria may not have pronounced that right. And Enterococcus, in order to produce serotonin you don't want to completely wipe out everything. And bacillus and serratia produce dopamine. Now there are a lot of other things that contribute to the chemical reactions that produce these molecules, but it's important to recognize that we do need the bacteria in our gut to help with the process. The Phytobacterium improves depression related symptoms through alterations in 5ht metabolism. Mucosal 5ht, that stuff in the gut I was talking about, plays a direct role in the regulation of intestinal permeability. Norepinephrine, epinephrine, dopamine and serotonin are able to affect gut motility, nutrient absorption, the gastrointestinals immune system and the microbiome. So when you're stressed and your levels of neurotransmitters alters it's going to alter what happens down here. When you take psychotropic medications, it's going to alter the levels of some of those neurotransmitters and it's going to also alter the gut microbiome. Psychobiotics may produce health benefits in patients suffering from mood disorders. And these are bacteria like your Lactobacillus that are helpful and healthy in the gut. But remember, if you, you can overdo it and you can actually, I found out many, many years ago, you can actually eat too much yogurt and it throws the system out of whack. So finding that Goldilocks principle, finding that sweet spot when you eat the probiotics are really important. And when you eat, practice the three color rule. @ any every meal on your plate have three colors. Condiments don't count and skittles don't count. But having something that's green, red, blue, you know, and white, brown at every meal helps make sure that you're getting the nutrients and the, and the antioxidants that you need to support gut health. Fermented foods are super healthy. Kefir or kefir, depending on where you're located, have inflammatory activity by inhibiting the activity of pro inflammatory Cytokines such as IL1B, TNFA and IL6. You can get kefir in the grocery store tends to be really expensive and have a lot of sugar in it. You can also make kefir at home. I've made kefir at home for the past decade I think and I like it, you know, and, and it takes a minute to get used to the taste, but you can sweeten it up with a little agave nectar or something if you feel like you need to. Using Keir and its byproducts as an inhibitor of expression of pro inflammatory cytokines. This has been recommended for people who tend to have inflammation or who have autoimmune diseases, making sure that they're getting enough fermented foods. Not everybody's going to want kefir or Kombacha or anything like that. So it's up to the individual. In a study of 124 healthy volunteers, older people mean age 61.8 years. Those who consumed a mix of specific psychobiotics including Lactobacillus helveticus and Bifidobacteria longum exhibited less anxiety and depression. Children with ADHD found had substantially improved symptoms on either a food coloring free diet or by dietary supplementations with polyunsaturated fat. Fat fatty acids Iron and zinc. So indirectly impacting that gut microbiome to increase good gut bacteria. Prebiotics. These are your microbe food. These are the things that you eat like that are fibrous that go down into your gut and it's what the the bacteria feed on. Chicory root, onions, leaks, garlic, fruits, whole fruits that have the fiber in them. Vegetables, including your leafy greens, your broccoli, your carrots, your cauliflower, your brussels sprouts and your whole grains if you can eat them, like oats, barley, brown or black rice and whole wheat. Now, black rice is not something that a lot of people have eaten, but it is amazing and it has a lot of antioxidants in it which give it its black color. And it has kind of a nutty taste. So if you haven't tried it, I would suggest trying it. And it actually does have a whole lot of fiber in it, more fiber than most other rices out there. Legumes like peas, lentils and chickpeas and nuts and seeds like almonds, walnut, chia seeds and flax seeds. None of these are really weird foods. And finding some, some preferably of different colors that you will incorporate into your diet on a daily basis can be really helpful to your gut. Polyphenols have antimicrobial activity against the bad bacteria while promoting beneficial bacteria. And it they also help increase mucus and modulate your bile acids. So polyphenols are kind of good gatekeepers. I don't know what we want to call them, but you find your polyphenols in the colorful foods and including cocoa and dark chocolate score. You can get cocoa powder or caico powder organic in the I get it in a big five pound bag and you can add it to your coffee or something so there's no fat in that or if you don't mind the fat, dark chocolate, berries, apples, grapes, tomatoes. The darker the color, the more antioxidants and polyphenols it has. And there are different polyphenols based on the color. So your yellows, your oranges and your reds, your blues, your purples are all going to have slightly different polyphenols in them. Factoid, I'm a big gardener. You all know I live on a farm. Red tomato genotypes have high, higher levels of the antioxidants, lycopene and carotene. Orange tomatoes have higher concentrations of the antioxidant to sulfurols and carotenoid. So those are your oranges. Yellow tomatoes had higher total polyphenol content, hydrophilic antioxidant capacity and greater expression of genes involved in carotenoid to suffer all and anthocyanin synthesis. Yellow tomatoes have actually been found, especially the yellow slicing tomatoes, interestingly enough, have been found to be some of the healthiest tomatoes. Anthocyanins, which are antioxidant pigments, were found in higher levels in purple and red heirloom tomatoes. Heirloom is important as we have made things hybridized and GMO and all those things, we, we've actually altered the structure of their proteins and their polyphenols and everything else to make them less, less healthy, to be brutally honest. Increasing good gut bacteria get good sleep and maintain your circadian rhythms. Just like everything else in your body. The workers in your gut switch shifts and if you mess up your circadian rhythm, then the workers that are showing up for work may not be the ones that are supposed to be there. So maintain your circadian rhythms. That reduces stress on your body and will also help reduce stress on your HPA axis. Maintaining your circadian rhythms, that's your timing. Sleep is part of it. Your circadian rhythms impact your sleep. And if you're staying up late or, you know, messing with your sleep schedule when you switch shifts, if you're a shift worker, it's going to mess with your circadian rhythms. And likewise your gut microbiome. Try to keep it as constant as you can during periods of circadian stress. Make sure to pay attention to how your gut's doing. Avoid these things that increase proteobacteria or your inflammatory bacteria. Carboxymethyl cellulose, CMC and polysorbate 80. Just read the ingredients. Soy protein. Now, some people love soy protein. Some people eat a lot of it. It doesn't bother them. Okay. You know, you may not be one of those people that has an imbalance of proteobacteria, but for other people, soy protein can increase systemic inflammation and has been associated with altering levels of estrogen and potentially contributing to increasing risk for breast cancer. Palm oil. Oh, I was devastated to find this out. Palm oil is one of your major constituents of peanut butter. I love peanut butter, but guess I'm going to be cutting back on that. Processed foods that are high in refined carbohydrates and low in fiber fuel the growth of the bad bacteria, which eat the sugars and starve the good bacteria that need the fiber. Alcohol and nicotine directly impact the gut microbiome and antibiotics after a short course. Most bacteria return after one to four weeks, which is what we most Most of us notice, but they have found that the microbiome is still technically a little bit off for up to two years. So what about meat? Some of you are hardcore vegetarians. Cool. Some people like meat and we don't want to completely demonize meat for those who still eat it. Chicken eaters have been found to have higher abundances of anti inflammatory beneficial bacteria, including Prevotella and the phaecal bacterium, compared to red meat eaters. So that's important. We don't want to increase inflammation. Chicken increases gut microbial diversity and provides tryptophan which can promote the growth of beneficial bacteria that will help make serotonin. Tryptophan metabolites when they're broken down. When the food, like the chicken, is broken down by the bacteria, the metabolites have anti inflammatory effects that support the gut barrier integrity. Remember that gut barrier is largely 5ht, which is manufactured from tryptophan. Unlike red meat, chicken does not increase levels of pro inflammatory compounds. Not saying you can't eat red meat, but chicken has been shown to be less detrimental and it actually does increase the biodiversity in the gut. Nutrition activates hormonal neurotransmitter and signaling pathways in the gut, which modulate brain functions like appetite, sleep, energy intake, reward mechanisms, cognitive function and mood. So pretty much everything we do, even if the person is eating healthfully, if the bacteria are not there to break down the nutrients to make the neurotransmitters and hormones, the person's going to have symptoms. If the workers aren't there to disassemble and reassemble, you're going to be out of luck. In a study of older adults, it was found that healthy nutrition reduced the incidence of depression in about 40 to 50% of people without medication. Healthy foods like olive oil, fish, fruit, fruits, vegetables, nuts, legumes, poultry, dairy, and unprocessed meat, that is meat without nitrates or nitrites. And no hormones have been inversely associated with depression. So the more you eat those foods, the lower your risk for depression. Magnesium, calcium, iron and zinc are also inversely associated with depression. If you're eating a healthy, colorful diet, you're probably getting plenty of these. But all of these vitamins and minerals serve as sort of spark plugs to the chemical reactions that take place. No spark plug, no reaction, then you're going to have a problem. Chromium can cause a secondary synthesis of serotonin, norepinephrine and melatonin. And it's been associated with reductions in depression in people with certain Types of depression. Vitamin C was also to have found to have an equivalent effect as amitriptyline for some people on improving mood. Folate, B12 and B6 combine to enhance cognitive performance and reduce the risk of depression. Vitamin D is associated with reduced depression, as are calcium and copper. Now, some of these you can take to toxic levels. Others, even though they're water soluble, can get to really high levels in your bloodstream. Again, it's better to heal using whole foods and a nutritious diet than to try to mega dose on something which anytime you mega dose on one thing, it's going to throw other stuff out of whack. Several medications, including metformin and gram negative antibiotics have showed a certain potential to treat depression, which is really cool. Metformin actually alters the way your body handles blood sugar as well. It's a diabetes medication. Prebiotics result in lower cortisol levels and improved attention to positive stimuli. Who knew your prebiotics include lactose and fiber? Now, lactose is from milk and fiber you can get from your vegetables, your legumes, your, your grains. Lactobacillus acidophilus induced the expression of the cannabinoid 2 and mu opioid 1 receptors in the colon's epithelium. So Lactobacillus is, which is the main yogurt bacteria, if you want to think of it that way, induce the expression of the cannabinoid 2 cannabis, your internal cannabinoid receptors and your mu opioid, your opioid receptors in your colon. And those are associated with reductions in inflammation. Lactobacillus farimus inhibited stress induced visceral hypersensitivity. So for people who, when they get stressed out, they get, yeah, really bad stomach aches, increasing this helped some. Now this hasn't been tested against Crohn's and colitis, but that is something that they're looking at right now. Lactobacillus helveticus is a type of lactic acid bacteria that's naturally found in the gut. And certain foods like Italian and Swiss cheeses, Parmesan, Cheddar, gray air milk, kefir, buttermilk and fermented foods. So yum. Ingestion of Lactobacillus casei, shirota, Lactobacillus and B. Longum reduced anxiety and depressive symptoms and cortisol levels. Elevated HPA axis responses and depression in rats can be reversed by administering a single bacterium, Phytobacterium infantis. Now again, remember, rats tend to get a Mega dose, thousands of times higher than what we would give a human being. So this isn't a one to one transfer, but this is giving us hope that they may be able to start looking at certain bacteria improvement in people with mood disorders as well as psychotic disorders and neurological disorders. There are some experiments, I guess treatments, I don't know what word I want to use going on with people with severe cases of those disorders getting actual fecal transplants to sort of reset the gut microbiome to increase the phytobacteria. Take probiotics, take eat high fiber foods, eat prebiotic foods with the carbs and the fiber, eat polyphenol phenols, whole grains, fermented foods and exercise. So I've said the same thing like three times now. It's pretty straightforward. Think about when you're working with clients, how anxiety or depression perpetuates itself via the gut brain axis. Because the brain says I'm anxious, I'm depressed, it sends that message down to the gut. The gut says okie dokie and responds to protect the organism. Gut disorders like IBS and Crohn's can impact mood because they alter the gut microbiome. Same thing. Autoimmune disorders can, well, by their very nature are associated with increased inflammation. And increased inflammation is a stressor. Brain's going to register that. It's going to be sent down to the gut. The gut is going to respond and alter its composition. Are there any questions? I know we went over a lot of stuff today, but ultimately this was an introduction to help you recognize to that gut health can be just like sleep. And you all know I harp on sleep a lot. Gut health can be one of those things that we can use as an adjunctive therapy or approach to help people reach maximal gains faster and to deal with some of their symptoms, especially their physiological symptoms like fatigue and headaches and even cravings. People with post acute withdrawal. Are there any other questions? Yes, you're right, Melissa. Chia seeds and flax seeds are awesome. Flaxseed oil are great. I actually use chia seeds. I grind them up and use them as egg substitutes so I get more Omega 3s and some of the, like the black bean brownies that I make that are so good, chock full of fiber and antioxidants and omega 3s. All right, everybody, have an amazing rest of your week and weekend and I'll see you on.