The Gut Zoomer: A Key to Longevity - Episode 301

Welcome to the Gladden longevity podcast with Dr. Jeffrey Gladden, where our passion is helping you to become an AJ hacker. On this show, we want to help you optimize your life energy, longevity, health and human performance with impactful and actionable information by answering four questions. How good can we be? How do we make 100 the new 30? How do we live well beyond 120? And how do we live young for a lifetime? Now, here's today's episode of the Gliden Longevity Podcast.

Welcome, everybody, to this edition of the Gliden Long podcast where we're here to turn you into an age hacker and answer the big questions in life. How good can we be? How do we live well beyond 120? How do we make 100 to new 30? How do we live young for a lifetime? And how do we develop a 300-year-old mind? To that end, you've probably heard that gut health is central to health in general, and we're fortunate to have Emmy Brown with us. She's a naturopathic physician with a bachelor's of science in dietetics from Florida State and a naturopathic medicine degree in res from Batiste University Clinic. She also headed up naturopathic residency supervisor at healthtopia Clinics in Encinitas, California. And she's joined Vibrant America, a lab testing company out of San Jose, California, that has developed a lot of very innovative tests for functional medicine physicians and longevity physicians. And today we're going to be talking about the Gut Zoomer, which is an updated version of a very comprehensive stool test. And I think you're going to learn a lot. I really enjoyed this conversation with. Welcome, everybody, to this edition of the Gladden Longevity Podcast. I'm your host, Dr. Jeffrey Gladden, and I'm joined today by Emmy Brown, naturopathic physician that works for Vibrant America. Emmy, welcome to the show.

Thank you so much for having me. Dr. Gladden, so nice to see you.

So today we're going to get into some deep. Well, we're going to get into some deep stool, I suppose. So we're going to be talking about Vibrant America's Gut Zoomer, which is a really cool test. In fact, they use Zoomer after all of their tests or most of their tests. What's the origination of Zoomer? Why did that come into play? Are you familiar with that?

Well, don't quote me on this. I've been with the company for three years, so, you know, I was not around during the inception. But the Zoomer, I believe when we're using the technology Using these proprietary micro array sequencing technology devices, we can zoom in on protein and peptide sequences.

Okay.

So generally it's the food sensitivity tests that were given the Zoomer name, so having to do with the technology, but it seems like they're running with it for some of these other tests, which include a lot of other methodologies included to pick up these markers.

So Vibrant America is a really interesting company. I've known them really since they kind of came on the scene, and they've been incredibly innovative. I've actually gone to the, to the labs there in California, outside of. What is it, San Jose, I think.

Yes.

And it's incredibly high tech. I mean, with all the mass specs and everything that they do there. It's. It was unlike anything I've ever seen before. It's. They're incredibly dedicated to performing ultra high quality testing, I would say. And you know, when you come to stool testing, it can be a little, a little mucky, just to carry the puns forward, so. And a little murky, I suppose. Do you want to update us a little bit on the Gut Zoomer, kind of maybe introduce the audience to the Gut Zoomer kind of what it is, how it, what's used clinically. We can talk about some of the updates.

Absolutely, yeah. Happy to do so. And I think the big take home point here is that stool testing is for everybody. It's not just if you have diarrhea or constipation, gas, bloating, heartburn, and we can get into later.

But so why is it for everybody? I mean, if somebody's listening to this, it's like, you know, I feel fine. My, my, I'm regular, I'm, you know, everything seems good. Why, why would I want to do it?

Because it's linked to longevity. We have this research. It's amazing. And you're probably familiar with the 2023 Nature article titled longevity of centenarians is reflected by the gut microbiome with youth associated signatures. But for your listeners out there.

Yep.

So who doesn't want that?

Yeah, exactly. So just so the audience understands, actually an altered gut microbiome is now one of the hallmarks of aging. You know, the formal hallmarks of aging. Things like telomere attrition or shortening, senescent cell formation, inflammation, mitochondrial dysfunction, altered intracellular communication, micronutrient sensing disorders, autophagy, proteostasis, all these things that our kind of fundamental processes in the aging process. Now having an altered gut microbiome is right up there in terms of its level of importance. So tell us a little bit about that paper from 2023. What, what did they, what did they talk about there?

Sure. Well, there are features measured on our stool test, the gut zoomer, that are mentioned just very briefly if you look at the abstract. So I quote, compared to their old adult counterparts, centenarians displayed youth associated features in the gut microbiome characterized by an overrepresentation of a Bacteroides dominated enterotype, increase in species evenness, enrichment of potentially beneficial Bacteroidetes and depletion of potential pathobiones. And those, those pathobionts, that's, that's a new term for me. And so these are microbes that are naturally present in the gut microbiome, but they can become pathogenic in certain circumstances, inflammat inflammatory cases, and nobody wants that. And we're measuring these Bacteroides and this, these Bacteroidetes microbes. We're measuring evenness.

Yeah. Okay, cool. So usually there's a Bacteroides firmicutes ratio that's pointed out. Right. And you want to talk a little bit about that ratio and then maybe how people can increase the Bacteroides. Well, I mean, what would you do if you're low on Bacteroides? Right. What am I going to do?

Right. We all want more of it.

Yeah, we all want more. So how do we get it right?

So that ratio, the firmicutes to the Bacteroides really helps us understand if we're eating too much refined carbohydrate, which is going to promote more firmicutes, a lot of fat in comparison to plant based fiber, which is going to feed the other side of the equation, the Bacteroides. Okay, okay. So, and we think about plant based fiber. We talk about fiber all day long. You know, it can be a little bit of a boring kind of concept for many people. It's not sexy and exciting, but it's imperative. So, and Dr. Tim Spector spoke to this also. 30 different plant based foods a week. It doesn't have to be a huge amount, but we're seeing this and it's such a good reminder. And that's seeds, nuts, fruits, veggies, who's eating, you know, beans on a regular basis and lentils, our spices. So I think, and I have to be mindful of this, otherwise I'm not getting it in, you know, these little, literally little things like chia seeds and flax seeds. Mix it into whatever you can, salads.

Smoothies, oats, and all the herbs. All the herbs are incredibly important. Too.

Yes.

Right. Basil and rosemary and tarragon and all these herbs are incredibly helpful for us or incredibly helpful for the arteries, which is another conversation. But they actually promote decreased oxidation in the arterial walls, which is very cool, but it's also incredible for the gut. So, you know, you think about dietary preferences now with a lot of people being on keto diets or high protein diets or carnivore diets or things like that. When those people get their gut biomes tested, I suspect that they're low on bacteroides. Right?

Yes. Yeah, we do see that, you know, a lot more people are eating carnivore and seems like, you know, it helps some people in a short period of time, depending on whatever the case is, if they're looking for maybe help with energy or insulin resistance, maybe I'd be curious, you know, what you're seeing as far as cardiovascular trends and laboratory findings. But it doesn't seem like a lot of people are sticking with it for that long, at least from my point of view and what I'm hearing.

Yeah, I think there are people that benefit from taking plants out. There are some people that just don't get along with fiber for whatever reason. You know, it's either bloating, diarrhea, whatever it is, and they can kind of settle their gut down by taking plants out and going to more of a carnivore, keto, even a more, let's call it higher fat, avocado, healthy fat kind of diet seems to be have a salutary effect for them. And then there are people that want to get lean. And to your point, if you're only eating protein, what people don't understand is that protein can become carbs. Most people think, well, if I'm eating protein, I'm building protein. But that's not true. Egg whites, which are the perfect biological protein, if you eat egg whites only, 49% of that goes into building protein in your body. The rest of it does get turned into carbs. So that's an interesting thing that most people don't realize, but I think that what we found is that when you're looking at it through the lens of how do we make more nitric oxide to actually keep our arteries healthy, that's all plant based, Right. It all comes from plants that are high in dietary nitrate and that also have good fiber. And so, you know, when I was making smoothies, I would always call them chunkies because you actually want to be chewing those plants and getting that fiber in there that your gut biome can ferment. And yes, you may get a little bit of gas, but it's kind of worth it because you do boost these healthy bacteria. Anyway, we're, we're kind of in favor of a plant based diet. Not a plant only diet, but certainly a plant based. Yeah, so that's how we think about it. But you know, there are people that benefit from something else. And so, you know, if that's the case, so be it. But it's interesting to see that on the longevity front, there is no substitute for plant fiber.

Right.

What you're saying.

So that's, that's the poignant piece here. And if there's digestion issues, well, there's something we can do about that. If we're not tolerating these foods. If we can lightly steam or cook these fibers support digestion using bitters. I'm a fan of bitter tinctures as I'm a naturopath. So I like the botanical side of things as a modality. And just eating bitter greens. Can we start our meal with some arugula, you know, with a vinegar based dressing? It's something that I think is overlooked.

So what do bitters do for somebody's digestion?

Yep. So bitters stimulate digestion. We think about hydrochloric acid, pancreatic enzymes, bile acid instead of replacing the pancreatic enzymes, which of course there's a time and a place for that intervention. But I like to start with bitters because this is going to naturally stimulate what your body already knows how to do. But sometimes we're stressed. Oftentimes we're stressed. Right. We're working, we're eating in the car, we're eating standing in the kitchen. And it's so it's hard to tap into rest and digest our parasympathetic nervous system tone when we're always going, going, going. So to have a little bottle of tinctures in your bag, that can be a nice workaround.

Yeah, that's great. Is there a brand that you like of bitters?

Oh, gosh, there are a few Wise woman herbals. Herb farm. It's ph farm. A little play on words there. Urban moonshine. You know, these are becoming more and more readily available at health food stores. And I always tell patients, also make it fun. It's not another pill. So you can put it in sparkling or still water and then you have a little mocktail before your meal.

There you go.

Right. We like mocktails, I'm sure on this show.

Sure. Yeah. We're not big alcohol fans.

Yeah.

Although a little bit of alcohol actually does have a longevity benefit. But yeah, no, that's, that's interesting. That's cool. So then take us through the guts. It's a test. It's tell people how they collect it, how they, you know, how they, how it's processed, where they send it, all that just kind of walk us through the whole journey with the Gut Zoomer.

Yeah. So it is a stool test and we have a QR code in the kit. So I think that sounds intimidating to a lot of people. I know it, it did for me when I first did it as a student, as a medical student. But the instructions are very easy to follow, you know, and so to get too graphic, you know, there is something to cover the toilet, to collect the stool. You know, there are tools provided so you can put the stool into the specimen containers and then it's shipped. You know, it's kind of a funny thing. You're shipping your stool to the lab where it's processed. And as I said, there are several methodologies that are used to look at the microbiome and look at inflammatory markers, look at digestion markers and so, and it's a pretty quick turnaround time. I don't have that in front of me, but I know they're trying to get quicker and quicker. I believe it's less than a week or so at this point. And it's so comprehensive. You're getting a huge report and you're getting infographics to teach you why this matters and where these inflammatory markers are coming from. And there are intervention strategies also displayed in this report. So you don't have to be a researcher or a gut microbiome PhD. The report gives you so much information in terms of interpretation, it's fantastic.

Yeah, I think talk a little bit about pathogens in the gut, you know, those are disease producing organisms and these can be anything from parasites to different bacteria to different viruses. And what the Gut Zoomer does is it actually reports out on all of these. How does it actually detect, detect those things? Because I don't think you're looking through a microscope to see a worm swimming around. Right.

So no, no, we're not using microscopy. We're using real time PCR.

Okay.

And so we have a 96% sensitivity, 100% specificity. So for those listening who aren't familiar 96% of the time, we're catching that pathogen if it's there. So pretty darn good considering other, other tests on the market. And then 100% specificity, meaning when There's a pathogen detected. There's no doubt that it is that pathogen. It's not cross reacting with something else. So I think about sensitivity as how good is the test at finding the needle in the haystack? Okay. Well, it might miss 4% of the time a false negative. And the specificity is how good is the test at making sure that needle is not something else that looks maybe like a needle, like a toothpick or something else. Right. So very good accuracy there. And we're testing for a lot. We're testing for not just H. Pylori, but this is a new one for me. We're testing for non Helicobacteria pylori, helicobacters, which is kind of an umbrella of these Helicobacter bacteria. And they can be pathogenic, but sometimes they're not tested for. I think oftentimes they're not tested for. So in a H. Pylori negative patient with gastritis, we might want to look for this particular pathogen. And it's on the. It's on the new one. So very exciting on that.

That's interesting. So with H. Pylori, it can be treated with an antibiotic and it can also be treated with certain herbals. How about for the other heliobacters? If you find those, how are those treated?

Yeah, so I haven't done a deep dive on that. It seems like the standard of care for H. Pylori, as far as I understand. I believe it's the similar antibiotic regimen, but we don't want to miss these things. I think that's really the big point here because you go to your primary care provider or you go to gastro, maybe you're even referred to gastro. And they're testing for these routine pathogens. So to have a more comprehensive list is, I think, really helpful for people struggling. And there's some risks associated with that one, too. Molt lymphomas in particular stuck out to me for this particular pathogen. So we want to be careful. We're looking for these things. If someone has ongoing gastritis, if they've got ulcers, if they've got issues, we don't want to miss it.

Yeah, it's interesting. We've. We've been impressed that we end up finding parasites for people they didn't know they had. So people that have traveled, people that are exposed to, I don't know, different water, different. Different environments with different food, whatever, they can come back and have several pathogens that they don't know about because regular stool testing will have been looking through a microscope to see if they see something. And if they don't, then they're, they're left with symptoms but no real understanding of why they have them. Being able to use the pcr, which is basically looking at genetic material, then you can actually have more certainty that you're finding it and then you know certainly what you have if you do find it. Right. So we've been able to treat people and have significant improvement in their gut health through that. It's interesting how many people show up with parasites.

I agree.

So not everybody, but it's certainly quite common. So tell us a little bit more about the test. You were talking about some of the new features with the updated gut Zummer. Compare the old to the new, if you would.

Sure, yes. So we do have some additional commensals. And so to your point, Dr. Gladdin, we have our pathogens, these are infectious organisms, but we also have our commensal bugs, if you will, or microbes. And so these are the normal inhabitants, if you will. But they can become, they can go a little crazy, they can become overgrown and that can be associated with GI upset. We can have gas bloating. I know a lot of our listeners are probably familiar with sibo, small intestinal bacterial overgrowth. So we can look for these imbalances in the normal microbiome, if you will. So we have added a couple of those microbes. We have one in particular that I find interesting is this. Ali Stips stipes. This is brand new to me. So this is a microbe that has been associated with mood regulation. GABA is produced by some of our microbes. And this is again why stool testing is for everybody, right? Who doesn't want a good mood, who doesn't want to live a long, healthy, happy life. So if this is implicated in GABA and short chain fatty acid production, that's, that's amazing. And I want to see if I have enough of this particular one.

That's a really good one because GABA is the, it's basically the counterpoint to glutamate in the brain. And glutamate is an excitatory neurotransmitter which can make it hard for your brain to turn off at night. And it can also kind of burn your brain out, so to speak, where you get a lot of fatigue or brain fog. Whereas GABA is actually kind of a rest and restore neurotransmitter, calms the brain down and it's really Important for sleep. So if people are struggling with sleep, if they're taking the right probiotics, and we'll talk about that in a second, to maybe boost the GABA production or the right diet to boost GABA production. Now you're, you're basically actually calming yourself down by having your gut working with you, right? It's. We know the gut is kind of a second brain. We know it makes serotonin, some other things that are actually salutary for us in terms of being calm. But to have more gaba, that's a big deal. So do you want to tell us how, how to optimize the GABA producing bacteria? Is there, are there insights into that or is that.

Yes. So I don't have the specific, you know, I think getting the specific, maybe nutrient intervention for the organism, you know, that's trickier. And to. Again, I'm referring back to another episode you had on the gut and longevity. Dr. Tim Spector, that we're really in the infancy period of understanding all of this, but we do know certain fibers will feed these microbiota. And so we need fructooligosaccharides, we need resistant starch, we need inulin. So overall, we want a collection of these fibers. And it can sound, you know, kind of like another language if you're not familiar with nutrition. But essentially it's eating all those things we talked about before, but we need a combination. So it's not the same. It's not your favorite fruits every single day, but buy something you've never seen before, like, you know, Jerusalem artichokes. I think I may have only had it once or twice in my life. I need to buy more. We all need to kind of work on this, I think, but it's, it's really being mindful of rotating, eating seasonally. I think that helps a lot too.

Yep. No, it's a good point. I try to. I adopted a habit, you know, when I heard about the fact that most of us eat about 16 foods, we kind of rotate around 16 foods or something like that. I was like, that's pretty narrow window. So. And then I had heard about the need for 30 plants or 40 plants. And so I started to adopt a strategy when I go to the store of trying to buy different things every time I go, yeah, and I may, I may circle back to it in three weeks or four weeks and get another, whatever, apple or kale or whatever. But trying to go into the produce section and just buy a bunch of different things and, and that variety you know, the gut, the gut loves variety. Your body loves variety. You're actually, your nervous system loves variety. Right. If you're doing the same thing habitually, you know, it starts to get boring. So you can think about it. It's, it's a little bit about being adventurous in your eating. And I think when you do that, it's actually a super healthy, super healthy thing to be doing. So.

Yeah, yeah, absolutely. And recreate what you like eating out. You know, I'm a big foodie myself, but when we go out, we get exposed to so many highly processed oils and you know, even if we're eating a salad, the salad dressing is probably using a very low grade vegetable oil that's sold in those huge plastic jugs. You know, that doesn't speak to quality very much. And so try to recreate it at home, you know, try to understand the origins of that meal culturally. I love to explore this and, and then find those ingredients. And there's a, there's a, going to be a way to cook it and make it taste good. All you have to do is Google it. Right? Our information is just everywhere now.

Yeah, that's right. That's right. Cool. So what are the other features of the new Gut Zoomer that you'd like to highlight for us?

So there are, we've got antibodies on this test. So for those of you who may be familiar with the. The older iteration, we had anti gliadin antibodies featured, but we do have an expansion and I'm just pulling it up on my end here too.

So anti gliadin is related to wheat sensitivity?

Exactly, yes. So it could be a sign of our gluten sensitivity, maybe a non celiac gluten sensitivity. So we've been tested for celiac and it's negative. Okay, but you're still struggling with gas bloating and maybe it's extra intestinal. So again, even if we don't have GI symptoms, we have brain fog, we have headaches, we have fatigue, we know that there are associations between wheat and gluten related disorders and neurologic complaints and neuroinflammation. So we are looking for immune system reactivity to gluten in the stool test. So you may not need to get a blood test. Maybe you're looking for a pediatric patient. And the stool test is obviously going to be easier than getting blood in a lot of kiddos. So I love this feature. We're including anti lipopolysaccharide. This is an endotoxin that comes from gram negative bacteria and oftentimes we have way too much gram negative bacteria when we have functional GI disorders.

And that's the dysbiosis, lps, lipopolysaccharide. That's a big one. That drives a lot of systemic inflammation, actually. Right, yeah. Interesting. And what about leaky gut? What are you doing with regards to leaky gut? Because I think a lot of people, you should talk a little bit more about sibo, which is small intestinal bacterial overgrowth, and what I call co, which is small intestine yeast overgrowth. Yes, right. And leaky gut. These are so common and the symptoms of it that what we see is systemic inflammation and brain fog seem to be two of the biggest ones, as well as bloating and you can have gas and constipation and whatever else. But talk to us a little bit about leaky gut and then walk us through the SIBO and CO scenario.

Sure. So intestinal permeability, or leaky gut, as we tend to call it, is something that can happen downstream of stress. To put it simply, we have so many stressors, we have physical stressors. And this might be poor digestion, this might be contending with toxins in the environment. I mean, that's a whole other conversation we can touch on. So the plastics in our environment is just to name one, the glyphosate. Right. On the food that we consume. So it's not just dietary processed foods and toxins that are creating intestinal permeability to the toxins in the environment and the mental emotional stress. I feel. And this all is going to impact, I think, about digestion as really being at the top. And I learned this from a clinical nutritionist thinking about the gut microbiome head to toe, meaning cephalic phase of digestion. We see the food, we smell the food, we start to salivate, we get excited for the meal. This is what we want to happen. But again, sometimes we're rushing around and we're not able to really kick into that cephalic phase. But that's what we need because then we have hydrochloric acid kickoff and digestion starts. If we're not digesting properly, we're risking overgrowth of these microbes further down in the large intestine. And this creates inflammation, it creates intestinal permeability, which is this widening between the cells in the gut lining. And that can lead to inflammation system wide.

So this is an interesting thing. It's the parietal cells in the stomach that are producing hydrochloric acid. And as people Age, they can start to develop something called achlorhydria, which basically means that they're not producing hydrochloric acid in the same way that they used to, which can have an impact on digestion. But it also has an impact having that acid pass from the stomach into the small intestine is healthy for the small intestine to kind of keep it purged from some of these overgrowing bacteria and yeast to some extent. Right. So having acid when you eat is good. And for people that, you know, you talked about the bitters, but also taking some acid, this is maybe where vinegar is helpful and things like betaine can be helpful for replacing the hydrochloric acid. Right. So people should keep that in mind, that these are pretty simple things that can be done with the meal that can help keep the small intestine from being overgrown. Right. It's a piece of the puzzle, not.

The whole puzzle, but exactly. Yes. I say hydrochloric acid is our natural antimicrobial because so many people, they want to take, you know, herbs that kill, they want to talk about killing first. As far as that first step, when we're thinking about GI healing or, you know, maybe I just need to take a course of antimicrobial herbs, but I always think about digestion first and the pancreatic enzymes, because this is what keeps everything in check and keeps it in balance. And that's what we should be producing on our own naturally. But sometimes we do need to take bet10HCL if maybe it's a higher level concern or dysfunction. Absolutely.

Yeah. Interesting. Yeah. And then talk just about yeast, because yeast is. Yeast is actually pretty common. We see Candida and some people will show up with systemic yeast symptoms, like they've got it on their toenails or their fingernails, or they've got it in their mouth or things like that. And what we've come to understand is that if you've got it in your peripheral areas, like that could be in a skin fold or something like that, you definitely have it in your gut. And so treating just the, the toenail, let's call it, is not going to be enough. You actually have to be treating the gut simultaneously. So getting a stool test if you have any signs of, like, skin infections is actually super helpful too.

Yes, yes, thank you for bringing that up. I agree. So it's this systemic impact we have from this overgrowth or this imbalance or dysbiosis, whatever you want to call it, in the gut. And I think a lot of people aren't aware they're not looking at their tongue. So thank you for bringing that up. You know, looking at your tongue, is there a white coating? Looking at your toenails, are they slightly yellow or they brittle? Are we itchy anywhere? Like you said, in skin folds, do we have a itchy scalp? You know, I think so many. Often these things are normalized.

That's right.

It's like, oh, I'm just itchy or I have this or I have loose stools and that's not normal. And again, that's why I think using this test as a screening for overall health and longevity is fantastic. And also looking at blood sugar. Right. So the metabolism conversation is huge when it comes to the gut microbiome.

Right.

So if there's yeast, what is their fasting insulin? Let's say their hemoglobin A1C is normal while their GP said, Great, see you next year. But their fasting insulin was never assessed and they're showing signs of insulin resistance and they've got yeast. I'm not surprised because the yeast loves sugar.

The interesting thing about that is that we also do two hour glucose tolerance tests with insulin curves on every client that we see.

Yes, I'm applauding that.

Yeah. And it's remarkable how many people we find with a normal hemoglobin A1C. Maybe it's 5.2 or 5.3. It's really quite good. And a fasting blood sugar of, you know, 91, 89. But my gosh, if you challenge them with 75 grams of glucose, you know, they may be diabetic for an hour. And there's a genetic reason for that. Right. They, they are slow on the TCF gene and a couple of other genes there that, that they actually don't get the incretin signals that glucose has hit the intestine to actually stimulate insulin release in a timely manner. And so the sugar for them can spike up to 180 or 200. It shouldn't go over 130. Right. So they're like diabetic for an hour. And then when they push out the insulin, instead of maybe their fasting insulin was four and it should go up maybe no more than four or five times. So say it should go to 20, it may shoot up to 60 or 80. Right. In fact, we had a young woman in here who developed ms, had developed ms, she was just graduating high school and her insulin level shot up over 200. Oh, gosh. Right. So the thing about insulin is that it's aging you very quickly. Right. It actually accelerates the aging process and the aging of your arteries. So being able to understand your genetics around how you manage glucose and then what your insulin levels are doing is super important. And we're in a continuous glucose monitor may not tell the story because you may control the blood sugar just fine, but in order to do it, your insulin is, you know, 10 times what it should be. So you're still not really getting the full information. So that's why we think it's super important to do that test. And in the, in the era of GLP1s, it's also interesting that I think it's Akkermansia in the gut that helps us produce natural GLP1.

Yes.

So you can take probiotic, metabolic or GLP1 probiotic that actually will boost the population of those bacteria to augment your GLP1. So if you're trying to get off your GLP1, if you're taking one by boosting the bacteria, just like you can boost GABA to sleep better, you can boost GL, your endogenous, be it GLP1.

Yeah.

To help you control not only your blood sugar, but your appetite and other things. Right.

Yes. Yes. The gut microbiome is communicating in all sorts of ways in terms of how many calories we're burning and do we even want to exercise? Do we have cravings, to your point? And I just have to say, you know, when you said diabetic for an hour, you know, I almost got chills because that's such a poignant way of looking at it that it's easy to miss. Unless you're doing the appropriate tests.

That's right.

And the gut microbiome plays a role. Absolutely. We're just learning more and more about this. So it, I think. And who doesn't want to be metabolically flexible? That's kind of a buzz phrase right now. I know that seems very appealing to me. That seems like a non negotiable. If you want, it's on longevity.

So metabolically flexible. This is a really interesting concept. It has to do with the ability to eat from a wide variety of different sources and have a, not have a negative impact from it. Right. It's, it's training yourself to be metabolically flexible. You can burn fat, you can burn carbs, you can do all these things and do it in a healthy way.

Not get hangry.

That's right, yeah. Do you have a tendency to get hangry?

Yeah, well, I did, you know, so I did when I was in medical school and it was you know, I'm learning about all this stuff and to that point we've come a long way since then in terms of the microbiome. But you know, skipping a meal in some cases when I was really stressed and I was not very active because all I was doing was going to school and studying was very uncomfortable. You know, feeling nauseous, feeling irritable. That's where the angry part comes in for hangry. And you know, I started lifting weights. You know, that's the game changer is strength training. And of course we need some cardiovascular exercise also. But gas. Yes, I think I'm definitely prone and there's a genetic component to your point. Also, my dad is type 2 diabetic and so it's a huge priority of mine to understand that there are things in my control and then there's kind of a predisposition which makes it a bigger priority for me. So. I know hangry, but I know you can reverse it too.

Yeah, yeah, exactly. It's a great point. What other points would you like to bring forward on the, on the gut Zoomer?

Sure. Yeah, well, I, you know, I wish that we had a visual here, but again, the infographics are great. Really a beautiful teaching tool. So for practitioners out there who feel like you, you want to draw out on. Maybe you have a whiteboard in your exam room and that's fantastic. Well, this is already drawn out for you in the report. So. And we're superimposing the results within the infographic. So it's quite sophisticated in terms of saying this inflammatory marker, let's just say calprotectin is circled in red because it was too high for that particular patient on this report. So really helpful there. And I just, I feel that you can get so much insight in terms of the categorization of where the microbes fall in terms of risk. So again, it's not just gi, but it's metabolism, it's neuro, it's hormones. Hormones is another piece that we could, another rabbit hole we could go down. But you're getting insight in terms of multi system impact from the microbiome on this test. It's great.

So talk to us about hormones. We're familiar with beta galactosidase as being important. It's, it's a molecule found in the gut. I believe it's produced by E. Coli and maybe, maybe that's right, I'm not sure. But beta galactosidase is a big deal because when you're metabolizing your hormones to break them down and get rid of them. They're excreted through the stool and a glucose molecule has been attached to the hormone metabolite for excretion, marking it for excretion. And beta galactosidase will come along and snip off that glucose molecule and then you end up reabsorbing that hormone metabolite, which can have some detrimental consequences for you in terms of breast cancer risk, endometrial cancer risk, prostate cancer risk, things like that. So being able to measure that is really important.

Yes, yes. And so we are measuring beta glucuronidase, but we also have beta galactosidase producing bacteria measured alpha on the test as well. Okay, but the direct beta glucuronidase. Yes. And so I think about the conjugation of the toxins and the estrogen as a little anchor, if you will. So, you know, and I'm an educator at this point, so I think it's helpful to paint these pictures and give these analogies for folks. And so if your conjugate or your anchor is pulled off of that estrogen, it's not going to come out in the stool because the anchor has been pulled off. So now it's going back into enterohepatic circulation and it in the stool for a reason. We're supposed to get rid of it like you said. So we don't want higher beta glucuronidase. And if you see that maybe in a patient you weren't even considering hormone testing for further assessment would be the hormone zoomer is a urine hormones test which also looks at endocrine disrupting chemicals. So that one's very comprehensive as well. But yes, that's insight that you maybe wouldn't glean otherwise in terms of poor detoxification of estrogens and toxins.

So are there things that you can do? I know there's Calcium D glucarate can be taken to basically neutralize the beta glucuronidase, but is there a way to actually decrease its production?

Yeah. So my two cents there, we all have opinions. It's an issue of the microbiome. So in a pinch, calcium D glucarate is great for maybe your premenopausal female who has PMS dysmenorrhea. She's got clotting with periods. And so this is what we typically think about as estrogen dominance. She's clearly struggling. And now you see she's got elevated beta glucuronidase. Can we inhibit that enzyme and get her some relief with calcium d glucarate in the short term. I say, absolutely. There's a time and a place, but I see it as symptom support, so I wouldn't use it long term. And I would say, ultimately, we have to get her microbiome in to order because that's where the enzyme's coming from.

Yeah, exactly. Yeah, exactly. So then the question becomes, how do you get the microbiome in order is, are there probiotics? Does this come back to more fiber or.

Yeah. So again, I would start with digestion. We are assessing digestion on the stool test. So you do get a pancreatic elastase, which is a standard marker. You're also getting a fat malabsorption panel, which is really cool because you can look at the pancreatic elastic and you say, okay, well, it's not too low. Maybe it's suboptimal. So maybe it's in this mildly low range. And you start to question, is this patient producing enough lipase? So the cross examining, if you will, would be to look at the fat malabsorption panel to look for excess fat in the stool, which might be further evidence that they're not producing enough lipase in addition to that mildly low elastase. And so evaluating digestion is the first thing I do after looking for a pathogen, of course. Right. We want to. That is really the first thing. Don't miss the pathogen. You know, if they're inflamed, they have high calprotectin, and you're scratching your head and you're getting nervous and you're ready to write a referral. Make sure you look at the pathogen report because there's a lot of stuff on this test. So that's the first thing. And then I look at digestion. So if digestion is not in order to your point about hydrochloric acid, that's very important. And I love the conversation of mealtime hygiene, which is, again, not very exciting or revolutionary. But can we sit down and enjoy the food and what kinds of techniques are there? One of my favorites, and this was passed on from a provider who we had on our podcast. She said, put on one of your favorite songs, you know, if you're working all day. Something. Something from childhood. You know, I think we all have those songs from our earliest childhood memories. You hear it instantly. Walking on Broken Glass for me is one of those. My mom would put it on, we would dance in the kitchen, and instantly it takes me out of my work mode and it puts me into my digest, my parasympathetic. And I love that.

Yeah, very cool. No, that's very cool.

Yeah. Thank you, Annie Lennox. Right. What do you do? I'm curious, if you don't mind me asking, to maybe get into. Get ready to eat. Eat.

Get ready to eat, Yeah. I usually grab something and start chewing. That's typically.

Typically nothing fancy.

That's typically what I do. But, you know, I tend to eat out some and then I eat at home. And again when I go to the store, I try to get a wide variety of different plants to bring in. But eating for me has always been like, if I never had to eat again, I'd be actually fine with that.

Like.

Like, I know some people, like, some people almost live to eat. Like they plan a whole vacation around where they're going to eat.

Sure.

For me, food is more fuel than it is anything. And literally, if I didn't have to eat, I'd actually be fine. If I could just take a pill, I'd. I'd actually be fine with that. That being said, I have a sophisticated palate and I can enjoy a whole wide variety of things. I'm a very adventurous eater at the same time, so I enjoy that. But I don't have a big routine. I was listening to you talking about putting on music and things like that and doing a little dance before you eat. I don't know, maybe I'll have to try that on and see how. See how it works. Right.

It's just, it's something that's so quick, and I think it's the. There's some neural pathways. I'm sure I can't speak to that, but it reminds me of scent, how certain scents can immediately make you think of a memory.

That's right. And I think a person, for that matter.

Yes.

You know, one of the things you talked about with being able to identify fat in the stool that's not being absorbed is it's really critical when we find that because we know that people may not be absorbing their fat soluble vitamins. Right, right. And so that's a big. That's a big deal. So making sure that people are getting enough of the fat soluble vitamin and also able to digest it. It. So if you're listening to this, this is another thing that a healthy person, you know, you may be taking your vitamin D, but if you haven't checked your vitamin D levels, you know, it may be because you're losing some of it in the stool. Right. And then on top of that, there are genetics, a Number of different genes, VDR genes and other ones that have to do with how well the vitamin D can actually interface with your genome. Vitamin D is not really a vitamin, it's actually a hormone. So it goes into the DNA, it goes into the nucleus of the cell, and it's actually modulating genetic expression and being able to take sulforaphane, which comes from broccoli or broccoli sprouts, particularly when it's combined with Myron aids to activate it can upregulate those genes so that you're actually getting the benefit of the vitamin D when you take it or when you consume it in a vitamin D enriched food. Right. This whole thing is. It's important to understand that food, we're talking about food and digestion. It's really important. I always like having the conversation with people that food is actually information.

Yes.

We think of it as calories, something to burn or some. Or a nutrient, something that we need. Right. For energy production in the mitochondria with the B vitamins or whatever else. But actually it's all information. And when you start to think about it as information, it's like, oh, well, what information do I need? And is the gut biome, is it working in concert with me to give my body the information it needs to actually live a healthy life? Right. So.

Right, yes. And that's epigenetics, which is also fascinating. And how do we influence what we're born with and maybe show up the best we can with what is in our control as opposed to what's not in our control? So yes, such a great point there. Nutrient status is. And again, another reason why it's for everybody. We need to make sure our nutrient status is intact.

That's right.

Just to. If we're feeling great, we're going to the, the provider, your primary care provider, because you say, I'm just here for a checkup. We want to continue feeling great. You know, it's just, it's very simple when you think about it that way.

There's another element to feeling great, which is that many times we'll normalize what it is to feel good. Right. In other words, and then if people come in to see us and they say, well, I actually feel good, I'm actually good. It's like, okay, great. Well, let's, you know, let's kind of look at some things and see where things are at. And then you figure out, oh, well, here's an opportunity and here's an opportunity, and here's one. And you actually address Those opportunities, whether it's hormone optimization or gut health or decreasing inflammation or, you know, whatever it is, boosting nad, for that matter, all of a sudden people are like, oh my gosh, I feel great. Great. Right. And I didn't realize, I didn't realize that I didn't feel great until I felt great. Right, so exactly. It's, it's really fascinating that we normalize the way we feel. So if you're listening to this and it's like, no, but I feel good. Why would I want to do that test? You can actually typically feel better than you do. So that's an interesting piece of this as well. Yeah.

Yes, yes. We want to optimize. And I think about, I just think about people going to bed so late and, and, you know, sleep again is another thing that we could talk about in terms of the gut microbiome. And we have our habits. Right. So waking up feeling sluggish, feeling that we're not energized and ready to start our day, we're relying on coffee so often. And so I think that that's just an example of how this can become overlooked. I mean, if you can wake up naturally, maybe not to an alarm, and feel that you're ready to start your day and you're looking forward to it without a stimulant, I think that, that, that's a really nice way of maybe trying to understand that there's always, there's something that we could improve, possibly. And I think that's empowering too.

Tell us. Maybe the last thing we'll address is talk a little bit about alcohol. What's the, what's the impact of alcohol on, on the gut, Gut, health.

Leaky gut, of course.

Leaky gut.

Back to the leaky gut. Yes.

Yeah. And, and what we found is that we can never fix somebody with leaky gut and bacterial overgrowth or yeast overgrowth if they continue to drink.

Drink.

It's not that we have anything against alcohol, it's just that the alcohol, those, those bacteria and those yeast love that. And it's really difficult to clean things up if alcohol keeps coming in.

Right.

So it's an interesting phenomenon.

Yes, yes. It's toxic, you know, really is what we think about typically with alcohol. And so it impacts, of course, our liver. And it's, it's going to be really hard. It's that obstacle is what I'm hearing. You're saying that some people have a harder time getting over than others, even if they're eating a very nutrient dense diet with plenty of Fiber. But I think there's. We can talk about moderation and, you know, kind of the curiosities of red wine and the antioxidants there in your field, I'm curious about. But yeah, there's a give and take there.

Well, there's. Yeah, there's polyphenols in. In red wine, of course, and there's resveratrol in very small amounts, which can be helpful in red wine. But we tend to see that alcohol in general has more negative. Negative effects than it does positive effects. With the exception. Yeah, with the exception of inducing an enzyme in the liver that actually metabolizes alcohol. And it turns out that having more of that enzyme decreases the level of other alcohols that our body produces.

Oh, interesting.

And that's associated with longevity benefit. So having some. Some of this aldehyde alcohol enzyme will actually has been associated with longevity. So the way I get a little bit of alcohol is drinking some kombucha, which has a trace of alcohol in it, which is enough to stimulate the enzyme production. And. And yet I don't think has much impact on my gut. And I don't drink it all the time, but it's. That's the way I handle alcohol.

Sure, that's a clever way of going about it. And fermented foods, again, we haven't really. We touched on probiotics a little bit, but. But kombucha is a fantastic fermented product. It's a beverage for those of you who don't know. I think most people know at this point, but yes, I love that along with kimchi is one of my favorite fermented food items. And even if you heat it up, and this was mentioned again in that. That episode I listened to prior on your show, you still get benefit even if you're heating up these fermented food products with postbiotics.

Exactly.

So there's so much good to come from all the things that we're consuming if they're whole foods. And I think so many people, they shy away from fermented foods. They, you know, you say sauerkraut and they run the other way.

Yep, I like sauerkraut.

Me too.

Yeah. Alcohol dehydrogenase was the name of the enzyme I was thinking about. So by stimulating alcohol dehydrogenase with a little bit of alcohol, that's got a longevity benefit. But apart from that, I'm not sure that the alcohol really does. Does much. So in a positive way. And what we do is we just have people abstain for a few months and we can clear up the gut. And then if they have a bit, it seems they can kind of maintain it, but it's hard to. It's hard to pull them out of the fire if they're continuing to drink.

Yeah, well, and that trial period, if you will, I think a lot of people, they learn on their own from that experiment. Oh my gosh, I feel so much better. As you said, then they make their own decisions, right? We're teaching them how to fit.

They feel, they feel better, they sleep better, they recover better, their exercises routines become, you know, more vigorous and better. They make more progress, their brain is clear. What I find is kind of the tripping point for a lot of people is the social circles they run in, right? They, it's like, well, the group I run with, you know, they all drink and if I'm not, if I'm not drinking, they're asking me, why? Why aren't you drinking? Right. Like, there's, like, there's this peer pressure scenario which I find really odd to actually be influenced by any peer pressure at this point in my life. But apparently that's a real thing.

Oh, yeah. Well, and it's just so many people, they go out to socialize and what are they doing? They're going out to get a drink, right? And it's like, can we go for a hike? Can we go to a painting class? I don't know, can we go to a dance class?

Yeah, there you go.

There's so many other great things to do to socialize, but yes, it's. That's, that's one big, big social point that people need to maybe consider.

Cool. Well, Emmy, it's been a pleasure chatting with you.

Likewise.

Yeah, I appreciate the updates on the Gut Zoomer. And if people want to, want to order a Gut Zoomer, I think you've got a promotion code that we'll put in the show notes where they can click and order a Gut Zoomer and get it. You might need a physician to help you interpret it, so you'll need to find somebody qualified to look at it. But that would be a good starting point.

Yes, yes. And to that point quickly, we do have clinical lab educators such as myself who can consult with your healthcare practitioner if you're not one yourself. And that can be very helpful for interpretation and for providers out there listening. We have a new Vibrant Academy. The Vibrant Academy is an interactive educational platform on the portal and so you can walk yourself through how to interpret. You can understand case based management protocols to address some of the findings. So that's another really nice new tool that we have for you. That's the Vibrant Academy.

Yeah. I love you. I love the commitment to, you know, democratizing the goodness that the test can bring forward. That's really. It's really commendable. A lot of labs are not doing that, and they're not creating the kind of. Of customized, personalized sort of infographics where it's like, well, here's a generic, you know, hormone panel, you know, metabolite chart or something. But what we're actually getting is we're getting the things that are specific to that client.

Right.

What's off on the oxidative stress genetics and what's off on the oxidative stress panel and things like that. Right. So, yeah, I really commend Vibrant for doing that. It's been great.

Yes. Thank you. We so appreciate that.

Yeah. All right. Thanks so much.

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