Probiotics & Prebiotics: What You're Getting Wrong (Microbiome Expert)

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Hi guys and welcome to the Love and Guts Podcast. Today I have the fabulous Dr. Jason Horlat to present to you. I absolutely love this discussion because it's all about the microbiota and digestive health which you know I'm a huge fan girl of. So in this episode we cover why did he devote 18 years to researching the gut microbiota? What our human microbiota organ does for us, what a prebiotic and probiotic actually is, what probiotics actually do in the body and it's not what we previously believed. Even though we all have a very unique microbiota, what healthy traits we would like to encourage and see see in our ecosystem. We talk about what harms our git ecosystem most, why probiotics strain specificity is extremely important when selecting a probiotic supplement, why Jason and I are huge fans of prebiotics and what are his favourites? We talk about my favourite topic, short chain fatty acids in particular butyrate and dive into Akkermansia Mucinophylla, Faecalobacterium prosnitzii and other exciting species. We touch on how the keto diet impacts our microbiota, stool testing and so much more. Believe me. But before we get into the podcast I want to introduce you to Jason a little more so Dr. Jason Horolak is a research scientist, an educator, naturopath and Western herbalist with more than 18 years of clinical experience. Jason practices at Gould's Natural Medicine, a 136-year-old natural medicine apothecary and clinic located in Central Hobart. He did his Honours and PhD degrees examining the causes of dysbiosis and the capacity of probiotics, prebiotics and herbal medicines to modify the gut microbiome and has written extensively in the medical literature on these topics including 16 textbook chapters. He is on the Medical Nutrition Council of the American Society for Nutrition and was recently awarded a Fellowship from the American College of Nutrition for his significant contributions to the teaching and practice of nutrition in Australia and North America. Jason is also a Fellow of the Naturopaths of Herbalist association of Australia. He is Chief research officer at ProbioticAdvisor.com, which I highly recommend practitioners all go and visit that website which offers a searchable database that enables easy evidence based prescribing of probiotic products and online resources for clinicians and health conscious members of the public to learn more about the human microbiome and how they can positively influence these ecosystems. Jesus Christ, this man has been busy. So guys, as always, this information is not intended to diagnose or treat a medical condition. So please ask your health practitioner before beginning any new treatment. And most importantly, just enjoy the podcast, share it with a friend if you find the information valuable. And leave a five star review on itunes as well as your feedback so that others can find Love and Guts too. Hi guys and welcome to the Love and Guts podcast. Today I'm just super excited to introduce to you Dr. Jason Horolak. I've been a bit of a fan of all of the stuff that Jason puts out there, so I'm so grateful that I've nabbed him on this Monday morning. So welcome to Love and Guts, Jason.

Ah, thank you. It's a pleasure to always have a chat with someone else who's passionate about gut. It's on my end, it's not a problem.

Definitely chatting with the right person, that's for sure. Which is why it was hard for me to whittle down these questions. I do have so many and I'm sure you won't get through them all, but there is so much to ask of you especially it's, it's a bit of a, it's a bit of an anomaly to get you on here, so I'm so grateful. Anyways, let's get into it before I start waffling.

I'm ready.

So let's just start with yourself. So you're a clinician, a practitioner trainer and a researcher, particularly in the area of pre and probiotics. So I really want to know, how did you get to be working in this area and devoting, I think you said, 18 years on the gut microbiota.

18 years, yes. It's funny because you go back and it's almost like a chance event that actually led me to this, but it was essentially a lecturer. By my final year of my undergraduate naturopathic training, there was a lecture by Dr. Steven Myers, who's our head of school of the naturopathic department, talking about gut dysbiosis and leaky gut. And his lecture on dysbiosis was just so intriguing and enthralling for me for whatever reason. I'm sure you can wait. This was 1999 and they had just started, they're about to start an honors program which lined up perfectly for me because I was just finishing my fourth year of my undergraduate course and it's like, okay. And I just approached him afterwards and said, I want to research this as part of my honors. So that that happened from in 2000 and then we tagged on a PhD after that, which ran for another five years after that to get all the research projects done that we needed to get done. So it was a pretty fantastic time because it meant that I could essentially spend five to six years of full time study looking only at the gut microbiome and then designing our own research projects. We got to do microbiology, in vitro research, we got to do systematic reviews and even human clinical trials, which was an amazing experience for me and it gave me a chance to put some of those, the research into real people, I suppose, even though I also worked part time as a clinician during that phase of my entire life, actually including that phase of practice, so you could put into practice in that way. But it was just interesting taking a cohort of people and giving them all prebiotics and all probiotics and other her medicines, etc. And I was really working with populations with irritable bowel syndrome and modifying their gut ecosystems. But we're looking more broadly at areas around dysbiosis in terms of its causes and how we could correct that using natural medicines.

Yeah, and I can't wait to get into it. I would have been just a kid in a candy store spending that many years on the microbiota. Seriously.

I know, truly, it was one of my highlights of my life. Five or six years, it's essential. For five days a week I would just be reading microbiota papers and back then there were only a couple hundred published a year. So you could certainly keep up to date with the microbiota, the probiotic and prebiotic research, easily. It's not like that now. There's thousands of papers published a year. So it's much harder task getting, you know, you can still keep up to date, but trying to keep up to date, but everything is actually impossible now. But back then, no, it was immensely doable.

Yeah, yeah. So let's go back to the basics so our audience can really start to understand the importance of the human microbiota. So you call this an organ, our human microbiota organ. So what does it do for us? What are some of the key points? I know it does a lot.

It does, and I've been a keen proponent to get more people aware of all the things that it does, because you can start appreciating and cherishing it and looking after it if you know what roles it actually plays in keeping you healthy. A number of things it does, we know, modulates the immune response, a balanced ecosystem helps protect against allergy development and helps us induce essentially tolerance, immune tolerance to either aerial allergens like dust and pollens to also food allergens like peanuts and kiwifruit and eggs, et cetera, and also just helps our immune system essentially upregulates the arm that protects us against viral and bacterial infections as well. This came out research that was done in the probably 50s and 60s in animal models where they could wipe out the gut ecosystem with antibiotics and put these little mice and rats and little sterile cages and give them sterile food so they couldn't regrow an ecosystem and they'd find that their spleen and their thymus glands would completely shrink down and their ability either way blood cells to deal with pathogens decrease dramatically as well. And all that could be fixed by essentially reinoculating the mice with an ecosystem. So some of those things we've known about for a while, including the ability of the ecosystem to improve the nutritional status, I suppose, of the non human cells. So we know that the microbes produce vitamins B1, B2, B3, B5, B6, folate and even B12. It's just sadly we don't have the a clonic transport for vitamin B12, whereas we do for the other B vitamins. Whatever that quirk of nature is, we're getting a lot of B12 produced, but we're just not able to absorb it and get the benefit thereof. But also other things like xenobotic metabolism. I think as a nutritionist and herbalist, a lot of the foods and herbs that I recommend have polyphenols as active ingredients. And what we know now is that 90 to 95% of ingested polyphenols are, are essentially unabsorbed and they reach the colon where they interact with the gut microbiota. Essentially the microbes eat part of those polyphenols and they convert that into a absorbable component which we then absorb and we get the benefit and we get the medicinal action of those herbs because of the microbiota. I think this is really fascinating for us that rely on herbs as medicines because we're living in a day and age where the dysbiosis is unparalleled in human evolution. And it may explain why some people don't respond as her medicines compared to others. You know, if you've got a very dysbotic ecosystem that's completely lacking species that are required in actually making those of those phytochemicals so we can get the medicinal benefit, we're not getting this benefit and they just get pooed straight out. So I think that's a key thing, but it's been really fascinating over the last decade looking at the connections between weight management, obesity, blood sugar regulation and the microbiome. That was something that was not discussed and even considered in the early 2000s or late 1990s, nor the impact of microbes on mood, anxiety, depression. And I think more broadly, I think one of the core aspects of the way that I'm looking at the microbiome these days is that the microbes in your gut are either contributing to or decreasing your systemic inflammatory load. Yeah. And given how much inflammation is behind pretty much every single Western disease that we have to deal with in practice, that's a huge thing because most people actually have an ecosystem that is contributing to that inflammation, either as a core contributor or an ancillary contributor.

And can you expand a little bit on the obesity and the blood sugar link?

Yes, and I think it's got to probably a couple of factors. One is the standard Western diet or standard Australian or American diet, SAD diet tends to starve off a range of microbes that play important roles in terms of gut integrity. So keeping so we have proper functioning of our intestinal membrane and keeping bacterial particles out as well as food proteins too. But bacterial particles primarily in this case, like endotoxin, for example. And they were also starving off the bugs that actually produce butyrate. And they're sort of connected there too. And butyrate we know, actually enhances insulin sensitivity. And when we take butyrate out of the equation, our insulin becomes far less able to pull the blood sugar out of the blood. And then we have something like the endotoxins that are now there. Because the standard Western diet tends to create an environment where there's more endotoxin in the gut and it's not being bound up, so it's being absorbed and contributing to leaky gut as well as endotoxin causes systemic inflammation and actually results in impaired glucose tolerance and a greater capacity to gain weight as well.

Yeah. Did you want to shed light for those that don't know what an endotoxin is? What it is?

Yeah. So it's essentially a component of gram negative bacteria. So it's not a toxin that bacteria are secreting to make you ill or to kill off other bacteria or anything like that. It's just a building block. All gram negative bacteria have endotoxin. It's just that what we eat or what medications we take change the balance of microbes in our gut. So we can have a greater amount of endotoxin containing bacteria in our gut or a smaller amount. A typical Western dietary pattern results in a greater amount of endotoxin containing bacteria in the gut, which means we get a greater amount that actually floats into our bloodstream and causes a range of issues including. But systemic inflammation is probably one of the key ones.

Yeah, absolutely. And as you said, it sort of underpins a lot of conditions in the body or a lot of illness. A lot of disease.

Huge.

Yeah.

Yes, yes, yes. The more research we're doing on endotoxin and its connection over the last five years has been stuff connection with endotoxins and depression, endotoxin, anxiety, chronic fatigue syndrome, because it impairs mitochondrial function, cardiovascular disease as well. And even I was reading some research in the past week on endometriosis and that women with endometriosis have six times the amount of endotoxin in their menstrual blood compared to women who do not have endo. Yeah. So it probably plays a very much causative factor in that condition as well.

Yeah, that's huge. And why is that? Do we know why that is?

People are still looking at that. Now this is research that's come out from 2016 onwards and they've essentially developed a new theory because with endometriosis it's always been different theories about why it's occurring, but their theory is bacterial contamination. So the. These women tend to have a lot more E. Coli in their menstrual blood as well, and that's what's causing that increase in endotoxin. Because E. Coli is a pretty classic gram negative bacteria. It's in the Proteobacteria phyla, which is a very. Which means all bacteria within that phyla have very pro. Inflammatory endotoxin. Yes. So that is either coming directly or indirectly from gut bacteria. Either the E. Coli are migrating through and inhabiting the vagina and then moving upwards, or they're actually translocating it through the gut or the endotoxins are and contributing to it that way. I'd say the research is not sure which of the two is more likely to occur and that might differ a bit per woman as well, but it's still very fascinating. And still if we decrease the E. Coli load in the gut, we're still decreasing the amount that can make that journey into the vagina as well. By correcting the gut dysbiosis. It can certainly help, or it should anyway. And certainly I've seen someone that was doing one of my meat your microbiome courses that was a member of the general public who had endometriosis. We were just Improving her gut ecosystem. We weren't doing anything about endometriosis, but she just shared with me after a couple months of following the dietary approaches which shifted her ecosystem and significantly decreased levels of proteobacteria in her gut, that all of her endometriosis symptoms were gone. It's just like, wow, that's interesting. Yeah, it is. And that's when I went and looked at the literature and said, okay, that's. There actually is research around that. It makes sense that it would work. So I'm looking forward to the research that evaluates that. But it's certainly something we as clinicians can do with our endo patients as well.

Yeah, far out. That's fantastic. And just again, going back to the basics, can you define what a prebiotic is and a probiotic is for those that don't know the difference?

Yeah, I sure can. And I think the term prebiotic is one of the most misused terms out there in the blogosphere and by clinicians. But it's essentially a selectively fermented substrate that enhances the health of the host. I think is probably the most accurate way of describing it. And the key aspects of prebiotics is the fact that they're selective.

Selective, yes, exactly.

And that through their fermentation, we actually get health benefit. Those two things that make a prebiotic different from a typical dietary fiber. And listen, I love dietary fibers and I encourage people to eat a whole range of soluble insoluble fibers every single day through their food choices, but they still don't work the same as prebiotics. Prebiotics have a very selective impacts and that we can feed them to people. And we see very consistent changes in one or two or three different species in terms of going up and other species going down, which is different than we're getting with a range of dietary fibers. Yes.

And a probiotic.

And a probiotic is a living microbe that when ingested, induces health benefit as well. And it's interesting because in some parts of the world, in some parts of Europe, for example, they're very pedantic about that definition. So you can't use the term probiotic unless one, your product that you're trying to sell contains live microbes. But two, you have human clinical trials showing it actually produces health benefits with that exact strain, which I think in some ways is actually a good system, because that way you actually know. And we can limit the claims that are made by manufacturers and what's on label to what's actually shown to be. To actually work because there are other supplements that would be microbe supplements that don't necessarily have. We don't know whether that health benefits or not. Not all products that claim to contain probiotic bacteria are actually going to produce health benefit. We know that from looking at the research and some are fantastic in their capacity to do so. Yes. So that sort of labeling aspect in Europe, I think it's got some advantages to it.

Oh, absolutely. It kind of reminds me of champagne versus sparkling water. It's like we want to make the point proper claims because of the clinical studies. And I guess this leads me onto the question that I was going to ask a little bit later, but it's probably more relevant now. So we know that the genius. The species and individual strains of the probiotics are really important to consider when selecting a probiotic supplement for an individual. So what I want to know is why is that important? And I'm coming from a place of. I worked for the company Metagenics for over seven years and we were talking about strain specificity for so long. So first question is why is it important for us to get the appropriate strain to treat a particular condition rather than your multi strains that you could just find in a retail environment? And why do you think it's taken so long for this information to filter down to companies and to the general masses?

Yeah, good questions. And I know from my perspective too that being trained as a naturopath in the late 90s is that there really wasn't anything about strain in my naturopathic training. We talked about probiotics, more broadly speaking, barely mentioned prebiotics at all. But it's just when I started doing my research for my honors PhD that I started reading the literature and was like, whoa, what's this strain stuff? And prebiotics? Oh my gosh, I didn't know anything about them. Look at the research on these. So yes, I think for me it was relatively new at that time point. Been an advocate of sharing that information about strain specificity since the early 2000s when I first started writing for naturopathic journals and teaching naturopaths about this information because I realized how important it is because it can really determine whether a supplement will have a therapeutic effect or not. That's the key thing, is that a few genes turned off or on make all the difference. I think the clearest example in the bacterial world is looking at E. Coli E. Coli. We've got the NSLA 1917 strain that's sold as Mutaflor, that's got human Clinical trials showing a range of health benefits including for constipation and diverticular disease. And Crohn's disease. Yes. And then you've got another strain of E. Coli. I think it's the OH157 strain that causes kidney failure and death and bloody diarrhea. Same species. All it is is a few genes turned off or on that makes a difference between a therapeutic strain, in this case a pathogenic strain. Now within the realms of lactobacilli or bifidobacteria, thankfully we don't have that same spread of helpful to harmful, but we do have the spread between does nothing to healthful. I think that's the thing. We've got to keep in mind that these traits, even simple things like the ability to tolerate gastric acid or bile salts so essentially survive the transit to your stomach and small intestine, are strain dependent, not species dependent. The ability of microbes to prevent the overgrowth or to inhibit the growth of things like Helicobacter pylori or Clostridium difficile, strain dependent. The way in which microbes actually attach to your gut cells is strain dependent. The ability of these microbes to produce antimicrobial compounds and how selective they are is strain dependent, not species. And once you realize that, you realize that it's completely futile trying to prescribe probiotics by species or futile net that there's a decent chance that this, that unknown strain they're using isn't going to do what the research strain did and that you really have to use the strain that was shown to work in research. Because we know it works and we know it has that attribute that we're after.

Yeah, absolutely. It's so important and it's not. They're not cheap. So you don't want to be just wasting this money a self prescribing. Particularly if you've got a condition like or you've got an instance where you're experiencing Helicobacter pylori, you want to be able to get the correct strain to support that. So I know that you've got the Probiotics Advisor website. Is that only for practitioners or is that for the general public too?

Well, it's a good question that there certainly is some content up in terms of free lectures around mythology about probiotics and just some general information on probiotics that I think the general public would benefit from for sure. But the database itself has been created for health professionals who are dealing with patients health issues on a daily basis so we can look through and see, okay, what research has been done on specific strains, what products can we find those strains in? So you can either search by strain, you can search by health condition, or you can search by product, you can go, okay, there's a new product in my health food shop or my chemist or that this company has brought out what strains are in it, what research has been done on it. And I think it takes, for me, it's an important thing, it's taking industry out of the equation, the prescribing equation. I don't want to get my prescribing information from industry and I don't think we as practitioners should, we should be getting it from the research independent sources and the productivity allows that you can actually go, okay, I'm not going to read any of that stuff that the industry rep has given me. I want to see what the research actually says this strain is useful for.

Totally. And if any practitioner out there, I highly encourage you to jump on. I think it's a really inexpensive platform. I think it's only about 50, the last time I checked, a year to gain that up to date information. And I'm just so grateful that you're, you're doing the work for us to that level and keeping it up to date so that it's easy for us to support our, Easier for us to support our clients, our patients.

Yeah, well, it's been fascinating seeing that amount of research shift over the years that 15 years ago I was telling people to choose strains that had at least survived transit to the stomach and small intestine and adhered to the gut, met the basic criteria because there wasn't nearly as much condition specific research. Whereas now there's very few health conditions that we see in clinical practice where the strains that have been shown to work aren't available to us as clinicians. So I think it's, it's fantastic to see that amount of research that's built up around that and how easy it is when you do have access to the right tools to choose an evidence based probiotic product to treat the condition that your patient has.

Beautiful. And we did skip over this question. I do want to ask it though, because we have for many years believed that probiotics colonised or seeded the gut, but we now know that that's not the case, that they're more transient. So can you shed light on how they actually work in the body?

Yeah, I can. And I'm just thinking back to, I went to an event many years ago and the speaker was talking about Lactobacillus granulosus, GG specifically, which is a very well researched, well characterized probiotic strain. And it was a researcher that was over from Europe and they said it only colonizes temporarily for one to two weeks. I heard some naturopaths in the audience afterwards said, hey, there's something wrong with that strain if it only sticks around for one or two weeks. And it hit me then that here's me who's just delved and surrounded by the research and like, yeah, of course that's actually a good outcome. If it sits around for one or two weeks, that's bloody good. Must just pass straight through you and don't stick around at all. But there is this perception that probiotics worked solely by colonizing and regrowing and reseeding. So that's been another one of my missions over the years. Is really trying to bust that myth because it really changes how you use probiotics.

I think you need to do a myth busting, myth busting book. A myth busting prebiotic and probiotic book. Anyways, I digress probably too actually.

Yeah. So I think we have to change the way that we look at probiotics to similar the way that we prescribe her medicines or nutritional supplements or more like herbal medicines or drugs, I dare say, and that we choose a probiotic because it has the action that we're after and when we cease taking that agent, it ceases having that action. So I don't give people chamomile because they've got chamomile deficiency. And I'm not expecting chamomile to start growing in their gut. It's the same way when I'm prescribing L rhamnosis gg. I'm giving it because it has the capacity to help heal up damaged gut or help improve immune response. But I know that once I stop giving it, it's going to stop having those benefits. Now maybe I've healed up the gut by the time I stopped giving it, fine, then I don't need it anymore. But I think it requires this paradigm shift in how we prescribe probiotic agents because that's what the research has really showed us. So we've got probiotic strains that have the capacity to do a range of things from improving our mood to speeding up gut transit time to, yes, healing a damaged gut to protect against pathogen overgrowth due to major dysbiotic events like antibiotics or chemotherapy. There's other probiotic strains that are good for helping to eradicate gut Pathogens like Helicobacter pylori or Giardia or Clostrium difficile. Other probiotic strains that help decrease overgrowth of pathobionts like Methinobracter smithii, which is the microbe that enhances or essentially is involved with methane overproduction. And having some methane production is good, but overproduction is problematic. And there's, you know, there's at least one strain that suppresses that overproduction of methane. Other strains that are helpful for type 2 diabetes, gestational diabetes, decreasing gut inflammation, improving gut integrity, and even others that are good for prevention of atopic disease. You know, like. Like eczema.

Yeah, And I'd love to hear some of these strains. I know I've got my favorites in, in certain conditions, but you've mentioned a few there, and I obviously look at digestive health quite a bit in particular things like constipation and sibo. So you've mentioned what would you use as. Is there any probiotics that you would use as a prokinetic or has some prokinetic properties? And for, for those out there, the prokinetic is just supporting that cleansing wave in the small intestine that just helps protect, push bacteria, toxins, all that sort of stuff through. So is there anything that sort of supports that?

Yes, there's been some animal research using a combination of L, Rhamnosis GG and the BB12 strain of bifidaturium lactis in combination for improving specifically the migrating motor complex. So that was specifically studied. And there's been other research in humans showing that some probiotic strains essentially speed up that sort of oral sequel transit time, which I just see as having a similar effect or whole gut transit time. So that would be strains like Bifactinium lactus HN019 and Bifactinium lactus DN173010. I think from memory that speeds up that oral sequel transit time, specifically.

And your thoughts on taking probiotics when you're undergoing SIBO treatment? I know there's just sort of conflicting information there. And is it just case by case, sort of air with caution with some people?

I would, I mean, I've been treating SIBO for a long time and I've, I suppose with my background in IBS research and the gut microbiome research that that started off before SIBO was even talked about. It meant that perhaps I approached it a wee bit differently because this information came out saying that, you know, 84% of people with I had SIBO. And at that point we already knew that probiotics helped for ibs, so it wasn't a big shift for me to think, okay, well, if that's really true, which I actually doubt that the number is that high, and my clinical experience tells me it's not, as does the research too, I should point out. But if it is that high, and if IBS is essentially a surrogate diagnosis of sibo, we already know that probiotics work. So I never had this hesitation around using probiotics. So for me, I've always used probiotics in my SIBO patients and when I started and still do so certainly for the constipation type or methane dominant sibo, I couldn't imagine practicing without probiotics as part of the treatment approach and have an agent that's able to work as a prokinetic rather than using a low dose antibiotic long term. Hey, I'd rather use a probiotic myself than antibiotic long term, even if it is, in theory, low dose.

Yeah, yeah. Beautiful. And intestinal permeability, otherwise known as leaky gut.

Yep. Yeah. I mean, I think my preferred strain for that is actually Saccharomyces cervaceae variety boulardii Biocodex, which we know can help heal a damaged gut from essentially any cause. It's very non specific in how it works by releasing those compounds called polyamines as it traverses through the gut, which speeds up healing and speeds up the regeneration. If you feel like that, well, you.

Just cut out for a moment there. But I think we've got the bulk of it.

Okay.

Yes, excellent. Thank you. And any other ones that have just any other conditions or probiotic strains that you've just gone, that is just amazing. It's just. It's going to take off. I'm so excited by that particular strain.

There was certainly that very cool research that was published last year looking at the DSM17938 strain of lactobacillus reuteri in its capacity to diminish methane overproduction, which I thought was very fascinating because there had been a number of studies showing that that particular strain was helpful for functional constipation, essentially was for normalizing bowel pattern, increasing number of bowel movements per week and softening up the stool. So that was known. But some Italian research teams said, I wonder if it works by suppressing methane output, because we know that methane, when overproduced, actually slows down gut transit. And it turns out that, yes, it did. So I was Immensely excited when I came across that research and I will say over a year of probably using it now that it is a bit hit and miss, which often hits. It is. There's no one treatment that works for every single patient with any condition. I wish there was. We all as conditions wish there was.

It would not be far too easy.

Yeah, yeah, yeah, that's right. But it does work amazingly well in some of those patients.

And is that strain readily available in Australia?

Thankfully, yes. So in Blackmoor's digestive biobalance they do have it in the little lozenge form. The only slight downside is a little bit of xylitol in that lozenge, which can be problematic for some saboteurs for sure. But you can also get it in an oral drop which is in base of sunflower oil as well as from as Solas Biogaia.

Yeah, yeah, I've heard you mention that one before. I've not tried that one yet. I must.

Yeah. The drop form is significantly more expensive than the lozenge, sadly, but it does take out the xylitol component which is problematic for a percentage, not everyone, but for a percentage of people.

Yeah, beautiful. Excellent, excellent. So we all have a unique microbiota. So outside of wanting diversity of bacteria in our git ecosystem, what else do you think is important in the makeup of a healthy gut ecosystem?

Yeah, yeah, so I'd agree that diversity is key and having a good number of actual species present too. So I would always sort of count the number of genera present as well as look at the diversity score to get a fuel for that aspect of the ecosystem in terms of species richness and diversity. But I think the other aspect is having higher levels of microbes that are butyrate producing microbes and that have, we know are important for gut integrity and gut healing as well as having low levels of microbes that essentially will do the opposite, that actually cause gut damage, gut inflammation. And that's not necessarily the traditional pathogens that we've been probably trained to look for, but would be pathobionts like Bilophylla wadsworthia and the sulfavibrio species which are the key hydrogen sulfide gas producers. And now that we've got access to more accurate molecular techniques to assess the microbiota, we can actually assess all those things. There's a range of gut healing species, a range of B tray producers and those pathobions that can be causing harm and frequently are in patients with IBS type symptoms or an inflammatory bowel disease. Perhaps it Was initially surprised at how often there's an overgrowth of those microbes in my patients with very sensitive guts.

Yeah. And I do want to get into some of the testing techniques a little bit down the track. But since we're on the subject of short chain fatty acids like butyrate, can you tell us why we love butyrate so much?

Yes, I love butyrate, I truly do. It's an amazing substance. And the more you read about it, the more wonderful you think it actually is. Yeah. And I think we think of butyrate as the main fuel source for colon cells, first and foremost. Us as clinicians are often prescribing things like L glutamine for small bowel cells for the same reason, because it's one of the main fuel sources for small bowel cells. But for colon cells, it's essentially butyrate. And we've evolved with these little butyrate factories in our gut producing the butyrate that our colon cells need. And we know by upping the amount of butyrate being produced, or at least providing sufficient amount that our colon healthy. But we also get a healing trophic effect on the small bowel too. So upping butyrate is certainly one of my core strategies for healing a damaged small or large bowel. It's one of the core aspects. We know that butyrate can actually prevent the absorption of endotoxin. And we know that in certain patients with IBS will have visceral hypersensitivity as an underlying factor, if not the underlying factor that's causing their issues, where they just don't tolerate any amount of gas in their gut without experiencing pain or discomfort. And they research this by putting special balloons in the bottom and blowing up those balloons so they get pain and discomfort at a much lower level than the average person would. So that's called visceral hybrid sensitivity. And it turns out that butyrate is very effective at actually fixing that. And it's also important for clottic motility. And it may do that partly, but through the suppression of methane producing microbes too, in that methinobrevobacteris methii can be suppressed with higher amounts of butyrate production. So those things are much more specific to the gut. But we now know that butyrate has a range of systemic benefits too, in terms of enhancing insulin sensitivity, protects against neural cell death, upregulates mitochondrial function, prevents neural inflammation caused by endotoxins, upregulates the production of brain derived neurotropic factor and essentially decreases systemic inflammation.

Love it. I love it even more.

And the thing to remember though is that we only get the systemic benefits if we produce more than our colon cells can use. Yes, I think a huge thing because if your colon cells are using all the butyrate you're producing to just grow and heal and be do their normal tasks, we don't get the systemic benefits because it's not reaching that circulation. So we have to ensure that we're producing enough butyrate, more than enough that for our colon cells, then we get the systemic benefits.

Beautiful. And what are some of your favorite ways to increase butyrate levels?

Yeah, it essentially comes back to feeding the microbiome and feeding the BAE producing microbes. So we can do that via supplements like partially hydrolyzed guar gum, which is probably the prebiotic of choice for enhancing the growth of butyrate producing microbes. But also psyllium husks, psyllium seeds even more so, enhance the production of butyrate and foods that contain certain soluble fibers and certainly resistant starches as well. So I tend to encourage people to change the dietary approaches so they're actually eating cooked and cooled grains and root tubers, for example. And legumes. And legumes I think have been pretty smashed about in the blogosphere in the last five years or so. But from a microbiome perspective, they're amazingly healthful food to consume. It's just that when your gut is very damaged and you can't tolerate much gas production, it's going to cause gas production and you're going to feel discomfort and potentially other symptoms associated with it. But when your gut doesn't have that grade of damage or inflammation present, you will fart more. Yes, but you're nourishing those B ray producing microbe very well because with a legume like. Sorry, go ahead.

Oh, no, go for it.

Sorry, I was gonna say with legume like black beans, you know black beans, we've got the black polyphenols, we've got a range of soluble insoluble fibers, we've got resistant starches and we have oligosaccharides all in one package. So you can't find anything else that's got sort of four or five different ways of feeding the microbiome that you get with like that.

And I just encourage people to make sure that you are preparing them well. You're soaking them, you're starting with small amounts, especially if you've avoided things like legumes for a long, long time. Or if you do have sensitive digestive function, then you want to kind of crowd in a little bit slowly and see if it sort of is self limiting. If it's sort of your gas production reduces over a period of days or a week.

Yeah, I share that with your advice with those more sensitive gut patients too. And in some people you can't go there initially. You actually have to fix the underlying issues with gut so they can tolerate those foods. Again, I think that's certainly a core aspect of what we would be doing in practice with people with very sensitive guts. I'd love to give them a whole range of things that would help fix their gut if they could eat it, they can't initially without experiencing severe pain, et cetera. So we've got to come through with a different angle and that's really focusing on decreasing visceral hypersensitivity, decreasing the gut inflammation first, and then we can start introducing those things. But I agree that smaller doses regularly are actually a far more effective way of inducing tolerance. In terms of gut symptom wise to legumes.

Absolutely. I want to go into certain dietary behavior people have taken on in a second. But I do want to ask you, what do you think is the most. What do you see as being the most harmful to our git ecosystem? What sort of impacts like medications?

I think medications certainly fit that bill. I think beyond doubt that antibiotics and particularly antibiotic cocktails cause the most damage. And for the longest period of time, you can see people even six months after doing an antibiotic cocktail for treatment of H. Pylori or for the treatment of. What we're seeing more and more commonly these days is people taking antibiotic cocktails, even sometimes few in a row, to try to get rid of blastocystis and dientamoeba in their guts. Now I'm seeing the consequences of that, which are very deranged gut ecosystem. Even six months afterwards. Ecosystem is really different. And we do lose actual species, go extinct through that process. You can handle the odd course of antibiotics every few years. The ecosystem tends to recover pretty well in adults. But you start throwing combinations around. Are you doing multiple courses per year? It's a different story. And we do get massive extinctions. The ecosystem never goes back to the way it was before. And I wish that information was more widely known too, is that you do that, you can't go back in time, you can't fix that bar fecal transplant, you might be able to, but that's still a pretty big intervention to get your head around and choosing a donor and a whole bunch of other issues that come into it. I wouldn't rely on that. I think you want to rely on protecting that ecosystem as best you can, because you just got the one. And there's certain species we know play pivotal roles that once they're gone, they're gone. I think Oxalobacter former genes is perhaps the core example of this, where it's one single species that we know eats dietary oxalate and when it's present, it eats the oxalate. We don't absorb it. Win, win situation. But 2/3 of people who take antibiotic cocktails, it goes extinct. So from that point, those people will actually absorb those dietary oxalates rather than having them broken down and they're at increased risk of kidney stones. That's just one species that we now know about that goes extinct and there's dozens of others. We don't even know what the names are or what role they play that go extinct through that predator. So, you know, there's no doubt that antibiotics save lives and limbs. And at that point you don't think about this, but for other conditions, I think sometimes you should think about that.

Oh, totally. And I want to actually ask you because, you know, obviously these different types of bacteria have different functions in the body that are so beneficial in so many ways collectively and probably as an individual species too. But what about dietary changes? So say if someone's been on a ketogenic diet for a number of years and not for a particular specific condition, just because they heard that it was great for weight loss or just, you know, overall, they, they decided that it's the thing to do at the moment. And so what have you seen in the gut? Microbiota by someone having that really low carbohydrate diet and quite high fat.

Yes, it has been interesting to. Just to see those dietary trends occur. I've been in practice long enough to see things come and go. And we're currently in the fat phase. Yeah, high fat phase is newly black.

Look, I'm all for fat. I'm all for fat. And we've been talking about keto diets for a number of years, asking naturopaths for particular conditions. It's just, I get a bit concerned when everyone is jumping on it and.

I'm like, yes, is it right for.

You at the moment?

And if you're not aware of the fact it has detrimental impact on the ecosystem, if not, and perhaps if you do certain, put certain things in place, you can prevent that, but you have to be aware of that first. I think we've got so much on the bandwagon that carbs are evil. And it's only carbs that feed bacteria, bad bacteria. Therefore, if you cut them down, all will be well. It's like, no. If you look at microbes really well, you realize that there's a whole bunch of the protein that aren't all that great to be feeding up. There's a whole bunch that survive on bile. So when we actually up our intake of fat dramatically, we increase the level of bile eating microbes dramatically, which I find so fascinating.

I'm glad you're talking about that. That was going to be one of my questions. The bile eating guys.

That's right. And they're the ones that are resulting in the hydrogen sulfide gas production, which inhibits colonic function and also causes gut inflammation and visceral hypersensitivity. So I see these patients too, that have put on very restricted diets in terms of cutting out plant foods, because plant foods cause gas. Most of my clientele are gut related patients. So they've often been put on these diets by other practitioners. And then their food allergies and food intolerances get worse and worse and worse the longer they're on that diet. And it makes sense when you look at what microbes are being fed by the current diet and which ones are being starved out. And as I hinted at or mentioned at the very beginning, that we're starving out the butyrate producing microbes and the ones that are important for gut integrity, at the same time, feeding up microbes that survive, thrive on bile, who cause gut damage and worsening gut inflammation. You don't get bloating, you don't get this tension from eating those foods. It's something that builds up over time. All of a sudden, a year into it, like, whoa, all of a sudden I can't eat all these foods that I could tolerate before. Yeah, that picks up. Looking at the research around this, we do see that we have a decrease of B trait producing microbes and decrease in B trait in people. On a typical low carb, high fat diet, we see increases in the sulfavibril concentrations. And there was one, one mouse study that described the ketogenic diet as having an antimicrobial like effect in terms of its impact on bacterial populations. But sadly it was levels of bifidobacteria lactobacilli and butyrate producing microbes like Roseburia that suffered where we had an increase in levels of Ones that could tolerate and go well on bile and protein, which were endotoxin containing bacteria, sadly.

And have you seen any strains go against extinct completely. I know that you've mentioned that sometimes it's we you have seen a recurrence or a return of particular species, is that right?

Yeah, thankfully that is right. And I suppose what we don't always have is lovely data beforehand. So I often will see patients afterwards, I'll see them after the triple therapy rather than seeing them before. So we don't necessarily know what the ecosystem was like before. It would be pretty rare that I've got a molecular stool analysis from before and then after to actually look at and go what species have been wiped out. But I certainly have worked with patients that have gone through a year or two years of restricted diets and herbal antimicrobials and antibiotics. And their diversity score was like the third percentile diversity, which is really, really poor. And it looks like the absence of quite a few species, including a range of beneficial species. But that particular case, I can think of that with third percentile, two months of working together, we got it up to I think it was 12th percentile. And that was pretty slow going to be honest. I had given up hope. I was thinking, I think you probably only way we can fix your ecosystem is getting an FMT fecal microbial transplant. Because I think you've just done enough damage through all a combination of factors, the antimicrobial herbs, antimicrobial like diets and the antibiotics combined. But that particular patient, through another eight months of work through diet and exercise and prebiotic supplements, was able to get her diversity score up to the 78th percentile. There was mid-70s. And that to me was pretty mind blowing because it was one of the worst ecosystems I had worked with at that time point. And to see that actually has a degree of resilience. And some of those species that were, were not apparently there initially were actually there in very low amounts. And I think that's the thing we're looking at here where someone like that we're not actually introducing new species, but we're encouraging those that are hanging on at the edge of extinction, those that are below detectable threshold for the lab technology that we use to grow into the point where they're actually contributing to the health of the ecosystem and your health.

Yeah, beautiful. Thank you, thank you for.

But it's those that have had most antibiotics. Antibiotics, that's okay. Sorry, I think there's a slight delay a little bit too with sound. But it's those that have taken the most antibiotics that I've had. The hardest point re establishing healthy or restoring a healthier microbiome. I think that's true enough too that there are some people where they actually have completely lost bifidobacteria and Akkermansia and there's nothing I can do to bring it back once it's gone. Bar probably fmt.

Yeah, yeah. And because you mentioned Akkermansia, I know it's a bit of a favorite of yours along with you've mentioned quite a bit is I'm gonna botch the name up. Faecala bacterium prasnitzii. Is that right?

Oh, you did well. You did well.

Akkermansia. I don't even know how to say the last time. Mucinophilia. You're a big fan of these two species. Can you tell us why?

Yeah. And I think it's been amazing seeing, seeing the research that's grown around these particular microbes that we didn't know existed until recently. And this is one of the advantages of using more recent molecular approaches to analysis of the microbiome is we can actually see what's there in a way that we couldn't before. We can now see that microbes like Akkermansia make 1 to 3% of the ecosystem in healthy people. On average that is maybe 30 to 300 times more than E. Coli makes in someone's gut. We all know about E. Coli because it was isolated in 1885, whereas this one we've only found out about recently. So even though it plays a much more key role, I think in many ways, both in numbers as well as actual roles in the gut, healthful roles in the gut, very few of us know it exists. And same with Fecalobacterium prosnitzii, we now know is the most abundant bacterium in the gut of healthy adults.

And it's a major butyrate producer, isn't it?

It is for most of us. It's the major butyrate producer because it's there in the highest amount. Yeah. But you'll still find that particular species tends to get really knocked around by those antibiotic cocktails and chemotherapy as well, where it gets really bashed about by chemo. And that's one of the reasons why I think the gut has a hard time recovering post chemo is because the ecosystem is so disrupted from that process too, that the microbes like Faecalibacterium that have a very key role for having a healing anti inflammatory effect in the gut, both through the production of butyrate, but it also produces other healing anti inflammatory compounds that scientists in Europe are still now trying to isolate what they are. We know it does it, but we don't necessarily what the compound is or compounds. But if that species is at 2% or 1% or 0.5% because of the chemotherapy, rather than at 15 or 20%, we're obviously getting a lot less of that antimicrobial gut healing properties being produced.

Yeah, it's fascinating. And so I want to move into some like, like actual prebiotic products or supplements or you know, food types. You're a big fan of prebiotics, like myself, and you mention quite a bit some of your favorites, which are lactulose, partially hydrolyzed guar gum, inulin, PHOs and GOs. So where do you find yourself using these most? And I guess you've answered that with all the other, all the, all the other things that you've mentioned in this podcast interview. But do you find that these, any of these particular nutrients excel most in certain conditions? I know that you use the partially hydrolyzed guar gum for methane dominant issues, which I have as well, which is, you know, probably thanks to you, I would say any other areas that you would use these things really successfully, Essentially.

Anytime where I think extra butyrate would be helpful, which from what we've discussed is probably most everything partially hydrolyzed guar gum comes into it. And I do use a lot. And it's a bizarre thing because I practiced for a long time and up to two years ago I never used, I never even heard of partially hydrolyzed guar gum.

And guys, it's different to the normal guar gum, so.

Exactly.

Yeah, don't be concerned, just guar gum.

No, no. Your gut will react very differently to the normal guar gum versus partially hydrolyzed. Yeah. And now it's such an integral part of my practice that I use with every, pretty much, I could say almost every single patient that comes to see me because it's got so many additional uses, whether that be for. If I'm looking at endotoxins, it's going to be helpful. If I'm looking at brain inflammation, depression, anxiety, I know it's going to be helpful too, let alone for gut specific conditions too. There's been, I think, nine clinical trials looking at partially hydrolyzed guar gum in irritable bowel syndrome. All nine have shown to be positive benefits in terms of normalizing stool form. So we use it for diarrhea type Ibs as well as constipation type ibs, decreasing abdominal pain and distention and improving quality of life. So there's a number of benefits we get in that sort of grouping of symptoms that we call ibs. And yes, there's research showing that even in Sibo hydrogen type Sibo, when given alongside this was a study using rifaximin. It dramatically improved the actual efficacy rate versus rifaximin on its. So I would use it in both hydrogen type as well as methane type SIBO patients. Gauss. I use a lot these days for anxiety and for depression as well as for irritable bowel syndrome type situations. And also there's some research using IT metabolic syndrome too. So I've used it in that scenario, but that doesn't make up a huge portion of my practice these days. Inulin FOS, definitely type 2 diabetes and metabolic issues, obesity. And very cool research using it in toddler age kids for decreasing the rates of infections. And that was one of the core things I've used inulin phos for since at least the last 15 years, is when I came across the research showing essentially in that taller age group, when they're going to daycare, they get sick a hell of a lot. And this is so frequent. And we can give this, you know, one teaspoon a day of fructoseaccharide powder. Tastes like sugar. Easy to get kids to take and it reduces their infection rates by 50%, reduces antibiotic usage by 2/3.

Yeah, that's fantastic. And inexpensive as well. Like, these things are considered like food in a way. They're all like forms and food and easy to implement, easy to take.

As naturopaths, we seldom prescribe anything that tastes good. Yeah.

God. Or we think they taste good and the masses don't.

Yeah. There is ones like that, like, I think of a herb, it's like iberogous, which I think is actually quite pleasant.

I like it. Yeah, me too.

And I've got patients who say that was ghastly. And I'm thinking, I haven't given you ghastly yet. I might. I do have a range of herbs.

But now I know, now I know I need to air with caution. Oh, that's funny. But. And I guess overall, these being amazing prebiotic nutrients, they just support everything. Everything. Especially when we consider what, you know, bacteria do overall function wise in the body. It's. Yeah, yeah, yeah.

So any condition where endotoxins or leaky gut play a role or butyrates can be beneficial, for example, then I think prebiotics actually play a role in promoting healing of that condition. And I think you'll see that adds up to a huge list or dysbiosis more broadly a role. And again, the list of conditions that we now associate with dysbiosis is growing by the month. It's absolutely huge.

Yeah, absolutely. And I know that the time is. Time is running out. So I've got a couple more questions for you. What is the difference between prebiotic like and prebiotic rich foods?

Okay, that's probably a separation that mentally works for me. Yeah, I know that divisions.

I like separation though.

Right. Prebiotic rich are foods that actually contain prebiotics. So that would be foods that contain galactyligosaccharides or in fodmap speak, galactans or fruct oligosaccharides or again, fructans in fodmap speak. So those would be foods that contain fructans would be asparagus, globe artichoke, truestum, artichoke, burdock roots, dandelion roots, chicory roots as core examples. And then those that contain galactic oligosaccharides would be essentially legumes of all description, beetroot. And you get small amounts and other sort of nuts, grains and seeds. But it's legumes that are pretty much the powerhouse of galacta ligosaccharides. And that's what makes people fart. It's the glycoligosaccharides which are indigestible to everybody. That's how they work. They reach the colon intact, where they can be used selectively by microbes that we want to grow there. But they do produce gas as part of that. And that's the same issue with the dietary fructans too, is that similar they're indigestible to everybody. But when they reach the colon, selectively utilize. But they do increase gas production. And it's some people that just cannot cope with that gas being produced.

And the prebiotic like is more your, you know, like your green teas and your cocoa and.

Yeah, so again, I've separated that out because prebiotic like are for me substances that have had human clinical trials showing that when ingested, induce beneficial shifts to the ecosystem. And you're right, it would be things like green tea, cocoa brown rice, blackcurrants would all fit that category.

Lots of fun foods, guys. I mean, really, there's no excuse not to get prebiotic or like, or prebiotic rich foods in your life. Colorful, you know.

Yeah. Yeah, that's it. It's going back to what I think humans have always eaten, which is a diversity of fibrous foods with color. I think it's just in the last 150 years that we focused on choosing the white and low fiber varieties of everything instead of cheating the purple and the reds, you know, like we used to.

Yeah, absolutely. And I'm also a big fan of polyphenol rich foods like yourself. So can you expand on why we love. Oh actually you did earlier on today, didn't you? Why we love the food so much and what are some examples of them?

Yeah, well, I think even that almond, almond skins would fit that category. So green tea, cocoa, blackcurrants, blueberries, raspberries, red rice, black rice, purple carrots, purple potatoes would all be foods that are rich in polyphenols. And as a general rule polyphenols, although differs per shape, but in general they support the growth of our, what I'd call more beneficial gut healing, butyrate producing microbes.

So Roseburea, what are the other butyrate producing?

Yeah, so we touched on Fecalobacterium before, which is said correctly was probably the dominant one in most people. But Roseburia, Blotia, subdola, Granulum, Anerostypes, Intestibacter, Anerotrunchus, buterovibrio.

They have the most fun name. Seriously, who has named these species?

Well, some they're named after like Blotty is named after a microbiologist called Blot who's still around here and now making writing microbiota research papers. So they obviously discovered that species relatively recently and hence named it after themselves. It's pretty common in the microbiology world.

Yeah. God, I think I'd want to name it after myself too.

I think of Prosnitiae. I'm sure that came from Prosnitz as well. But Faecala bacterium obviously means bacteria isolated from feces. That fits. But the Prosnitzii was named after himself.

Yeah. So Horlac. Horlac species, a major butyrate producing bird. So my final question, or what if my second last question to you is what do you think the limitations of a stool culture is versus the molecular approach and do you see any limitations with our current molecular testing approach?

I think perhaps the biggest limitation with our current ones is perhaps it would be either cost or time waiting.

Yes, time is ridiculous, isn't it?

Exactly. For ones like you Biome that I use in the States where the cost is great. Turnaround time can vary between. Listen Sometimes it's four or five weeks which is great, but other times it's 14, 16 weeks which is not so great. And the ones that there's going to be a new one that's going to come on stream in Australia in the next six months, which will be around the $400 mark but have a four week turnaround time. Much quicker turnaround, but the cost is going to be more so doing follow up testing, I think it's important the cost comes into it when you're doing that for an initial test, I think people outlaying $400 or $200, I think that's probably okay for many people. But when you start doing follow up tests to see whether your interventions have actually changed the ecosystem as well as helping them feel better, many patients like doing this. Like I can say from my practice, it's nice getting the objective data, seeing whether we have managed to bring your Bifrobacteria back from extinction or not. The difference between 100 bucks or $400 is quite substantial for doing repeated follow up testing. But going back to the first part of the question, I think the biggest issue with culturing that we now know is that culturing just doesn't pick up most of what's there. By far that's the biggest issue. And you can't actually assess the health of, of the hundred species that might be present by looking at four of them and four of them that actually make up a small percentage of what's there. But we isolated them 100 years ago. So you can't just look at, oh, look at their E. Coli, their Lactobacilli, bifidofactory and go okay, well E. Coli makes up 0.1% of what's there. Lactobacilli 0.1 or 0.01% in bifidobacteria if you're in a healthy gut, might be 2, 3% of what's there. So I don't think you can make much assumptions based around that because a range of species, including all these butyrate producing microbes, we can't test for using culturing. And the pathobion that produce hydrogen sulfide, we're not getting by culturing either, we're getting them from using molecular techniques. So I think it's limitations of what you can actually see. But I think as clinicians in the field, the other issue is just how accurate the culture results are from the stool sample when we have to ship the poo somewhere else for analysis. And I've seen that firsthand with A number of patients, as well as when I've done my own sort of experiments on this, is that microbes die on the way to the lab and you get a zero result that is not indicative of what's there in the ecosystem. It's like a false zero and that makes a big difference. And then that stool analysis experiment that you'd be familiar with, where we sent one stool, same stool, same person, to six different labs, and some labs said there's no Bacteroides, other labs said there was no Bifidobacteria lactobacilli, yet they were clearly actually in the ecosystem. It's majorly problematic. And that to me has got to do with the fact that the time frame differential, whereas if you look at the gold standard of culturing the 80s and 90s and 70s, when that was the best technology, we had to assess the health of the ecosystem and assess what was there. People were doing APU in the lab, culturing it or freezing it at minus 40 degrees under nitrogen fresh off the boat. Exactly. And that's very different from putting it out on your doorstep, waiting for the traffic truck driver to come and pick it up and then dropping it off and it goes onto airplane and then flies over.

We know different temperature changes.

Exactly. The reality is those bugs change and I've got enough data with enough patients to see that firsthand.

So we always need to marry up a couple of approaches though, because the molecular testing doesn't do all of the digestive parameters that some of the other path labs do. Yeah. So that you need to develop one, Jason, please, for us all.

But I think you're right though, and certainly for some patients, I'll go. Okay, well, I'll order this test here to do the functional aspects of digestive and immune system function and looking for bits of gut inflammation, short chain fatty acid profiles, ph, things like that, which are great. But I won't rely at all on their assessment of the microbiome. I'll use something like eubiome to complement that. So it brings the cost up, but it means that you can fully trust the results of what's there. You get a clearer picture looking at the 80, 90, 100 species that are present and how much they're there and how much of a role they're playing in that ecosystem and compare that to the more pro inflammatory ones and how much role they're playing that you can't get with culturing and nor with culture can you assess species richness and diversity. And we know that all microbotic scientists Would argue that these things are immensely important.

Yeah, 100%. The final question I have for you is what are your daily non negotiables for cultivating a healthy gut microbiota?

Yeah, good question. It is essentially every single meal I eat has to feed and nourish my microbiome. That's the way I look at it. So I think I've embraced the concept that I think most of us will embrace in the next 10 to 20 years that we are actually meta organisms that are partly non microbe and mostly microbe. Those microbe cells are just as important to our optimal functioning as our human cells or non microbe cells are. I think people are really pushing this idea that it's going to take a long time before that filters down to the day to day level. But it means that we focus so much on dietary approaches that have been on around focusing on nourishing your human cells, but really neglecting the microbe components of you. For me, every single meal I have has to have a range of compounds that feed and nourish my microbe cells.

Do you have a couple of favorites that you just absolutely love and you know that it just feeds your microbiota?

Well, sometimes I go to places where I can get a rare treat for my microbes. I was in Indonesia about two weeks ago and I could get a dragon fruit. And a dragon fruit had the most beautiful fluorescent red sort of coloration. And I know those red compounds feed my Akkermansia. So when I'm eating it, I'm thinking, eat my little acromanzia. Eat.

Yes.

My taste buds enjoy it, but my microbes like it too. But I don't get them very often. Here in Tassie. Here we stick with black currants and blueberries would be far more likely foods on our plate. But also things like red rice and black rice, purple potatoes, those things would be probably more core aspects in heated and cooled. And legumes would be core aspects of what I'd have on a daily basis to make sure my microbiome was well nourished. And when I certainly did that functional stool analysis testing, my beetrate production is double. The these are called high end of normal. So I was very happy to see that.

Well, yeah, you were a subject of a lot of your. I mean, obviously I mentioned to you I'm doing your course, which is awesome, by the way. Practitioners out there, meet your microbiome, I think it's called for practitioners. Amazing. And you were a subject of a lot of the testing that you did. And Yeah, I think you did have a great diversity and a healthy little kicking around microbiome.

I was pretty happy given how I started. So I started life in a way with you know I was at least vaginally birth but but I was formula fed from the get go and had a lot of antibiotics as a kid. So I was pleasantly surprised to see I discovered sort of naturopathic medicine when I was 18 which is relatively young and completely changed my life from eating junk food and smoking cigarettes and I did a whole bunch of other unhealthy things at that age to not and been eating extremely well since that point and that goes back to 1992 now. So I was happy to see that I actually probably repaired a fair bit of damage over that time.

Well, you do look a picture of health. You definitely do and you're a good advocate for it. I'm waiting for my eubiome result to come back and I was hoping it was would be ready for this conversation because it will be interesting.

I, I, oh, that would have been interesting.

Oh totally. And, and also because yeah I was formula fed but but I did do the keto, very low carbohydrate for a number of years and had a really quite high fat diet and and now just starting to bring back a little bit more, a bit more variety, you know and so would be interesting to see what it looks like at this stage.

Yeah, for sure I'd be interested too. And the science part of me is always very intrigued to do this and I can't wait for these tests to become a quicker turnaround time and more and cheaper. I suppose that's the thing because then we'll start doing testing. I had someone do a new biome test during triple antibiotic cocktail to see exactly how damaged your ecosystem was at that time point. The diversity score was zero and there's still about 10 species that were present but I think it was in pterobacteria made up 98% what was there. So you just created some very potent strong superbugs that could survive the antibiotic onslaught for that time period. But that would be look forward to the time where we can just do these subsequent tests and see exactly how each individual is responding to things like chemotherapy or that antibiotic that they had to take. And then we can tailor treatment more accordingly when you've got a 4, 6, 8, 12 week or plus turnaround time immediately makes it harder to work with acute scenarios like that.

So are you doing any research at the moment and can others sort of do you need people to participate in things like that.

I wish I had such a project.

The Endless Supply.

No, I was certainly involved with some research projects, one of which was a clinical trial running through the University of Melbourne with a PhD student looking at running the the trial looking at specific probiotic supplement and a diet rich in prebiotics on mood and seeing if it improves depressed mood, for example. So there's exciting research underway. Yeah, but there's a lot of projects I would love to do. Even simple things. I'd love to just check out the impact of slippery elm on the gut bacteria. No one's ever looked at that. And that would only be probably a 10 to $20,000 study.

Just a measly 10 to 20.

Yeah, that's exactly right.

Anyone up for the challenge?

Cough up such things. But that way we could see exactly what slippery elm actually does to the gut ecosystem. My hypothesis is that it feeds up Akkermansia and that's how we get sort of those colon anti inflammatory effects that we tend to see with slippery elm. Whereas we know it certainly coats the upper gut. Undoubtedly. But when you start talking about a tablespoon of slippery elm coating your small bowel and colon, which have the surface area of your tennis court, it seems less likely. But I think it's working by enhancing Akkermansia. That's my hypothesis, but it's yet to be tested.

Well, there you go. There's a call out 10 to 20 grand. Someone that's keen to know a little bit more about slippery elm. Just so I don't keep you for too much longer, can you let us know where to find you and about your programs and we've mentioned a little bit about Probiotics Advisor, so yeah. The floor is yours, Jason.

Ah, thank you. Well certainly I've got some online courses via the Probiotic Advisor including, including that as well as that database that allows you to prescribe probiotics in evidence based manner and looking at putting up when I find some time a range of other lectures on top of what I've got there now. But I have a meet your microbiome for the general public. So to teach people about the importance of that ecosystem. And that goes alongside a Typically you buy them stool analysis and they can assess their own ecosystem ecosystem and we go through changes in dietary and lifestyle they can implant to improve that ecosystem. But then I've got a whole workshop for practitioners based around this too. And I think it's very important for us as clinicians because naturopaths and integrative practitioners and functional practitioners have been talking about dysbiosis and doing microbiota manipulation and modification for 40 plus years. This is not new stuff to us, but I think we're almost at risk of falling behind if we don't change our diagnostic approaches with the change in technology, if we're still stuck using old culturing stuff when now we've got researchers and mainstream medicine is now talking about dysbiosis in the microbiome, but it's all using the more modern techniques. So I think it's important that we shift with that. This course is certainly designed to help practitioners make that shift because I like them were taught some things around CDSAs in my naturopathic training. But we have to move. That might be a component of what we're doing, but we have to make sure that we're looking at the microbiome itself using modern technology.

No, I agree with you and I'm so grateful that you've put this out there. I've enjoyed that. As I said to you before we jumped on, I've absolutely enjoyed the learnings and I'm going to go back and listen to it a few more times and I think it's really important. A lot of the education, well, a lot of the information and research is forever evolving and we do need to kind of keep our finger on the pulse a little bit and make sure that we're up to date with our knowledge. And so I'm grateful for yourself and for others that have platforms like this. So guys, if you're a practitioner or just want to know a little bit more about your microbiome, please go and check out Jason Horlack's website, the Probiotics Advisor. And it's all on there, isn't it?

Yes, there's certainly the link to the online course portal is there as well. And then there's. I mean I do regular speaking events around so I can speak to people in real life because most of what I do is teaching online. So I'd love.

Yeah, I'm trying to convince a fellow to go up to Tassie to do one of your workshops and experience it in the flesh. So it'll happen, It'll happen.

Okay. Well, certainly what I enjoy most is actually engaging with interested practitioners like yourself and talking about it, but in a live, face to face format.

Beautiful. Well, thank you so much for giving up your Monday morning to shed some light, more light on the microbiota. So very grateful to have you on, Jason.

You're welcome. It was fantastic actually.

Very good questions yes, well hey, I'm as passionate as you are. I think so as always guys, if you've enjoyed what you've heard, please share us with a friend. And don't forget to to leave a ratings on itunes and some feedback because that's how others find Love and Guts and can fill up on the content from our valuable experts too. Thank you for listening to Love and Guts. If you would like to get on top of your digestive or overall health, you can schedule your naturopathic and nutrition consultation with me via my website under the tab labeled Book and Appointment. You can also purchase a bag or three of my lovingly created Better Me Tea, an all organic herbal tea blend that helps promote healthy daily bowel movements and reduce some common digestive complaints. And if you have someone in your life that you know would benefit from the podcast, from the tea or from a consultation with me, feel free to share everything with your friend.