71: Discover How You Can Transform Your Gut to Prevent Disease and Boost Immunity with Dr. Vincent Pedre

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Hello and welcome. I'm Dr. Jen Simmons, a breast cancer surgeon turned integrative oncologist on a groundbreaking mission to transform the conversation around breast health. If you're seeking to redefine the way that you think about breast health, you're in the right place. Breast health isn't just an aspect of well being. It is health, integral and indispensable. Here on the Keeping Abreast podcast, we delve deep into the innovative ways to diagnose, treat, screen for, and prevent breast cancer. But it's more than that. It's about having the crucial conversations that empower, enlighten, and drive us all to a healthier place. As someone who has navigated the front lines of breast cancer treatment and now champions an integrative approach, I bring a unique perspective to these discussions, blending rigorous science with holistic health principles. Health is a journey, not a destination, and I am truly honored to accompany you on this path. Each episode aims to provide you with actionable insights and cutting edge strategies to take charge of your breast health and your overall well being. So whether you're here to learn about the latest in medical advancements or seeking tips on lifestyle changes that foster real health, then the Keeping Abreast podcast is your go to resource. Let's embark on this journey together, because when we talk health, every conversation matters. And now, stay tuned for this week's episode.

So typically, I think of my space, the breast health space, as the center of the universe. And as you guys always know and hear me saying that breast health is health. And the same things that are going to give you healthy breasts are going to give you a healthy brain, healthy bones, healthy heart, healthy skin, healthy muscles, joints, everything, really. But I have to defer to today's guest because truthfully, the gut truly is the center of health and the center of wellness. And if you don't have gut health, you do not have health. And so many people are unaware of what gut health is, what gut health means, the implications of not having it. And so I brought who I think is one of the top world experts on this topic to be with us today. So, Dr. Vincent Pedre is an author, a scholar, just very well known in this area. And so, Dr. Pedre, welcome. I have actually been, like, somewhat stalking you for the last year to get you on the podcast. So I'm so glad that this is finally happening.

I'm glad we made it happen. I'm so happy to be here with you and also to share a very important piece of the puzzle with your audience.

Yeah, yeah, and we're going to get a little geeky today because I think that there are some, like, nitty gritty things that people need to understand and know about. And we throw a lot of terms around. We throw like microbiome and intestinal permeability. And whether people really understand what these terms mean, I don't know. But I think it's important to understand what these terms mean because they have huge implications for our health. And all of these things play into that one thing that we talk about that's really at the root cause of everything, which is chronic inflammation. And chronic inflammation is so ever present. And we really are an inflamed society that is just living with the ramifications of all of that. So let's geek out, let's talk about all of it today. But first I want to know, because most people have a pain to purpose story, what made you so interested in gut health?

I think it's like any other story that it lands on your lap unexpectedly. I didn't choose to be a sensitive child with a really sensitive digestive system. It just happened. And I didn't choose to be put on 20 plus rounds of antibiotics from the age of 10 to the age of 19, because my, my pediatricians just threw an antibiotic at every infection, whether it was throat, sinus, pulmonary bronchitis. And I think since we're going to geek out a little bit, I think you would appreciate this because it ties into the story that back in the 1980s, a lot of times I wouldn't even respond to an antibiotic. And so my mother would take me into clinic and they would give me a gamma globulin shot. Now, gamma globulins are pulled globulins from, you know, from blood donors. Thankfully, you know, I look back at that time and I think, wow, thankfully I didn't end up getting some sort of chronic disease that they couldn't screen for at the time from these pooled globulins. But I remember that every time I got the globulin shot within 24 hours, I felt amazing. It was like someone had given my immune system back to me.

Well, essentially that's what it is, right? Isn't it? Essentially an immune transfusion.

It's basically immunoglobulins from healthy donors. And the thing is that the reason. And I would go to the pediatrician and they would tell me, you're, you know, you're, you're underweight, you're not eating enough, you need a multivitamin. They would give me These horse pill multivitamins, if you remember the multis way back when, they were horrible in the 1980s, that probably had the worst synthetic vitamins in them that were not bioavailable in any way. And so I would eat, eat and eat, and thinking that I was underweight but couldn't gain any weight. And, you know, I was eating tons of bread, pasta, cheese, dairy, ice cream, cereal with milk. Like, talk about all the Kellogg's cereals out there, like Fruit Loops and Frosted Mini Wheats and, you know, all the sugary cereals. That's what I was raised on. And because it was considered the normal way to eat back in the 70s and 80s, the combination of the wrong foods. With so many rounds of antibiotics that destroyed my gut microbiome, I ended up developing leaky gut sensitivities to gluten and dairy and some other foods. And, of course, because not only is the gut the foundation, but the gut is ground zero for our immune system. Right. 80% of our immune system resides all along the gut lining. So my immune system was fighting a chronic battle that wasn't allowing it to be able to survey for viruses, for bacteria. So I was so susceptible to that. I actually became a hypochondriac as a child. And I was really afraid of being around anybody that was sick. And part of my motivation in going into medicine, aside from my desire and love of helping other people, was to figure out, like, how do I not get sick? Because I get sick all the time.

All the time. Wow.

And it all tied back to my gut health.

Yeah.

And so that's kind of my. My origin story, which then turned into IBS during my 20s, and I had no understanding IBS being.

Irritable bowel syndrome.

Yeah. Yes, irritable bowel syndrome. And I had no understanding how anything was interconnected. However, my dad was really into diet. And back in the 80s, he went to a doctor that did some sort of food allergy testing. And then my dad had a whole list of foods that he couldn't eat. So there was, in my family, there was some level of psychology that food does matter, even though we still were eating the wrong things, you know, and I still grew up eating the wrong things. But I watched my dad and I. And I always was curious, like, is there a food connection to how I'm feeling, to how my gut is? But I didn't completely understand. And some things happened just by accident. When I became a medical student, I couldn't sit and eat a bowl of cereal anymore in the morning. So that went out and I was more like picking up an egg sandwich or something that was non dairy. So I noticed that I reduced my dairy intake and I wasn't, I was getting sick 50% less than before. And so as, as the scientific observers that we are, I was always like paying attention. I had reduced dairy, I had increased my fat intake like avocados, olive oil. Now, now remember I grew up in the 80s when fat was vilified. Yeah, that was like, so like I grew up during this time thinking that fat is bad. So I used to love eating Snackwell cookies and all those like fat free cookies that were full of sugar. Again, the wrong thing, also full of wheat. All these things destroying my gut barrier, causing increased intestinal permeability, leaky gut, and no wonder I couldn't gain weight. My energy sometimes wasn't great, sometimes tanked. I started developing a lot of mental fogginess. By the time I was in my training in the hospitals and doing my residency in internal medicine, I started having eczema on my hands. And I thought it was from washing my hands so much or using hand sanitizer, but turns out that it was actually connected to the fact that I had become gluten sensitive and it was manifesting as eczema on my skin as well as brain fog and as well as energy issues. So it honestly, by the time I was in my, you know, late 20s training as a doctor with as much as we learned in medical school, I thought, well, I'm the unlucky one out of my, my three, my two siblings and I, my two older sisters have no problem eating anything. And meanwhile I was the canary in the coal mine. Things sometimes didn't sit right. I didn't understand, like go out to dinner, then I don't feel well the next day, or I'm running to the bathroom multiple times or sometimes running to the bathroom right after having pizza and I wasn't making the connection. And finally, you know, I was always searching for what I call the truth. And I always, I don't know if you've ever, if you feel this way with medicine, but I always felt that what we were being taught was only part of the picture and there was a whole other piece that was missing. And it was, for me, it was because the medical training is so connected to pharmaceutical medicine that it disconnects from the underlying mechanisms of disease.

Yeah, it's so interesting that you say that because I think when I was in training, when I was in medical school, when I was in residency, I don't know that. I recognize that. Like, I. I was drinking the Kool Aid. I was buying it hook, line, and sinker. Like, this is. This is how to. How to cure. This is how to heal. This is. This is what there is. And, you know, I was. I was a good little soldier. I mean, when you think about it, when you're in that stage, what is rewarded, right? You're rewarded if you can memorize it, regurgitate it, do it. That, you know, as a surgeon, if you did it just the way your attending did it, you were the rock star. You were the superstar. Like, no attending wants to hear, I think we should do it this way, right? Like, they do not want to hear that. Innovation is not rewarded in medical school and residency. Even as an attending, if you are doing something that is outside of the scope even a little bit of the way that it's done, you are outcasted fast. I mean, when I left surgery, I went from being the smartest person in the room to the craziest person in the room in, like, a day.

My gosh.

Right? Like, she lost her stuff, she lost her mind, she lost her, you know, whatever, Right? So I did not have that perspective until I got sick. It wasn't until I got my own diagnosis that I even was able to see that there was something more. So I applaud you for having that. That instinct, that innate sense that this is not all there is. But you also, very early on, were thinking outside of the box.

I was. Yeah, I was. And actually, I almost didn't go to medical school. I. As I was completing the MCATs and getting ready to apply to medical school, I started thinking about, like, you know, up until then, it was all science and. And just theory. And then I started thinking about how I can't get my blood drawn. I can't get a shot without passing out. How am I going to become a doctor? Every time I was a needle with doing something with me, I would go into Vasovagal and I would pass out. And I actually came home in, like, the fall of my. I think I had just taken the MCATs of my junior year in college, and I told my parents, I don't know that I want to become a doctor there. Of course. I mean, my family is Cuban. My family is Cuban. And Cubans, you either become a doctor, a lawyer, or a cpa. That was back then. You're either going to be one of these three.

Same thing with Jews.

Yeah. Yeah. That's why sometimes I say that Cubans are the Jews of The Caribbean. I used to joke with my parents. I'm like, we're just like Jews in a really good way, you know, because. Very hardworking, very dedicated. But my older sister was cpa, my second oldest, my other sister a lawyer. So I was to become the doctor. And my grandfather, who I'd never met in Cuba, was a doctor who never. He never left Cuba, never got to meet him. He was the only other doctor in the family. And so I think my mom had this dream for me, becoming a doctor, and she was very distraught when I said, I don't know that I want to become a doctor anymore because I'm afraid of needles. And how can I be a doctor if I can't handle being around needles? That's part of being a doctor. And, you know, we sat down for an hour, and by the end of it, my parents were very good at persuading me. So by the end of it, I had agreed that, yes, I'm going to apply to medical schools. But it was lingering in the background. And the reason I'm telling this story is because it applies to one of the very important inflection points in my journey to becoming the type of doctor that I am today. Because, as you know, our challenges become our greatest strengths. And when we're able to overcome those obstacles, the lessons that we learn along the way empower us to move into our future in a very different way. And so I actually finished college in three and a half years, came home. I had eight months off before medical school. And I started thinking about this needle phobia that I had, and what am I going to do about it? And I started wondering, okay, well, what happens to my body? Like, my heart starts racing. I break out into cold sweat. I start feeling dizzy. I sometimes feel, like, a little bit nauseous. And the next thing I know, I pass out. So here I am, not in medical school yet, and I start going to the library, the bookstore, and I'm like, what is happening to me? And I learn about the vasovagal response and the vagus nerve and the parasympathetic sympathetic nervous system. I'm like, well, this is great. How can I get this under my control? Is there a way to control the autonomic nervous system? Autonomic meeting, automatic. I'm like, well, if there is a way to control this, I want to figure it out. And I finally found a book that talked about using breath, work, and meditation as a way to gain control over that automatic system that we thought was not under our control. So I start doing breath work, meditation. Soon after that, I start doing yoga. This is 1995, so you can imagine this is in a world that most people haven't heard of meditation. Most people are not doing breath work.

This is early, early on.

This is very early on.

Yeah, yeah.

And I'm doing it like I am training for the Olympics. Like, I need to conquer this. I need to be able to control that internal state in my body. And I delayed, you know, for. For medical school, you have to get the Hep B vaccine series. And as long as I got the first shot before this first day of medical school, it was. They accepted that you could complete the series in your first year. So I delayed it for the last minute up until August. And From January of 95 to August, I was meditating, I was doing breath work. I would lock myself in my childhood room at home, and I would take 10, 15 minutes and do this every single day. I started listening to guided imagery on CD ROMs. You can go back, like pre ipods, pre smartphones. And I was determined to gain control over that part of the nervous system. And when I went and got my first Hep B shot, I found I started having that response. Like the trigger came. I could feel my heart rate going. I could feel beads of cold sweat. But then I went into my breath work. I went into my guided imagery. I started like, visualizing myself in, like I had my safe space at the time was a hammock on a beach under some palm trees. And so I would close my eyes and take myself there, do the breathwork, and I get that shot and I don't pass out. And it's the first time that's happened. And imagine how empowered you feel when you see that you have changed something within yourself without supplements, without medication, without any other thing other than your own internal body systems, which our bodies are these incredible machines. Breath work, meditation. And it's funny that I started there because, you know, in. In the world of functional medicine, when finally learned functional medicine and realize that I could reverse a lot of the issues that I had basically acquired from having been on 20 plus rounds of antibiotics, from eating all the foods that were wrong for me, from having a chronically imbalanced gut microbiome that had been decimated by the antibiotics and leaky gut, that I could reverse all that. But in this long journey of becoming a gut expert and working with so many people on gut health issues, it's funny that in the end, I've come all the way back to the start realizing that the nervous system response is just as important as almost any other piece of it. Because if you can, and this is by, I think, by and large for any complex chronic health issue, if you can't get the person into a more relaxed, parasympathetic state more of the time, yeah, you can't heal the body. The body will not allow that healing to happen.

That's exactly right. And I think that we have a mutual colleague, Ashok Gupta, that his entire platform is getting people into that healing state. Because unless you are in that parasympathetic state, you cannot receive the signals from your body to heal.

Right.

Because our, our bodies, we only understand two states. We understand safety and we understand danger. And if you are in that danger state, your body, you can't heal, you have to run. You have to run. You have a saber toothed tiger on your tail, you have to run. Your immune system gets turned off, your brain gets turned off, and everything gets turned off except for your muscles, because you have to run.

Exactly.

So.

It is literally impossible to heal when you are in that state.

And the interesting thing is that it all ties back into the vagus nerve. And when you talk about safety, our safety comes, or the feeling of safety comes from, from the activation of the ventral vagal fibers which respond to your breath and to the stretch receptors in the lungs that when you take those deep diaphragmatic breaths, stimulate those stretch receptors that then cause that ventral vagus to fire, which then takes you to that place of feeling safe in your body, just so important for healing. And I think another thing that's really important to point out is I think there's two types of stress that are registered in the body or two ways that stress is registered. It's either registered in your mind, you've got this, like mentally, you're stressed. But the other stress I think is possibly even more important than the mental stress. I call it biophysical stress. It's the way that your body is registering what is happening to you in your environment. And that can be not getting enough sleep, not eating at the right times, like sometimes starving yourself, like creating that internal stress, or constantly being rushing from place to place, or your job requires you to travel all the time and you're in airports and you're airplanes and there's so much stimulation and a lot of external stimuli that are cause that creating biophysical stress for your body and being. And living in New York, where people have a distorted view of what stress is, right. Because they're so used to living amped up that Their perception of stress up here is like, oh no, my life is normal. And a lot of times I have to tell people when they tell me I'm not stressed, like. But do you realize that your body is stressed? That even if you don't feel stressed here in your mind because you've basically adapted?

Yeah, that's a protective mechanism in itself.

Yeah.

Right. Yeah. I think another thing that should be on that list is over exercise because there are a lot of people who are, from their body's perception, running from a saber toothed tiger for two and three and four and five hours a day. Right. These people that are just endurance athletes and things like that and they don't understand, they're so healthy and then they wind up in my office and don't understand why. Right. And so the body perceives stress to your point, in so many ways and we have to be mindful that even things that, that are healthy in a certain dose are healthy for us. Yeah, yeah, yeah, absolutely. So I would love to go back to a couple of things that you said before in your story. The first is that you started to talk about the immune system and the connection between your immune system and gut health. So can you expand on that? Because I think that that is a poorly understood concept and people don't understand the importance of gut health and its, and its relationship to a competent immune system because so many women have breast cancer. Because that immune component that is supposed to be surveying our body and recognizing these cancer cells in their infancy, our immune systems are exhausted and they're mostly exhausted because all the work that they're doing in the gut.

Exactly, yeah. I like to think of the gut as command central for the immune system. So. And as a command central would be if, if it is overwhelmed, it's not going to be able to basically survey for things like viruses, bacteria or cancer cells effectively in other parts of the body. It's like you're. When your gut is chronically inflamed because 80% of your immune system is all along the lining of your gut. When your body, when your, when your gut is inflamed for a multitude of reasons that we can talk about, then you develop leaky gut. When you have leaky gut, you get chronic activation of the immune response in the gut. And that also creates almost like a distraction because your immune cells are being recruited to the gut so they're not as carefully surveying other parts of your body.

Yeah, it's like an army that's exhausted. Right. Like it's on guard 247 in this place. And so it can't guard the other place.

Exactly.

You talked about. First of all, I want you to define intestinal permeability, leaky gut, what's happening there and then talk about the things that cause leaky gut.

Yeah, Basically we have to think of our gut barrier as this very thin membrane. In actuality, it's just one cell layer thick. Those cells are integrated together through these tight junctions that are these protein complexes that fit together like Velcro. When you have leaky gut, what happens is that these tight junctions break down. Imagine if these are two cells and the tight junctions break down. Now you can see through the holes and those holes allow for the passage of molecules that should not be getting through that gut barrier. Another way to think of it is that your gut barrier is like a coffee filter. And when you use a coffee filter, you want the filter to keep the coffee grounds on the other side and you just want the nice coffee infused water to enter the other side. Right. But say I took a coffee filter and now I took a little needle and I poked a hundred holes in that coffee filter, then added the coffee grains, then the hot water. What's going to happen? Some of those holes are going to be big enough for coffee grains to come through. Well, we know that what happens just from studies they've looked at found bacteria circulating in the blood, bacterial DNA circulating in the blood, and then one of the key components that are secreted by certain types of bacteria, especially in the large intestine, it's called endotoxin, also referred to as LPS or lipopolysaccharide, is a major activator of the immune response. And actually there are receptors to endotoxin not just in immune cells, but also in fat cells in the liver, in muscle tissue, and also in the brain. That receptor, what it does when it gets stimulated by endotoxin is it turns on a very specific genetic pathway that codes for inflammatory proteins that activate the inflammatory response within the cell. Now, you're not necessarily going to read that as you know that you're inflamed, your body's going to tell you your muscles are sore, they don't recover so well from workouts, your memory is not so great, you can't remember things easily, or your insulin levels are high, you're not processing sugar well, you start develop insulin resistance. When you're activating those fat cells in the belly, they actually produce the same chemical signals as our immune system. So now you have your immune cells producing activating interleukins IL6 and stuff. And then you have your fat cells secreting the same substances and you create this general environment in the body that is inflamed and like you said, distracted. Because if you're fighting a war in your gut, you don't have enough troops left over to survey the rest of your body. And to tie this back to my own journey, that's what was happening with me. That's why I was getting sick. Like major illnesses with fevers and like they thought were bacterial infections two, three times a year, every single year as a child.

Wow. So can you talk about, I mean, certainly help us understand what caused that intestinal permeability that set off that cascade for you, but what do people need to be thinking about? What are the things that cause intestinal permeability?

The way I think of it is it's kind of like a cascade, but there can be different pathways to coming back to those tight junctions, things that just cause the breakdown of the tight junction. So to understand that our good bacteria are living in a very thin layer that's only nanometers thick, that is all along the inside lining of the intestine.

And are you talking about our microbiome now?

That's our microbiome, our gut microbiome. And the microbiome serves a very important purpose because when it is healthy, it is keeping those tight junctions sealed. And it's helping our gut maintain a well regulated immune system that is alert enough, but not too alert. It's actually keeping it from over, activating through something called T regulatory cells that actually get stimulated by bacteria like Lactobacillus. So when you alter the gut microbiome in different ways, you kill off good bacteria by being on antibiotics or causing disturbances in the gut microbiome that promote the growth of bad bacteria, like eating too many processed foods or sugar or drinking alcohol or even studies have shown being under chronic stress with high cortisol levels is going to alter the gut microbiome. That gut microbiome is keeping that gut lining healthy. So when that microbiome gets altered, then we are not able to maintain the integrity of the gut lining. That permeability increases. Maybe it's just a few little holes, maybe some cracks in the lining. And as it progresses over time, you get more and more. There are also some directions, things that increase gut permeability that don't necessarily have a mechanism through the gut microbiome, like over the counter NSAIDs that people take just for aches and pains, that's going to increase gut permeability if you're taking them too often, you know, if you take them once in a while, that's probably fine. But if you are taking them chronically over time, that's going to affect gut permeability. Birth control pill also increases gut permeability through the effect of the estrogen in the pills or the different synthetic hormones that are used. And some other drugs can do it as well. If you think about a typical person has probably been on antibiotics, has probably taken NSAIDs at some point, has probably suffered from chronic stress, maybe is a comfort eater having too much sugar. So now you're adding multiple factors that are going to affect the ecosystem. The healthy balance of good and bad bugs in the gut, which is then going to lead to a breakdown of the tight junctions. They've actually also, this is really interesting, they've done studies in mice where they looked at the integrity of the tight junctions and what happens right after they get an antibiotic dose. They found that within hours of an antibiotic dose, the tight junctions started to dismantle and they started to get leaky gut. So there is even a potential mechanism directly through just being exposed to antibiotics.

That cause beyond, beyond its effect on.

The microbiome, you think it has a.

Direct effect on the intestinal integrity.

The reason I say that is because in this study it happened so quickly after dosing the antibiotics. So interesting. It's possible. It's possible that there could be a direct effect.

And then what about.

And the crazy thing is that it can happen after the first dose.

Yeah. What about the effects of things like gluten or pesticides, herbicides, fungicides, all of that too. Yeah.

So those are the other factors that we have to think of. Pesticides are technically some of them, like glyphosate is a chelating agent. What that means is it binds minerals. That's how it keeps weeds from growing. It starves them of minerals while in the gut, by chelating minerals, it actually kills off good bacteria and it as a result increases intestinal permeability as well. So being exposed to pesticides is sort of like taking low dose antibiotics that are over time breaking down that ecosystem. Gluten also has a direct effect where it stimulates a receptor in the cells that line the intestines that stimulates the release of zonulin. Zonulin is a protein signal that controls gut permeability. The more zonulin, the more permeable the gut is. So gluten can have a direct effect on the secretion of zonulin because a lot of people wonder, what is the problem with gluten? Is it just that people are sensitive to wheat? Are they having an immune response? But it also actually does increase gut permeability. And they did a study where they looked at the effects of gut permeability of gluten on three different groups. They looked at patients with celiac disease, patients with what we call non celiac gluten sensitivity, which is what I am. I don't have celiac, but I'm gluten sensitive. So I'm not normal. But I'm also not to the extreme of celiac disease. And then people who are normal. And they looked at all three groups and it was really interesting because they found that gluten increased gut permeability in all three of them. The difference was the degree celiac patients had the highest increase in gut permeability. The non celiac gluten sensitive had the second highest. You would have thought that people who have no sensitivity, no celiac would get zero increase in permeability. But they did have slight bump in permeability with gluten. You can imagine that an accumulation over time, over a lifetime. You know, when I was back in medical school, I'm not going to assume that I don't know how age matched we are because you look great.

You're very kind.

Back when I was in medical school, celiac disease was a pediatric diagnosis. And if it was going to be found, it would be found within the first years of a child's growing up. When I started looking into this, I diagnosed a 52 year old woman with celiac disease and no one had picked it up ever.

Well, I diagnosed three people last year with celiac disease who the first presentation of their celiac disease was their breast cancer diagnosis.

Wow.

And so now I'm just in the habit of actually testing everyone with a breast cancer diagnosis for celiac disease. Because. And tell me if I'm wrong, But I think 40% of people with celiac disease have no GI manifestations.

It's very possible. And how it will manifest is with all the other connected conditions, you know, and, and I will also say sometimes people are not. Aren't aware they may have. Be. I've had patients where they're just not so connected to their bodies so they think they're not having GI symptoms, but. But they just attribute like, oh, I'm always bloated or you know, so they, they kind of normalize the background.

Right.

It's their normal. Just like when you talk to people about constipation and they say, no, I'm not const, I'm regular. And you say, how many times do you move your bowels? And they say once a week.

Yeah.

And you're like, I feel like, I feel like Kevin in Home Alone.

Yeah, exactly. The patient that I mentioned, the reason I ended up diagnosing her with celiac is she had Hashimoto's and they were having difficulty balancing her thyroid. And some of the thyroid medications can cross react with someone who's super gluten sensitive. So the, the other thing to note is some people with celiac will also have a lot of difficulty with corn because there's, there are some cross epitopes between proteins and corn proteins. And someone who's super sensitive might actually cross react with corn.

Yeah, Well, I think Peter Osborne's book no Grain, no Pain really talks about that connection between celiac and all grain avoidance. Because there are many celiacs that if you just pull them off gluten, they don't get better. And that's because there is so much cross reactivity between wheat or the gluten containing grains, the barley, rye, wheat, oats, whatever. And what we think about is the non gluten containing grains, but there's enough cross reactivity in the basic protein that these people don't get better unless you pull them off grains entirely. And I also think that there is some cross reactivity with dairy because we have to remember where those dairy proteins are coming from. They're coming from the consumption of grains. Yeah, there's going to be some common talk.

Those are probably the top two sensitivities. Surprisingly, lately I've had a round of patients where they're sensitive to wheat gluten but not sensitive to dairy, which I love when I find that combo because then I can talk about bringing in fermented dairy as a way to heal the gut. So I'm not, you know, so a lot of people get very anti dairy. I think if a person is not sensitive to dairy, it's actually a good vehicle for doing some gut healing using fermented forms of organic grass fed dairy. But one thing I want to say back to the celiac is another thing. Not just thinking about grains, but also being really careful with cross contamination when eating out. And for anybody who's listening to this and you're thinking, well, I've gone on grain free diet for the last few weeks or for a month and I still don't feel better. It can take a good six months for the body to metabolize and remove all the Gluten metabolites that get into the circulation. So a lot of people don't have the level of patience. One of the things that I do when I'm working one on one with patients is really teaching them that there is a waiting game. Like you're going to make changes in your diet, but the true, like the maximum effects of those changes, you're going to feel something. Like a lot of times I can get people from bloated to not bloated within four weeks, who have been bloated for over a year, for 18 months, even for years. But the, the true healing takes a bit longer. And I can say from the time when I discovered that I was gluten sensitive to when I felt a certain layer of healing, like getting to, you know, I felt great within two weeks, like my mental, my energy, my mental sharpness, my ability to get through a 12 hour workday as a doctor was amazing. But at six months I felt even better than I did at two weeks or one month. And the only reason I arrived there is because I stuck with it. So a lot of people, they, they're making changes in their diet and they get frustrated, they get bored or they think, oh, I'm only 50% better. And I think it's really important to mention that it does sometimes take 6 to 12 months to see the full effects of these changes.

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Back to our show. So I do want to go back to the topic of antibiotics because I think that this is particularly controversial. I want to be clear. If you need antibiotics, you need antibiotics, right? If you have pneumonia, you need antibiotics. I don't think they're particularly helpful in situations like sibo. I think that most people who go on antibiotics for sibo, they just recolonize with the same microbiome that they had before and it, and it, it does.

Not resolve anything or they get fungal overgrowth.

Yeah, yeah. So they, then they have fibo. Right. And so, but there are times where people need antibiotics. So talk about what antibiotics are doing, why they are problematic, and then help us to understand how you heal, how you recover after a necessary course of antibiotics.

Yeah, I mean, I'll start with echoing what you said. I've saved many people's lives. I've kept them from being hospitalized by using antibiotics in a judicious fashion and targeted to the person. I use antimicrobial, anti parasitic medications many times to treat people that have parasites because as much as I love the herbs, I find that sometimes they need that little accelerated healing that using an anti parasitic medication can accomplish while then using an herbal remedy to make sure that we clean out the parasite in the gut. I'm one that doesn't have patience to wait for results. I like to get results as quickly as possible. That might be my western doctor training. So it's important for people to realize like I'm not anti antibiotics, I'm anti the over prescribing of antibiotics, which we know like 30 to 40% of antibiotic prescriptions are unnecessary. They do, they're not required at all. And a lot of things will heal if all you do is instead support the gut and the gut microbiome and the immune system. So there's always different pathways. But even then, like anybody who's prescribing antibiotics, like the true responsible thing to do is to know that you are damaging the gut microbiome, that a five day course of Cipro can take 12 months for your gut to recover from that, a five day Z pack can take six months for your gut to recover from that and maybe never returns to normal. So when prescribing antibiotics, as practitioners, as doctors or any health practitioner that's able to prescribe antibiotics, nurse practitioner, they really should be paying attention to the fact that you are messing up the person's gut microbiome. And what are you going to do to repair that? Because if you don't, you're setting the person up for repeat infections, for a weakened immune system because of dysbiosis, because of leaky gut, because of all the other things that we talked about. And not to mention that antibiotics are also mitochondrial disruptors. So a lot of times you put a patient on antibiotic and they say, oh, I feel horrible, I feel so weak, I feel tired. It's because you're also basically causing mitochondrial dysfunction in other cells in the body. And we know this is big with the quinolones as a group of antibiotics, they're incredibly disruptive of mitochondria. Depending on the duration and length of the antibiotic course, I like to make sure that I'm also protecting the person's gut. And that can include using a well researched and studied friendly yeast called Saccharomyces boulardiae, which has been shown to protect the gut lining and help prevent the deterioration into leaky gut, especially when being on antibiotics. I also like to follow antibiotics with a probiotic course depending on the patient and their underlying issues and what we've been working on. LISA Comprehensive probiotic with multi strain, with clinically researched strains that help reduce inflammation, help improve the diversity in the gut microbiome. One thing that people don't understand is they think, they say, well, you take a probiotic, it's only good while you're taking it and then it washes out and you're only taking that probiotic. But what we know now is that probiotic bacteria are digesting the non digestible fibers, the short chain carbohydrates in our diet and producing these short chain fatty acids and other metabolites that cross feed other bacteria in our gut. So probiotic is actually helping support diversity in the gut microbiome. We haven't talked about diversity, but diversity to me is the holy grail of gut health. Because if you have diversity in your gut microbiome, that gut microbiome will take care of you will help heal and seal the gut lining and it's also going to lower inflammation and it's going to regulate your immune response. So I also, again, depending on the person and if they're able to tolerate, because not everyone can tolerate fermented foods and not at the same level, but I think ferments are a very important part of, of healing the gut from any type of dysbiosis and especially after being on antibiotics, I think it's very important to incorporate that. And it depends on what the person can tolerate, you know, because if they have a dairy sensitivity like we were talking about, then I can't have them have Greek yogurt or any sort of dairy yogurt. But we may be able to bypass that by having them have coconut yogurt or even goat milk yogurt, because goat milk has a different protein sequence that's much easier for our gut to break down and digest. Or having other types of fermented foods like sauerkraut. Always want to be careful with the kombuchas because they do have yeast. And a lot of the commercial kombuchas are very high in sugar. I personally, if I'm going to have kombucha, like, you want to make sure that you're getting a brand that has very low sugar. Or brew your own kombucha at home. But not necessarily a big fan of kombucha right after antibiotics, because antibiotics also kind of come in. It's like. It's basically like you want to kill the. Let's say it was a rainforest, and there's a part of the rainforest where there's some bad trees, and you want to kill those bad trees, but you throw in this antibiotic and it kills all the trees at once. And when you do that, then you're allowing for opportunists to come in and take hold of real estate. One of those is yeast. So you mentioned that the treatment of sibo and using antibiotics for sibo. A lot of times I see people who have been treated for sibo. They come in to see me because they have the same symptoms. I'm going to say they have the same symptoms. Their doctor wants to put them on another round of antibiotics. They don't do testing. This is actually. I don't know how I feel about this, but I can't tell you how many gastroenterologists I've seen who will just treat empirically and not do testing.

Not all of them.

Not check to see if there is actual hydrogen or methane predominant sibo. And a lot of times these patients that are deteriorating after the treatment, it's because now they have sifo, small intestinal fungal overgrowth. So they have yeast overgrowth in their gut. The symptoms overlap, same symptoms. So now they think that they've got sibo again, but they actually. What they have in their gut is yeast overgrowth. And the more that yeast takes hold, the harder it is to get rid of that yeast.

It's very, very hard. And I agree with you. There are so many people. I mean, you're lucky if you get them after one round of antibiotics. What usually happens is you get them after three rounds of antibiotics because they felt a little better after the first round, and then all their symptoms came back, but the doctor was encouraged by the fact that they felt a little better the first time. So then they give them a second round, and that doesn't work. They give them a third round, and then the patient just gets frustrated and go somewhere else for answers. So you're really lucky after the first round.

I've seen so many cases of yeast overgrowth after a round of rifaximin, which is one of the primary antibiotics used for. For Sibo. And it's so crazy. I sat in. I sat in, you know, one of those pharmaceutical rep dinners for this particular antimicrobial, and they were talking about how it's both an antibiotic and a prebiotic and how it supports bifidobacteria in the large intestine, and yet not mentioning that. Oh, but you can also get yeast overgrowth as a second, as a side effect from being on this antibiotic. You're not. There's no. It's like going back to the fact that there's no medication that doesn't have a potential side effect.

Yeah.

And we have to be aware of those, and especially with antibiotics, because they. They cause problems that are downstream that later on you're dealing with. And you might not realize it because you're just presenting with mental fog or you're feeling achy or you just don't feel so great, or you have swollen lymph nodes and. And you think like, oh, I'm just run down. I'm working too hard. You know, you're always. People are always blaming it on other reasons in their lives and not realizing that it could be because of that course of antibiotics you had a few months ago that has left your gut microbiome in a poor state.

Yeah.

And it needs some help.

Just depleted. Yeah.

And.

I've heard you talk about this before, and I think that we have a very similar philosophy when it comes to this, but our medical system is very, very broken. And this is a perfect example of one of the things that's wrong. So if you had your druthers, like, how would you redesign this? How would you approach it so that people are not. Do not fall victim to this system? Like, what are we. What are we getting wrong? What are we doing wrong?

We need so much education around this. And I think also doctors in training need education around the gut microbiome and the important and wide impacts that are scientifically research backed. I'm not talking about stuff that is. Yeah, this isn't woo woo, right, wacky like, you know, because the naturopaths have been talking about the importance of gut health since the early 1900s or late 1800s. And yet when medicine diverged, because we originally were more of a naturopathic tradition, and then pharmaceutical medicine came in and medicine split between naturopathic and Western medicine, Western medicine had the potential to make a lot of money. So then that became the primary driver behind our medical system. And again, not to say because the discovery of penicillin helps save a lot of people's lives. Right. And modern medicine is great for a lot of things. What it's not great for is for chronic disease. And we're not training our doctors properly to understand, like every doctor should know, if you're putting a patient on antibiotics, you're disrupting their gut microbiome. You could potentially be causing the, you planting the seed for future chronic health issues that this person is going to face as a result of those antibiotics. We should be conscientious of that. But even as a society, like, I think as we move further and further away from like traditional ways of preparing foods, of understanding what is required to be healthy, even just the lack of fermented foods in our diet just plays such a significant role in improving gut microbiome diversity, which then lowers inflammation. And we know this from a study done at Stanford University where they looked at the effects of a high fermented foods diet and how that affected gut microbiome diversity and how that affected inflammation. They looked at it in contrast to a high fiber diet. It was interesting because I think they only had two intervention arms in this study. I would have probably had four. I would have done high fiber group, a high fermented foods group, a normal food pyramid diet, and then I would have done a group that was both high fiber and high fermented foods.

Yeah, absolutely, I agree with you completely.

And there's actually a group that did a study like that. And when you combine fiber with fermented foods, they call it a psychobiotic diet because it has, it can have dramatic gut brain health impacts, including reducing the brain's perception of stress. So it actually can reduce your perception of stress by eating a diet that alters the gut microbiome in a certain way with fermented foods and fiber. But in this Stanford study, What they showed was that the high fermented foods diet increased gut microbiome diversity and lowered all 19 inflammatory markers that they were testing.

It's so amazing and so simple. And the fact that we're not talking about that is disgraceful. The fact that you can't get doctor information.

Food has been the ongoing, I think, biggest driver of disease. Right. One of the biggest drivers of disease and we don't pay enough attention to it. On the fiber rich side, what they found was that fiber was an immune modulator and it either activated the immune system or actually toned down the immune response.

Yeah.

They decided, they asked the question, okay, in the fiber rich group, why are we getting these different responses? What is their underlying microbiome diversity? They found that they could divide the fiber rich group into three groups, high diversity, middle diversity and low diversity. They found that in the group that had the highest diversity, the fiber actually down regulated the immune response. Then the group that had the lowest diversity, the fiber upregulated the immune response. Interesting. You know, because if you look at it from the outside without having looked at what is the underlying diversity, you think, well, fiber has contradictory effects. Sometimes it's increasing immune activation, sometimes it's decreasing. Thankfully, they decided to look at another thing and note that there was a difference in the underlying diversity. So people who stepped into the study with a higher gut diversity, naturally, when they went on a high fiber diet, it actually helped regulate the immune response. It's so fascinating.

Yeah, it's really amazing. Really amazing.

I think we need fiber and I think we need more fermented foods while tiptoeing into the fermented foods because they're not right for everyone and they're not right for everyone at the same quantities. So you have to test it out and see what's right for you.

So can you say a little more about that?

Who's going to struggle with fermented foods?

Anybody who has histamine issues, Anybody who has mast cell activation syndrome, they're not going to be able to have fermented foods.

Okay, so what does that look like? How do you know if you have histamine issues or mast cell activation syndrome?

You eat and you get a headache, you get sinus pressure, you get abdominal pain, you get brain fog, you get fatigue. So your body is responding poorly to foods. You can even get a migraine trigger because there's a connection between histamine and nasal congestion and migraines. So anybody like that who's having a response to certain high histamine foods, like if you have wine and you get a headache immediately, or you have chocolate, or you have fermented foods or even cured meats, and you don't feel so good after that. Your head feels kind of wonky. You might have histamine issues. The place where I think a lot of people get it wrong is that you get this diagnosis of mast cell activation syndrome and now you become this mast cell activation patient. But I think we have to go a step behind that. The reason people have mast cell activation is because their gut microbiome is disturbed, because their gut lining is disturbed. So you've got to go back and do gut healing, not just put these patients on antihistamines and basically block the histamine.

Permanent affliction, right? It's not a permanent affliction. If you work to heal the gut, you then can heal this. This is not an allergy.

Exactly. And it's, and it's not something that you were born with. It's something that you acquired because of a series of cascade of events that disrupted the gut microbiome, disrupted the gut lining. So for those people, they need to go back and do some gut healing first. And then once we can start to test out ferments, person listening to this might think, this is crazy, but I might start a patient with a half teaspoon a day. And it could be, it might, even if I think they're overly sensitive, I might say, let's just do kraut juice and just have a half teaspoon, see how you feel. And as you feel better, you can go to a full teaspoon, or it could be yogurt, just a half teaspoon. It sounds ridiculous because it's such a small amount, but in someone who is really sensitive, you have to tiptoe into it or else you risk making them really bloated. You risk making them feel sicker than they were.

Yeah.

Although what was really fascinating in the study that they did in the high fermented foods diet, they were having them eat anywhere between four and six servings of fermented foods per day. Some of those were coming in as fermented vegetable drinks, so they could drink the, the juice of fermented vegetables. But in the first four weeks, they did get a lot more gassy and bloated. And as they continued past the four week mark, they found that the gassiness and bloating decreased. And it's very possible that when you're, you're having fermented foods, they're like little warriors. They're going into your gut and they're going to fight off some of the bad critters in there. And when they're doing that, they're actually causing some die off. And that die off might feel like extra gas and bloating. Yeah, that's happening because they're actually going in and they're cleaning out the field.

Yeah. And those non beneficial organisms that are there, they don't want to go away so easily. Right. Like they're in survival mode too. And so I think for a lot of people, as they're on this healing journey, sometimes you can feel a little worse before you feel better. And as long as you're aware of that, as long as we educate people, usually they do cross over to the other side. And it's like taking someone who's on a very low fiber diet and all of a sudden introducing a lot of fiber into their diet. As that microbiome is changing over from the low fiber organisms to the high fiber organisms, you're going to get some revolt in your gut. Right. There's going to be an objection like, hey, I was here first.

Right, Exactly.

But as that plays out, if you maintain that high fiber diet, you are going to replace that population with population that are fiber consumers.

Exactly. So it's important for people listening to this podcast to realize that things can get a little wonky initially when you're working on rebalancing the ecosystem inside your gut. Now if you're trying to do this on your own and you're and you feel kind of wonky for two months, three months, and things aren't getting better, that's the time to raise your hand and ask for help. Go to someone who understands the gut microbiome, gut health, and work with a practitioner. Because I know there are a lot of people out there doing things on their own. And I see them, they try 10 different things before they come in to see me, and they're just kind of like faltering and treading water. So there is a moment where you have to think, okay, this has gone on for too long. What I'm doing is not working. I need some sort of professional guidance here to figure out what is it that I'm supposed to do.

Yeah, yeah, I agree. And speaking of that professional guidance, I would love to transition. You said before that you can get people from going from bloated to, to not bloated in 28 days. You wrote a book about it called happy gut the 28 day program. And I know this is designed to cleanse and heal the gut.

Can you tell us about this program?

This was my original book that I came out with back in end of 2015, and it was based on my work in healing patients and helping them improve their gut health. And it's basically taking out the biggest insults to gut health like gluten, dairy, soy, corn, peanuts, a lot of legumes, as well as sugar and even artificial sweeteners we have to be careful of. So it's basically a very strict diet. I've actually kind of segued since then. So this is what, eight years ago now or almost 10 years since I actually wrote the book. And now you might, you might feel a little bit shocked that I'm going to say this, but I've just from experience and what I've learned now, a lot of my patients that come in with severe, severe bloating, I'm getting them unbloated within weeks, and they might have been suffering for months, years, by putting them on either a carnivore diet or a carnivore modified diet for a certain period of time. While figuring out, because I'm not just doing diet, I'm also doing gut microbiome testing and stool pcr, looking at inflammatory markers, looking at other internal markers of digestion like pancreatic function and secretory IgA. So what I like to do is I put people on an intervention diet to start off, to start to work on changing the internal environment. But also I like to be scientific. So I still want to get data and I want to look. Do you have reactions to different wheat metabolites? Do you have evidence of leaky gut, like anti zonulin antibodies or anti actin antibodies, actin being one of the tight junction proteins? Or do you have anti LPS antibodies to endotoxin, all signs that there is leaky gut, then looking at their stool. Because I can't tell you how many times I am shocked at how many different types of parasites that I'm finding or some other overgrowth of bacteria that shouldn't be overgrowing in the gut that's causing some of the underlying background issues that people are facing, whether it's inflammatory bowel disease, chronic bloating, chronically not feeling well. There's such a connection to other things like headaches, migraines, skin rashes, all of that. Like how you were saying in the beginning how everything is interconnected, including breast health, to the gut. I look at the gut. If we were a tree, the gut is our root system. And like a tree can't live without its Root system. The body's root system is the gut, and that's if that is not functioning properly because of gut microbiome dysbiosis or leaky gut, then the rest of the body is going to suffer. Yeah, it's the upstream domino in a whole series of dominoes in the health of your body.

So this is your gut smart protocol that you're talking about.

My gut smart protocol is also a little bit different. So I've come up with different solutions for different people. The uniqueness of this book, my gutsmart protocol, which came out last year, is that it's actually designed to find your gut type whether you're mild, moderate, or severe. And depending on where you're at, through a quiz that I designed. And the quiz not only asks you about gut health issues, but asks you things like, do you have autoimmune disease? Do you suffer from headaches? A lot of what I teach in this book is it's almost like the book I wish I had written first, but I needed all the experience to get to this second book, the Gut Smart Protocol. I teach people about all the interconnections with gut health in the hopes to get people to see that if you want to be healthy overall, you've got to work on your gut health. But over my years of working with gut patients, I realized that you can't treat every single patient the same. Some people have severe issues. If you have severe gut issues, you will very likely not tolerate fermented foods. I can't start you there. Yeah, we need to start with some more basic gut healing and gut healing nutrients. And if they're not producing enough butyrate in their gut, like getting in certain supplements that help enhance but butyrate or even giving butyrate L glutamine as well. But really meeting people where they're at with their gut health and showing them that the way you eat if you're severe, isn't the same as if you're moderate and isn't the same as you're mild. And so it was basically realizing that there's not one all size fits all when it comes to gut health. And I wanted to create a book that's kind of like, it teaches you how to eat for your for your gut type, but it also helps you go from severe to moderate to mild. The goal is to eventually to get to mild or just get to where things are great. It doesn't mean you're going to be able to eat processed foods. It doesn't mean that you're Going to be able to eat everything. Like, you still have to be really cognizant of what you're putting into your body, because that's super important.

Yeah, yeah. I think that, you know, there's that disillusion that being healthy means that you can eat a bunch of garbage Franken foods.

Right.

Being healthy means that you don't eat those garbage Franken foods, and you have earned and acquired your health by eating real food.

Yeah, right.

And it's not a punishment. So speaking of real food, I want to ask you about a couple of foods and just see what your take is on them, because these are pretty controversial foods in most arenas, certainly in mine. Soy.

There's so much studies with soy. Right. Like contradictory studies. I think the big thing that, from the gut health perspective, perspective that we need to focus on with soy is that 95% of our soy is genetically modified. And what that means is it's going to be sprayed with an. With a pesticide called glyphosate. Glyphosate has been not only patented as an antimicrobial, so it disrupts your gut microbiome. It kills off good bugs. So we were talking about that before. But there's also evidence that glyphosate is a carcinogenic agent. And if you're eating crops that were sprayed with glyphosate, you're going to be consuming some glyphosate and absorbing that into your body. So that's really important to realize. And surprisingly, we are also one of the biggest exporters of soy in the world. So when I was at this, we're.

Sending our garbage food to the rest of the world.

I did a presentation on genetically modified foods and their effect on the gut and the gut microbiome. In this probiotics conference in London, this was years ago, and there were people from all over the world. And one of the things that I mentioned is that Korea actually imports most of their soy from the United States. States.

Oh, that's horrible to hear.

And the Korean delegation that was there came up to me afterwards, like, wait a second. So we are buying genetically modified soy and bringing it into our country. And like, yeah, because 95% of the soy crop is genetically modified. And unfortunately, I. I have to mention this because I was watching a documentary about the deforestation of the Amazon. And part of what they're doing is they're raising grain crops to feed cattle in this defi. You know, they're. They're basically destroying the forest, taking away forests, which is going to Affect probably our, our global climate. But in, in its place they're adding these grain crops like soy and of course spraying them with a ton of pesticides.

Yeah, monocrops and pesticides which has, what.

Is, what is your view, I'm curious, what's your view on soy? As a breast cancer physician, I love.

Soy for its phytoestrogenic properties because it does stimulate the beta receptor on cells, the estrogen beta receptor. So that is very calming and non proliferative, non gross. So soy is extremely protective. But that you have to be mindful about the soy. Right. So it needs to be organic, it needs to be non GMO and it needs to be unprocessed or minimally processed. So we're talking about edamame, we're talking about soy milk, we're talking about tofu, we're talking about miso, these forms of soy which are minimally processed that you can, you can preserve all of the phytoestrogenic.

I'm a big fan.

Without creating like I don't tell anyone to eat soy protein isolate. I don't care if it was from non GMO organic soy. That is not a substance that our body recognizes. Right. Like we don't want these highly processed foods no matter what the source was.

We want, I love as a, you know, bringing in the fermented foods like miso, tempeh, fermented soy. Again, like you said, organic, non gmo.

Yes.

Another great way to, to populate the gut microbiome. And I'll tell you something interesting. I went to Japan, I took my son to Japan back in 2018 and one of the things that I did while I was in Tokyo is I did an Airbnb experience where we basically met a chef at the market, showed us how to shop for miso and then took us back to his home and taught us how to make miso soup. And so we made a miso soup together and then we had this. Then he sat us down and he said in Japan we don't eat the miso soup until the end of the meal. Not at the beginning of the meal.

That's right.

Because it's considered a digestive because of the fermentation. So he sat us down and we had this exquisite multi course dinner at the chef's place. One of the things that he made was salmon that had been marinated in miso for one week. It was the most delicious piece of salmon that I have ever had. Yeah, like so infused with the flavors. And then we ended the meal with a bowl of our miso soup, which, by the way, uses kombu, Kombu seaweed.

To make the dashe, which is the broth. The broth, the base of miso soup.

And kombu actually has an enzyme that for anybody who, you know, I'm not anti vegans or vegetarians, I do think I have my opinions on how that diet can be harmful to the gut. But one way that you can make beans more gut friendly is to put kombu seaweed while you're cooking them. Because the enzyme in the kombu helps break down some of the sugars that are fermented and cause a lot of gassiness with the beans. So that's a little trick to know is buy some kombu. If you're big on beans, make sure you soak those beans overnight, rinse them, but then when you cook them, cook them with some kombu to help break down those sugars.

Yep. You just need one stick of kombu right in the water, and it makes a huge difference. And it also infuses the beans with all of the nutrient that is in the kombu. So I also tell people if they're making quinoa, to put a stick of kombu in with your quinoa while you're cooking it, and you can just take it out afterwards or you can eat it. You can chop that up and put a little toasted sesame oil and rice vinegar on it. It's actually quite delicious that way. Okay, let's go to the next one. Collagen.

Ooh, collagen. It's very high in glycine, and glycine is a cellular repair and amino acid. So again, it can be really good for the gut, but the sourcing has to be good. So either grass fed or if it's marine collagen, wild caught. So for me, for me, collagen can be a really great adjunct. I think it's also great for the skin. But what a lot of people don't realize is it can actually be a great part of a gut healing program as well.

Yeah, Bone broth.

So great. So great. I think the very important thing with bone broth is to be a savvy consumer because there are so many companies making bone broth now. And when you read the ingredients on some of these labels, sometimes I'm the type that they're always asking, do I need help at Whole Foods? Because I'm there reading ingredients, Because I like to just look at what ingredients are in different products. And some of the Bone broths, you'll see that it has been bone broth and then water. So the bone broth has been diluted and it might not be as thick. I have a favorite brand because the bone broth that they make is so collagenous. And then you know that you're getting all the immune factors, the gut healing growth factors. So bone broth, to me is a really great adjunct for gut healing protocol. And, and if you notice a lot of the things you know so far, like collagen comes from animal sources, bone broth is going to come from animal sources. And it makes it hard sometimes to work with vegans. Again, not to say I'm not against vegans, but sometimes we got to get away from a certain dietary style in order to heal the gut. And there's so many good things that can come from these things, regardless of your. Your underlying philosophy. Hopefully I'm not making anybody angry by, by saying this, but it's just what I've learned as a gut health expert, that if you want the fast track to healing, these are the fast tracks.

Yeah. And I think it's important to have these conversations because I think that people can't make educated decisions without being educated. People can't make an educated decision without seeing the landscape and the perspective. And there are so many areas within this conventional medical system where people are not able to make an educated decision because they're never provided with all of the facts. They're provided with such a narrow perspective and then told, like, make being pressured to make that. That decision that that's being presented in front of them without any ability to see another perspective.

I mean, I want to add also that, you know, like, at the beginning, you were talking about over exercising, and exercise is something that is perceived as good, right? Yeah. Another example of that in relation to gut health is eating too many raw foods. When your gut is. Your gut microbiome is destroyed, your gut lining is destroyed, and you're not making the enzymes that can handle that, and you don't have the gut microbiome that can help you digest those vegetable fibers. So in a person like that, they think they're being healthy by eating a bunch of raw salads. But then they're gassy, they feel horrible, they feel tired, their body's achy, and they're not making the connection that those raw foods are actually not right for you right now. It doesn't mean that they're not right forever. It just means at this moment, if we want to heal the gut, then we've Got to take away something that you think is good and instead replace it with cooked vegetables for now, because those are going to be easier in the digestive system than eating raw veggies. So it gets so tricky because the things that we think are good are sometimes not good under a certain situation, during a certain period when healing needs to happen in a certain way so that your body can adapt and adjust and be able to break down those foods.

Yes.

All right, here's my next one.

Coffee.

Oh, wow. Yeah, that's a big one. Because coffee is one of the top 10 most heavily pesticide ridden crops on the planet. And there are potentially other than pesticides, which we talk about as being gut disruptors. There's also potentially the risk of being exposed to mycotoxins or mold through coffee. Probably at least around 50% of coffees are contaminated with mold. And if you're not buying or drinking an organic coffee, you very likely could be getting exposed to pesticides. So it's very. It's one of those things that is right under our noses. We do every day. And we don't think about the potential damaging effects because it is part of our normalized cultural behavior. Even just going to a coffee shop and getting a coffee to go in one of those paper cups that's lined with plastic on the inside. And then those microplastics get released by the hot water and they get into your body. And we know these are persistent organic pollutants. These are things that accumulate in the body.

And they're also xenoestrogens.

They're xenoestrogens.

Who is concerned about estrogen dominance, Estrogen overload? This is where it's coming from. It's not coming from your ovaries.

Exactly. From environment. And the interesting thing that I've been looking at from the gut perspective is what do the microplastics are due to the gut. And there are. There. There's a correlative study that was done. So, and we know as physicians like, just because you find something in a group of people doesn't mean that there's a cause and effect relationship. But you do have to start asking a question. So they looked at normal people versus people with inflammatory bowel disease, and they found that people with inflammatory bowel disease in this particular study had higher levels of microplastics in their gut. So you have to start wondering, again, this is not a cause and effect, but it's a correlative study. And you have to start wondering, is there some connection between microplastics and inflammatory bowel disease. Like a patient that was diagnosed with ulcerative colitis. And he was asking me, how did I end up with this? Like, why do I have this?

That's super scary.

But they've looked at. So the good thing is that we, even though we don't have all the human studies, we have studies in mice that show that microplastics disrupt the gut microbiome and lead to leaky gut. We have another study in zebrafish showing the same thing. That the microplastics cause alterations in the gut microbiome that lead to the growth of bad bugs and also cause leaky gut. So you can only imagine, you know, like, no, we are not zebrafish. No, we are not mice. But if it's causing something in them, it must be doing something in our guts as well.

Yeah, yeah, absolutely. So we're not giving up coffee though, because coffee has a lot of benefits, right? What, what are the benefits of coffee? I mean, I, you, you can't take my coffee away from me.

I know, right?

Like you cannot take my coffee away from me. And there are so many benefits to coffee. So can you talk about them?

A coffee that is organic is going to be higher in polyphenols. The polyphenols in coffee are antioxidants. So the. Imagine polyphenols are these big antioxidant molecules that plants create to protect themselves. So organic plants are going to be more robust, whereas plants that are not organic, the pesticides are coming in and they're basically taking away that need of the plant to protect itself. So then the plant doesn't produce as many polyphenol antioxidants as it would if it's an organic plant. These polyphenols, what they do is they get gobbled up by our gut microbiome. And when the microbiome gobbles them up, it produces these smaller antioxidant molecules. Like one in coffee is chlorogenic acid and that gets absorbed and has anti inflammatory antioxidant effects in the body. Interestingly, to the polyphenols in coffee stimulate the release of GLP1, which is what everybody is trying to get on right now to lose weight.

I heard this statistic that 1 in 8Americans are on a GLP1. Now I don't believe that that's true. I don't think it's possible because I think it would like bankrupt our system. But maybe that's the projection number. One in eight Americans.

That's crazy.

Yeah.

Just the thing is that we produce our own DLP1. And there's dangers to these unnatural GLP1 inhibitor. You know, like Wegovy and Ozempic, they cause weight loss, but they make you lose twice as much muscle as they do fat and bone and bone loss. So you're, you may be losing weight, but you're ending up in a worse overall health state.

Yeah, this is actually going to create a metabolic crisis worse than the one we have now. If you can imagine, I have so.

Many patients who are, who have been put by other Doctors on these GLP1 medications and their weight loss stalls because I think they think like, well, I'm on this, so then I can eat whatever I want. It's not an if then or this or that. You still have to do the diet. But also recognize, like going back to the beginning when I was talking about how I discovered that breath work and meditation unlocked my body's ability to regulate itself. Our bodies are these magic engines. They just need the right input. And drinking the right type of coffee that is high in polyphenols, that is rich in those antioxidants is going to help unlock those things and at the same time, devote of mycotoxins and pesticides.

So I got a lovely package in the mail yesterday. It was a box of Happy Gut coffee. And I took it out of the box, I smelled it like the aroma is so heady. And I couldn't wait to brew my cup of coffee this morning. And that's what's in my metal container. It is outstanding.

It's going to show, I'm going to show what it looks like, even though it's going backwards.

Yes, it is rich and nutty and complex and so delicious. So delicious. Tell us about Happy Gut coffee.

Well, I realized that, you know, for years I was telling people to give up coffee. And the one thing that people always say, but don't take away my coffee, you know, if I have to do a cleanse, gut healing.

That's how I started this. Right? Don't take away my coffee.

And so when the opportunity came to look at coffee as a potential, say, an adjunct to promoting better gut health, I started looking at the research behind coffee and the polyphenols and how that helps to build a healthy gut microbiome. But also thinking about the other things that people deal with with coffee, but just in general. 60 million Americans suffer from acid reflux and heartburn and they're taking some sort of antacid medication while still continuing to drink very acidic coffee that feels sour to their stomach. So not Only did I want to have a coffee that was mold free, toxin free, free of pesticides, glyphosate, and heavy metals. But I also wanted to have a roast that would be gut friendly as well. And I managed to team up with a team that has incredible sourcing from small farms in South America that are all organic. And then we bring the beans to the lower Hudson Valley in New York State and they get micro roasted. That way the beans are never burnt. It's a dark roast, the darker the roast without burning the beans. Because then if you burn the beans, then you're getting these n glycosylation and products that are, are bad for us. But roasting them to the perfect dark roast lowers the acidity, lowers the bitterness, makes the coffee quite smooth. So now we have a coffee that is toxin free, but also low acid and not bitter, can sit in your gut and not give you an upset stomach or a sour stomach. This is one of the reasons that I had given up drinking coffee. The second reason is that I'm a slow metabolizer. And 50% of the of the population are slow metabolizers. So they're sensitive to caffeine. Caffeine's gonna amp you up, it's gonna make you anxious, it's gonna make you irritable, it's gonna lower your patience level with people. But a lot of people, they need it, like, they just power their day and they're just like, you know, they're, they're frenetic. And 50% of people are those slow metabolizers like I am. So I would avoid caffeine like the plague because, like, my body can't tolerate it. But one thing I learned with the dark roast is that it lowers the caffeine content to something that's a bit more manageable. By doing that, it doesn't give you that big energy spike than the crash that follows. And for me, being I had my happy gut coffee this morning and I never feel an energy spike. I just feel this nice consistent energy. It doesn't drop off. I don't get a crash. I don't feel like I need to have a second cup later in the day. Although some people, they like to have their second cup of coffee. I always recommend, like, try to stay below 200 milligrams of coffee per day to not affect your sleep cycle and all the other things.

Yeah.

And I think also the other reason people don't realize they'll get a crash after they drink coffee like an hour or two later is it could be mycotoxins in the coffee that are affecting your brain health. And then what you think is, oh, I'm tired now, I need another dose of coffee.

And what you actually are is toxic.

Exactly. You're not tired, you're toxic.

Yeah, yeah. I happen to be one of those slow metabolizers. So I have not drank what people think of as traditional coffee in decades because it would make me very anxious, very jittery. I would feel like a nervousness about me. So for years I've been drinking the organo coffee that is infused with ratio mushroom. And that was enough to help me compensate so that I didn't get that feeling. And when I had your coffee this morning, I was a little wary, like, oh, my God, am I going to get wired and am I going to get that horrible anxious feeling? And I don't have it at all. And you know, I've had one and a half of these.

Wow.

It absolutely, for me at least did not give me any of that anxiety. It's totally delicious. I'm thrilled and delighted that you shared it with me and we will certainly share it with my audience so that they can go ahead and try it. I obviously highly, highly, highly recommend it. I'm so grateful that you did this because it gives me another option. And quite frankly, as much as I enjoy mushroom coffee, my husband does not enjoy mushroom coffee. So now I have something to offer him so that he doesn't go out and buy coffee outside of the house.

And I do want to say something because there are a lot of mushroom coffees out there and people need to realize that a lot of those mushroom coffees are not free of mold or mycotoxin contamination.

Exactly right. You are exactly right. All the rules that applied with what you were talking about, how to like, doubly apply there.

Yeah, it's very. It's more likely that a mushroom coffee could be contaminated. And I was actually on the mushroom when I was coffee free, not drinking any coffee again because I couldn't find, find a coffee that would agree with me. I, I was, I went on the mushroom coffee bandwagon for a while and it just was not sitting right. Every time I had it, I was running to the bathroom. I did not feel well in my gut. And I think it depends. Like, everybody has different sensitivities. If mushroom coffee works for you, great. Sometimes, actually, I'll have a very pure. I have a powdered chaga mushroom and I will have that in the afternoon if I want like a little pick me up without caffeine. So you have to find what works for you. Like always listening to your body and doing what's right for you, not what others think is right.

Yeah, absolutely. This has been amazing. Usually I summarize, but there's like two too much that we talked about today to even begin to start to summarize. But just know that in the show notes we will have all the summaries and also how to get your Happy Gut coffee. But please tell people where they can find you, where they can learn more about you.

I'm. I'm active on Instagrams. You can look at Up Me up as at Dr. Pedre D R P E D R E. And they can learn more about me and my brand and just get a ton of free educational content about gut health by going to happygutlife.com we produce blog posts all the time. We actually did a blog post on the dangers of microplastics, and now we just followed up with another blog post on the K cups, those plastic cups, pods that people use to make their coffee conveniently in the morning and how that also can dangerously expose you to microplastics. So we're constantly trying to, you know, produce content that's research. We always try to have some scientific backing to some of the things that we're. We're saying. But I do take, I take great pride in our blog because I think they are really good and there's a ton of free content there that people can consume. So for anyone who wants to dive in deeper and check it out.

And just so you know, if you're drinking those K cups, I think the statistic is that you are essentially eating a credit card a week. So if you wouldn't eat a credit card, I think you should probably rethink how you're having your morning brew. And with that, I will thank you so much for coming on today, for sharing your brilliance, for doing the amazing, amazing work that you're doing. Because I'm sorry to say, the gut really is the center to health. But if you're doing all those things for a healthy gut, you're probably taking care of your breast health at the same time. So I will stand by my statement that breast health is health.

Absolutely.

And we will certainly have you back on because there are infinite things to talk about here. And just know that I will be back next week, same time, same place. It's Dr. Jen. Bye for now.

Thank you for tuning in to the Keeping Abreast podcast with me, Dr. Jen Simmons. I hope today's episode has inspired you and equipped you with valuable insights to take control of your breast health and overall well being. If you found our conversation enlightening, please consider liking and sharing this podcast. Every like share and comment helps us to reach more listeners just like you who are on a journey to better health. Let's spread the word and make a collective impact. If you or anyone you know is dealing with a breast cancer diagnosis, I highly recommend picking up a copy of my best selling book, the Smart Woman's Guide to Breast Cancer. It's designed to guide you through understanding the root causes of breast cancer and provides you the tools you need to navigate the complexities of a breast cancer diagnosis, the complexities of treatment, and all the while providing you the tools you need to reclaim your health. If you or someone you know is navigating a breast cancer diagnosis and seeking integrative breast cancer personalized care, Visit us@realhealthmd.com We're here to support you every step of the way. Also, for those interested in the latest breast screening technology that's safe, painless and accurate, be sure to check out perfectionimaging.com and remember, perfection is spelled with a QT in the middle. Our innovative approach is forever changing the way that we think about and conduct breast cancer screenings. Remember, health is a journey, not a destination. I'm honored to be part of your journey towards health. Stay tuned for our next episode. And until then, remember, breast health is health.