Dr Marvin Singh MD on Gut Microbiome - Brain Connection and Mental Health

This episode is brought to you by Nourish Me Organics, the Gut Health superstore. We are currently going through one of the most difficult times certainly in my lifetime, and that's the COVID 19 crisis. Nourish me Organics are the premier gut health store, and Gut Health is one of the most important things you can do for your immune system and immune function. So head to www.nourishmeorgan organics.com au and have a look at our range. We have a huge amount of probiotics, prebiotics, home fermentation kits. If you're home and isolating yourself at the moment, this might be the best time to learn how to make fermented foods. And our kits will be delivered directly to your door. So head to www.nourishmeorganics.com and use the code drmarvin for 10% off. Hey, guys. Criben Govender from the Gut Health Gurus podcast. I've got a background in food science, and today I have an amazing guest, Dr. Marvin Singh, all the way from San Diego, USA. Marvin, welcome to the podcast.

Thank you. Thanks for having me.

And you know, Marvin, I think you're making some huge waves in that kind of you're a gastroenterologist, you're making some huge waves on Instagram, you're getting onto a lot more podcasts. I saw you're doing some work with Dr. Mark Hyman. Definitely caught my attention. I'm really excited to have this conversation about particularly gut and brain, because that's one area that's of huge importance to me, being someone that suffers from anxiety and depression and having my own personal battles and struggles with that. So if I can get some insight into what's happening in the scientific realm, that would be amazing. But I'm sure we're going to go down many different rabbit holes like we do on this podcast. So firstly, Dr. Marvin, I always ask at the start of my show, who is Dr. Marvin Singh?

Well, it seems like I'm still trying to figure that out. Every year I'm reinventing myself. But in short, I'm an integrative gastroenterologist. So that means that I did my regular medical school. I'm a medical doctor. I went to residency in internal medicine, then did a fellowship in gastroenterology. Along the ways, I kind of realized that we practice really good medicine most of the time, especially when people are sick. But a lot of the people are not acutely sick, they're chronically sick. And I felt like we were kind of missing Something as far as how we take care of people and how we practice medicine along the ways. I discovered Andrew Weil and his Fellowship in Integrative Medicine at the University of Arizona. And I decided to enroll in the program. And it was like a breath of fresh air just blown straight into me and I felt like a totally different person. I started using some of the things that I was learning in my own practice and my own life and noticed a lot of changes pretty quickly. Actually, once you start learning about the things this is learning, that takes the longest time. I found out once you actually start applying that information, you can make huge changes in small periods of time along the ways. I started using that and changing the way that I practiced, started trying to use more natural treatments, talking to people about a lot of mind, body connection, mind gut connection, and started seeing a lot of great outcomes. Now I'm very interested in, in trying to use all the latest cutting edge technology and science that we have available to us to help people on a larger scale, because that's kind of how I did it to myself. I did all these tests on myself, genetics testing, nutritional genetics, microbiome testing, all these things and try to learn and understand about myself. And once I was able to figure some things out, I was able to optimize how I eat and how I live much better. So that's who I am now. I'm the precision guy. I love that.

Dr. Marvin, that's such a cool intro. And there's a couple of different rabbit holes I'd like to go down. Firstly, is there any particular struggles that you went through that prompted you to go and look for all these different types of testing? Was there anything in particular that you could share?

Yeah, I mean, when I first got into integrative medicine, started learning, studying the stuff, I was overweight, I was around 200 pounds, had fatty liver on ultrasound, my liver enzymes were elevated. And I had the director of my fellowship program telling me I better get in shape, otherwise I'm going to have a problem later on. And I thought I was pretty healthy other than that, you know, wouldn't eat fast food a lot, wouldn't go out to eat, you know, but, you know, that's just a mere component of health and wellness. Even as a doctor, was kind of oblivious to that because it's not really a focus of our training or education. And so that was kind of one of the main things that was focused for me. And like I said, after I went through that transformation, I lost over 30 pounds in three months. So quite rapidly and, you know, it kind of builds on each other. So you start doing one thing and you start feeling the improvement. That gives you the momentum to do something else or go to the next step. So I tell people kind of like how things can snowball out of control. They can also snowball into control. So, you know, once you start, you know, changing your diet and getting rid of the sodas and reducing the alcohol or the fast food or the carbohydrates, getting rid of bad habits, you may start to feel a little bit more energy. You may start to lose weight. That may motivate you to exercise better. Exercising better lets you sleep better. When you sleep better, you're more relaxed. In general, you say, hey, let me try this meditation thing out. Everybody's talking about this meditation thing. You try the meditation and then that just kind of wraps itself around back again, full circle, and you just keep it going, keep it going, keep it going, and things just continually improve.

That's amazing. And isn't it interesting to hear it straight from the horse's mouth, a doctor talking about, talking about, I guess, the struggles with your particular health. And you almost, like people in society, assume that, I guess doctors are going to be healthy, but doctors also have their own personal struggles. And I think also to be perfectly respectful, also blind spots, you know, sometimes because you're so specialized in some areas, like for instance, nutrition, it might not be a huge area of focus in the training. And it's just, it's no one's fault. It's just the, just the byproduct of the training and the history of it and where it's at and where it's at in the, at the moment. But I'm really excited about what's happening in the, the testing and precision medicine space. And you touched on it and we'll dig into it deeper. But things like genetic analysis, like microbiome analysis and other markers, I mean, the price has just dropped so much over the last few years that now it's like really accessible to everyone. So let's talk about some of the. When you went through this investigative process, some of the methods that you use to track your own biomarkers, and what did you actually use at that point?

So at that point, and what's available now are different, actually, because in the last three, four years, a lot of stuff has been more available or, you know, that have come out. Like, now you can check, you know, microbiome metabolite levels with the finger prick instead of kind of going through this whole process. And even the microbiome testing process has kind of evolved as far as the reports, quality reports, what information you can glean from it. But when I did it, I did do a microbiome test. Originally, I looked at nutritional genetics to understand about what foods I need to focus on so that I can prevent deficiencies. I looked at my micronutrient levels, I looked at toxic burden. So I did a toxin test to get an idea of what my environmental exposures might be. Because these things all play a role in your overall health and metabolism and how the whole body works. So these are some of the original pieces that I put together. I've recently done whole genome sequencing on myself, so I know every single gene that's been sequenced in my body and redoing some things out of curiosity. Now I'm in the. Let's try this against this and try compare this outcome to that outcome in myself. Just kind of like hacking my way through how to use these tests in the best way for people.

Totally, totally. And we're going into an age where whether it's the microbiome or whether it's genetics, the nuclear genetics or even mitochondrial genetics, which is an evolving field as well, where it's very personalized to individual circumstances. And I went through the same thing. I, I used, I think 23andMe, like years and years ago to get my initial genetic information. And then you can use different tools on the Internet to actually delve down. I use the Sterling Hill app. I'm not sure you're familiar with that, but you can really upload your genetic data and then work out what your particular polymorphisms are.

Cool.

Dr. Rhonda Patrick has a great little service as well where you can plug in your genetic information and then she kind of provides a report very cost effectively. It's a, it's like $10 or something like that. And you can get a breakdown of all the different polymorphisms that she's particularly looking at. So what, when you mentioned whole genome sequencing, like, what did that look like? Was that a saliva test or.

Yeah, saliva test. So that's even. That's like one of the easiest tests to do because it doesn't even require a blood draw. So it's a lot of spit. So it's like, is this line ever going to get filled up? But you keep spit and spit and spit until you get to the fill line and then you usually pop the lid over which has a reagent in it that stabilizes everything. Then you pop it in the envelope and mail it and it takes a while to get the results back because it's your whole genome, maybe like a month or so on average, four weeks, sometimes four to six weeks, and you get the information back. Quite interesting and insightful. I tell people get freaked out about, oh, I don't want to know this or that. But it's one thing to be reactive, wait till you have a problem and then react. It's another thing to be proactive, really, in order to increase your longevity and your quality of life, it's better to be proactive. If I know that I have a couple of different risk factors for, say, colon cancer in my genes, then what I'm going to do, that doesn't mean that I have colon cancer, doesn't even mean that I am 100% going to get colon cancer. It means that I have a genetic predisposition to colon cancer. So then what you want to do is look and see what is the most effective way that you can modify your risk. Then you start doing that to help modify your risk. Because there could be actions that you take. It could be literature to support some of these actions as well. Then maybe you pay closer attention to yourself, you get yourself screened more often, you pay more attention to these kind of things. And then if you did develop a tumor or a precancerous polyp, you get it removed before it's a problem. It's the people who don't use these types of information, who don't understand how helpful it can be, and you don't do it. And then you kind of wait until you're having a problem and then you have to deal with the problem. And medicine is good at taking care of that problem as well. But I think it's much better to be proactive and try to prevent the problem from happening than to wait till it actually happens.

Absolutely.

That's my philosophy.

That's a great philosophy, Marvin. And just out of interest, who actually does that testing these days?

Oh, there's a lot of different companies. There's a lot of competition. It's a growing field. Human Longevity Inc. Has the Health Nucleus. They do whole genome sequencing. Chronomics is a company out of the UK that does whole genome sequencing. And they actually have a little bit something different where they do epigenetics on the whole genome. They're looking at the methylation burden across the genome as a predictor for biological age, which is better than looking at telomere lengths, which is what kind of what they say is the old way of looking at biological age and nieuw Amsterdam Genomics is another big company that I work with as well. So all these companies are good. They all looking at whole genome sequencing and the cost is about comparable. It's still not super, super cheap. But I tell people when the whole genome was sequenced the first time, I think it cost $100 million or something like that to say that we went from $100 million to a few thousand do in such a short period of time. I mean, that's a huge accomplishment, I think. And as time goes by and technology advances and we're able to do these things faster, more efficiently, I'm sure the price will drop as well.

Absolutely. And how does these technologies compare with something that's direct to consumer like a 23andMe?

Yeah, so some of these other tests are just looking for certain number of gene SNPs or single nucleotide polymorphisms. They're looking for mutations in a particular gene. So whether it's 23 genes or 45 genes or 100 genes, it's still not the same as your whole genome. Because the interesting thing is actually the same way as the microbiome works, if you do a stool test. Everybody likes to do particular kinds of stool tests. I won't call out too many names. These tests are only looking for a whole handful of microbes, for example, same thing as looking for a whole handful of genes. You get a little bit of information, you get some insight, and maybe that's okay because they're cheaper than doing the whole whole thing, but it's really not as accurate. It doesn't give you as much information as looking at the whole thing in total. Because you may, for example, find out that we'll use one gene example or one microbe example. You may find out, for example, you have one really bad gene for colon cancer. What if that's the only gene checked? Then you think, oh my God, I'm going to get colon cancer for sure. They said positive, so it's positive. Right? But what if you have 10 genes that protect you against colon cancer? Tells you a different story, Right. Still, you might be concerned. Still you might be interested in trying to optimize change. But maybe you don't need to be so freaked out because you have a mix of genes that weren't necessarily tested for that may help kind of counteract that issue. Same thing for microbiome. You do one microbiome test or supposed microbiome test, basically a stool test that checks for some microbes and maybe there's 20, 25, 50 microbes whatever make up a number that they're looking for. And they tell you, oh, you have this, you have that. This is your proportion of good to bad. This is what you're predisposed to. Really the value is so low because you're not looking at the entire microbiome. It's not necessarily the individual bugs that are the problem, it's what's happening in the system in total that's important. So you could have. So an example that I tell people in the office is say you're sitting in an empty room and 10 guys walk in the door and they look like regular guys, but as soon as they all sit down next to you, somebody says, by the way, all 10 of these guys just got out of jail and they all killed two people, just make it up. So at that point, should you be freaked out, like, oh my God, I'm sitting here with like, you know, 10 murderers. They all killed two people and now they're sitting with me, I'm in this room. So most people would actually, most people, I actually asked this in the office, majority people actually say yes. I would be worried, I would be alarmed, I'd be looking for a way to get out. But then what if I turned around and said that all 10 of these people while they were in jail for killing two people, actually became very, very religious people and their life's goal changed to helping other people and they helped rehabilitate a dozen inmates themselves while they were in jail. And now they are all together to start a non for profit to help other people. Now what would you say? Would you tell me that those 10 people are still bad guys and you'd be worried about them? Not really. So that's the same thing with the microbiome. You could have 10 bacteria that look like they might be bad, but are they actually collectively doing something bad or not? And that's the key. It's good to know who's there, it's good to know who the players are, but it's even better to know what they're actually doing, what the collective system is doing. So that's the important thing that I think a lot of people miss out on.

Fully agree there, Marvin. I mean, it's important to know what's in there. But again, just to put things in context, the technology is so, so new and revolutionary. I mean, we went from growing bugs on plates, like using agar plates and then using morphology to actually to classify them like in E. Coli or, you know, based on the shape of the organism, giving it a name now. Now we're using DNA based technology where most of these, most of these species and strains and subspecies, we don't even know what they are. They're still being classified. It's moving. It's so fluid and it's that the naming is changing. They're discovering new ones all the time because it's based on DNA, it's based on genomic material. We're getting into right into the gut and basically going on an excursion of discovery and finding new species. That's how exciting this field is. But there's only so much that we can gleam out of it so far.

What's even crazier is that there are so many influences on these microbes as well. So we all talk about nutrition and things like that. Yes, nutrition does play a large role. What you eat does play a large role. But whenever I give a talk or a lecture, I usually talk about diet last because I want to emphasize that the other components of your life actually play just as equal or important of a role. For example, when there's stress, some chronic stress especially, you get these, what we call stress hormones, these catecholamines that are produced in the gut. When these chemicals are present in the gut, they're what we call quorum sensing. They can bring the other bacteria to the site of where the issue is happening, and they can become pathogenic just by being together. Now think about that for a second. That's crazy, right? Somebody who might not be a bad guy might become a bad guy just because you're stressed out because the lady cut in front of you in line.

That's crazy.

So that's why, you know, like, when people come to me and they talk to me about their problems, I start talking about stress and things like that. Like, look, I'm talking to you about my bloating, not my stress. But in order to handle the bloating, we got to talk about that too, you know.

Totally.

So it's a very important part that I think we're learning more and more about, and it's quite fascinating.

I'm 100% with you, Marvin. Diet is a big driver of the microbiome. Equally as important are things like lifestyle factors, exercise, movement, sunlight, environmental exposures. It's like we can't look at one thing in a silo. It's this. We're an organism that's connected to the environment and we're being impacted by environmental stimuli. Like simple things like just being exposed to sunlight can then trigger a whole raft of interactions within the actual microbiome itself as well.

Microbiome and maybe even our genes, you know, or the microbiome initiates some change that causes some genes to be expressed and some other chemical to be produced. So I mean, it's very complex, yet very simple at the same time. If you really think about it, the complex part is that we don't really understand all of what we're talking about entirely, but we understand that this happens. So we may not know every intricate pathway of exactly how, what comes to what, and it may be very long time, or we may be chasing these ideas forever. Because my feeling is that there are number of ways to get to the same endpoint. Just like if I want to drive from here to Los Angeles, yes, there might be one main road, one main path I can go, but there are probably 20 different ways I can go and still get there at the end of the day. Because I have other mechanisms built inside of me that help me understand that there are other roads and I can go here and I can turn here and I can still get there at the end of the day. Maybe it's longer, maybe it's shorter, but I'll still get there. And that's how the body's designed.

Totally, 100% agree. And the other emerging field is the other little colonies in your body, the mitochondria, which from the latest studies I've looked at most likely could be archaea based remnants of a very ancient microbe, which is interesting.

Ancient, ancient dinosaurs that decided, hey, you know, what's going to be the best way for me to survive? I'm going to actually become a part of this animal's cell. So they will always need me.

Yeah, that's it.

Crazy, right?

It is crazy. And you know, it's, it's, it seems complicated, but for me it always comes back to almost like how we evolved. It always comes back to nature. I'll always go back to nature because even though we don't fully understand these things, what we do know firmly is that we came from nature. So it's like nature has the answers. That's my thinking. What do you think on that?

Yeah, I totally agree. And it's kind of making me think about Dan Siegel's work. I don't know if you know Dr. Dan Siegel. He's a psychiatrist actually in Southern California. And he has really kind of redefined how the mind works. And really how the mind works is exactly how the human body works. It's complex if you think about it kind of abstractly, but it's actually like we were saying before, very simple. So he talks about this thing called integration. So when a system is integrated, you have harmony, right? Things work well if everything is going together. When you don't have this integration, either there's chaos and, or rigidity. So something's not going right when things don't work together. And so how he describes understanding integration is that in order to first understand how to bring about integration, you need to understand that our mind is not just within our bodies, it's actually between us. So it's inside of me and interacting with my environment and your environment. We're all connected to each other. Just like all the elements, the genes, the microbes, the immune system, the brain, the gut, the heart, the lungs, they're all connected to each other. And so once you realize that this is the concept by which your brain and your mind works and you can understand how to actually optimize that, how do you open the door or the gateway to integration? And it's quite simple. It's through kindness and compassion, taking care of yourself and your surroundings and your environment, not being mean to the guy next to you, not harming somebody else or doing something bad and trying to help people, help your environment, help your community. It's the same concept for inside of your body. And I tell people, if you give yourself the ingredients that your body needs to do the job that it was born to do and meant to do, it will do the best that it can under your circumstances. And so that's like one of my favorite lines. I always like telling people that in the office because it kind of hits home the point that everybody's environment and their circumstances different, that's not something we can really control or undo. If it happened, it happened. I mean, you can't take back the past, but what we can do is try to optimize the present. It's not about the past, it's not about the future. It's about the present. And that's the way the mind works. That's the way the body works.

That's beautiful. I love that. Talking to a gastroenterologist, Marvin, all the way from San Diego, talking about kindness and compassion and humanity, because there's something beautiful about. And we'll get to mental health straight after this. There's something beautiful about gratitude, I think, and also doing good and helping others and helping your communities and spending time with people that you love and that we can talk about the science and the microbiome and all that jazz, but it's pretty easy. As you mentioned, it's pretty simple to be kind. It's a choice, isn't it?

It's hard sometimes because you're just innately programmed to react to something. So I tell people, don't react, respond. And actually the Dalai Lama teaches you that when something happens, you immediately want to react to that. That's your human nature. But if you just take literally three seconds, take a deep breath, sit back in your chair and appreciate what just happened and think and decide, what should I do in response to that? Most likely it'll be different than your initial reaction would have been.

Totally, totally. It's that kind of fight or flight response that wants to manifest initially. But I think just having that present state awareness to just catch yourself breathe and then respond rather than react. I love that. That's beautiful. That's beautiful. So someone listening to this podcast now, and we set the frame very early on, that we're going to talk about gut and brain and what's a good place to start that conversation?

We can start anywhere. I mean, the microbiome and the digestive tract, which is its house, is very closely connected to the brain and the nervous system. There's a nerve called the vagus nerve which we all hear about, especially listening to all the podcasts and blogs and things like that everybody's talking about. The vagus nerve is basically like an information superhighway. So information is just continually zipping up and down, up and down. And it's not just a one way road, it's a two way road. So the gut sends information to the brain, the brain sends information to the gut and it happens so fast that you wouldn't even know that it's happening. It's like a split second. So truly, when you feel the pleasure of eating something that you know is like a cheat food, you are having that brain gut connection right there. When you have butterflies in your stomach from being nervous or you're about to propose to get married, that is a brain gut connection happening right there. So we all talk about them abstractly like, oh, butterflies in your stomach. But that's actually kind of what's happening. It's quite fascinating that the brain can actually influence the composition of the gut microbiome. So situational stress can actually change the composition of the gut transiently so that you can adapt to the situation. That's my theory on that as to why that happens is because this whole organism that we call the human body is a very adaptable organism. So and we need to be, otherwise if anything happened, we would just die. Right? So oh, we had a fire in our backyard. There's smoke there. Bad smoke, bad die. I mean, that doesn't happen, right? It can't be like that. There has to be multiple different levels to adapting to the situation. You might get sick, but you're not going to die. So the human body is quite resilient as a whole organism, most likely because of these types of things. When the situational stress occurs and the microbiome changes, it may be changing so that you can adapt to that situation of stress. The microbes don't know what the problem is. The problem, though, is when you're chronically stressed or anxious and there may not be any apparent reason for that. Not like somebody is banging down your door because they're going to rob you or that your house is actively on fire every day of the year. But when your brain is tuned in to feel like that's what's happening all the time, then those transient changes in the microbes become chronic changes in the microbes. And that may not be a good thing. That may be a trigger for inflammation and imbalance in the microbiome. All that does is feed the originating process. That's why it can be really hard to break through these cycles of anxiety and depression. It takes a multi pronged approach to try to peel back the onion and find out exactly where are the areas that I need the most work on and try to work on them individually, slowly by slowly to try to get back to that stable point totally.

And what's the actual solutions to addressing this? I think it's a global epidemic at the moment. Just about every news article you read, there's some mention of mental health or mental health crisis pretty much around the world right now. And there's many different reasons why this is happening. But we won't go into this for this conversation. But what are some actionable steps that people can take to feel the best they can every day?

I think first realizing that, you know, my favorite way of trying to help people understand is this equation. S equals P times R, suffering equals pain times resistance. And so a Buddhist philosopher came up with this. And basically we're all going to experience pain in life. It's impossible not to experience pain in some shape or another. But suffering could be optional if we understand and appreciate that our resistance to that pain actually drives the suffering. So if I walk out to the parking lot and I see that my car is on fire, that's the pain, right? The car is on fire. I could react in two different ways. There is always an Alternate way to react. I could react in anger. Oh my God, this is terrible. My car is burned now I don't have a way to go home. My life sucks. Why does this always happen to me? Boom. You just gave yourself 100 units of resistance to maybe that 10 factor of pain. So you have 100 times 10 units of suffering. Or you could walk out and say, oh, wow, this kind of sucks. But this car was old anyways and I was thinking about getting a new one and everybody made fun of me that I drove a 10 year old car. So maybe this is a good thing. It's a blessing in disguise. Maybe you didn't make that resistance zero, but maybe it's a one. But 10 times one is a heck of a lot better than 10 times 100 units of suffering. So a lot of this is in understanding that there's a difference between reaction and responding. It's kind of a tough concept to implement regularly, but one of the things that can help you get there is learning a mindfulness based practice, learning breath work, and learning to use these techniques on a regular basis when you are not in these stressful situations. Especially because when you are in these stressful situations and you always will be because you're a human being and you live on earth, so there's always going to be something that's happening. You know, when, when those situations arise, you now have a tool that is integrated into your being that you can call upon on demand and it'll work much better. When the black cloud is on top of your head, it's really hard to push it away. But if you understand that when I see the black cloud coming from a mile away, I can do these things and allow myself to understand that there's a difference between how to respond and how to react and how to handle this and that. You know, I am right here in the present day, in the present time, and I'm not going to let this thing from 10 years ago bother me today. And I'm not going to worry about what's going to happen in 10 years. Because who knows what's going to happen in 10 years? You know, I'm going to worry about right here, right now and use that practice to help you get through that pain that is about to show up at your doorstep. That's one nice technique. That is the cheapest technique that anybody can ever teach anybody is just being still and appreciating the present.

Absolutely. And you know, I have meditation practice every single day. I do transcendental meditation first thing in the morning for 20 minutes. And this is such an underappreciated element of the gut brain connection because Marvin, you so eloquently highlighted the bidirectional connection, connection between the gut and the brain. And often so much is focused on getting the gut right to get your brain right. But I think you've also highlighted it's also equally as important to get the brain right, to get the gut right. So this is a great conversation because not many people have come onto the podcast and actually highlighted that. Like having a mindfulness practice, having a gratitude journal, that's something else I do on a daily basis. And all these things really help to foster a good kind of present moment frame. And also having the ability to not be reactive to circumstances when they go wrong, but really just to stay still in the moment and reflect. And I love that equation. What was the equation again?

I've got to remember that suffering equals pain times resistance. I wish I made it up myself. I didn't.

But all the time that's so brilliant. Because a lot of the struggles that we go in our lives are much in our heads. A lot of it's imagination. Like for instance, a perfect example, you brought up the traffic example. Someone cuts in front of you on the freeway as you're driving. Just imagine you're driving down the freeway, you're rushing to work, you're all stressed out. Then this black suv, this big black car cuts in front of you and you think, oh my God, this is a rude, terrible person. But what if this is a. A mum that's just about to give birth and then the husband's rushing to the hospital together in time and then just. It's a totally different frame. Like the thing is, you don't know what's going on in that person's life. But often we jump to the most negative conclusion. This person is terrible, you know, But I love that how you remind us just to be mindful that a lot of it's just imagined.

And what I like to do is, even if it's hard to figure out why, you follow this concept called fake it till you make it so exactly. Somebody cuts in front of you on the freeway, you're never going to know why they did that. So your initial presumption is to go with the negative. That guy is a terrible person, he's going to kill someone, blah, blah, blah. But like you said, he could be rushing to his wife who's about to deliver a baby, or you can say he was just called from the hospital, that his wife is Dying. And he has five minutes to get there to say his goodbye. If you knew that before you had that angry thought in your mind, I guarantee you you wouldn't get angry. Because ultimately human beings want to be compassionate. We're social beings, we want to care, we want for each other. It's just that the stresses of life kind of sometimes muddy the waters and we need to remind ourselves of that humanity, of that compassion. And so many problems in our whole world. Would be better if a lot of other people did that too. But we won't get into politics too much.

Totally. I'm a huge. I love the fake it to make it concept as well. Because if you're gonna. If most of it's imagined anyway, why don't we resonate towards something positive? Because we don't actually know. Like the brain is guessing as to what the reason is. This person is behaving in a way that's not acceptable to us.

But what if he's having diarrhea and he's pooping his pants as he's driving and he needs to go home real quick because he's got a big in an hour, you know, I mean, make a joke out of it, who cares? You're never going to know the answer anyway, so might as well think it positive.

That's it. And you know what? When I have a bad experience, like a simple refrain, and this is something I learned pretty much during acting school for a whole year, is your imagination is incredibly powerful because the brain can't tell the difference between what's imagined and what's real. It's like when you're watching a really scary movie. The body's physiology is reacting like this chainsaw massacre guy is going to kill you, right? So your body's having all these reactions. So that's how powerful imagination is.

Yeah, exactly. If you want to tie in the gut brain connection with eating, this is exactly how eating works too. So eating is not just a digestive experience experience, it's the multi dimensional whole body experience. So the brain will take in the smells, the tastes, the textures, what you're listening to at the time, what you're feeling, what your mood is, and it packages it together with what the actual food is and how it makes you feel once it's inside your body and your digestive tract and the metabolites that are formed by the process of digestion. So this is where this whole comfort food thing comes from. So maybe when you were a teenager and you broke up with your first boyfriend or girlfriend and you were really sad. You had a candy bar right there and you ate the candy bar. And just for a minute, just for five minutes, that candy bar made you feel good. That sugar rush, let go of all that dopamine, you got some serotonin there and you really felt good for a second. Now fast forward 20 years after that and you just broke up with your fiance and you're really upset and you're in the grocery store, your brain is going to tell you candy bar. Your brain remembers that back at that one time when you were really upset and you really felt bad that the candy bar actually helped you feel good. Now, it didn't help you feel good forever, but it made you feel good. The brain doesn't know all of that, but the brain can remind you that, hey, you should get the candy bar. Get the candy bar and it'll drive your cravings. Then you'll want to get the candy bar. And it's for that reason. It could be the same thing as why people cry when they hear a sound, a particular song, or when they feel that. You walk into a room and it smells like fresh baked chocolate chip cookies. And you remember grandma from when you were a kid, right? Same thing. The brain packages all these pieces of information in little bundles and stores them as memories. And it'll call it to action when you do or don't want it. So the key is realizing and understanding that, okay, candy bar brain is telling me to have candy bar. I know because I have the ability to control my own actions that this is an urge, it's a feeling to satisfy. Something that is not going to actually get me any long term benefit. So instead of eating the candy bar, I'm going to have a cup of green tea and do my transcendental meditation practice for 25 minutes. After I do that, if I still really need to feel like I want to have something sweet, then I'll think about it. But most likely after you've let that time pass, that craving will probably pass as well. So making that intervention before the black cloud comes, it's the same concept we were talking about before. Understanding the tools that you can use and using them at the appropriate time. And you will fail probably millions of times before you actually get it right. So it's not to like beat yourself up over it. You know, they say, when's the best time to exercise? Well, exercise period. I mean, that's the best time. Whenever you can make time to do it. So, you know, same concept. When is the best, when are you going to be able to figure out how to do this. You know, do it whenever you can, as often as you can. How you know and learn from your experience, what works, what doesn't work, what's the best situation? Not best situation, but the point is to keep doing it over and over again. Because your brain has been programmed to equate stress sadness with chocolate bar. So you can unprogram it, too. You just have to make the efforts to do it. When you're an adult and you've lived more years, it's a little bit harder because it's like you develop this. This is what this neural circuitry we're talking about is. And so it's already kind of ingrained. But that's not like ascendance for life, that it's going to be like this forever. We talk about this to help you understand that you can reprogram these neural circuits as well. You can take that program, that app that's downloaded in your brain that says sadness equals candy bar to sadness equals asparagus, and you can get the same dopaminergic surge from that. Because you've reprogrammed your body to feel that way.

Yeah, totally. For me now it's something like a nice organic chocolate.

It can still be chocolate. Just make it or get it dark chocolate.

Preferably dark chocolate, like 85%, which I know is loaded with polyphenols and is great for my gut. And it gives me this huge serotonin dopamine hit at the same time. Plus it's feeding my gut microbiome. So that's a perfect reprogram. But I think a point you highlighted there that's really important to underscore, Marvin, is the importance of awareness. Just to be aware of these little programs that are running in your head and just not take it for granted. Like, how do you react to certain circumstances or how do you react with food? Just to be really cognizant of the fact that these programs, a lot of them are from childhood. So it's just being totally aware and things like meditation, yoga, whether you do an improv class or you do an acting class or something, that teaches you to be really self aware of this. The biggest screen ever is the mind. It's a massive screen that you're watching all the time. So just watch what stories are going on in that little system called your brain and be aware if something is not serving you and to reframe and reprogram if you need to.

Yeah, I mean, you may even think that I have a food sensitivity to X, Y or Z food. Because every time I see or smell the food, I get nauseous. I feel like I have an upset stomach. But until you start really appreciating that there could be more than meets the eye, you may realize, and you may have a food sensitivity. You may have an allergy. That is definitely one problem that people can have. But sometimes people may have the problem that comes from a deeper place. It could be that you fell off your bike. Here's a better example. You got in a really bad car accident with your family when you were three years old. And it was just as you were leaving the pizza place. Your brain, you were three years old. You may not even remember that this actually happened until you start talking to your family and your parents and things like that, until you start digging into it. But it could be that your brain has equated fear and anxiety and stress and slowing down of the motility of the gut as a result of that with pizza. Now you think that I can't eat pizza. Not that you should eat pizza, everybody, but just using that as an example. But now your brain says pizza equals bad because of that. And it may not really be a food sensitivity.

It's almost like little anchors or triggers that potentially came from a negative scenario. So maybe it might be an allergy, it might not be. Sometimes it might be something that's sitting in the mind from some form of trauma. And hence that's why you see studies with correlations between cognitive behavior therapy and the microbiome composition. I'm not sure that you've seen some of those studies and those types of research, because what's happening from those stimuli, like going through cognitive behavior therapy, working with a psychiatrist, talking through issues that could be really deep seated in the psychology, and then dealing with that then has a benefit to your gut health as well. So I love that. I love this conversation. It's very different to what we've had in the past and certainly not what I expected. But I think we've got some gold nuggets in there. We're pretty much coming up to time. Marvin, if you wouldn't mind, I've just got a couple more questions and we'll start to wrap. So being someone that's a gastroenterologist, so we're going to go a bit of a sideways tangent. What's the common things that you see in your clinic? People coming in, what's the common thread?

So I have two kinds of clinics. Basically, I do everything. I do acute care medicine, whether you're in the hospital with a major problem. I can come there, help you there. I see patients in the office who are having just typical gastrointestinal issues. And then I have my precision medicine practice where I help people optimize and prevent. But focusing on the gastrointestinal side of things, I'd say some of the most common complaints are bloating and bowel issues. Either you're going too much or you're not going enough. Probably that and heartburn. Probably the top four complaints that people have. And we call it the irritable bowel or whatever. But those are some of the symptoms that people generally have.

And how do you go about dealing with those issues?

That's a good question. What I do first is make sure that there's no warning signs or anything that would require a colonoscopy or an endospy or a scan of some sort to make sure that there's not something there. Because sometimes things that sound simple, like a change in bowel habits, could actually be a tumor in the colon. So we don't want to miss those things. We want to make sure that we do the right thing, follow the guidelines, and do what we're supposed to do. Oftentimes there is nothing there going on, even if we did a colonoscopy. And you have to kind of dial back exactly where these symptoms could be coming from. Is it a medication? Is there stress? Are they sleeping enough, getting enough hydration, exercise? All these same things we've been talking about with lifestyle actually drastically affect how the digestive function is even heartburn. People that have stress, There are people that are on twice a day antacids, and they're still having heartburn. You're like, there's no way there's any acid left in your body. You press the heck out of it. And yet they still have heartburn. But the problem may actually not be heartburn. The problem may be stress because up to a little under a third of people that have refractory reflux is really stress issue because the stress is slowing down the motility of the stomach. The stomach isn't functioning as well as it should be. Now, you throw that on top of low acid hypochlorhydria, and you have a recipe for undigested food that sits in the stomach for a longer period of time. Now, regardless of antacids that you're taking, you're getting reflux symptoms. You make sure you do the right thing by practicing the right kind of medicine. And then you use as many integrative approaches as Possible, practical for the person to help them optimize their symptoms as naturally as possible. So it's kind of integrative medicine I look at as the best of both worlds. You make sure you do the right thing for the person, you're not missing a diagnosis, and then you try to help them in the easiest way possible that makes the most sense for them. And some people need medications in order to feel better for a period of time with the hopes of transitioning off. Some people don't need medications and they're okay with trying more natural therapy straight off the bat. Just kind of work with whoever. Everybody's got a different feeling and philosophy behind it, and I just try to help them as best as I can from that perspective. We talk about diet, sleep, stress, all these kind of things that a lot of people don't talk about as much because to me, that makes huge impact. I always tell a story. I don't know how it is in Australia, but in medical practices in this country, the pharmaceutical reps always come by the office and give you samples and things like that, which is nice to have on hand for people to try something out. They always ask me, how are you doing with such and such medication? Sometimes I don't even know what the medication is because I don't use it or find a need for it or I know about it and it's like, I don't really use it. And they're like, why? It's like the number one medication for constipation. I said, well, I talked to them about stress reduction, hydration and diet. And I don't really need those medicines. If they do, I give them a little triphala or magnesium or something like that, and that just seals the deal. You know, I'm not scared of using medications, but if we can do it without it, then more power to it, because every medication is a chemical you put in your body and that could potentially complicate things downstream as well.

Wow, I love that. Marvin, you are such an inspiration. I mean, I wish we had access to more doctors like yourself here in Australia. Maybe if you're listening to this podcast and you like, you're like minded to Marvin, certainly reach out and I'm happy to have you on the podcast and have a chat and get people to come and see you, but that's very, very inspiring. I actually had tingles down my neck while you were talking about that because it's like you're going back to nature as much as you can to deal with the issue and then only using Medicines which are life saving, don't get me wrong, when they're really needed, which is so inspiring. I wish there were more doctors like yourself. So thank you so much for being you, Marvin.

Appreciate it.

And I have to ask you the question because you piqued my interest. What is precision medicine? What's going on there?

So precision medicine is my little baby. So we know we have all these super cool tests that we can use and a lot of them are direct to consumer. So people are going and getting the test done and trying to self teach themselves, which is fine. But like we were talking about earlier, it's not just about the genes, it's not just about the microbiome, it's not just about the metabolome or the immune system or your sensitivities or your environmental toxins, about all of it together because all of these things play a role in your health. And so if you're only looking at one test or two tests, you're missing the picture from the other test. The hard part is in taking all of these pieces of information from these tests and then synthesizing it together to make some meaningful action. Because at the end of the day there's only one question anybody ever asks and that is, so what do I do?

That's it.

So that's the problem with basically every test that exists. They give you some suggestions, but really, you know, what do I do? Oh, you said I should do this, but you didn't know that on the other test I had this problem and then on the other test I had this problem. So what do I do? Nobody really knows. I'm basically reinventing preventive medicine by taking all this information. I'm even coupling it together with whole body imaging, CT coronary calcium score, integrating that with genetic testing, microbiome testing and all these different elements, then synthesizing all that information. And I am figuring out where there's correlations and where there's a pattern. I don't rely necessarily on one single test to give me one single answer. I really like it when I can find the same answer in two or three different places. Because to me that means that this may be something real, that yes, this person really does have leaky gut because they had this test and this test and the microbiome supports it. And this is how we should maybe try to intervene on that. We should tell them to do this or that or add this supplement in, or that supplement, supplement so that we can try to help fix the situation and then we can monitor it from the future. Going into the future. And so that's what I like doing. So precision medicine, to me is finding out what your body is, saying, what messages are stored in your body, and trying to interpret those messages in order to stay on top of health. So I say it's better to stay on top of health rather than being underneath disease. And to me, that's what precision medicine means. It's not. Precision medicine isn't going get your physical every year and doing a stress test and getting your cholesterol and your vitamin D level checked. I mean, that's good. It's better than not doing anything. But real precision medicine is really understanding what your body is. This is an ultra, super, ultra precise physical exam. Basically, every year, you kind of get an update on some of these things and then modify your behavior, because we want to know what we're doing. We want to know if we're doing the things that are right, and we want to stay on top of it so that we can stay healthy and have a good quality of life. That's my philosophy on precision medicine.

Wow, that's so exciting, Marvin, to see a gastroenterologist using the latest tools to actually make a difference and move the needle in the world. So totally applaud what you're doing and 100% support your endeavors. So we'll start to wrap now. So if there was a couple of things, like, pick one. What's one thing that you do for your gut health that someone listening to this podcast could implement very easily in their lives?

I think integrating fermented foods into your diet, I think that's something that's super easy to do. You can do it yourself after you get the hang of it, if you like it, you know, and you find pleasure in cooking and doing things for yourself. But there are plenty of very good quality companies that make organic fermented products. And I think continually trying to integrate that into your routine. I mean, some things you may not like taste wise, some things you may like taste wise. My understanding is you can ferment basically anything so you can figure out what your tastes are along the way. But basically, fermented foods is like, you can think of it as like a probiotic food. So we want to have a diverse, resilient, strong microbiome. And how you get strength in the microbiome is by having a lot of different players, a lot of different players there that can add different kinds of value to the system. We were talking about before earlier, it's not about one guy or two guys, but what's happening in the system. And so by introducing a wide variety of different foods, particularly including fermented foods, we can make the system more resilient by making it more diverse. I think that's a quick, easy thing that anybody can do. It's just a matter of trying it and putting it in your mouth.

Wow, I love that. And I didn't pay Marvin to actually mention the fermented foods, but Nourish Me Organics, the company that I run, we teach people how to make fermented foods like kefir, kombucha, fermented vegetables. We have kits where it's so easy and cost effective. You know what, Marvin? A lot of these cultures you only need to get once. For instance, a kombucha culture or a kefir culture, you literally get the culture once and you make it literally kefirs every 24 hours from one culture for the rest of your life. And the research is suggesting anywhere between 50 to 100 probiotic strains in milk kefir, plus all the functional peptides and all the other goodness that goes with it as well. I'm just about to embark on a clinical study with milk kefir, so. But I mean, spot on. I mean, fermented foods. Great tip for people who want to get started to improve their gut health. Marvin, thank you so much for coming. This is such a cool conversation. I love the mindfulness. My pleasure, man. I mean, sometimes I think the universe just speaks out and draws people to one another, and I think that's certainly in this case. Your energy is just beautiful.

So thanks.

Thank you so much. And if people are listening to this, they're vibing with you. You've touched their heart. How can people find you?

Oh yeah, they can find me on social media. My handle is pretty easy. It's rmarvinsingh D R Marvin Singh S I n G H and my website is the same thing. Www.drmarvinsingh.com Cool, man.

Thank you.

My email, everything is there too, so they can feel free to reach out.

Wonderful, Marvin, thank you so much for being you beautiful person. Thank you so much for coming onto the show.

Thank you. Thanks for having me.

We hope you enjoyed this episode of the Gut Health Gurus podcast with Dr. Marvin Singh. If you want to access the show notes and links, they're available at www.podcast.nourishmeorganics.com au guys, your support means the world to us. So please leave us a kind review and a comment on Apple podcasts or your favorite podcast app. And also share with your friends and family members. You may not be aware that the videos to these podcast episodes are important. Available on YouTube guthealthgurus We're also really active on Facebook and instagram also @guthealthgurus and we have a flourishing Facebook group also @gut health gurus with now close to 13,000 members. This is an extremely trying time for US with the COVID 19 crisis impacting the whole world, so sending you lots of love and support. A lot of the world at the moment is going through social isolation, so we really send you lots of love and lots of blessings and we wish you the best of health and a safe environment for your family. Guys, until next time, take care.