3 Things That Destroy Your Gut Health

Coming up on this episode of the Doctor's Pharmacy.

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Welcome, Drew. Mark, we've done so many episodes on gut health and we've talked a lot about food and how food plays a major role, both foods to eat and to avoid. And we might hint at some of those today, but we wanna talk about the other categories. And we have three that we've identified here. I'm sure we'll break down more. Give us the top three things that you see in your practice and through your own experiences over the years of being a functional medicine doctor, three categories that are major contributors to poor gut health function.

Well, I mean, the first one is what we call dysbiosis, which essentially means an imbalance in the microbiome in the gut. You've got maybe a hundred trillion cells in there, maybe 10 times as much your own cells, a hundred times much your own DNA. And they're not just hanging out, they're doing stuff. They're producing all kinds of proteins and molecules. And if you have bad bugs, it creates bad downstream effects. And if you have good bugs, it creates beneficial effects. Your microbiome produces vitamins and it produces all sorts of beneficial molecules like butyrate that can prevent cancer and so forth. But if you're feeding the wrong things are in your gut, it can actually end up causing more havoc. We call this dysbiosis. It's not necessarily an infection, but also infections can be a problem. So you have a worm or parasite or overgrowth of yeast or small bowel overgrowth of bacteria. Those are forms of dysbiosis that are more extreme. But those all are related to disturbances in the equilibrium in the garden that you have inside your gut. It's like any garden. You don't want too many weeds, you want the right plants, and so forth. that's a huge area that I think has not even been on the radar of medicine, which is how do we optimize our microbiome? Now there's companies out there that are have microbiome kits at home. There's people talking about the gut, but in day-to-day medical practice, your doctor, if he's not trained in functional medicine, does not understand how to optimize the microbiome, doesn't even know what to do to look at it and test it properly. They'll do look for parasites, look for worms, they'll look for infections, they'll look for, sometimes they'll look for inflammation, sometimes they'll look for digestive enzymes if they're super fancy, but it's really not a comprehensive view of the gut. The second is toxins, and I think this is something we don't really appreciate very well, and I think I'm gonna share a story later about how toxins have impacted a particular patient in a very profound way that disrupts the normal equilibrium in the gut. So if you have heavy metals, if you have pesticides, toxins, they create all kinds of problems. There's even things in food that are not food, that are chemicals like emulsifiers, for example, carrageenan and other thickeners that are hidden in food that actually cause leaky gut and all kinds of gut damage. One of them is called microbial transglutaminase, and that is basically manufactured gluten. buy bacteria in a lab that they put in food to make it stick together. Because gluten is glue. That's what I call it gluten, because it's sticky and it's way to hold food together that otherwise would fall apart because it's full of processed, nasty ingredients. And the third is stress. So any kind of physical, psychological stress will cause a leaky gut. If you go in the ICU, if you're healthy, you get a leaky gut. It just happens because of the level of stress. If you take soldiers on a forced March overnight in the morning, they'll have a leaky gut. so stress has a huge impact. And by the way, your microbiome is listening to your thoughts. Okay, so it's, it's involved in constantly, dynamically changing, depending on your relationships, your experiences, your feelings. And, and what we don't understand even the profound nature of how the microbiome influences our health. And this was shocking to me. I was on a panel at Cleveland Clinic with a colleague named Stan Hazen, who's one of the top cardiologist there, but who studied the microbiome and heart disease. And I said, Stan, how many of the metabolites in our blood do you think come from the microbiome? And I thought he was saying like 5%, 10%. He's like, I don't know, maybe a third to half. So think about a third to half of all the molecules and thousands and thousands of molecules floating around your blood come from the bugs in your gut.

And if you're bad bugs, they're going to create havoc. And if they're good bugs, they're going to keep you healthy. Well, let's dive into each one of those a little bit more and let's start off with dysbiosis. You mentioned one in particular. You talked about overgrowth of the wrong type of bacteria or even fungal overgrowth Candida. Just give us a little bit of a big picture of how does that come up in the first place?

Yeah, so why are we having a pandemic of dysbiosis? It's basically the question. And the reasons are multitude. One is We've over sanitized our world. So we're really not living in relationship to nature in the way we were. And the microbiome of the earth helps our microbiome. We're in the symbiotic relationship. So when we're over sterilized sanitized world, we end up creating imbalances in our gut flora. There's books written about this called Missing Microbes, the Epidemic of Absence, which are great books talking about how our modern life has really taken us out of an intimate relationship with nature. if you grew up on a farm, if you're, you know, living in a developing country, you're much less likely to have an autoimmune disease or allergies or any inflammation because of how those microbes have helped you regulate and normalize your immune system. And then there's, there's all the gut busting drugs that we take. The antibiotic, you know, is just massive amounts of antibiotics are used in this country and overuse in animals as well. acid blocking drugs that people are taking like Candace, it's a third leading class of drugs after statins and psychiatric drugs. Basically, Prozac, Pravastatin, Aspirin, Nexium, all those drugs that you can buy over the counter now and people are taking horrible for your gut. They prevent you from producing stomach acid, which you need to digest food. And so you get all these imbalances and the pH goes up, which means you grow different bugs and you get overgrowth of different bugs and One of the side effects of these drugs is irritable bowel syndrome. So you fix your reflux and your heartburn, but you get irritable bowel, which one do you want? And then there's obviously drugs like the non-steroidals, aspirin, which is irritating the gut, Advil, Aleve, all those drugs that we take for inflammation. Also damage the gut, the birth control pill, also changes the gut flora, steroids that people take. So there's a whole bunch of gut-busting drugs that are really common that we use. and of course C-sections, lack of breastfeeding, early introduction of the wrong foods, the hybridization of our food supply, the extra antigens, all these weird things we're eating, chemicals, toxins, all the stuff, pesticides in our food, additives, all those go to destroying our microbiome and ends up causing this epidemic of gut issues. The number one reason for doctor visits is gut problems. It's huge. Irritable bowel, we think, oh, it's irritable bowel, it's not a serious disease, but it accounts for 10% of the healthcare costs of major corporations for insurance. It's a big deal. So I think we have to understand that we live in a gut-busting culture and a gut-busting world. And that's why we're seeing such challenging issues around gut health and all the downstream consequences of poor gut health, which leads to so many other chronic diseases. We know that the microbiome now is involved in heart disease, cancer, diabetes, obesity, autoimmune diseases, allergies, dementia, Parkinson's. I mean, autism. I could go on and on. Pretty much every disease in some way can be linked back to the microbiome. And if you don't believe me, just go on PubMed, just Google PubMed, and they'll send you a link to the National Library of Medicine. Just put in microbiome and whatever disease you have or whatever thing you want to learn, and you'll see there's amazing amounts of data emerging. And this is all new stuff. Like when I was starting out in functional medicine, we knew the gut was a big deal, and we knew it made a huge difference when we work with the gut, but all the data wasn't there. And now it's just mountains and mountains of data. We're learning so fast about how the microbiome works and all the different species and what they do. But we've ended up with most people having pretty messed up guts in modern world. And I mean, there was one study where they looked at the stool from kids in Burkina Faso, which is an African country, and America, and they found that their stool was so different. The microbiomes are so different based on what they ate. Dennis Burkitt was a famous scientist from the UK, you know, decades ago, who studied the differences between the hunter-gatherer societies and their cousins, basically, who moved to the city in African cities, and the differences in their diseases. And they found that the hunter-gatherers didn't have all the chronic diseases of Western civilization. But the city dwellers did. And he found that these city dwellers, their stool weight was four ounces. The hunter-gatherer stool weight was two pounds. Why? Because they were eating tubers and roots and roughage and all this fiber. And so they had giant poops, whereas the city dwellers were eating processed food and not a lot of vegetables and who knows what they were eating. And they had these tiny little poops and it had a huge impact on.

Chronic disease and their health. On the topic of gut dysbiosis, before we get to toxins and stress and unpack those, what do you want to say about a lot of the microbiome testing laboratories that are out there. What can we know from them? What are their limitations? And are there any ones that you feel are more superior?

Yeah. So here's the deal. As a functional medicine doctor, the microbiome typically means what bacteria or viruses or yeast or parasites are in there, right? What's in there? So it's basically like taking a population survey and seeing what you got. and it's helpful. And there are certain keystone species we need like our keramancia and others that make mucus layers for our gut to prevent leaky gut and the biofilm layer. And there's really, really importance in knowing what the balance of overall flora are. Do you have more Firmicutes, more Bacteroides? So you kind of get a sense of what's the overall ecosystem. And that's helpful. And there are a lot of companies that are testing that. but correlating that with particular conditions or diseases, you know, there's some degree that that's happening, but it's still in its infancy. And I think there's a lot of over interpretation of tests. And, you know, I think we have to be really careful. As a functional medicine doctor, I look at the actual microbes, but I'm also interested in the function of the gut, not just who's living there, but what are they doing? And often the indirect measurements are way more relevant to me. for example, I look at digestive enzymes and absorption of food and see if you're having fat malabsorption, because I know maybe other issues. I look at the immune system in the gut, things like Calprotectin, eosinophil protein X, the antibody levels of IGA. I look at is there some kind of irritation or inflammation? I look at something called short chain fatty acids, which are the downstream byproducts of bacteria consuming the food that we feed them. And there are certain of these short chain fatty acids that are extremely beneficial. like butyrate. And if you're low in them, it's a problem. It means you don't have a healthy ecosystem. Or maybe you have high levels of propionic acid, which is a, another short chain fat, but it's a bad one that can cause autism and cognitive issues. Or maybe you have high levels of an enzyme that's produced by bad bacteria called Clostridia, called beta-glucuronidase that actually is linked to increases in estrogen and estrogenic diseases like cancer or fibroids, or maybe you, you know, you have problems with various kinds of, of, of, of kind of commensal bacteria that are a little bit pathogenic. So you're not looking for a true infection, but you see, oh, this, this has a little bit too much of this nasty bug called Klebsiella. It's been linked to arthritis. I, I know I had to deal with that. I'll change my, my patient's treatment based on that. And then of course we look at parasites and we look at things like lactoferrin and we look at all kinds of things that we can look at yeast. So we start to look at the whole environment. And that to me is way more relevant. And the test that I use is called GI Effects from Genova. They don't really have any relationship with them. We just been using them for decades in functional medicine. And I think it's a really important way to look at the gestalt of what's going on. Because just looking at little bits here and there, I think we'll be missing a lot of what's actually happening and.

More clinically relevant things to do now. Yeah, the reason I wanted to bring it up is that people always write in from your community are like, great, you know, I always hear Dr. Hyman talking about going and test your stool, and there's no shortage of companies that are out there that are offering to test people's stool and send them information, but it's a little bit art, it's a little bit science is what I'm hearing from you when it comes to the interpretation of how to do it. That's where a good functional medicine practitioner could be helpful in helping people navigate that journey. Okay, let's go into the next categories. We have toxins and we have stress. So let's talk a little bit more about toxins. and unpack exactly how like toxins, how can toxins contribute to an overall unbalanced microbiome?

Yeah. So toxins interrupt normal biology. They poison mitochondria, they jam up enzyme systems, they create inflammation, they create oxidative stress, they directly affect the microbiome, for example, like glyphosate. I was shocked because I I eat pretty healthy. I try to eat organic. I try, I never eat GMO that I'm aware of when I buy food. But I go out to eat if I'm traveling. And you never know what you're getting. I could be getting canola oil. It's a GMO thing sprayed with glyphosate. It's made my, it's on my salad dressing or it's made, they made my vegetables in or whatever. So I don't always know what I'm eating. And I check my urinary glyphosate levels and they were like pretty high, like they were in the 50th percentile. I thought it'd be like really good, but they weren't. And I was like, oh boy, this stuff's everywhere. And that is a microbiome destroying chemical.

For example, heavy metals or nothing. Let's just pause on glyphosate because I think some people hear that and they're like, shit, this guy watches everything that he eats and is like paying attention and is like the guy that's teaching people. So it was a little bit of.

Like, I just didn't want to leave it hanging there. Is it like, kind of like we're all doomed or is it no, like, how are you mitigating that? well, now I'm a little more careful when I go out and I, I'm a little more cautious about what I eat and I, I'm just more smart about it. But, you know, if, unless you're, you know, buying all the food yourself and cooking all yourself, you always don't know what's in stuff.

And it's also a reminder that all these other things that you do regularly, you know, working out, sauna, Etc. Taking the right supplements, those things are helpful to get rid of that buildup in your body.

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Okay, let's go into stress next. What do you want to talk about when it comes to stress? And what do you want people to know when it comes to how stress can significantly destroy our gut health?

Stress is one of those things that is ubiquitous. We all experience it and learning how to deal with it is an important life skill, whether it's through meditation, yoga, hot and cold plunges, sleeps, whether it's massage, whether it's deep relational connection with somebody else, whatever it is that resets your nervous system. But many of us are just bombarded with chronic stress and it leads to changes in our health. And one of the ways it alters our health is through changes in our microbiome. Uh, and the microbiome literally is listening to your thoughts. The bacteria know what you're thinking and they, they actually change. And when you are under chronic stress, it changes the bacteria to be more toxic. The bad ones grow, the good ones die, and you end up with more and more dysbiosis, which has all these downstream consequences. So we know that, that, you know, people, they, they get gut feelings, right? this is a real thing that my stomach's in butterflies or my stomach's in knots or my whatever the venom force we use because the gut is directly connected to your nervous system and there's more neurotransmitters in your gut than there is in your brain, right? Which is crazy when you think about it. And there's a whole separate nervous system called the enteric nervous system, which is the basically means the gut nervous system and it communicates with your brain but it's bidirectional. So stress here will cause stress in your gut. Stress in your brain causes stress in your gut. Stress in your gut will cause stress in your brain. So we used to think irritable bowel syndrome was because people were neurotic and that was what was causing the problem. But actually we found out that the inflammation from the irritable bowel because of dysbiosis in the gut creates inflammation in the brain, which makes you anxious and depressed. So it's kind of a bidirectional system. So stress will mess up your gut, but your gut can mess up your stress, if you know what I mean.

Yeah, it makes me, you know, it just reminds us that like there's so many things that can all build upon each other and lead to a whole host of gut challenges. There was recently a, a friend of mine that was on the, on my podcast. Her name is, Nishtha Patel. She's a nutritionist that's based out of, London. And she had shared that her daughter who suffered with irritable bowel disease and had a situation where it sort of showed up out of nowhere for her daughter. And in unpacking it, and that led to her to a path of learning about functional medicine and becoming a fan of yours and, you know, your podcast and everything. For her daughter, what had happened is that they were on a trip, I think it was in The Mediterranean, and they were jet skiing, and they were around this area where there was some either algae buildup or oil spill that was there, and her daughter fell off the jet ski, ingested a bunch of water, swallowed some sort of items, and pretty much her symptoms started to show up after that process, which naturally, especially when you didn't know where this came from, leads to more stress that stress builds on top of the dysbiosis that's.

There and it all cascades. Yeah, it's true. It's true. So, you know, I think you kind of have to deal with all the things that disturb the gut, right? It's your diet, it's stress, it's sleep, it's exercise, it's the right environments, you're not exposed to toxins at an excess level. All that is so important. And I think we're so bad in medicine and dealing with gut issues, it's just It's just embarrassing given what we now know and actually what we were doing. And unfortunately, in conventional medicine, you're either told to eat more fiber or do a five-meths diet if you have irritable bowel. Now they're treating bacterial overgrowth, but they just give you antibiotic and they don't deal with anything else to restore the gut. Or they give you acid-blocking drugs for heartburn, which makes more problems downstream. And it's really a crime because we know so much about how to deal with these issues. I've written many, many blogs about irritable bowel and reflux and heartburn and encourage, you know, check them out or link to them in the show notes. But the reality is that we now know so much about how to handle these problems in a much more effective way through diet and lifestyle and through dealing with looking for root causes and things that, and diagnostic tests that we just don't get at the traditional doctor.

Mark, you talked about your first sort of bout with gut issues when you had mercury. There's a second time that you had gut issues that came up more recently. Can you share about that?

Absolutely. I basically have had the privilege or the curse or the blessing, I don't know, it depends how you look at it, of getting pretty much everything and having to figure it out. And I've shared about this before, but about five years ago, I had chipped a tooth, it broke, I needed a crown, it didn't work, I needed a in a root canal and the root canal went bad and I had to take the tooth out. And a doctor who was a friend of mine, the dentist, said, look, and he's, it was an integrative dentist. He says, look, I think, you know, it's pretty infected. You should take an antibiotic. And he gave me clindamycin, which, you know, is a regular antibiotic. It's been around forever, but it is associated with a particular super infection called C. Diff or Clostridium difficile, which kills about 30, 000 people a year and pretty nasty and it, it, it's very hard to treat. Uh, many of the traditional medicines, which give other antibiotics to kill, it's like you give, you take an antibiotic, cause a problem, you take another antibiotic to kill that and it causes more problems. And, and, and, and, and, and then one of the best treatments is actually fecal transplant, believe it or not. It's actually 98% effective where you take the poop out of a healthy person and give it to someone with this infection. But that, that, that same time I had that, I also had a few weeks later broke my arm. and I was in pain and so I was taking like a non-steroidal anti-inflammatory because I didn't wanna take narcotics like morphine or whatever they were giving me. I mean, maybe I should have taken the morphine, I don't know. And I ended up having terrible gastritis, which messed up my gut. So my stomach was awful. I was in pain, nauseous, it was awful. And then I developed colitis. So some people get C. Diff and they just get the infection and then it causes diarrhea. stuff and they get an antibiotic, it goes away. Other times it develops into colitis. So the walls of my colon were thick, they were red, they were inflamed, my markers of inflammation called Calprotectin were through the roof. I mean, normal is like 20, 30, less. Mine was like a thousand. And it was bad. I developed ulcerative colitis as a consequence of taking this antibiotic, which was for a dental procedure that I, you know, in retrospect, I probably wouldn't have taken it. I would have used other things. I may be nasal rinses or ozone or something else, but. It was kind of bad and I think we have to be very careful when we take these medications cuz they can create untoward side effects that have long-term consequences. And so it took me a while to rebuild back my gut, but now I've, I've been doing that and I feel much better and I developed a, we're actually launching a product that I developed out of suffering from that called Gut Food soon, which is basically designed to rebuild your gut like a multivitamin for your gut. Yeah.

And you know, it wouldn't be a Dr. Hyman or Doctor's Pharmacy podcast episode if we didn't at least touch on a little bit of food. So we covered a lot of non-food contributors, again, stress, toxins, dysbiosis. But when it comes to healing the gut, let's give people a top three. So top three things that you think that support gut health and top three things food-wise that you think take away from gut health.

Yeah, I mean, the top three things that are likely to cause problems for the gut are gluten, dairy, and refined starch and sugar, like one, two, three. Those are big. If you have gut issues, get rid of those and see what happens. If you wanna go a step a little further, try getting off fermentable starches, greens and beans are a huge issue and certain vegetables can be problematic. There was a very amazing book called Breaking the Vicious Cycle by Elaine Gottschall years ago written that talked about how to treat ulcerative colitis by using what she called a specific carbohydrate diet. so it took out all sugars that needed to be digested. So you didn't get this fermentation and this bloating and distension and inflammation. So those are the things you wanna get rid of. The things you wanna add are three key things that are in foods that are not specific foods, but they're in specific foods, which are prebiotics, probiotics, and polyphenols. Prebiotics and prebiotic foods are things that provide fiber to the bacteria that they like that we can't eat. I mean, that we can't digest. So they're just food for them. And they're in all sorts of plant foods. Jerusalem artichokes, regular artichokes, plantains, asparagus. A lot of foods have a chicory root. A lot of foods have these prebiotic fibers that can be consumed as part of our diet. And, and just fiber in general, high fiber diets in general are good for the bugs in your gut. then there's prebiotic foods, which we just talked about, and there's probiotic foods. So those would be sauerkraut, miso, natto, tempeh, you know, just things that are fermented that have been around for a long time, that have been used to preserve food that end up actually having probiotics in them. And we barely eat any of those anymore. Pickles and pickled vegetables. Even pickles, you know, I grew up on pickles, but pickles count. And then, and then the third are polyphenols, which is set up a new discovery that that good bacteria like to eat these colorful compounds in plant foods. The reds, yellows, greens, purples, oranges, and the more you can include these polyphenols from a colorful rainbow colored diet actually helps to fertilize the good bugs. Things like cranberry, pomegranate, green tea, turmeric, various kinds of compounds that we can get is just part of our diet to help fertilize and help gut. So yes, it's cutting out the bad stuff and it's actually eating gut supporting foods.

All right, Mark, this is the part of the episode where we go into community questions. And the first question that we have here from our audience is, I struggle with chronic constipation. What are some things that I could be keeping in mind to alleviate my symptoms?

Well, constipation is very common and it's often, you know, we call it Irritable Bowel Syndrome C or constipation. There's Irritable Bowel Syndrome D, which is diarrhea. but constipation is very common and it can be many reasons for it that are not food related. Hydration is a big one, people not drinking enough water. Magnesium deficiency is a huge one. Now, magnesium deficiency is sort of food related, but not necessarily. It's really because one, our diet is so deficient in magnesium, which comes from greens and beans and nuts, which we eat very little of. And two, we do a lot of things that cause us to lose magnesium. Caffeine, sugar, alcohol, stress, all cause you to leak magnesium. So getting enough magnesium is important and magnesium citrate can be very, very helpful. And then there's other factors that can cause constipation that are based on dysbiosis, like yeast overgrowth is a big cause of constipation. Dairy is a big cause of constipation. Even though for some people it can cause lactose intolerance and diarrhea, it can cause constipation for many people. In fact, it's the number one cause of constipation in little kids. And it's also the number one cause of anemia, which is kind of striking. Why? Because it's an irritating protein in a set of proteins in dairy that irritate the gut and cause bleeding in the intestines of little kids. Wow. Now think about that. I'm not making this stuff up. This is in National Library of Medicine, PubMed, major journals. So constipation is really common. and it can be also caused by parasites or other issues. So, in one case I had was really fascinating. She had a tick infection, Babesia, which caused a nerve paralysis in her gut, which is really unusual. So there's some unusual causes, but usually constipation is really easy to fix by upping the fiber, upping magnesium, upping vitamin C, upping hydration, For most people, you know, that'll work. I had a patient once who was a radiation oncologist. She was a resident actually at the time, and she had severe headaches, migraines, and she had been treated, she was a resident at the Mayo Clinic, right? She was a doctor at the Mayo Clinic, which is where everybody goes to figure out problems that no one can fix. And she saw everybody and no one could fix her. And she was taking all the preventive drugs and all these different drugs. and it was just stuck. She was on narcotics and Zofran and chemo drug, like chemotherapy, anti-nausea drugs that would be used for chemotherapy. I mean, it wasn't working. And she came to see me and said, okay, she had migraines, but what else do you have? Let's talk. And so we went through a list and she had constipation that was severe. She had palpitations. She had anxiety. She had insomnia. She had muscle cramps. These were all magnesium deficiency symptoms. I said to her, so how often do you go to the bathroom? She says, well, I'm pretty regular. I said, well, how often do you go? She's like, I go every week. I'm like, that's not regular. Well, she says, regular for me, I go every week. I'm like, you should go every day or twice a day. She's like, really? It's amazing people don't even know what's normal. And so I gave her enormous doses of magnesium because it was what it took to get her to go to the bathroom and her headaches went away, her muscle cramps went away, her constipation went away. palpitations went away, all this insomnia went away. And so, really she had a magnesium deficiency problem.

All right, Mark, this is the next question from the community member. Is there a connection between our gut health and reflux?

Well, clearly reflux is a gut problem. So it means that you essentially have acid coming up into your esophagus or in your back of your throat, and it can cause all kinds of problems. It can cause cancer in your esophagus, cause vocal cord issues, it can be uncomfortable. And people, you know, people had a heartburn. Call it heartburn. Right. And you see all these commercials. Oh, don't worry. You can eat your sausage and your peppers and onions and don't worry. You just have to pop this purple pill and everything's gonna be fine.

Right.

And you remember, remember, you know, those, those, that, that, that commercial. I can't believe I ate the whole thing. And it was this guy eating Alka-Seltzer or whatever. So these are really common problems, and, and often they're treated very simply in with traditional medicine using acid blocking drugs. They're problematic because they actually cause you to block stomach acid, which is needed to digest your food. It's needed to actually keep the pH of your lower part of your intestine normal, and you end up with all these secondary problems. And the causes are often the medications we're taking, which can actually be an issue. It can also be a bacteria called H. pylori. It can be because of our diet is too processed and junky. If I eat fried foods, if I eat junky foods, I can get heartburn. So it's not, it's not that my stomach's a problem, it's what I'm eating is a problem. So, so I've written a textbook chapter on this. I've written many articles about this and it provided a guide on how you can get rid of reflux. But essentially, it's, a lot of it's common sense. It's getting rid of the trigger foods. So it's often fried foods, processed foods, spicy foods for some people, citrus food, tomato foods can be an issue for some people. Smoking, alcohol, caffeine, all those things are worth taking off the table for a short period of time. And then seeing how that works. Checking for H. Pylori is really important and also treating imbalances in your gut. Magnesium deficiency can be also caused because the sphincter in the lower part of the stomach has to relax in order for you to actually let the food go down. So there's a lot of things you can do to help calm the stomach down. We use glutamine, zinc, carnitine, another form of zinc that can be very helpful. and Licorice, Deglycyrrhizated Licorice, DGL, which is also very helpful. So there's a lot of ways to treat this and almost all of my patients with reflux get better pretty quickly.

By following a functional medicine approach. All right, Mark, so those are the questions that we had for today's episode. So this is a great opportunity to do a little bit of a recap on the top things non-food related that.

Contribute to dysbiosis inside of the gut and just overall poor gut health. Well, thank you Drew for asking that. But it, you know, people think, oh my gut is only problematic because of food, but it's so many other things we don't think about. It's imbalances in the gut flora that come from our gut-busting lifestyle and medications. It's environmental toxins and it's stress and sometimes it's latent infections or things that we haven't even thought about. So, uncrystalline does not take at face value that they have X or Y disease. I have reflux, I have aerial bowel, I have, you know, inflammatory bowel. These are just names that we give to people who share certain symptoms. They don't tell you anything about what to do about it or what the cause is and that's why in functional medicine, we focus so much on the gut and we're so good at addressing gut dysfunction. So if you've been listening to this podcast and you know some with gut issues or you have them, please share this with your friends or family. We'd love to hear from you about how you've helped yourself with gut issues that maybe weren't related to food. Subscribe or ever get your podcast and we'll see you next time on the Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into the Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introducing you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health. It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you have to do is go to drhyman.com/pix to sign up. That's drhyman.com/pix, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer.

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