How POOR GUT HEALTH & Inflammation AFFECTS Endometriosis | Mark Hyman

Chronic inflammation creates an environment where it continues to grow and continues to scar and continues to be a problem. It's estimated to affect as many as 10% of American women. Women who have chronic pelvic pain, it's 70%.

Welcome to Doctor's Pharmacy. I'm Dr. Mark Hyman. That's Pharmacy with an F, a place for conversations that matter. And today, if you're a woman and you struggle with menstrual cramps, with infertility, with weird periods, with weird menstrual hormonal symptoms. This conversation is something you should pay close attention to because this problem is way more prevalent than we think and affects so many people and is so missed. And we're going to talk today about endometriosis. And we have our special guest today for this week's special episode of House Call. It's Dr. Cindy Guyer, who I've known for decades, worked together at Canyon Ranch over 20 plus years ago. In fact, I hired her as one of the key doctors to help us build the whole functional medicine department, which is really the beginning of the story of how functional medicine got really popular. We were out there just on the front edge trying to figure it out and we did it together and it was so much fun and we have come a long way since then. Cindy is Triple Board Certified in Internal Medicine, Integrative Medicine and Lifestyle Medicine. She served as the Medical Director at Canyon Ranch for decades. And it's just one of the most extraordinary doctors and people I know. And we're so thrilled and glad to have her here now, joining us at the Ultra Wellness Center, where I begged her to come work for me for 15 years, but she refused. But now she's here. I made her an offer, she couldn't refuse.

So welcome, Cindy.

Thank you. I'm so excited to be here, Mark. It's really great. So let's talk about this topic, endometriosis. And you might be like thinking, oh, this doesn't apply to me. I don't know. But like, I bet you or someone you know might have experienced some issue with this. And the challenge with traditional medicine is endometriosis, it's a really a struggle to get it under control. And with functional medicine, we really found that there are ways to really help resolve this for people. So let's talk about, you know, what are the common symptoms of this? How common is it? And, and what, you know, what is a traditional approach to this? What is it?

Yeah. It's, you know, it's interesting. We still don't know all of the factors that come together to lead to endometriosis, but what what it is as a condition is when cells that normally line the uterus somehow get into the abdominal cavity. We think maybe it's retrograde menstruation and then they set up residence there and they create this ongoing cycle of growth and inflammation and scarring that can lead to heavy painful periods, pain with intercourse, infertility. And it's number one, very difficult to diagnose. It often goes years before it's diagnosed. It's estimated to affect as many as 10 10% of American women, but if you look at women who have- that's millions of people. That is millions of people. And if you look at women who have chronic pelvic pain, it's 70%. So, that's huge. So, a significant cause of reduced quality of life and chronic pain and difficult to diagnose.

Yeah.

And basically the idea is that like your uterine lining gets out of where it's supposed to be and starts like depositing itself on your kidneys and your bladder and your intestines and your lining of your abdomen, all those places that shouldn't be. And so then when you're having your period, or all of a sudden you're having a period in your kidney or your period in your bladder, a period in your intestines, and there's no place for it to go. And also blood in the abdomen is really irritating.

Very irritating and painful. Yes, yes. And it turns out that those endometriosis ectopic or implants of endometrial tissue that are outside the uterus, they develop their own ability to produce estrogen and propagate the cycle. So even though we don't know all of the factors that cause it in the beginning, what we do know is that chronic inflammation creates an environment where it continues to grow and continues to scar and continues to be a problem.

Yeah. So that irritation just creates a lot of inflammation in the abdomen and it can scar things, right? Which leads to the whole infertility issue.

Absolutely.

A lot of women struggle with getting pregnant have and we kind of, I learned in medical school that it was sort of a mechanical thing that, oh, you know, somehow the blood from the period blood got through the fallopian tubes and back out into the abdomen and squirted around and landed in places and started growing. But it turns out it's, it's way more than that.

Right.

It's like. Right.

So, so that still may play a role, but it also may be that once those sites are there, they can be dormant and not cause a problem. But if there's coincidental inflammation, then it feeds the process, it accelerates the process. So that's really where we focus a lot of our efforts is figuring out where the inflammation is coming from and how we change the environment so that those implants can either shrink or go away.

So what kind of we silo things in medicine, right? It's hormonal, it's immune. Right? Turns out that endometriosis is both.

It's both.

And in fact, it's seen by some as an autoimmune disease.

Yeah.

Which changes how I think about it.

Absolutely.

And how I treat it.

Absolutely. You know, in the traditional treatment, so often it's hard to diagnose, it's usually diagnosed by a laparoscopy, but the traditional treatment is to do surgery to get rid of the scar tissue and remove those implants and Hormonal therapies to kind of keep them from growing and developing, but unfortunately it tends to come back if we don't address the underlying autoimmune inflammation in the environment.

Yeah, so the treatment is like they open your tummy or they laparoscope and they burn all the spots. They hope they don't come back. They don't go, why are the spots coming in the first place? Like, let's just not putting out, it's like bailing the boat while there's a hole in it instead of fixing the hole. Right. Which is pretty much fishy, man. And the hormone therapies can be effective, But they're pretty nasty and they shut off your hormones and they turn you into kind of a menopausal woman, right?

Yeah, they can.

In some ways, it's like it's not fun. I feel bad that we have all this stuff causing these hormonal issues. But, you know, I kind of have, I don't know what your religious or spiritual beliefs are, but I definitely think there was some higher intelligence that helped create us and that nature is designed to work. not malfunction, right? All natures and it can get screwed up and out of balance. And so functional medicine is really about like, where do we get out of balance? And how is it that 10% of women have this? How is it that 70% of women with pain have this? There's some causes. So what from a functional medicine perspective, you know, from nutritional medicine, it's like, we don't know the cause. You've just got this thing, take these drugs, let's cut it out. What from your perspective and the functional medicine perspective, what are the root causes of endometriosis?

Well, I think we should touch a little bit on the ones that we probably can't do as much about. There is a genetic component. There's no one gene, but there is a genetic component to it. It's more common in first-degree relatives of women who've had endometriosis. There also seems to be an epigenetic component. In other words, the intrauterine environment when a baby was developing can also influence her future risk of endometriosis. The strongest link there has been exposure to endocrine disrupting chemicals like dioxins or PCBs or phthalates or bisphenol A. So, those intrauterine exposures may also play a role.

And, those names, you know, phthalates, dioxins, PCBs, bisphenol A, these sound like weird chemicals, who knows. They are everywhere in everything, in every plastic and, you know, and everybody has these things in them and more or less. And, and so they really do act like hormones.

Yes.

They call them xeno, biotics or xeno estrogens, and they're, like, super nasty, and they, and they're often synergistic, and they're often not just additive, but they're multiple. In other words, you know, 101 is in two. It's, it could be 10 or 100. Right. And so these, these compounds are everywhere, and they, and then some women are particularly susceptible to them, and someone can't detoxify. And we don't really think about that when you go to your, you know, gynecologist, they go, oh, let's look at your toxic load and let's figure out how to detoxify you and help your hormones work better. I'm like, they don't do that. That's what we do in functional medicine, and it's it's so satisfying because we get to see people really get help where often they can't. So, you know, family history is true. I want to sort of just kind of loop back to something you said because it's a little bit abstract for people. This whole idea of epigenetics.

Okay.

And what you were referring to was what happens to your genes as you are entering the world in utero and then even after how your genes can be affected by your environment and ways that affect their expression. It doesn't change the code, but it changes which ones are red or not red, and that can affect your function.

Yeah, and I think that's actually, it's a message of hope for many of us that your DNA is not necessarily your destiny. That these switches, and it's often by a process called methylation, the genes that you come into the world with, they can be switched on or off, depending on the environment they've been exposed to, not just in utero, but after you're born and the way you live. And to me, that's really the message of hope that these lifestyle choices, like the foods we feed and the things we're ourselves and the things we expose ourselves to and how we live our lives have the ability to reprogram our DNA in a way.

Yeah.

And in a way, it's like, it's kind of like, can be really mind-blowing I mean, if your mom loves KFC, eating KFC while she's pregnant, you're probably gonna like KFC. And if your mom's eating broccoli and grass-fed beef, you're probably gonna like that. And it really conditions your genes. And we see this all the time in the data and literature. So really important to early life, but also all our exposures over our whole life.

And I think where a lot of the data now in terms of endometriosis and making it worse is really connected to the health of the gut microbiome and the intestinal lining. For example, they found higher levels of bacterial endotoxin and lipopolysaccharide in the menstrual fluid and the peritoneal fluid inside the belly of women who have endometriosis, which is suggesting that gut bacteria are somehow making their way into the uterus and into that peritoneal lining. And we know that that is big contributor to ongoing smoldering inflammation.

Okay, this is mind-blowing. Here's what you just said, just for those listening, because it was a lot to dig in. The products of bad bacteria, they're like bacterial toxins called LPS or lipopolysaccharides. These things get absorbed through a damaged gut and they somehow end up in the menstrual fluid. Like, wow. Right? So your gut's talking to your uterus, right? That is just mind blowing. And so when you see a traditional doctor, they're not thinking about all these interconnections of the body as a system. They're like, oh, you have, you know, ectopic uterine tissue and it's, we better cut it out or give you drugs to turn off the hormones. Not, gee, why is this happening? And is it inflammatory? And what's, is it toxic? And is it, where is it coming from? And, and when you start thinking about autoimmune disease, you start to ask a different set of questions, which is what's pissing off the immune system. And it's a short list, right? It's toxins, allergens, microbes and imbalances in the gut flora, poor diet, stress, and how those interact with our genes. And so, really, you have to go down that path of investigation. And in traditional medicine, they'll look at your labs, they'll look at your hormones, and they'll look at maybe like an endoscopy or they'll look at a CAT scan or an MRI of your belly, and they'll to try to get a sense of what's going on, but they don't really don't look at these other pieces. So tell us like, what is your approach when someone comes in and struggling with endometriosis from that lens of everything's connected? What do you tend to think about? What are your diagnostic tests you do? And what do you tend to sort of begin to advise people to unwind this process?

So first we're going to do an in-depth history. We want to know somebody's family history. If we can figure out what they might have been exposed to, that's great, but we also want to know where they to be potentially having ongoing exposures to these endocrine disrupting chemicals that we mentioned before, their personal care products, foods, whether they're eating organic or not, and targeting, let's at least reduce the burden. We will probably measure hormone levels even though and estrogen metabolites to see how efficiently somebody can process the estrogens that they're already making, as long as we keep in mind that what we see in the blood may not necessarily tell us what's going on inside the belly. I certainly want to know somebody's health of their gut microbiome and health of the intestinal barrier because I think those are really critical. And I'm going to want to look at their inflammatory markers. What's their C-reactive protein? There's another molecule that's emerged as a predictor and a driver of the scarring and inflammation called galectin-3. And it's a lectin that's part of the immune system and it seems to fuel cellular growth and inflammation and scarring and it's been implicated in many fibrotic conditions like interstitial pulmonary fibrosis, congestive heart failure, and endometriosis. The reason it's important to identify galectin-3, interestingly, there are some drugs being developed that target it, but modified citrus pectin blocks the activity of galectin-3. So there might be a time and a place to even bring in a food supplement that could potentially slow down the fibrosis. When you mentioned autoimmune conditions, we know that that gut lining is such a critical component. Anybody with an autoimmune condition, number one, we want to look at the health of their gut because 70% of your antibody producing cells actually line the wall of the gut. So it's kind of a canary in the coal mine. We also want to identify whether there's a gluten issue. Anybody with an autoimmune condition, there's statistically speaking a higher prevalence of gluten related disorders because we know that in people who are gluten sensitive or celiac disease, eating a meal with gluten causes a disruption in the health of that gut lining. And there was a 2012 study mark in women with endometriosis that found that when they went on a gluten-free diet, a significant proportion of them got improvement.

What do you know?

What do you know? Yet another condition, right?

Who knew? Yes, we knew. We've known for 30 years.

Yeah.

It's such a simple strategy for approaching people's health using functional medicine. It's really about, okay, what are the things that could be pissing off your body? And what does your body need to function better? That's what we call functional medicine. It's like there's not a long list, right? Here's the things that are troublesome to humans and let's get rid of them: toxins, allergens, microbes, stress, right? And one of the things the body needs to thrive and function the right food, nutrients, light, air, water, sleep, love, movement, you know, community, all those things. So I feel, you know, what you just unpacked was so critical for people to understand that if you are suffering from a hormonal disruption or some kind of hormonal condition, this is true for anything and not just endometriosis, but particularly endometriosis, you have to think deeper, you have to peel back the layers and look at things you wouldn't look at. Yes, we look at hormones. We also look at hormones quite differently. We look at, a 24-hour urine sample, for example, that looks at how estrogen is processed by the body and whether it's producing toxic molecules that are more likely to cause problems or not.

And why?

It could be because of environmental toxins that disrupt those pathways. It could be because of folate or B12 or B6 deficiencies that cause those problems. It could be a lot of other things. So our job is to look at not just at the regular hormones, but more sophisticated hormones. And like you said, we look at the gut. and the poop testing, which, you know, seems weird, but yes, we look at, we look at food allergies and sensitivity, we do gluten testing, we look at environmental toxins. We can do tests for a lot of things like dioxin, PCBs, phthalates, a lot of the BPA, a lot of these compounds we can check in the urine. And we can even look for things like heavy metals. And, and, and all these things are so important to look at because when you miss them, you're just kind of trying to help people. symptomatically get better and you're not really getting to the root cause. So I know you've done this and you've seen real changes in your patients and improvements. And I have too, I mean, I have patients who had infertility, struggle with getting pregnant, chronic painful periods, just chronic pelvic pain, and you start to design an anti-inflammatory lifestyle, which is the basics, the usual diet lifestyle, but often an elimination diet and exercise, stress reduction, sleep, all that. but then you start digging in, you start doing detoxification and you do things to manipulate the hormones. So let's talk about this whole idea of how do we look at estrogen metabolism and how do we look at the detoxification of hormones and the role that plays in various hormonal conditions and what we can do about it? Because the beautiful thing is, it's one thing to just say, oh, you have this thing, It's another thing to say, oh, well we know exactly how to modify these pathways and fix this dysfunction to get you feeling better.

Yeah, so this is a complicated one to unpack, but let's see if we can walk through it. So estradiol is the primary estrogen that your ovaries make. Your tissues can make another form of estrogen called estrone from conversion of testosterone and DHEA. Those estrogens get processed by adding an OH group, a hydroxyl estrogen, and it can get attached at different positions. And the reason it's important is they have different levels of reactivity. There's something called a two hydroxy estrogens. There are four hydroxy estrogens and there are 16 hydroxy estrogens.

What do you mean? There's not such a thing as estrogen.

There are all these different kinds of estrogens.

Yes. Right.

And they have different impacts. So which pathway we tend to go down with our metabolism is going to impact how it functions as our bodies. For example, we know that the four hydroxy estrogens in particular are potentially damaging to DNA. They're really reactive and they have much more of a damaging tissue response. There is a genetic piece to that, but lifestyle again plays a role with which pathway we tend to go down. After we make those hydroxy estrogens, we can either methylate them, adding a methyl group to it. We can glucuronidate them so we can sulfate them. So there's other detox pathways. There's plenty of different chemicals on them that package them up. So they're not going to cause a problem anymore. But if somebody's not able to package them up, then you accumulate more of.

Those reactive molecules and they cause a problem. So- and then cause breast cancer, uterine.

Cancer, cervical cancer, you know, all sorts of things. Yeah, it's not just about endometriosis.

Right. Right.

So what are some of the lifestyle factors that influence this? Well, interestingly, adding that methyl group that I mentioned, your stress hormones share an enzyme with those, they're called catechol estrogens. We have catecholamines.

That's- Adrenaline.

Adrenaline, yes. They need the same enzyme to be able to methylate and make them, package them up so they can't be a problem anymore. That enzyme needs good B vitamins and magnesium to do its job. So now you're starting to look at this interconnectedness about how, okay, if somebody has a slow methylation enzyme and they have a lot of stress that's putting a demand on that enzyme and they're eating a diet that's not meeting their needs for magnesium and B vitamins, that whole thing then drives production of those reactive estrogen molecules.

So basically, you can be genetically set up, you can be nutrient deficient, you could have all these exposures and stuff, and that just drives these nasty estrogens. Yes. But the beautiful thing about understanding it is you can actually fix them. You can do something about it. You can actually give the B vitamins, you can get rid of the toxins, you can improve some of the pathways. You can, you know, I mean, even, you know, food plays a huge role. When you look at sugar and starch, that drives in the nasty estrogens. And if you eat more broccoli and soy and flax seeds, it helps improve the estrogen.

Absolutely. Absolutely. So we want to support those other pathways, the sulfation pathways, you of all the smelly foods like the broccoli, but also garlic and onions and the allium family.

And we talked a little bit about this in the podcast before that there is this phenomena of estrogen imbalance in our population. It's basically too much estrogen in relation to progesterone. So maybe an absolute or relative difference. But this, we live in an estrogen dominant universe. And I don't mean because there's more women than men, but I mean because the very things that drive excess estrogen production in the body are the very things that are the dominant features of our society. High sugar and starch, alcohol, low fiber diet, stress, environmental toxins. These are just things that we all deal with deficiencies in certain nutrients and yet the they're all correctable.

Yeah.

And I think the big drivers we can measure insulin and inflammation.

Yeah.

So it's an upregulation of estrogen production. Yeah.

Yeah. Yeah. And, and, and, and obesity plays a huge role because your fat cells make estrogen, too. And that's why men who, you know, are really overweight or you lost starch, your sugar have beer bellies. They'll get man boobs. They lose the hair on their chest, the hair on their legs. They get, you know, it's just, it's just a real estrogenation of, of men from the same phenomena. Do you want to know my secret for living a long and happy and healthy life? Well, all I have to do is check out my weekly newsletter, Mark's Picks, where I share my favorite tips for health, longevity, well-being, and lots more. Check it out and the link below. Actually, this is more of a hopeful story than most people think around endometriosis because if, you know, these are all diagnosable underlying causes and there are ways to address them all, then it's not just, oh, well, I'm stuck with this and I've got to take these drugs and have the surgeries and I won't have a baby. And, I mean, I. I'm, like, just amazed. I remember this one woman who had all these inflammatory issues, autoimmune issues, endometriosis. She was, like, 26, 27 years old, struggling with chronic painful periods and, you know, infertile, trying to have a baby, and it was just a mess. And we just kind of went through this approach that we just talked about. And not only did all our autoimmune stuff go away and inflammation go away and her joints get better and her gut get better, but she got a baby. She got a baby. So I think there's hope for people out there if you're struggling with any kind of hormonal disorder. The functional medicine approach is really effective in understanding the root causes of hormone imbalance and then I'm treating them. Well, Cindy, it's been awesome having you on the podcast. You know, at the Ultra Wellness Center, we're here in Lenox, Massachusetts. We see people from all over the world. We do virtual consults now as well. And we're able to diagnose these things, looking at these diagnostic tests, help people get better and use a combination of diet and lifestyle supplements and other features detox to help people get their systems right.

So the first thing I did was I went back to basics. And so I did, you know, I did not suddenly just start seeing an acupuncturist or start, you know, trying energy medicine or anything that's really alternative. I was like, okay, no, I'm a doctor.

You started off with crystals?

No, I didn't. And oh, God, meditation was like pulling teeth. So, no, I went back to basics and I took out my Pathology 101 textbook. Pathologic basis of disease.

Ramsons and Co-tran.

Exactly.

We all take it first second year medical school.

Right, and Kumar was my pathology teacher.

Oh, wow.

So I took it out, I still had it, it was highlighted, dog eared, and it actually was good for me. If I know neuroplasticity, it kind of brought me back to this time where I had more of a sense of agency over my life. So in that sense, it was also healing. I didn't recognize it at the time. But I started reading about how chronic disease develops and you know about cellular repair and cellular injury. And I was like, wait a minute. And they actually talk about this was published, I don't even know which edition, but 20 years ago, where they say the one cause, one effect paradigm does not work anymore. Yeah.

Right?

We're in this complex living environment where nutrition matters, where environmental toxins, I mean, this is 20 years ago. And they probably wrote that several years before that, that was published, right? So I started reading that and I thought, wait a minute. And then that diseases are not defined by a set of criteria. They're this continuum, this process.

And that- Yes, I remember going back and reading chapter one and it said, any pathologic change is always preceded by a biochemical change. Yes. Which means that anything you see on a microscope, there's got to be a lot of years of stuff going wrong with your biochemistry and physiology before that happens.

Yes, in years.

And we don't know how to look at that in Western medicine. We just wait till you have something wrong and then we go, oh yeah.

Now I know what it is. Right, right. Because in the way that we've been trained, inflammation, which is what I had, widespread inflammation in my nerves, inflammation in my gut, inflammation in my brain. In my thyroid. Exactly. It doesn't qualify as a treatable disease.

Inflammation.

Right.

No, that's what I was joking. Say functional medicine doctors are inflammologists, you know?

Yes, I love that. I remember that from the first functional medicine conference I went to.

Yeah. Well, I gave a talk on that, right?

Right, right. So, and, but so that was a really big aha moment for me was, wait a minute, okay, I understand this sudden disturbance, what I call it in Beijing. But then I had the thyroiditis before that, which was sort of right the preceding trigger. And then before that, okay, wait a minute. You know what? When I was in residency, post call, 36 hour shifts, my muscles would feel really cramped.

Fibromyalgia.

Like I felt like I'd run a marathon. And I was dizzy. And I just assumed, well, of course everyone feels this way because they're exhausted.

You're just sleeping, right?

Right. And so I started going backwards and realizing, okay, this has been going on for a long time. And for some people that can be really, you know, sort of disheartening. But for me at where I was, it was a little ounce of hope because it meant that I could sort of stepwise, piecemeal, address inflammation in a way that I could tolerate. What I was really afraid of because I was so brittle, was having any kind of setback that would push me down further. And so if I could do it in a way that was more controlled and gentle, then it felt like something I could move forward with.

So what did you do? Or the things that helped you recover?

So, well, one of the things was, yeah, was I could... Because by the.

Way, chronic fatigue syndrome was not something most people recover from. fibromyalgia is not something people recover from. Unless you see a functional medicine doctor.

Right, right. Or have some one of those spontaneous remissions, which is one in a million probably. Yeah, so what I ended up doing also was distancing myself from the diagnosis and the prognosis. It was more despairing. My marriage was held together by a single thread. I had two young kids. I had everything to lose. So I was like, if I don't get my act together and start trying differently, then I'm going to lose whatever, what little I have left. So I was really motivated. And the first thing I did was really, I started reading about, well, I knew I had to get sleep. If I can't get sleep, I'm going to not have enough energy. So really looking, understanding the circadian clock. And, you know, I learned things that I was surprised I didn't know already. You know, I knew about the pineal gland and the hypothalamus, and we have this master clock, and we have jet lag, and that's why. But I didn't know about every organ having its own clock, its own rhythm.

Even a whole field of chronobiology where the different kinds of chemo is better given at different times of the day to work better. This is in conventional medicine.

Right, and it makes, I mean, it makes complete rational sense, right? So I started, first of all, being more regimented about just, okay, you know, I'm gonna wake up, you know, and get up out of bed, even if I feel kind of miserable, but I'm gonna, my body needs to know that that it's awake and that it's alive. So really basic fundamental steps. And I learned that when we deviate, I mean, particularly when you're brittle like that. I mean, of course, when we're more resilient, like now, I have much more flexibility. But when I was brittle, when you stray away so often from a routine, it causes stress on the body. So I was like, oh, okay, this is maybe an easier way.

Right.

I can reduce stress in my body. Yeah. Rhythm.

Yeah.

We all live disrhythmically. I feed my dog at the same times every day. Why don't I do that for myself?

You know?

And he gets walks now at the same time. Why don't I do that for myself?

So.

I started syncing myself also with my kids. Like, okay, I'm going to take care of my kids. I can take care of myself at the same time. So, I think that also as in that caretaker mentality, you know, as a mother or a partner or a doctor, is we tend to put ourselves last. And so it was kind of time to put myself first, you know, as my first patient.

That's good. And so you did the rhythm and what else? Changed your diet.

And then, yeah, and you know, a lot of it was just asking new questions. The diet piece, I thought I was eating, quote, healthy. you know, which was largely vegetarian. I was cooking meals, but also doing a lot of prepackaged meals, but you know, not a lot of processed stuff. And it wasn't until I saw an acupuncturist. So the acupuncturist that I saw, Robert Levine, who's in Berkeley, California, he was brilliant, really brilliant. He's still practicing and he's a good dear friend of mine, a mentor of mine. I learned a ton from him about understanding the body in terms of systems. So when my thyroid was out of whack, it wasn't just my thyroid. It was my whole hormone system.

Yeah.

Which is tied then to the digestive system, which is tied to the immune system. Like it suddenly started making- Bones connected.

To the thigh bone, right?

Yeah, exactly. And the body is connected to the brain.

Which is actually amazing in medicine that our entire training teaches us the opposite, that there's all these organ systems, right? We take the GI system and the liver and the lungs and the brain and the heart and the hormone. And you go to specialists for every different part of you and nobody connects the dots. Right, right. And traditional Chinese medicine is actually a system of thinking of the body as a system. And that's what functional medicine is. It's a systems thinking of the body.

Yes, absolutely. And so, you know, we can extrapolate that to, any size system, right? We look at our communities and our world, right? And one of the things I feel like that drives almost everything, if not everything, that we do as individuals and that we do as societies is how do I get more energy?

Yeah. Right?

My Qigong teacher was talking about that. How do we get more energy? You know, whether it's through, you know... Chi means energy. Yeah, whether it's through solar energy, you know, fossil fuels, whether yeah, I mean, it's food, nature, movement. So, you know, I began to shift my thinking in relationship to health and disease in a much more living sort of embodied way. So the, but the diet thing, he was the first one. He was like, you know, you're so deficient right now. Like, I think you need more meat.

Yeah.

Oh, and you need more of these heavier foods. Like you're doing lots of salads, which are great, but not for you right now. So I hadn't even thought about a personalized diet. And I was like, More meats? What are you talking about? And this is before Paleo days and all that.

Sure.

Meat was the enemy. I began researching ancestral diets and the work of dentist Weston A. Price.

And Price and Melvin Connor's work.

Right. And it suddenly made sense. Like, oh yeah, okay, I'm gonna eat like my ancestors ate. I'm gonna prepare food the way my ancestors prepared so I can maximize nutrient density. Nutrient density equals more energy. And then the gluten issue came up. I was really skeptical of it.

It's one of the biggest drivers of thyroid disease, Hashimoto's.

Yes, yes. And the celiac experts know that, but endocrinologists don't. So there's no crosstalk there either. And this is in conventional medicine, right? So, and I do remember asking my endocrinologist, like, what can I do? What can I do? And he said, nothing. It's genetic.

Oh, gosh, no, it's not.

It's a predisposition, but not predetermination. And so the gluten thing didn't actually arise. I think I was partly in denial about it. There were lots of rabbit holes that I knew about and I just didn't want to go down. as long as I was steadily getting better, it was my older daughter who, she was five at the time, I was taking her to her first dentist visit. And I felt like, as a family, we ate pretty well. She didn't do a lot of sweets, but she had not just one cavity at her visit. She had six cavities.

Wow.

Yeah. And I was floored. And the dentist kept saying, well, don't feel guilty. Don't feel guilty. And I was like, wait a minute. I wasn't feeling guilty until you just said that. But it made me investigate like something else is going on. Like I know how we eat, I know how she brushes, and I know cavities happen, but like six, it just it didn't compute. So I started researching and that's when I came across Weston A. Price's work around the condition of teeth tied directly to diet. Diet. But then going deeper and then in my research I came across gluten. and gluten causing enamel defects, gluten causing inflammation in the gut, which therefore could translate into poor oral hygiene or just conditioning of the gums and the teeth. And so that was just kind of another step in that process when I realized, oh, I gotta go back. And again, this is not unconventional. This is traditional Hippocrates said all diseases begin in the gut.

Right.

So we're just kind of going back and I realized I have to learn how to heal my gut as another step.

Did you still have digestive symptoms after that initial gastritis in China or did it get better?

They were largely quiescent until I removed gluten. I removed gluten and I had massive withdrawal. Diarrhea, irritable bowel, and again, this was kind of before the time that I realized I understood about detox and how healing happens is that often it gets a lot worse before it gets better and that it could be a good sign. So I was really frightened by how severe my reaction was when I stopped gluten. So I was thinking it was a bad thing. But then, you know what? I stuck with it and a week later it calmed down and then my health improved a notch. So and not only that, but you know, we changed the way that our whole family ate. And my younger daughter, so my older daughter's teeth really basically resolved. I mean, they became really strong. Some of her cavities even filled, like they recalcified and didn't have to get filled. My younger daughter who didn't really have anything that was alarming, but she had like this perioral eczema. which is this dermatitis, which is very difficult to treat with- It's often dairy or- With steroids, which is how we treat most dermatitis.

Anything red on the skin, they put steroids on it.

Exactly.

Why is the skin irritated coming from the inside, not the outside?

So she had that and she would get asthma when she got colds. And both of those are totally resolved.

Off of gluten.

Well, off of gluten, but also doing the ancestral diet.

So off of dairy.

Yes.

Yes.

And so it was just one of those things, I was like, you can't make this stuff up. And this stuff isn't written up, and it's very individualized.

But if you look in the literature, doctors say, Where's the evidence? Where's the evidence? Well, there's 900,000 papers published every year. Most doctors haven't read that many of them. And the truth is that most of the ones that are on these subjects are completely ignored. and when you put all the dots together, there's a pattern there in the data that suggests that these things are real, that there is something called leaky gut, that there is inflammation that comes from the microbiome, that foods do cause reactions in the body that lead to all these diseases, that heavy metals and toxins are an issue, that they cause disease. I mean, there's no lack of data.

It's just not data that doctors pay attention to in literature. Right. And it takes, on average, 14 years. I thought that was- 17, I think.

Oh, 17.

Oh, God.

That's not a good day.

For information.

That's not a good day.

For information and research to translate over to clinical care.

Yeah, I think it's a good day. The guy who discovered that we should wash our hands before giving any surgery or childbirth was basically ridiculed for suggesting that doctors could be causing their patients to get sick by not washing their hands. And he was basically exiled and ended up dying in sort of disgrace with no money. excommunicated from the medical community, semio wise. And it took 50 years for them to go, oh yeah, maybe we should wash our hands. Oh my God. Where's the science on that?

Yeah, right.

Well, it was in an ethmoid at a doctor, is that, oh you could suggest that a doctor would be causing their patients to die from childbirth fever because they didn't wash their hands. That's nonsense.

So it is tough to change medical paradigms. Right, right. But I mean, some of it is common sense. we don't need science to show us that, right?

Well, I mean, when they didn't know about bacteria, common sense was, you know, yeah, that's true.

That's true. Yeah. So, yeah, I mean, I kind of just did this stepwise progression to get to the point where I was much more able to get out of the house.

Yeah.

And then, and one of the things I also explored, which I would say maybe is down the unconventional path, was I began to shadow integrative doctors on.

Just.

Different paths in integrative medicine or sort of, you know, I didn't actually know about functional medicine at the time. So I was shadowing an anthroposophical medicine doc, you know, someone doing like sort of anti-aging hormone therapies. And then it was when I was shadowing a integrative pediatrician who said, well, what are you, this was, I mean, I was still unwell. I had taken off work for a couple of years. But I was starting to think, oh, how would it look if I were to return to work? What are the different ways I could practice? And it was the pediatrician who said, what are you interested in? I said, well, I love the traditional Chinese medicine paradigm. It makes so much sense to me, the systems thinking about the gut, being the foundation of healing. I'm really, you know, ancestral health, you know, figures into it. And she said, it sounds like you, you know, you're interested in functional medicine. I was like, what is that?

What's that?

What is that?

So, and she really strongly recommended that I go see the, take this course with Institute for Functional Medicine. So I, it was sort of a bone for me, right? Like I could, I was aiming to get healthy enough to be able to travel to go attend a conference. And so, and it came to Santa Monica, and I live in, in the Bay Area. So it was, it felt doable. It wasn't, yeah, across country. And, and I went, and it was, I think I had that aha moment like you did when you, you know, listened to Jeff Bland. I was like, oh, my God. Oh, my God. And, like, this is something that's been developed and developing, and there's a framework. I don't have to make this up.

-No.

-So it was a really important turning point for me. It gave me hope both in, you know, as a patient, but also as a doctor.

-What you just said was very profound, which is that prevention, as we think about it in traditional medicine, is absolutely not prevention.

-Exactly.

-Early detection. Do a colonoscopy so you can find a polyp or an early cancer. Do a Pap test, you can find early cancer. Do a mammogram so you can find early cancer.

How about not getting cancer in the first place? And that's what goes back to what I was just saying about the mammography. I would say to them, I'm not interested in finding out if you have early disease. I'm interested in helping you create a disease-free or cancer-free life or zone. And when we talked about hormones a little bit later, we'll talk about estrogen. and xenoestrogens and how that creates that environment for women that where they're more likely to get cancer. But that's going back to the point we need to prevent, not just detect.

Yeah, and I think that's what people get sort of confused about because doctors don't learn how to truly prevent. They learn how to detect. And what functional medicine is, it's really a science of creating health. So when you create health, you allow disease to show up, right? If you create a healthy system, which is going back to your osteopathic training, it's what functional medicine is, you absolutely don't have to worry so much about disease when you create health because the diseases often just go away as a side effect of creating health. You create an inhospitable environment. And we see this over and over again with, you know, diabetes and chronic illnesses where you actually figure out how to build and create the body's functional systems and treat the whole system, the diseases just kind of get better without actually treating them. They do. I don't treat disease anymore. And that's what we do at the Ultra Wellness Center here. We don't treat diseases. We create health.

And as a side effect, their symptoms go away and the diseases go away. Yeah, and it's hard work. When I practiced traditional medicine, it got to a point where you weren't required to think necessarily too deeply because you have specialists, everything got siloed, right? We learned that basic science of interconnectedness, we learned all the beauty of the organic organicity of the body and how it can heal itself, and then we forget it, and then not only do we lobotomize it in terms of our science and thinking, we do it as a system. We break it all up into organ systems, and then we're in trouble because now one silo is not talking to the next. next, I would refer somebody for a rheumatologic problem, very bright doctor would see my patient, and if it wasn't a rheumatologic problem, the patient came back and told me, nothing you can do for me, told me to go back to you. I didn't get even an idea of where else I should look or a collaboration of here's what I did find and here's what you might want to look next, but it's not in my purview. It was isolated silos. So, you know, developing, you know, starting to think about functional medicine, it's really hard, well, before we think about functional medicine, it's really hard for a patient when they're sick to get better if nobody's integrating the whole message, all the data. And so as a family doctor, I took a lot of pride and I put a lot of emphasis in being that quarterback for my patient and trying to get as much of that information to integrate create a good health plan for the patient, hopefully to get them better, then to help them not only be better but to optimize the performance. And in functional medicine, we do that. And here's the really cool part is we have the time to do it. You don't have the time to do it. In conventional medicine, so you have silos, you have no time, and now you're treating really chronic disease and you just can't do it.

Yeah, so I think that the point you bring up is really important because when we're trained in traditional medicine, the rheumatologists do their thing and they just focus on the autoimmune stuff. The gastroenterologists focus on their lane, the neurologists focus on their lane, and on and on. And people go from doctor to doctor and are super frustrated because they have all these symptoms. When people come in with 10 or 15 different diagnoses, I'm like, is this just a coincidence? And they're all treated separately. The headaches are treated by the migraine doctor. share their rheumatology, doctors treating their joint pain, their gastroenterologist treating their IBS and so on and so on. And they're getting different drugs for every different symptom. Instead of going, well, gee, is this just a coincidence or is there something linking all these things together? And how do we think differently about them? And that's what functional medicine is. It's a way of thinking differently. So you mentioned, you know, the rheumatology issue and you mentioned the gut. You know, the microbiome is one of those areas that is blowing apart our traditional concepts, right? So the microbiome is this ecosystem of bugs in our gut. It's trillions of bacteria. it outnumbers our cells by 10 to 1 and outnumbers our DNA by 100 to 1. And it has been linked everything from autoimmune disease to cancer, to heart disease, to diabetes, to obesity, to autism, to Alzheimer's. I mean, the list goes on and on. So when you go to the rheumatologist, they don't go, how's your poop? But we do. Absolutely. So let's talk about the gut in connection to some of these diseases. We treat something a lot that's called SIBO. Now, when I went to medical school, this wasn't even a thing. but essentially it means small intestinal bacterial overgrowth, which means bad bugs growing in the small intestine where there should be sterile that have an impact on our health. So what are the symptoms? How would people know they have it? And what kinds of problems are they connected to? And let's kind of get deep into what our approach to diagnosing and treating it's going to be. Sure.

So, you know, I just want to be a little cautious here because we're jumping right into talking about a disease. Yeah, right. Well, it's not a disease. It's a phenomenon.

It's a phenomenon. causes all sorts of other problems.

Right.

We do have to give things labels, but it is a phenomena that's connected to many different parts of our body and getting somebody better involves the whole lifestyle spectrum and it involves us using something in the functional medicine realm that we call the matrix. And the matrix is looking at not diagnoses but conditions.

Yeah, let's talk about the matrix.

Yeah.

Tell us more about the matrix. What is the matrix? How does it differ from traditional diagnosis? And why do you use it?

For me to tell you about the matrix, you have to swallow the red pill. Which one do you want to swallow? I think I'll take the red pill. Okay, take the red pill. That's the right pill. Okay. So anyhow, now I can tell you about the matrix. So the matrix is basically a construct that we have in our minds where when you start telling me, I have headaches, I have fatigue, I have belching, I have bloating, I have a diagnosis of Hashimoto's thyroiditis.

-Migraines.

-Migraines. -They don't become the endpoint. They become part of the narrative of your disease. And we put it together into a story we call the matrix. And so we look at assimilation, which is the gut. We look at energy that takes us from an idea of fatigue, we rattle it down on our brain to what are the things in the body that control energy? energy, right? And so we think about mitochondria when we think about energy. We think about toxins. How do toxins influence the rest of your well-being? We think about our transport system, our blood vessels, our lymph drainage, and the connection between lymph drainage in the brain and your gut, leaky gut, leaky brain, things that we'll talk about. And we think about the hormonal system, neurotransmitters to adrenals to thyroids. We place this all in our mind in this matrix, this paradigm of thinking, and then we make the connections. We say, okay, what's SIBO? Okay, well, it's going to be symptoms: bloating, distension. I feel like you've used the term food baby. There's something always in my gut.

Yeah, you have a food baby, something and you feel your belly bloat up. That's called SIBO.

Right, that is SIBO. You don't feel like you fully evacuate when you have a bowel movement. you're fatigued, you get depressed and you can actually feel your depression and it's related to how your gut feels. I had that food baby, I'm anxious, I feel depressed, it impacts my life.

And it can link to all sorts.

Of other diseases, right? Fatigue, and then when we think about fibromyalgia, we need to think about the gut and what's been impacted there, and we think about Parkinson's, 50% of people with Parkinson's actually have SIBO. Now, asthma. And we don't know. We know there's an observational connection there, we don't know anything about causation. causality, but it's something you have to consider when you're thinking about other diseases. So, the fatigue, the brain fog, the potential inflammation and joint pain, all of the gut issues, that's SIBO. And a lot of SIBO, we don't know all the causes. There used to be some standard ideas what the causes were, but now we know that it's hard to determine. So, the use of proton pump inhibitors.

And other- Acid blockers like Prilosec, previously, all that stuff.

All that stuff. And then we have stress plays a major role. And so that's some of the cause that's a CIBO can look like. And now how do we address it?

How do we get back up for a second? You mentioned these acid blockers because, you know, they're giving out like candy. You can buy them in the drugstore. They're over the counter now. And people think they're safe and fine. I remember when I went to medical school, they just came out. and we were told by the drug reps, these are very strong drugs. They completely shut down acid in the stomach. You never want to give them more than six weeks. And now people are on them for six decades, you know? And what they do is pretty frightening. Literally, they will help your heartburn, but the side effects, which are not really side effects, they're effects. We just don't like them, so we call them side effects. Are bloating and diarrhea and distension, all the SIBO symptoms. And by the way, they cause osteoporosis and pneumonia. and prevent B12 absorption and zinc absorption and mineral magnesium absorption. So, they're not exactly the same.

I just have to say this, Mark, and you know, is that this is the concern we all have for medicine when we've been unplugged. And this is the issue, is that we have pharmaceutical companies that provide medications to our patients support sick lifestyle that perpetuates disease.

Yeah, love those advertisements on TV where they're like, Don't worry, eat your sausage and peppers and don't worry, just take this Prevagen or Prevacid, take the purple pill. It's ridiculous.

It is. But on the functional medicine side, here's where the hard work is, changing the lifestyle to make it a healthy lifestyle so people can be healthy, prevent disease. If they do get sick, then we help them change lifestyle because that can impact disease more than anything else. and then for people who are well or have gotten better, we can use lifestyle to optimize their aging. And again, using a term, I've heard you use age young, you know, and that's part of what we do here at the UltraWellness, the whole spectrum, prevent, treat, and then help people optimize and age young.

Yeah, my goal is to die young as late as possible.

So, back to the SIBO thing, right? It's a, you know, so once we we make that. Now, how do we make the diagnosis? So, I always tell people tests are good, but there's no perfect tests. And, you know, your cognition, your doctor's ability to think through problems is the most important thing that they do.

That's what we do in functional medicine, right? We are thinking differently. My mentor, Sid Baker, who's one of the leading, I think, medical minds of the last century, who's really pioneered a lot of the visionary concepts of functional medicine. He says, we're in the name it, blame it, and tame it game. We name and blame. We name the disease and we blame the name for the problem and then we tame with the drugs. So we say, oh, you're sad and hopeless and helpless. You have depression. That's what's wrong with you. No, it's just the name of what's wrong with you. It's not the cause. Then we go, I know what you need.

You need an antidepressant.

And that's like, it just doesn't make sense. Instead of, oh, we're doing functional medicine.

It'S called thinking and linking.

We actually think and link. Everybody everybody, you know, thinks you treat the same disease with the same treatment. And in functional medicine, you can have.

10 people with migraines or treat everyone differently.

Everybody's different. Absolutely. 10 people with lupus and everybody's treated differently because you're looking at what the root cause for them is. And. Right. I think that's really profound. Yeah. And I want to get back to the SIBO thing, but I just want to come back to the Matrix because that's such a key concept. And, you know, you described all these biological networks, you know, assimilation, which is a gut. defense and repair the immune system, energy, how we make energy, detoxification, our transport system, our circulation, our communication systems, hormones, our transmitters, our structural system. And all those are influenced by our lifestyle, right? By our thoughts, our feelings, our relationships, our diet, our exercise, our sleep, all those things. Intrinsic relationship. Yeah. And then they're also influenced by external factors like toxins, allergens, bad bugs, stress, poor diet, and those impact our genes to change the expression. And so we have basically our inputs that are a problem and then our lifestyle and that causes disturbances in these systems. And no matter what disease you have, we use this model and every single chronic disease and even acute, many acute disease are caused by disturbances in our biological systems. And that is what functional medicine is so unique at diagnosing. and treating in a totally new way.

Absolutely. And so it's that constant work around the matrix. And one of the things that I said earlier is functional medicine is hard medicine. It's hard for the doctor, it's hard for the patient.

Yeah, because you think you have to think.

Right. And you're constantly thinking and as you treat the environment of the patient changes. So you begin the treatment plan, and the patient comes back with a particular response. And that response will be based on what is their lifestyle, what part of their lifestyle have they been able to change? Because it's a real struggle for people to change lifestyle. That's hard work. And then, you know, what are their genetics? You know, and how are their genetics? Because we, you know, use a lot of genetic testing here that help us identify that. And so once they come back and they've responded to our first step of treatment. Then we go around the Matrix again.

Yeah.

And we rebalance and we look. Okay. Okay.

It's like tailoring.

You adjust every time they come. It's like. It's like a fine watch. And you're just constantly working the gears, asking questions, having them tell their story again, retell their story. I can't tell you how many times I have sat in an hour and a half initial visit, only to have the patient come back over. Over Zoom or a physical visit to the office. and I ask them the same questions and all of a sudden they're in a different place and I get a different answer that opens up a whole new realm of thinking about their disease, their health, and even their goals for their life. So every time I go around the matrix, I get that person better and better and better.

So we don't treat 155,000 diseases, we just work with optimizing our biological systems in the matrix. That is the key to functional medicine. In a way, it's very simple, but it's also very unique because each patient's different. And for the patient, some of the changes are hard because we're asking people to change their diet or take different supplements. But the truth is that it's actually, you know, ends so much suffering and helps them so much that people are so excited about it. Oh, they do it. And so it's actually, in many times, very easy for patients to change because they see the results so quickly. So, let's talk about the SIBO. Let's get back to SIBO and talk about its cases. I think we should share some cases. We should give an example of what we're talking about. Because it's sort of abstract.

I would say that very rarely do I see SIBO by itself. And why is that? Because, Mark, you've already talked about it's the microbiome. When the microbiome is disordered as it is in SIBO and you have these bacteria growing or they shouldn't grow. And so, you're now changing how food is processed, you're changing where it's processed, and you're changing the body's ability to absorb it. And what we know about the microbiome is those bacteria actually train our immune system. They're very closely related to our immune system, and they will, our immune system identifies antigenic material from the bacteria, and the bacteria is able to tell the immune system, here's what you need to be worried about, here's what you don't.

Need to be worried about.

And so when we alter that gut immunity, we can create inflammation and we create inflammation, we begin to break down that membrane that's responsible for opening and closing and letting good compounds and good nutrients in and keeping the bad guys out. When that breaks down, we have leaky gut. And now all of a sudden, our immune system starts to see proteins and that have not been completely processed down to the peptide level that they're accustomed to, and they start making antibodies against commonly eaten foods. So now this person with SIBO is sensitive to a plethora of foods that they eat every day, which they might not be allergic to those foods, but they're sensitive to them. So now they're not eating. So they're coming with all these symptoms. It gets exacerbated by almost everything they eat in their diet. And it, because now the disease is-.

They're cross-eating and they don't know what to do not eat because everything bothers them.

Right, right. And so, now they can come in that sick. Now that their immune system is triggered, they have muscle aches, they have joint pains, they have brain fog because now they're having fatigue. They have fatigue, their mitochondria being affected, their brains are inflamed. they're being affected. So now this person comes in and they may say to me, I have brain fog. I have this, I have that. I get the whole story and I hear the gut. Always start in the gut, right? So now what do we do? When they tell me there's symptoms, we order a test. It's called a small intestine bacterial overgrowth test. Before you end the testing, I just.

Want to recap because what you said was so profound.

Yeah.

Which is that...

I like being profound, thank you.

No, I mean, it's a total frame shift. So most doctors don't think much about the gut unless you have direct digestive symptoms. And even when you do, they treat it kind of in a very linear way. But what you're saying is when those bugs that should be in our large intestine migrate up to the small intestine for various reasons, it causes an imbalance in there. And that leads to a breakdown in the barrier, which causes this leaky gut. And then all these foreign proteins and bacterial components leak into the system. Your immune system goes, ah, that's not me. And it starts creating a response. And then you get systemic inflammation, which is why you get brain fog and muscle aches and fatigue and joint pain, all these things. Skin rashes, acne, whatever. And, and, and people think these are.

All not connected, but they're all, they are connected. That's why SIBO is such a great.

Topic to start with.

Yeah.

Because it connects the entire Matrix. So tell us how we test for it. Now let's get into a case. okay, so testing will be with a breath test. It's a, it's called a SIBO breath test. And we starve you for a day. Basically, we want to starve out those bacteria that are living in the small intestine, so they become metabolically inactive.

And then you wake up in the.

Morning and you take some lactulose, which is like a non-absorbed sugar. Not non-absorbed sugar. But before you do that, you breathe into a little balloon, and then we put that aside as your Baseline test. Then you drink the sugar drink, and now the bacteria are like, we got some food. We're excited. We were starving out, thought we were doomed. and then they get very metabolically active. And then within 30 minutes or 60 minutes, when they're metabolically active, they start producing the exhaust of their metabolism, hydrogen and then sometimes methane and even sometimes sulfur gases.

So, it's not just the cows that are burping methane?

Nope. Humans. Nope.

Yeah, Uncle Art's been built up.

So, if you have SIBO, you're contributing to climate change, is that it? Yep. That was gonna be, when we get.

To the magic wand question, I'll talk about my wife.

Yeah.

So there's also other tests, like urine tests.

You can look at metabolites, right? Yep. You can look at. Yeah. So, yeah, we can look at metabolites that will show us markers for dysbiosis in the gut using an Organics test. So an Organics test is when we look at all the organic acids that are products of your metabolism. And so we're able to tell, we know what should be, you know, in the metabolism appropriately, and we can look.

At organic acids, and we do that as a part of our GI work, which is a test. traditional doctors don't do. They'll do the traditional breath test, but.

They'Re not going to do an organic acid test. Organic acid test for something even more advanced called an ion profile that looks at all of your amino acids. And that's important when I do a SIBO workup because if I look at your amino acids and you're depleted, then I know you're really in trouble with your SIBO because you're not getting good nutrition, you're not absorbing. And then I can see markers of inflammation on the ion test. I can also see the organic acids are really critical because there are things that the bacteria produce that will end up in our urine that indicate to us that, wow, those things are in the urine because you have bacteria overgrowing or don't belong in your gut. And now we find out.

I think you're right. I'm going to jump in with a case that just reminded me of a little girl I saw years ago who was nine years old and she's a pretty little sweet looking girl who was a monster. her like a terror. She would constantly get kicked out of class. She literally couldn't make it home on the bus without the bus driver having to stop 10 times to settle her down. She was violent. She would rip, you know, her pictures of a part of her family at home. She would terrorize her sister. And I'm like, what's going on with this girl? Right. And we did a whole workup, and we found her organic acid test, and we found she she had massive levels of overgrowth of bacteria.

Yep.

And she had overgrowth of yeast, which is not called SIBO, but SIFO, or small intestinal fungal overgrowth. And what I did was I gave her an antibiotic and an antifungal, and literally the girl completely transformed. So you think you're treating a psychiatric disorder. Absolutely. With antibiotics and antifungals. How does that make sense? Well, it makes sense when you understand the connection. between the gut and the brain. I mean, this was over 10 years ago and I remember writing about it in the UltraMind Solution. I was like, wow, you know, the gut is so connected. I had another one with OCD, the same thing. She had high levels of ammonia and she had severe OCD. She wouldn't put up anything off the floor. I gave her an antibiotic and literally.

She became like a neat freak. It was the weirdest thing. Oh, you know, so I would, so in those cases, in the cases I've seen, SIBO is very commonly related. to neuropsychiatric disorders. So when I have people with memory loss, brain fog, ADHD, just as you've said, I've had multiple patients of mine, autism. The first thing we do is treat their SIBO, change their diet, and within the first six weeks, we're starting to see significant change in their behaviors with ADHD and in their verbal abilities with autism kids.

So.

That I was going to talk about a fibromyalgia case, but I will talk about a ADHD. I had a actually an anxiety depression case.

Talk about both of them.

Yeah, I'll talk about them. There's so many cases I could choose from. Um, there is, um, a recent case, um, from a patient from a different part of the world, actually, came in and they were having lots of difficulties with their child. very bright siblings, but this particular child was having lots of issues with impulsive behavior, attention in the classroom, moodiness, to the point where there was the child would speak of not wanting to live anymore. And so I went through all their symptoms and the biggest thing that this child had difficulty with was the bloating and the distension that was constant. Mom noticed it from almost day one of life. So, we did not only the SIBO breath test, but we did something called a GI MAP test, which you'll look at, it will using DNA and PCR technology, look at all of the bacteria in your gut, the major colonies, the major species, look for Candida, and then also look for markers of inflammation. Those two tests on this patient indicated severe disruption of the balance of the microbiome. The patient was put on a brief elemental diet, which is a diet that takes out most foods.

All the foreign proteins.

All the foreign proteins and then was put on an autoimmune paleo diet. And very difficult to put a kid on a diet.

Which basically starves a lot of the bad bacteria. Absolutely. Instead of feeding them with all the starch and sugar. sugar and carbs, which they love, you're giving them less of that.

And we combined it with a low FODMAP diet to make sure that the.

Child got all the nutrition they need.

FODMAP is like what? It's like- so those are long chain sugars that get fermented very quickly by bacteria and when you eat them and.

You have small intestinal bacterial overgrowth, you.

Get a very big food baby. You start nine months pregnant. Right, you know, and the food baby is this, basically. You're fermenting food where you shouldn't be. Food's meant to be fermented in the large intestine and that's like Florida, right? But, you know, what's happening with small intestinal bacteria over with bacteria up in Maine and the food's coming into Maine, Maine's not ready for gas. So now, all of a sudden, you've got this gas where it doesn't belong geographically, you feel very uncomfortable and it starts to impact everything we talked about, your nutrition, your inflammation, and that translate to that gut-brain connection. The brain gets affected. That's why we see so much benefit when we treat diseases like SIBO and dysbiosis in our patients with neuropsychiatric disorders from ADHD to OCD to anxiety and depression. And you've noticed it. I know we've talked about even like Parkinson's and other disease processes that will stabilize once we start addressing gut issues.

So what happened to this kid then?

So within the, when we had the six-week follow-up and we had started, it was actually not the six-week follow-up but the six-week follow-up we went over all the testing and we started the second part of the nutrition plan. Once we started the nutrition plan, and I used some natural herbs to get rid of some of that overgrowth, sort of antibacterial herbs. Antibacterial herbs that come in different compounds that we use. At the eight weeks later, that child's behavior, the mood swings were completely gone. Yeah, completely gone. Impulsivity was drastically reduced and the teachers were saying he was now paying attention in class. And that was just with food. No stimulants. That's remarkable. No stimulants.

Just herbs like oregano and oregano, and thyme and things like that. Absolutely. Yeah, powerful stuff.

Yeah, and so that's the SIBO story. Yeah, it's that gut-brain connection.

It's so powerful. Brought back some bad memories because we talked about the food baby. When I got sick, sick from mercury poisoning almost 30 years ago. One of the things mercury does is it interrupts all your enzymes and your functions. So, my gut became very dysfunctional. And, I remember literally having food babies all the time. I literally almost couldn't eat anything without my stomach blowing up and feeling like someone just pumped my intestines up like a bicycle tire. And, at that point in time, we didn't really think about SIBO. We didn't really name it and we weren't really aggressively treating. I was trying things that I thought would work, but it was really tough until I got rid of the mercury. I couldn't get rid of the SIBO. So often there's something underlying it, right? There's often a root cause. I've seen people with gut issues that maybe were caused by Babesia, for example, which is a tick infection.

Oh, absolutely. So Lyme disease. Paralyze the gut. Right. So if I have a SIBO patient, it's not getting better, I think two things. One is I think about Lyme disease because if one of the symptoms of Lyme and is a trigger to test somebody for Lyme is when they get Bell's palsy. Lyme disease can affect the nervous system. And so, Bell's palsy is when you have your facial nerve is paralyzed and it can be caused by Lyme. The same thing can happen in the gut. You can get a paralysis and a dysfunction of the migrating motor complexes and now the peristalsis of the intestine is declining. The intestine won't move.

Now these bacteria can stay there and populate. So again, It's all these things. And that's the thing, you know, when you go to a traditional gastroenterologist, you might say, okay, we do the breath test, you have SIBO, take these antibiotics, forget about the yeast stuff, and like I'll see and hope cross your things. And there's so many times it fails because they're not getting the root cause.

So, the root cause may not be SIBO, it might be something that's causing the SIBO, like lime or like mercury or something else. And there's something else too, going back to lifestyle. When I can't get a person better with SIBO, and I start going around the matrix again, are you sleeping? Are you exercising? Are you, how's your marriage? How your relationship? Do you have a toxic relationship? Because the people that I've done everything for, I've given them bone broth and colostrum and elemental diets, they're not getting better. It's the fifth R. We use the five Rs, right? We use remove, repair, restore, And I can't remember before.

It's remove, replace, reinoculate, repair, rebalance, rebalance.

And the rebalance piece, the fifth R, I call it fifth R. It's the fifth R. It's getting people to rebalance their lives. And that is basically, are you dealing with your stress? The people that aren't dealing with their stress aren't getting their sleep, aren't exercising.

And how does stress have to do with your questions.

That's another podcast.

Come on. Give us a nugget here.

Okay.

So.

Stress. So stress is probably the start of all disease. It impacts everything from your hormones in your own body, but stress actually creates some neurochemical changes in your brain. and there's a communication between your brain and your gut microbiome.

And your gut, it's called the second brain.

It's the second brain, right? Well, some people think the gut was the first brain. Maybe.

Right.

You know, and that our brain only developed once mitochondria, we're starting to make energy for us, and then we're able to convert, use that energy to make a second brain that allowed us to reason and so forth. However, once you have that gut brain connection, stress can actually you know, we have this vagus nerve. It's a superhighway from the gut to the brain.

And more, there's actually- It's the relaxation nerve.

It's the relaxation nerve. And your brain can communicate anxiety and stress to your gut microbiome and actually.

Change the makeup of your gut microbiome. And your nervous system. And your nervous system. And it literally paralyzes, stress hormones literally paralyze your gut. Your sympathetic nervous system and your fight or flight, you don't want to be digesting your food when you're running from a tiger.

You want your gut to shut down so you don't have to poop or do anything else.

Your gut shuts down and that's what happens. We live in a state of chronic.

Stress and our gut's not working. It's not working and then you end up with, you know, now you create.

That environment for SIBO to develop.

Yeah.

Hey YouTube, if you like this video, you're gonna love the next one. Click on it to check it out today. If you are suffering, there is a.

Road for most people that recover. Stress is probably the start of all disease.

Your doctor says your labs are fine, you don't have Lyme, but actually if you look deeper, you can actually find it. I always tell my patients, that's like.