The 3 Steps To FIX YOUR GUT HEALTH & Live Longer! | Steven Gundry & Mark Hyman

The more you stay away from processed foods, from ultra processed foods, that's really the fundamental starting point. The more you actually use whole foods, the better off you're going to be. The microbiome talks to the mitochondria, and my eyes went up and I said, well, how do they do that? And he says, well, we don't know yet, but I'm telling you, We're going to find out that the microbiome talks to the mitochondria because they're literally sisters.

And I said, well, you know, that's interesting.

He says, yeah, they send text messages. Well, lo and behold, Marlin was right because the language, what's called the trans kingdom communication system of how the microbiome talks to mitochondria and to our DNA. was discovered. And it's as big a discovery as the Enigma Code discovery in World War II, the German Code. So what that discovery was is the discovery of postbiotics. And postbiotics, everybody knows probiotics friendly bacteria. Most people are learning prebiotics, which are the fibers that friendly bacteria need to eat. But when those bacteria eat those fibers, they produce either short chain fatty acids like acetate and butyrate, but more importantly, they produce gases. And they're called gasome messengers or gasotransmitters. And it's these messaging system that's now been discovered that actually talks actually tells mitochondria what to do, whether to make more energy when things are good or whether to throttle back because things are bad down in the engine room. The whole discovery is like, holy cow. We are this incredible symbiotic organism. For instance, the Nobel Prize for discovering how nitric oxide works and where it came from. was awarded in 1998. For years in cardiac surgery and cardiology, we knew what nitric oxide did, but we didn't know how it did it. But nitric oxide is a gas-o-messenger. But here's something really wild. Hydrogen gas is a gas-o-messenger. Part of the fermentation process, of bacteria eating fiber is to produce hydrogen gas. And hydrogen gas is the world's smallest molecule and it diffuses right across our gut wall. And one of the shocking things as I was researching this is if you look at patients with Parkinson's disease, they have a microbiome that does not make hydrogen gas, whereas people who don't have Parkinson's disease have a microbiome that produce hydrogen gas. And you can give patients with Parkinson's disease, hydrogen water. And that's the water that has hydrogen dissolved in it. And they will symptomally improve once consistently start taking hydrogen water. And so, as I joke in the book, in Boy Scouts, what we used to do, you know, we'd eat beans on the camping trip, and we'd have bic lighters, and we'd actually literally light our farts with this blue flame.

I've seen that happen at a campfire a couple of times.

Exactly. That's hydrogen gas. And little did we know.

So methane too, maybe.

I don't know.

Exactly.

Well, it turns out that is actually a gas-o-messenger as well. As well as hydrogen sulfide, that rotten egg smell. And for years, you and I were taught that hydrogen sulfide is a toxic gas. but we now know that the effect of hydrogen sulfide is that of a hormetic agent. And a hormetic agent is basically that which doesn't kill me makes me stronger. So that no hydrogen sulfide is not good, a little hydrogen sulfide is good, but a lot of hydrogen sulfide will kill you. So a little dab will do you of these things. And so getting back to your original question, the more we feed our microbiome, the foods that they can make these literally text messages that tell your mitochondria to produce energy, the better off we are. And again, you look at a tribe like the Hansas who they eat about 165 grams of fiber a day. if we're lucky, the average American may eat 20, probably not. But there are what?

I think it's eight is the average American. Yeah, if we're lucky.

And half of the five we eat is actually insoluble fiber, which is actually really bad for you in a lot of ways. So long story short, we are so deprived of the energy producing compounds that are available to all of us if we'll just feed the microbiome what they need. And that's a big part of both.

So a lot of the key is.

Fixing your gut to get your energy back.

Yeah.

The second key is we are overfed and underpowered. And what the heck does that mean? We in general, Americans eat nearly 16 hours a day, almost continuously from sun up until well after sundown. We have what's called mitochondrial rush hour, which living in LA is easy to understand, but simplistically, our mitochondria can handle sugars, fats, and proteins. And we use a slightly different system for making energy from sugar, from fat, and from protein. And in the good old days when we ate whole food like you advocate and I advocate, these different components, sugars would arrive first in the mitochondria. They'd be followed by protein sometimes later, and a long time later they'd be followed by fats. and mitochondria have, if you will, basically a freeway, an energy producing freeway. Now, when these things arrive in a staggered fashion, the freeway moves great. But what happens is with our modern diet with processed foods, with ultra processed foods, we have combined simple sugars, simple proteins, and easily absorbed fats that hit our mitochondria simultaneously. And the mitochondria actually can't handle all these. So we actually have stagnation in the energy producing highways. And we have systems on freeways, okay, we're gonna have traffic lights that's gonna control the onslaught of all this, but we get mitochondrial gridlock. and I use the example. So, okay, let's have breakfast at 7 o'clock in the morning. All of a sudden you're slamming with all three of these components and your mitochondria literally go into gridlock for two or three hours. You begin to get sleepy at 10 o'clock and you say, oh, I need a little pick-me-up. I'll have a donut and a cup of coffee. And once again, traffic gets slammed. By that time it's lunch. we slam it again. And so this process of gridlock really never stops until we go to sleep. And even after we go to sleep, there's still two to three hours of backup, if you will, on the mitochondrial freeways. So our mitochondria is really never have a chance. And in researching this book and trying this out on my patients, one of the things that was dramatic was that if I could lessen the period of time that you're asking mitochondria to handle food, the better off you're going to be because they have a chance to recover and heal themselves, if you will. And that gets into part two of the book. How do you put this into practice?

So your book is quite extensive and.

It really goes into detail about a.

Lot of these unusual compounds that come.

From a disturbed gut microbiome that have broad spectrum challenges in the body. This is what we've been doing in functional medicine for decades. It's really the foundation of my practice. It's really the key to getting people healthy. I sort of agree with you that a lot of the beginning and the end of health starts in the gut. It's really always the first place we start with food and gut repair and functional medicine. But you talk about the plan of how do you do this? What are the dos and don'ts? of the energy paradox when it comes to eating?

Well, first of all, the more, and you and I, I think, would agree completely with this, the more you stay away from processed foods, from ultra processed foods, that's really the fundamental starting point. The more you actually use whole foods and literally foods in their whole state, the better off you're going to be. Number two, I can't resist telling people to get lectin containing foods out of their diet. Lectins are part of the plant defense system against being eaten or having their seeds being eaten. These are proteins that Dr. Fasano and others have shown disrupt the gut wall. and they in themselves are antigens that in my original line of work, heart disease attract inflammation to the wall of blood vessels. And so they're a nasty bunch of compounds and they're in so many of our favorite foods, such as whole grains. The nice thing about beans is beans are loaded with lectins, but pressure cooking and soaking beans and fermenting beans actually eliminates the lectin problem.

So there's no pressure cooking grains do the same thing?

Great question. Pressure cooking will not break the gluten in wheat, barley, or rye. Gluten resists pressure cooking. There is a gluten-like protein in oats. that also resists pressure cooking. And I can't tell you the number of people who have gone on a gluten-free diet with autoimmune diseases with celiac who are not cured, they still have celiac, because the foods that they're eating, like oats, like corn, are loaded with lectins. And just recently I had a gentleman who we, I don't like to use the word cured of rheumatoid arthritis, but his markers vanished by following our program. And then he was a snowbird and he came back this winter and his rheumatoid, one of his RA markers was elevated for the first time in like four years. And I said, you've been cheating. He said, no, no, no, are you kidding? I wouldn't do that. And I said, well, something's getting into your diet. I said, what do you have for breakfast?

He says, oh, glad you asked.

I've been on a pressure cooked oatmeal kick. Every morning I have a bowl of pressure cookouts. And I said, wait a minute, you can't do that.

It's on your list.

You can't pressure cook oats. And we pull out the list. He said, oh, oh no, that's the change. And so we took it out.

A month later, his RA was back to normal. Yeah, absolutely. I see that so often. Yeah, I see that so often. So getting out lectins, eating whole foods, Any other sort of key dietary do's and don'ts?

Yeah, so one of the, I think the shocking benefit of time-controlled eating, and that is limiting the amount of time during the day that you consume food, is probably one of the number one fixes in our current energy crisis. And it seems almost contradictory, paradoxical, if you will. You, the more you kind of snack throughout the day, the actual harder it is for your mitochondria to make energy. And the more you limit.

Yeah, you have to eat to get.

Energy, but what you're saying is if you stop eating, you actually are better at, at the end of the day, making more energy.

Yeah, that's exactly right. I'll give you an example. We're actually supposed to have significant downtime for repair work, for repair work for our brains, repair work for our mitochondria. And that would normally have happened because we were sunlight creatures and we were controlled by sun and we get up when the sun came out and we basically go to bed when the sun went down. And even the advent of fire 150,000 years ago, we were still exposed to orange light and red light and we certainly weren't exposed to blue light. So we still had a limited period meeting. And the evidence is if we have a 12-hour window of no eating, which is really easy if you think about it, that's 7 a.m. to 7 p.m. That's a 12-hour eating window and you'd have from seven PM to 7:00 AM of not eating, we begin to shift into mitochondrial repair. And what's really exciting is the more you go beyond 12 hours, the better the repair work goes. Let me give you an example. There's not a lot of repair work done on LA freeways during the day because the traffic is so bad. I drive into LA very early in the morning or to Palm Springs very early in the morning from Santa Barbara, and that's when the repair work's going on. because there isn't much traffic on the road. Well, our mitochondria do the same thing. If they're doing work, they have no time to repair. And it's the repair of mitochondria undoing the damage of our eating that actually allows mitochondria to get back to full power. So the more we can limit the time period that people eat, the better.

I always tell patients that When you're eating food, you want to be choosing your food, not just for you, what you like, the things that are pleasurable for you, but you also want to be feeding the good bacteria. And we talked earlier about the Akkermansia muciniphila. That's a specific bacteria that is in the body and that you want to have on high levels. And when we do the testing, we can actually determine do you have high levels of it or do you have low levels or do you have no levels or very low levels. And there are certain foods which you can incorporate into your diet, things like pomegranate and and maca and acacia fiber cranberries and things like that. These are foods which are basically pre-pre prebiotics. And when you incorporate them into your diet, you, it's like putting Miracle Grow on that garden. They start to flourish, they start to take over, and they help balance out the whole ecosystem.

Yeah, I think it's one of the biggest advances in our thinking about gut. We've done give probiotics and that'll fix it. But, you know, you're giving like 50 billion is a lot, right? But you have a hundred trillion bacteria. So it's like a drop in the ocean. Exactly. And one of the big insights I had was actually from an experience I had last year where I developed colitis. It's a long story, but I had been sick for mold and I've told that story and I had a recurrence of my gut because I had the C. Diff and that was kind of really messed me up. And I checked my stool and I had really low levels of this Akkermansia, which has been linked to autoimmune disease, been linked to poor response to immunotherapy for cancer, it's been linked to cardiometabolic disease and diabetes. and I'm like, whoa, this is not good. So I started to research it and created this cocktail of cranberry, pomegranate, green tea, acacia fiber, some probiotics, other prebiotics. And I took it and it literally within three weeks, I went from full-blown colitis to completely normal, perfect.

Yeah.

And it was sort of a wake-up call for me, which was, you can't just get probiotics, you've got to feed the whole inner garden. And what it likes is certain foods, and it likes all the polyphenols.

Yes.

And the polyphenols. The colorful the dark, rainbow-colored chemicals that are in plant foods. There are certain plant foods have more.

Of them like the berries and so forth. Absolutely. Yeah, the polyphenols are goal. And to me, I think that's actually probably one of the things that plays a role with the French paradox is the polyphenols that are found in red wine. I think that's definitely what you're doing is you're actually feeding the patients love me because the two things that I.

Always prescribe to my patients is chocolate and red wine.

Right. And they're high.

I say people like wine drinking, but I wouldn't give it as an extra thing.

No, right, right. What I'm just razzing, but the polyphenols are the miracle food prebiotics for the gut, absolutely.

So tell us a story about a patient who had a screwed up microbiome and what you did and how they got better.

Oh, I've had, I mean, multiple patients. I mean, for example, I just had a patient this, I followed up today. 18 year old with fatty liver disease and sort of pre-diabetes picture. And lo and behold, I did the testing for him, and his acromancy mucinophila was almost undetectable.

Yeah.

And now fatty liver, typically, like you said, we used to see that in patients who were drinking alcohol. What we're now finding out is that fatty liver is the thing that is being driven by disruption of the gut microbiome. So what's happening is When you destroy the mucous, the protective mucous lining of the gut, some of those bad bacteria get into the body, get into the circulation, they go into the liver and causes systemic inflammation, which in turn causes fatty liver. And, I don't know if you saw the recent paper about this, about what is termed non-alcoholic fatty liver is actually from alcohol produced by gut bacteria.

Yeah.

So, some bacteria will actually produce alcohol, which in turn poisons the liver.

It ferments, right?

It ferments. Ferments.

It's like you get this bloating food baby. that's actually your bacteria fermenting the food you're eating and certain foods are more fermentable like starches and sugars.

Exactly. Yeah.

We actually have seen cases of patients who literally had elevated blood alcohol levels.

The auto brewery syndrome.

From the bacteria in their gut. And they literally got pulled over and found, you know, they had like for drunk driving.

Exactly. It actually, the auto brewery is, I've had a couple of patients with that and typically that's usually been attributed to yeast overgrowth. But there also are cases specifically with bacteria that can also produce alcohol. I mean, you're basically, it's like a brewery in your body.

Yeah, you don't need a Budweiser.

No.

Just Bud's for you.

So, what happened when you had this.

Patient and you said, yeah, so, I mean, basically you work on doing dietary.

Do you get better when you fix this or you just sort of... Well.

This was just, I was just offhand because I just had this patient this morning and it was a very interesting case because the thing that really stood out is that his protective anchor of his immune system was quite low. He was also a vegan, which we could discuss, what is the best diet? I don't believe that veganism is actually the best thing. I think we're omnivores and I come from a family of dentists. So, I always talk to my patients, see that thing right there? That's a canine tooth. And a canine tooth is designed to chew meat and to chew fish. And we have specific enzymes in the body which are pancreatic elastase and proteases which are designed to digest protein. So we are, you know, like Michael Pollan said it best, eat plants, eat food, real food, mostly plants, not too much. So a plant-based diet with healthy amounts of fish and lean meat on occasion is really probably the best type of diet. And I think some of my most difficult patients are the ones who are sort of strict vegans, for whatever reason, ethical or spiritual or whatever religious can oftentimes get into really difficult situations because it's like a cat chasing their tail. They don't have the specific nutrients to patch up and, and heal the body. Doesn't all that plant stuff help the microbiome?

It does.

Absolutely. It's going to help the microbiome. But he was, he was.

He had almost no Omega-3s. It was really nutritionally deficient to see. Unless people are supplementing, they get super nutrition.

Well, exactly. You can have a person like it was just in the news recently. It was a 22 year old, I think it was over in England, who was living on potato chips, white bread and french fries.

And went blind.

There's no vitamin A. Yeah, went blind. So, you can be walking and talking and, you know, you can be severely malnourished. Yeah. Because there's a, you know, there's about 40, nutrients that your body needs on a regular basis. And I like to also make the analogy to my patients is like your body is like a house that's being built and broken down 24/7. You need all those building materials to make that house. You may need carpeting, you need wood, you need glass, you need all these materials. And if those materials aren't there, then the structure may still be standing. But if you don't have glass, the wind comes in, the rain comes in, the snow comes in, and then you're going to have problems with your problems.

The problem with traditional medicine is they don't look for those building blocks. They don't test for them. And that's what's different here at the Ultra Wellness Center. We actually look for these things. We find them. I mean, when was the last time a doctor looked for acromania in someone with fatty liver? Probably never, right?

Other than us here, some functional medicine.

Or check their Omega-3s or check their vitamin D. Exactly. Yeah, right. And so those kinds of diagnostics are available and help us really think differently about treating disease. I most doctors understand hepatic encephalopathy, but most doctors who are treating fatty liver don't actually think about what's going on in the gut microbiome or how to treat it.

They don't even know how to fix it. Well, you know, the thing that one of my pet peeves, Mark, and I'm sure you've heard this too, is that patients will go see the expert endocrinologist for their diabetes and the expert gastroenterologist and they tell the patients to eat anything they want.

That is absolutely.

Wait, you mean food has something to.

Do with our health?

It does?

Oh my God.

What a radical idea.

My favorite was once I was at.

Canyon Ranch, I was playing basketball at lunch because they used to have these basketball pickup games. And there was one of these people there was playing and he was a gastroenterologist. And I said to him, you know, you ever thought of like how, you know, food might impact what's happening in the gut because you're putting literally pounds of this stuff through that tube every day? You think it might have something to do with why people have digestive symptoms? he's like, gee, you know, I never thought of that. That seems so interesting. Yeah, that makes a lot of sense. And I'm like, holy crap. You know, but, yeah, I mean, your microbiome is dependent on what you feed it. How you grow your inner garden depends on what you're eating.

Yeah.

And you can create a nasty garden with weeds and toxins and bad stuff and poisonous plants, or you can create a really flourishing, Rich garden that actually takes care of you.

Yeah, absolutely. And then also, the other thing that a lot of, even Physicians aren't even aware of is that most of your immune immune system is in your gut.

Yeah.

So when you disrupt that, that ecosystem, that, that rainforest inside of you, you are disrupting the, the immune system. And we're talking about fecal transplants. There's a recent study that showed that children with autism who got stool transplants had a marked Improvement up to two years out from just replacing the gut microbiome.

Yeah.

I mean, that's pretty powerful. So there is no pharmacological.

Autism is like an encephalopathy. It's a metabolic. To some degree, absolutely.

Hepatic encephalopathy. Yeah. I mean, that's, that's, that's. to me, that's, that's sort of the canary in the coal mine in our environment today, you know, that with, we have what, what, one in 68 kids having autism now, depending on where you are living in America and around the world, that is a big, big issue. And what we're finding out is there's more and more connection to the, the microbiome.

Yeah.

I mean, so 60 of our immune system is in the gut.

Yeah.

And essentially, there's a sewer that's on the other side of the lining of your gut, which is only one cell.

Thick.

And on the other side is your immune system. And there's a breakdown which can come from having C-sections antibiotics, acid blocking drugs, stress, poor diet.

Yep.

All that stuff damages the gut, creates a Sleaky gut, gluten, dairy, all those things. Then you get this inflammation. So we treat a lot of people autoimmune disease here at the ultra-wanna Center.

And.

And often the place we start is the gut. Tell us how that works and about some patients you might have had with autoimmune disease and how working on their gut helped them.

Yeah, so I had one patient in particular who I saw who came in, it was a great story. She came in and she was having MS as her diagnosis. She also had- Autoimmune disease. Autoimmune disease, multiple sclerosis, and she also had infertility. and I did a complete workup on her. She had dysbiosis, had bacterial and yeast overgrowth, also had sensitivity to gluten and had also some, not a heavy, not a big level, but some level of mercury in the body. So I worked on a diet, worked on, you know, both prebiotics and probiotics to clean up the gut, got her completely off of gluten, and lo and behold, guess what? Her multiple sclerosis went away.

Amazing.

Disappeared. All right, not to say that- and you got her metals out too. Yeah, not to say that all cases of multiple sclerosis are due to that, but there are many pathways to multiple sclerosis, just that there are many pathways to Alzheimer's disease. Or any disease. Or any disease, exactly, because the body will manifest it in only certain inflammatory pathways. And then, so ultimately, she got off of her medications, her MS to this day is in complete remission. She has no symptoms on no meds and as a side effect, she got pregnant. Wow, that's a good side effect. Yeah, and she was happy.

So that's an amazing story. And I think, you know, for people who are listening, functional medicine is a new way of thinking about disease. It's not based on the label, MS. It's based on the cause. And you can have one disease that has many causes, like MS, which can be caused by heavy metals, by Lyme disease, by Epstein-Barr, by the gut microbiome by gluten, B12 deficiency, you can have so many things that are driving this same syndrome. And the personalization of medicine is what functional medicine is all about. And that's really what's different here about how we practice medicine at the Ultra Wellness Center, because we're looking at each person as an individual. We're creating personalized medicine and personalized health, which is a radically new way of thinking. And we just lump everybody with the same symptoms into the same categories, but it doesn't tell you anything about the cause. And I always say, just because you know the name of your disease doesn't mean you know what's wrong with you, right? And that's what we do through very detailed histories here, through very advanced diagnostic testing to look at some of these things.

Oh, absolutely. And I think the enjoyable thing that I'm sure that you experience yourself is that every patient is unique.

Yeah.

You know, I've never treated two patients the same way from a functional approach. No. Completely different, even in the same family. It's everyone is. and that's actually the fun part about it is the, I call it, the person comes in with their own genetic uniqueness, their own personality makeup, their own story, all of these things that you can paint the picture of where were they when they got sick, where are they now, and what are the things that we can remove? It's like being Dr. House, right?

It's like medical detective.

Yeah, like medical detective. Exactly. and, you know, I think, you know, one of the most important things that, that I always tell people who are training in medicine is to listen to the patient.

Yeah.

They'll tell you what's wrong. Absolutely.

And when and what? Exactly. And, and, and sometimes I just have to sort of bite my, my mouth because you want to always interrupt patients, say, oh, what about this? And what about that? I just sort of let patients talk more and I just sort of listen, and then I'll ask the questions later. And when you really do that and let the patients tell their story in their their own way in their own terms and get that out. You really find out all the little details and you can play house and play detective to try to piece the pieces of the puzzle together.

Yeah, in regular medicine, we are trained to create an exclusive history. In other words, someone comes in with a symptom, let's say they have heartburn or reflux or chest pain. We don't want to know anything else about them except about that. We want all the details about that. We don't know if they have a rash. are their fingernails cracked? Do they have eczema? Is their butt itch? Like, don't talk to me about any of that because that's not relevant. And in functional medicine, all of it's relevant because it's a clue that could give you a clue to what's actually happening for that patient. And that's what's so beautiful about this process. You know, I think I used to work in the emergency room. I think you did, too. It's boring. It's boring because someone comes in and he's like, okay, it's the heart attack treatment. It's the asthma treatment. It's a kidney stone treatment. It's a protocol. It's like you just look at the nurse, you go, heart attack. Okay. They know what the orders are. They know what to do. You just barely write it down. And it's like rote and boring. It's a formula, like a recipe. In functional medicine, there is no recipe. There's actually having to think every time.

You see a patient. Right, right. And being trained in traditional medicine and also in a functional medicine approach, there's definitely, if you're having a heart attack, I want a thrombolytic.

Absolutely.

I want you to blow out your knee. You need knee surgery. I want you to follow the protocol that has been shown to work. But, for chronic conditions, acute care medicine, which is basically the scalpel or the prescription pad, are probably some of the more toxic things that you can have. A lot of what I see in my patients here is Iatrogenica Imperfecta. All right, which translates like that, doctor. Translates like that, which basically means the doctor did it, right? So, the patient comes in and they're on a whole laundry list of medications. and these are interacting, you know, they're on proton pump inhibitors, they're causing acid blockers. Yeah, the acid blockers, they're causing calcium deficiency, mineral deficiency, B12 deficiency. So there's, you know, there's these, these drugs have their, their risk benefit. And the, the less drugs you use in medicine, the better off the patient is.

Yeah, it's hard because that's what we know how to do. It's what we're trained to do.

Yeah.

It's like we don't know how to treat people with food as medicine. We don't know how restore a gut from a messed up gut to a healthy gut. And that's really what we do in functional medicine.

Yeah. And I also, the other important thing that it's important for Physicians out there who are new to functional medicine, also for patients, is to realize these things don't happen overnight. It can take time. But usually sometimes you can see a difference in, in, you know, days to weeks. Sometimes it could takes months and sometimes it takes years.

It depends. Depends on what's going on. So true. I mean, I, sometimes it's like, it's almost miraculous. And you go like, it's hard to believe. I remember when I first started practicing, I would, like, go okay, do these things, take this, eat this. And then they'd call back a few weeks later, or, you know, a month later, I'm like, how you doing? I'm all better.

I'm like, what?

Any better from that?

Because it was so.

It was such a contradiction to everything I learned. But then I started to trust it, and I started to expect it. And I just remember this one patient, she had psoriatic arthritis, which is a horrible condition where you're. You've got psoriasis, but your joints are being deformed, and it's. destroyed, you're in pain all the time. But she had a bunch of other stuff, which, quote, was unrelated. She had depression, she had insomnia, she was overweight, she had terrible reflux and heartburn, and she was having bloating and SIBO and irritable bowel. And I'm like, okay, well, let's see. She's inflamed. Everything that she's got is inflamed. The weight is inflamed, depression's an inflammation in the brain. Her gut symptoms are about inflammation, the gut. You know, everything is related to inflammation. So why don't we sort of just start simple and clear out things that are causing potential inflammation. So we got rid of gluten and dairy in your diet and sugar and starch and all processed food. We got her gut cleaned up. I gave her an antibiotic and antifungal and a little gut program and a couple of nutrients to help her fight some, some inflammation that she was suffering from. And six weeks later, she came back. Her psoriasis was gone. Her arthritis was gone. Her reflux and irritable bowel was gone. Her depression was gone. She lost 20 pounds. I'm like, and she got off her medications, even the one that was costing 50 grand a year to suppress her immune system from the psoriasis. And it seems like a miracle, but it really isn't when you follow this methodology. And that's what we've been doing here for decades, practicing functional medicine up in.

The Berkshires, in the middle of nowhere. It's pretty amazing. Well, it's really interesting because most of the patients who have psoriasis are going to see dermatologists. And most dermatologists do not have a clue about the gut microbiome, nor are they testing or thinking about it. Then if they get psoriasis and they develop psoriatic arthritis, which is arthritis in addition to the skin condition, because I always tell patients is the skin is contiguous with the gut. So if I draw a line on the skin and I keep drawing a line and go down my tongue and I go into my esophagus, down to my stomach and my intestine, I'm still on the same surface. So oftentimes, and you know this, Mark, is that's true. I never thought of that. Yeah, it's, yeah, that's kind of a cool thought. That's how I explain to patients. So the skin is contiguous with the gut. it's an ectodermal tissue. And when there's skin issues, think gut.

It's really a tube. It's outside your body. It's your gut. Yeah, it's true. I mean, when I'm a patient with psoriasis, eczema, acne, rosacea, I treat their gut.

Yeah.

And I don't put stuff all over their face or on their body.

Exactly.

To suppress the inflammation. I get rid of that. And it's like a. It's like. really an American miracle.

It is.

Dermatology is not something that I'm an expert in, although I was trained as a family doctor in dermatology. But, I feel like we get the most amazing results just for something as simple as fixing the gut and changing the diet.

Absolutely, yeah, exactly.

Yeah.

The body is this interconnected, complex, self-healing organism. I mean, that's the big thing is I often ask patients, I mean, do you think you're going to get better? and, and if I have a patient who thinks they're going to get better, then together we're going to get better. But if I have a patient who doesn't think they're going to get better, then I try to get them to change their mindset. Because somebody, even though somebody comes to me, they, they really almost believe I'm.

Not going to get better. Well, that's what they've been taught. Exactly. You have to live with this.

Exactly.

You have to manage your disease.

Right. And, and I want to manage it. I want to get rid of it. And, and, and the, and the body's ability to self-heal is amazing. as you, as you know, it's really amazing. There's an intelligence in the body that we, you know, we haven't, you know, as much as we know about the body, there's a lot more that we don't know. And I, you know, the more I practice medicine, I think the more humble I become because I realize how little I know. It's how complex it is. It's really, really complex. But, but there's so much that we can do for patients that, you know, they've gone to, you know, the Mayo Clinic, they've gone to Mass General, they've gone to X, Y, and Z everywhere else. And, as you say, the resort medicine, we come here for last resort.

I mean, I literally just walked from my office to here after seeing a patient who went to the Mayo Clinic who had chronic dizziness, chronic constipation, fatigue, insomnia, all these different symptoms that they couldn't find anything wrong with him. And, I'm like, well, I know what's wrong with you. You've got this, this, and this and this based on looking at it through.

The functional medicine lens.

Yeah.

And, the other thing is, I think it was Sid Baker, I think, who made the analogy or maybe it was Jeff Blen, is that if you have a dime and you're on a dark street and you lose your dime over there and the street lights over here and you're looking under the street light, which is where you're testing. So, most of the testing is basically looking where the dime isn't. So, the type of testing that we do here, which is nutritional, metabolic, toxic genomic testing is spreading out the searchlight to find that doc.

Absolutely, that's such a key point because you go to the doctor and they say, well, we've tested everything and all your results are normal. And the implication is it's all in your head. But I would say I don't agree with that because either two things are true. One, the patient's crazy or the doctor's missing something and I'm gonna bet on the doctor's missing something. Because when we start to look, we find all sorts of stuff in places that nobody's looked before because they're looking under the street lamp instead of actually where the problem really is.

Exactly. That's exactly right.

And I think what you alluded to before was really important, which is that functional medicine is about getting rid of the things that impair health and putting in the things that help the body thrive. And then the body can take over and with this amazing intelligence can repair and heal from all sorts of things.

In our food, yes, but in that food are toxins. and in our environment right now. And we have medications and we have, you know, we have endocrine disrupting hormones, all of which end up in.

Our.

Gut microbiome and are very disruptive. And if a person has a genetic predisposition to ulcerative colitis or Crohn's inflammatory bowel disease in general, then they're going to be at high risk for triggering that gene and developing that disease they have a predisposition for. It's our diet, it's our environment, it's the stress. All of those can trigger your genetic predisposition. Absolutely. Because you have to ask yourself the question, why have we had such a rapid increase over the last several years?

Yeah, what's going on?

And this is your area. that you just, you know, you're, you are the leading edge of the medical voice in understanding agriculture and food production in our country and how it is, it is toxic and why it's toxic. You know, we don't have healthy soil. And that's where it begins because if we don't have healthy soil, we're not going to get the nutrients in our gut soil to grow good bacteria and have a healthy microbiome. so that our intestines can stay healthy and do their job for us.

Yeah, it's such a big deal.

And, you know, from a conventional perspective, the treatments are really to shut down your immune system, right? Oh, yeah. Prednisone, steroids, chemo drugs, TNF alpha blockers, things that, you know, increase your risk of cancer and infection. They're pretty extreme drugs, and they can be very helpful and they can be life-saving and they can work for people. But the question is, is there and it alternated.

Yeah.

And do, you know, do we have to deal with this the same old way we've been doing with it? And then, of course, for a lot of patients who haven't, sometimes they need surgery. They total colectomies for ulcerative colitis, so they remove your entire colon or resect whole sections of your bowel with Crohn's disease, which doesn't really even cure the problem.

It's just a rough, rough disease. It is rough. And I think you and I can bring people some really good news today. that using functional medicine and what we understand about the gut microbiome, what we understand about food is medicine, you can get better and stay better without having to use the kind of drugs that you just mentioned that can lead to cancers down the road. People on immunosuppressive drugs, you know, followed for 20 years, or, you know, they're already at very high risk. They're already at increased risk of inflammatory bowel disease for colon cancer. And then if you put them on an immune suppressive drug and follow them for 20 years, they have an increased rate of skin cancers by about 40%.

And.

During that period of time, they have increased rates of infection. They have side effects to the medications. They have to come on and off them. They have to try new medications. and, and, and by, by and large, you know, they're, they're moderately effective and sometimes not effective at all for some people, for sure.

And I, you know, I think that.

People suffer a lot from this and they can manage the disease, but it often doesn't go away or it's not curable. But from a functional medicine perspective, it can be really curable. And I can tell you so many patients that I've had, I mean, I just actually how I got the job and probably how I got the job. job at Cleveland Clinic was because I met someone to the CEO who whose niece had severe colitis, was tried all the medications, wasn't working, was about to have her total entire colon removed at 32 years old. And I said, look, just have her come to me. No promises, but no It's worth trying before she rips out her entire colon, which is irreversible. And, I think she was skeptical. She was from New Orleans and probably wasn't the healthiest lifestyle down there. And, she agreed to do it. I told her to do it, but she was quite skeptical. But, I changed her diet. I reset her gut microbiome. Simple things. Simple things. And, six weeks I talked to her. She said, Perfect. I'm fine. I'm on no medication. And I'm like, what? Literally six weeks and they were gonna take her colon out and she's symptom.

Free and offer medication.

And I can tell you story after story like that. Another young kid was 25 years old. Same thing about take his colon out. Just some simple dietary lifestyle changes and, and getting the gut microbiome straight and resetting the gut with the functional medicine.

For our 5R program is so key. So I think Well, we had talked earlier as we were preparing for this, and one of the first things that happened—and you can correct if I'm wrong—but you met with Dr. Ruggerio, who's a GI doc at Cleveland Clinic, and you guys set up a collaborative to work with functional medicine and traditional and conventional forms to treat ulcerative colitis and inflammatory bowel diseases. That sounds like a phenomenal a partnership.

Absolutely.

It really is.

And I think there's a real openness to understanding there's, there's really room for this, including with everything. It's not either or.

Yes.

How do we, how do we create the best conditions for a patient to get to health?

And I think, you know, I just.

In terms of causes, let's sort of dive into that because from a functional medicine perspective, you know, we really look at root causes. And today I was, you know, going through my medical research that I do every day and just sort of looking at what's new and I was sort of shocked to see this. Well, not really shocked, actually kind of expected it, but I was shocked to see it sort of published so prominently in, in a medical journal. We're really, really discussing the way in which food sensitivities, I mean, sorry, food additives and Ultra processed food will drive changes in, in people's gut. So when you look at this data, it was quite interesting. They looked at mice and people, and they basically show that high sugar processed food diet affects the gut in a harmful way. We also know that there's a lot of emulsifiers and additives in food like that. They're thickeners, even things like microbial transglutaminase, which is a, like a gluten product that's put on purpose in food to make it stick together because gluten makes it glue, makes it stick together. And, and, and so we, we have to sort of think about when we take care of these patients, what their causes are. And, you know, and I, and I've seen all sorts of cases. of Crohn's and colitis. And, you know, I just share another story of a guy who I saw years ago who had severe colitis, was really losing weight, struggling. I tried all the normal functional medicine stuff, reset his gut microbiome, did the 5R elimination diet, you know, tried everything, the right supplements, and he just wasn't getting better. And so I went back to the principles, first principles that I learned from Sid Baker, which is what could be bugging this person? that needs to be gotten rid of. Is there something else that I'm missing?

And what am I missing?

Is there something I'm missing?

Yeah.

So I went back to the drawing board as my medical detective had on and. And found out this guy had really high levels of mercury. And it wasn't until I chelate his mercury that he was able to correct his colitis and is now symptom free. I personally had a different cause. You know, I was. I was somebody who mostly had a healthy gut most of my life, and then I developed mercury poisoning and. messed up my gut. I didn't get colitis, but I had really bad irritable bowel and bacterial overgrowth and all sorts of issues that I cured. But then a few years ago, about five years ago, I got a confluence of events where I ended up having to take an antibiotic for a bad tooth and. And the root canal, and it was clindamycin. And this antibiotic is known to cause C. Difficile, which is a really common intestinal infection that causes death in about 30,000 people a year. And all of a sudden, I started getting not just, you know, diarrhea and this and that from it, I started getting really severe pain, nausea, going to the bathroom 20 times a day, bloody bowel movements. It was just, it was miserable. I literally was in bed five months running back and forth to the bathroom. And turned out I had developed colitis from the C. Difficile and then continued even after we cured the infection, the colitis continued. and so I had to really go back to the drawing board to think about what do I do? Because I also had mold exposures and I had all these imbalances, I had low acrylmanzia. So I learned a lot about, on a personal level, which I really didn't want to learn that way, but I learned about what the symptoms are, what it does, and how to actually start to think about fixing it differently.

Yeah.

And for me, I did a number of things. I used a cocktail of, I call it gut food, which is a cocktail of components that have, I think, not really been put together too often, including prebiotics, probiotics. polyphenols and immunoglobulins and things that really helped the body to reset the gut. And I also dealt with the mold that I had in my house. And I also used ozone to help boost my immune system and kill infections. And it was really amazing. Within a very short time, I was able to really recover. And I think a lot of us sort of struggle without really knowing what to do. And even sometimes when you do an elimination diet, if you have colitis, you don't necessarily always get cured because there may be something else going on. There may yeah, like what I had. Maybe there was, you know, C. Def, or maybe there was mercury, or maybe.

You know, there was something else going on.

But you can, you can really help these patients so much. Crowns is often a little more challenging, but we do a lot of different approaches. So traditional medicine, it's pretty cut and dried. So what are the kind of things we find that work the best? And, and talk about from a dietary approach and then sort of drill down into the other. aspects of our treatment for colitis and Crohn's disease.

Right.

So.

Neck and neck, it's diet and gut microbiome. It's really neck and neck. I will say with the gut microbiome, it's very intriguing because there's more and more research being done into the differences between a healthy gut microbiome in the gut microbiome of a person that has inflammatory bowel disease. And there are significant differences.

And.

In a person that has inflammatory bowel disease, one of the key bacteria, as you mentioned earlier, is Akkermansia. Akkermansia plays a role in keeping the mucosa, the gut lining, the goblet cells, really healthy. It breaks down the mucin, and then when it breaks that down, it turns it into short-chain fatty acids. We know that short-chain fatty acids are the, that's the honey of the colonocyte. It just loves its short-chain fatty acids, and that keeps it really healthy. People who have inflammatory bowel disease tend to have really low levels of akkermansia. and it's not uncommon for me to find that they're not even detected when I do the complete diagnostic stool analysis on the patient. So replacing Akkermansia has been shown to have an important role in helping the gut mucosa heal. There is a study that I had come across and preparing for this. It was in the European Journal of Inflammation. 2020. And it basically in this study they took bifidobacterium, another strain of bacteria that is found to be really low in patients with inflammatory bowel disease. And they took a specific strain of bifidobacterium lactis and they combined it with xylitol glucan which is a non-digestible fiber source. They had a prebiotic probiotic together in a patient with ulcerative colitis. They followed all of the patients in the study and control groups, and they found that there was at six weeks, the study group had significantly more healing and resolution of their symptoms. more healing of the gut mucosa and healing and resolution of their symptoms. This is just they had no other therapy. This is just a prebiotic and a probiotic that they use. Using probiotics to control and to resolve an exacerbation can be really critical. I think we're learning more and more about how they work. There are other probiotics or there are other bacterial species that are missing or in low concentration in patients with inflammatory bowel disease, including Lactobacillus GG, Saccharomyces boulardi, and when you replace these, you find huge benefits. So I use probiotics pretty quickly in a patient. I also will use, there's a probiotic called VSL number three. A lot of people know about that because it's frequently used and it's really powerful. It has all the strains of lacto bacillus and bifidobacterium that are low and are also very helpful in healing the gut lining and gut mucosa. And just by using that, I've been able to help people start to feel better and see their symptoms resolve. So as you can tell, the gut microbiome using probiotics are really a big part of how I'll treat my patients. But that has to be balanced about what they can tolerate and where they are in their disease, because the diet then becomes really important. Sometimes I can't give probiotics right away. Sometimes, I've got to get this person eating. I've got to get them feeling better.

Before.

They can actually tolerate the addition of the probiotics.

What are the kinds of diagnostics you'd see us using with these patients to figure out what's going on with them?

Well, traditionally, first you're going to get their symptoms. I always like to go back to the basics. We've got to remember that we're doctors are cognitive beings. We are medical detectives who like to think. So I think you need to make sure that you're listening to the patient's story, hearing all of the symptoms, doing a really good examination, and making sure you do that part because that's where you find those predispositions, you find those triggers, and you find those mediators that are so important because that begins to those are the categories you think in to solve the mystery. Okay, so once we've, you know, I've done that piece and I have a really good idea of what the predispositions are. I have a really good idea of what the potential triggers are, because those triggers can give me an idea of how I'm going to help them get better and control it down the road. And some of the mediators and perpetuators, you know, that could be, you know, stress or that could be their diet. once I have those pieces, then I say, okay, you know what, I'm pretty sure you have ulcerative colitis. How do we know for sure? We can check inflammatory markers like something called Calprotectin, which will be very elevated in people with inflammatory bowel disease. Then we can also visualize, and it's the gold standard, is to visualize with the colonoscopy, the intestines. and you can you'll probably do both in upper and lower and you'll see that with Crohn's disease it can involve the entire intestinal tract whereas with colitis it typically just involves the very end or the distal part of the large intestine, the rectosigmoid and the first third of the or the last third of the colon. and that will be that will visualize it through colonoscopy. So those are, that's the conventional way. And then, once they land in my lap after, you know, being frustrated by just not getting better or finding that their diets are really restrictive and they're constantly having symptoms and they're not finding any answers in the places they're looking in the conventional medical world, Then I immediately go into action and I'll look at the complete diagnostic stool analysis where we will get a full complete picture of your digestive processes. Are you making enough gastric acid, pancreatic acids? Do you have markers of inflammation? Is your detox system in your gut working correctly? Is your immune system responding? overresponding, under responding. And it will also tell us very specifically the diversity and abundance of your gut microbiome. And so it's one of the, it is the first test that I'll get, but I'll also look for other things. And we should have mentioned this earlier, but I'll look for SIBO, which is small intestinal bacterial overgrowth. I will look for food sensitivities, particularly to gluten. I'll look for leaky gut, and I'll also look for those cross-reactive foods, foods that act like gluten, that can create inflammation if you're sensitive to gluten, and then be a trigger for your ulcerative colitis. So those are some of the tests. I'll do an ion profile or a micronutrient, it's a functional evaluation. of all the most important biologic processes that your body does. And it allows us to determine which systems are or aren't working. And if they're not, what nutrients are you missing? Do you have, particularly when it comes to the mitochondria, do you have compounds or toxins that might be impairing those functions? Like with you, you had mercury elevations that probably were impairing your mitochondria, probably impairing your immune system. And on top of the other conditions you had may have tipped you over and made you more susceptible to the adverse outcome with an antibiotic. So we're looking at all those things and those are the tests that I look at. And I may do some Well, yeah, I usually will stop there in my first tier. I usually get most of all the information I need with those tests.

If you love At Last, you should.

Definitely check out the next one on Food is Medicine.

Because you don't need a doctor's prescription for health.

What you need to do is to.

Make that part of your life in a natural way.

Well, if we can get food reimbursed.

By healthcare, it's a game changer.

I'm actually working on that at Cleveland Clinic with the Food Pharmacy, which is the idea of actually paying.