The Confusing Gut Killer That Fogs Your Brain, Strips Your Body Of Nutrients & Strips The Fun Out Of Food: Everything You Need To Know About Inflammatory Bowel Disease.

On this episode of the Ben Greenfield.

Fitness Podcast, get IBD patients into remission and get them to live their lives again and be able to eat what they're going to be able to eat, not worry about something causing them to go run to the bathroom 20 times a day. New synapses are being formed, some are being strengthened, some are being weakened, and new brain maps are being created as learning takes place. If you come and you join our community, we will literally keep working with you until you are healed and we will not stop until we are done.

Performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show. Hey, this podcast that you're about to hear is actually the second in a couple of podcasts I recorded at the Ancestral Health Symposium. Can check them out@ancestryfoundation.org recorded this down in Los Angeles, walking on the beautiful sunny UCLA campus with two new friends I made down there, Andrew and Amy, who are specialists in irritable bowel, inflammatory bowel. I don't remember the IBD word that stands for something that you'll learn about in today's show. Anyways, no, I'm not joking. It's an important topic and you may think you know what IBD stands for, but perhaps you do not. And perhaps I'm playing stupid just trying to lure you into listening to this podcast. Anyways, though, it was a great chat and super relevant. If you have gut issues, all the show notes are going to be@BenGreenfieldFitness.com IBDpodcast well, I'm at the Ancestral Health Symposium and you may already have heard some other content that I put out while down here at this fantastic event. But there's a couple of folks I met who are particular specialists in what's called ibd, and I know that a lot of you have struggled in the past with gut issues. I get tons of comments and feedback about just the uphill battle a lot of people face against digestion, constipation, bowel movements, you know, what foods, as confusing as it can be, can seem to trigger it. What foods seem to help it. And anyways, the two folks who are out on a walk with me today say hello, Amy and Andrew.

Hi there, I'm Amy.

Hey, I'm Andrew. It's an honor to be here.

Well, I've been hanging out with them a little bit down here and, and they presented a poster which actually makes you guys sound really smart. Like poster, poster. And what that means is they basically laid out in a, in a really Beautiful, well thought out way, you know, really, really how to deal with IBD and how it happens in the first place and their unique approach. I thought that they had some information on there that I really hadn't seen before and that I wanted to unpack with them. So that's what we're going to do for you guys today. But actually, before we. Before we jump in, I was asking you, Andrew, like out in the lobby, if you'd ever done a hoppe, the alkaloid infused plant from the Amazon that you kind of huff up each nostril sometimes for ceremony, you know, before you'll do, I don't know, like, you know, the frog poison combo, or sometimes the. The warriors down there, the hunters will do it before they go on a hunt to improve sensory perception. Some people will do it before breath work or before meditation or before a plant medicine ceremony. But I got a shipment of all these different, like, varietals of this hoppe from a company called Planet Combo, like right before I came down here on this trip. And so I had a few in my bag and one of the caripes, you know, that allow you to kind of huff it up each nostril.

Sure.

I did a little hoppe ceremony this morning, actually.

How are you feeling?

Well, after the sensation of burning out the entire back of my eyeballs went away, I'm doing pretty well. But up until about 15 minutes ago, I was kind of seeing stars. Like, whatever they sent me was pretty potent stuff.

So let me just say this real quick. If someone has ibd, which is inflammatory bowel disease, there's a difference between the two main types of IBD in relation to something like hobby. Because hape contains nicotine, Is that correct?

Yeah, yeah, yeah. I think it's one of the primary active constituents.

This is such an interesting place to just say something really weird about this disease and really weird about human health.

You mean about ibd? Yeah.

Is that I have Crohn's disease and nicotine for someone with Crohn's. For me, it's sort of okay. But usually for almost everyone with Crohn's is really a risk factor in the disease. It makes the disease worse. People don't do well. The opposite true for ulcerative colitis, that nicotine, it's crazy that we don't understand why that nicotine actually seems protective and that ulcerative colitis comes about often when people quit smoking.

Wow, that's. I mean, it seems like nicotine because I'll like, chew nicotine guns sometimes or Use one of the lozenges or even do the hop A. Like I mentioned, it seems kind of like irritating and harsh. I wasn't sure if it was the other plant constituents that kind of come along with it that do that, but the fact that it seems to do that in just like a gum or a lozenge kind of makes me wonder, like if it makes the inside of your mouth burn, what's it do to the rest of your digestive tract, you know, once it kind of gets down the back of your throat or whatever, so.

Well, it's clear that nicotine has some sort of immunomodulatory effect, you know, and I think that's probably where it's coming from.

Interesting. So I guess since you've been. You already have been hogging the mic, Andrew. Geez.

Come on, man.

I'm going to go to Amy first because what I'm curious about is if you. I mean, as you mentioned already, Andrew, you had Crohn's. What about you? I mean, is this like something that you have experience with yourself? Like, have you had ibd?

So I am one of the few people on our many person team who actually does not have ibd.

When you say our many person team, you mean your guys is like IBD coaching program. Correct. Okay, gotcha.

So on staff, which gives me a unique perspective of a person who lives with someone who has ibd. And so I do a lot of like family support for the loved ones of our members, but also has some limitations where I can see what is going on from the outside. But I have never experienced the type of GI conditions or symptoms that our members go through.

Lucky you just get to rub that in everybody's faces.

Oh, I have my other chronic conditions that I'm seeing.

I'll help you, but I have the perfect gut.

But as far as gut issues, I seem to have gotten the luck of the draw on that one.

So. So was this something that you studied? Like, do you have a degree in or some kind of background in health sciences?

So I studied anthropology and have like a pretty winding career. But the to get me here. But the way that I got involved with this is actually that I am married to Andrew and have lived with him for the last seven years through his condition. And so when he started moving in a direction of helping others with the condition, it seemed like the natural thing for me to join on as well.

Yeah. Interesting. And your background in anthropology, I would imagine has kind of been able to steer you in the direction of the ancestral approach that you Guys take.

Absolutely.

Dealing with this, which we'll get into, I'm sure. And then, Andrew, like, how. How bad was your condition?

I almost died, Ben.

You almost died?

It was serious? Yeah. At one point when I was diagnosed, when I was about 16. So, I mean, I think we should say. What, do you want me to just tell people what inflammatory bowel disease is and kind of like.

Yeah, yeah, for sure. Although, of course, I'm certain some people would love to hear, like, that personal perspective on you almost dying.

Let's just remember that it's different than irritable bowel syndrome. This is not something that.

Okay, so IBD is not irritable bowel. Like, what's IBD actually stand for?

So IBD stands for inflammatory bowel disease.

Okay.

And it's an. It's a condition that affects millions of Americans. It affects millions of people around the world. It's a serious inflammatory condition that affects different parts of the gut. Crohn's disease affects any part of the gut, but often terminal ileum, small intestine, ulcerative colitis affects the colon. I was diagnosed with Crohn's.

Okay.

It was a very serious case. I was losing a lot of weight.

How did they diagnose that?

They diagnose it usually with a colonoscopy.

Okay.

But they're seeing that mine, you know, this is back in 2006 when I was diagnosed. They're seeing that my inflammatory markers are high. They're seeing that different markers are out of whack. And I was going to the bathroom, you know, 20 times a day.

Holy cow.

It's a very debilitating condition, and it can be very serious. I actually have a great uncle who in the 1940s was diagnosed with something. They didn't know what it was back then, and he was just pumped full of steroids, and he passed in his early 20s. So clearly there's probably some sort of genetic component to this condition. It's highly lifestyle based. And what happened was, is that I was, you know, given powerful immunosuppressive drugs. A specific drug that goes into the bone marrow. It essentially turns off white cell. White blood cell production goes into the DNA, interticulates. It's a pretty nasty medication, but was often used as kind of an old school medication. And ibd, it helped me maybe to the point that I was functional and I was no longer in. Probably the immediate danger had a lot of side effects, but I was able to matriculate to the University of California. I studied neuroscience and psychology, and we did A lot of interesting things there. But it wasn't really until I graduated and had essentially a very severe flare, even though I was on these very powerful medications, that I was having side effects to that I really discovered a systems based lifestyle approach that really incorporates concepts like neuroplasticity, ancestral health, first principles into designing a protocol for myself that ultimately I think saved my life.

I definitely want to talk about neuroplasticity later on because you mentioned it in your poster. And that's not a word you see thrown around in the context of ibd. It's actually not a word you see thrown around at cocktail parties in general. We'll get into neuroplasticity later on.

You're not at the right cocktail.

I guess so. So when it comes to predisposing factors or the reasons people would get ibd, you talked about your uncle. He was your uncle, right?

Great.

Yeah, your great uncle. Fantastic, great uncle. He seemed to imply, or you seem to imply that it may be genetically related, but I'd love to hear a little bit more about that or any other predisposing factors that actually caused someone to be more susceptible to something like ibd. And you guys can just tell me because just to open the kimono for you guys listening, I got Andrew walking on one side of me and Amy walking on the other side. So they'll just elbow me with. Who wants to answer that question?

This disease did not exist, you know, thousands, millennia ago. And I think Amy can attest to that in her studies of anthropology at UC Berkeley. It's obviously, sure, there's probably a genetic component, but we know that there are multiple factors that have contributed to the this. We see distinctive microbiome profiles. Lucy Maling could tell you all about it. She's on my science.

She's like a gut expert. She's been on my podcast before.

She's incredible.

Yeah.

You know, we can see the differences between the microbiomes of people that have IBD and those that don't. There are very distinctive markers between ulcerative colitis, Crohn's disease. We see, you know, immunological overreactions. We know that stress, psychological stress, almost certainly plays into it. Diet often plays into it. The rise of the standard American diet feeding inflammatory microbes. This is probably the problem. And you know, Ben, IBD is not. It's interesting because it's not a traditional autoimmune condition. In a traditional autoimmune condition, something like rheumatoid arthritis or lupus or something along those lines, you Actually, I believe you see antibodies against tissue of the body. Whereas in ibd, what's happening is that there's a leakage of bacterial organisms, of food particles, of the other constituents of the microbiome, and essentially leaking across that mucosal membrane of our guts, of that first layer of cells, into an area called the lamina propria. And in that area, there's an overreaction by the human immune system.

Is that lamina propria considered to be in the gut or is it now like in the bloodstream?

So the lamina propria is a space that's described in multiple parts of biology that's below sort of an epithelial layer of cells. This is just a biological term that I'm using. And what we see is there's an overreaction to this bacteria because they're inside of this first layer of cell. They're in the wrong place. And the immune system says, hey, this is not right. But there's obviously a reason why they're leaking across. So sometimes we see dysfunction in what are called tight junction proteins, which are between the cells of the gut. We see dysfunctions in certain interleukin factors, certain Cytokines, one called IL10, which is in charge of, of the anti inflammatory response. And this is really the pathogenesis of ibd, I think all of us.

Pathogenesis, meaning how the disease genesis is how it occurs. Correct.

Look, a lot of us have leaky gut. I think a lot of this bacteria and stuff is leaking across our membranes, especially, you know, those of us that live in modern society. The difference is that people with ibd, we are those that react to it, and that has devastating consequences. Because if your small intestine, you know, where you're digesting your food, or even your colon is so inflamed it no longer functions. And obviously in Crohn's disease, me, I was extremely malnourished because I wasn't able to digest my food. And it's a horrific disease. And outcomes right now for this condition, just like other chronic conditions are very poor in the United States.

Did you ever do like a vitamin IV or some way of delivering food, like, or what you'd be getting from food right into the bloodstream? Like, do people do that to just say, oh, screw it, I'm gonna pass the gut just to survive till I figure this out and just get like, IVs?

Absolutely. People need to do that often. It's a kind of a last resort, you know, maybe before surgery, before something is going to be removed. But these Days. They don't even do that. They just are very quick to take a section out.

Right.

And you know, this is the thing, is that many of our members have joined the program, you know, day, you know, at least two or three of them just days before they were going to get their colon removed.

Wow.

And they have been able to keep their colon.

Oh, my gosh. Imagine that you're going to cut out, like, the cut. Like, why wouldn't you want to get your colon removed? Like, explain that to people. Or at least not the whole thing, but they cut off a part of it.

Each part of your digestive system really helps with the absorption of different nutrients. And so if you remove entire inches of this, not only are you limiting your ability to absorb the nutrients that get absorbed in that area, but also the colon is a host to the entire gut microbiome. And all of these little beings that live inside us, that help us digest.

Our food, kind of like the appendix, like the appendix houses some of the information about your microbiome as well. So we get that removed. Isn't that kind of a similar situation? It's not a throwaway organ.

I don't think that there's anything in the body that is really superfluous.

I think that we're finding that mustaches, maybe.

So look, if you have your colon removed, that is the housing of your microbiome. Okay? So someone without a colon doesn't have a traditional microbiome. And we know from research by Lucy Maling and other experts of the microbiome that this. This organ, okay, this ecological organ now that we're calling it, synthesizes vitamins, synthesizes neurotransmitters, is involved in metabolism, helps us digest our food. The list is endless.

If you get, like, part of the colon taken out, does the rest kind of take over and do those things? Or do you really see, like, a remarkable change in colonic flora or something like that?

Do you guys know, in ulcerative colitis, it's rare that only a section of the colon would be removed? 98% of the time, they just take the entire thing.

Oh, my gosh. Wow.

Because they're just like, oh, at the point that it needs to be removed, there's no point of even saving it. And these poor individuals are then left to essentially excrete their waste into a bag that they have. And it's hard, you know, it's a hard way to live. There's no way to live.

It's kind of a sad way to treat things. Obesity, you Know, gastric bypass, just tie it off, IBD colon, just cut it out and yeah, snip, snip, cut, cut. So you mentioned something when you were discussing the predisposing factors to ibd, Andrew, you did about the, about the microbiome and about how it's different in people with ibd. There's all these different ways to test the microbiome. Like we've got companies like Viome or Ubiome or Longevity doing like the genetic analysis. There are other companies and this is usually what I find to produce more actionable information. But I don't know what your take is on this, like Genova Diagnostics that are doing like the, like the three day stool evaluation for parasites and yeast and fungus and inflammatory markers and things like that. But when you talk about the microbiome being different in ibd, is there like a test that people can get that says, oh my gosh, like this, you know, the ratio of this bacteria XYZ to this bacteria ABC indicates that there are some serious issues going on here.

Yes, absolutely. I think though that we are at the point where these microbiome tests are more interesting than they are actionable right now.

But what I guess what I'm asking is like what bacteria would you actually be looking at?

So we see that certain keystone species. And I'm going to ask Amy for some pronunciation here. We know that like, you know, fecal bacteria and Prasnitzi. I think that's pretty good right there. You know, we see that almost very, very low in Crohn's disease and ulcerative colitis achromensis. That's another one that Lucy talked about in her talk. Very highly implicated in ulcerative colitis. So yes, it's important that we get the microbiome tested and we see that eventually. But right off the bat, that's probably not the most important thing to do right now because when people come into our program, they're flaring out of control. Often they're running the bathroom 20 times a day, they're on a lot of medications and we help them to essentially build a robust and comprehensive, a holistic, multi dimensional protocol working in collaboration with their health team and other factors to make it happen. But the microbiome test becomes more important as they become more advanced. But a lot of the time it's confirming what we already know. We see the patterns that are already documented in the literature. So initially it's kind of safe to just assume obviously this person has an altered microbiome.

Right. You're Bleeding out your butt. We don't need to test that type of thing.

Literally.

Yeah. Okay, so you mentioned genetics. If somebody's got like a 23andMe or some other kind of genetic test, is there like a SNP that you could look at that you would see and it would show you that you might have higher susceptibility?

Yeah. So I think the party line usually is that there's over 200 genes, whatever that means, implicated in predisposition for IBD. But none of them are like a defining factor. You wouldn't be able to get the same sort of details from your genetic profile that you would for something that is a lot more targeted. And so knowing that there's over 200 genes potentially implicated in this condition, it becomes more important to pay attention to environmental factors. And we see that a lot. That, like, people who come to us and people that we interact with in the IBD space have other stuff going on in their life. Whether it's intense acute trauma or they're overworked, or we have a lot of people who are in caretaking professions like teachers and nurses, who tend to get this condition. There's definitely something there.

I have talked to so many people who had great guts, like, till they were 25 or 27 or 30, and then they have like a house fire or a relationship breakup or a stressful traumatic event, and all of a sudden they have ibd. And that's just something that seems to materialize as a response to stress in many cases is what I've seen. Is that what you guys have experienced?

Absolutely. That on top of the standard American diet, on top of the lack of nature that we all get out, a lot of these factors play into it.

Okay.

Yeah. So let's think real quick about fight or flight, you know what I mean? And the stress response and why that might cause chronic conditions in general or inflammatory bowel disease. Again, we look at IBD as an entrance point to human health right now. But why would the stress response cause or worsen ibd? Well, Ben, if we're walking here and we run into transported back in time and we run into a California grizzly.

Bear or a big scary UCLA frat boy.

Exactly. We're gonna be having a lot of stress hormones that are pumping through our body. Cortisol being one of them. Let's just remember cortisol. My understanding is that it's essentially a resource driven hormone, and we're taking away resources in the form of glucose and adenosine triphosphate, ATP that you all learned about in AP biology, we're taking those resources away from organs of the body that we don't need in an immediate fight or flight situation. What are those? We don't need to be fighting microbes if we're trying to run away from frat boy. Okay. We don't need to be digesting our food if we're trying to run away from frat boy.

We need, we don't need to be making babies. Right. So you see all the endocrine system down regulation.

Exactly. We don't even need to be storing memory in the same types of ways. So there's actually brain damage occurring in the hippocampus of the brain. So obviously there's a dysregulation of the immune system and a disease like IBD or any other autoimmune or inflammatory condition will tend to spiral out of control when under a lot of stress.

That actually kind of makes me think of something I saw on your poster as a potential treatment strategy. You guys list vagal nerve stimulation and I know that that's something that people have kind of like amped up nervous systems seem to benefit from some type of, some type of vagus nerve work, including the use of such stimulators. But perhaps I'm putting the cart before the horse because you actually have like a whole three step model that you guys use. And I would love for you to kind of get into what the three steps are and what people can do.

Sure. So we looked at IBD and we looked at it from a scientific perspective and we looked at the current treatments. And what I noticed is that the science doesn't seem harmonious with clinical practice. As in such many chronic conditions, there's a disconnect between the researchers and between what's actually happening. And the most common mechanism to treat IBD right now is to intensely stop the inflammation by blocking certain cytokines, the most notorious being tumor necrosis factor alpha or tnf. So what we see essentially is that there's a lot more than just the inflammation. So in IBD we see that there's, like I said, microbiome imbalances, there's, there's barrier issues and there's also inflammation. So our first step is to of course stop the inflammation. You have to stop it in some type of way. Sometimes they.

And that's always step one.

It's got to be step one. If your inflammation is high, we got to get that down in some type of way. And we can throw all the amazing anti inflammatory foods and all these other things. But at the end of the day, sometimes pharmaceutical therapeutic interventions are needed here, either in the form of prednisone or in the form of biological therapies if the patient doesn't respond.

What about peptides? There's like that one body protection compound that they say is actually found in the human gut. Some docs, even though the FDA seems to be cracking down on these, are using like TB500 or Thymosin Alpha. Have you looked into peptides as a potential?

Absolutely. And I use BPC157 from time to time time I've noticed a lot of benefit from using it. But again, like any supplement here, it's just part of the picture. It's part of a much more complex, you know, and multilateral, multidimensional approach that we take to this condition.

Are there any like real foods or herbs or spices you would work in to down regulate inflammation?

Yeah, sure, I'm gonna let Amy take that one.

Our go to anti inflammatories tend to be things with like turmeric in them though. That's an important thing to remember with people with ibd, that turmeric can contribute to more bleeding if bleeding is a thing that your body's currently prone to.

And correct me if I'm wrong, but when turmeric is consumed along with biopurine, the active component in black pepper, which can increase its absorption, I think it can be even more irritating because of the pepper component.

I've definitely heard about the black pepper thing and wanted to know what the latest was on it.

It's a controversial, I think adding the black pepper, there's a lot of debate on it, even among GI doctors who are using this, of whether to put the black pepper in the turmeric.

Well, what I guess the kind of the word on the street is from the research that I've seen is that turmeric combined with bioperine or black pepper extract increases absorption and allows for a better systemic anti inflammatory action of the curcuminoids and the tumorosaccharides and everything. But then if you don't combine it with black pepper, apparently it stays in the gut longer and has more anti inflammatory activity localized in the gut.

Well, I just learned something new that makes a lot of sense and I want to look into that more because that sounds really actionable for our folks.

Okay, so we got turmeric. What about ginger?

Ginger is really, really helpful. I think the one that we're finding to be a. I'm not going to go so far as like a game Changer. But in terms of inflammation is quercetin just seems really, really powerful as an anti, as both an antioxidant and also an anti inflammatory.

It's super like quercetin and oleopurine. A lot of functional medicine docs I know they're prescribing those peptides I talked about for long haul Covid. And even for like a lot of the acute inflammatory reaction to the initial onset of COVID it would make sense that if they're that powerful at quelling that inflammatory firestorm, that they could potentially be beneficial for quelling the inflammation from ibd.

And there's a lot of other supplements. But I do want to just emphasize that people tend to have this notion of supplements that, oh, they're going to be these magic fixes. I'm just going to take one of them. And they are supplements. If you're not practicing a robust dietary strategy and a robust lifestyle, a stress reduction protocol, don't even bother with the supplements. Yeah, not even there yet.

Yeah, I want to get into diet in a little bit. But then so we stop the inflammation and then what's step two?

So step two is to then essentially really look at the microbiome and see this might be a chance for us to do a test right there. But to help clients to nourish that microbiome through eating different prebiotic foods. We know that flavonoids are prebiotic clinic quercetin is probably prebiotic as well as anti inflammatory. Certain fibers and resistant starch can be helpful.

But I'm gonna interrupt you because I do a really good job derailing people and that's exactly what I'm doing to you. Just messing with your head, seeing how all that neuroplasticity is coming for you. But the now I just derailed myself. The thing with the resistant starches is those seem to give a lot of people really bad gas and bloating like inulin and chicory root and stuff like that. Like are there resistant starches or prebiotics that don't seem to cause as much bloating or fermentation.

So yes, a lot of people, let's just remember that IBS is a different condition than ibd. And yes, there's a lot of comorbidities between them, between those two conditions. But we see more of the gas and bloating in ibs. That's not to say it doesn't happen in ibd, but there are probably actually some things that people with ibd like I don't have ibs. I Just have ibd.

So for you, it's not like bloating, gas, constipation, it's more just like pain, inflammation, that type of thing.

Absolutely. And, you know. Yeah, you know, we need to, you know, diet is a crucial, crucial factor.

What kind of probiotics do you use?

You know, I really use the term Pandora's box when I think of probiotics, and I think Lucy's teaching has been Lucy Maling. Lucy Maling. You know, her teaching has really been, look, just because there's a specific species does not even necessarily mean it's maybe the same as the same species you see written on the probiotic bottle. Because there's a strain difference, and companies are not even required to tell you what strain they're using. And so really, when we're looking at the scientific evidence and even the practical evidence with IBD and probiotics, it's kind of all over the map. With that said, I would say that probably most probiotics tend to work a little bit better in ulcerative colitis rather than Crohn's. Crohn's is a little bit more mysterious in some ways in ulcerative colitis, a specific probiotic called Visbiome.

Is Visbiome like the brand name or is that like the bacterial strain?

It's also used to be referred to as VSL number three, but I've heard.

Of that one before.

There was some sort of lost.

What happened There is some sort of lawsuit and some sort of drama. And so it's important that what you now see as VSL3 is not the same as what it used to be. So Vizbiome is the new name.

I think it was Dr. Rhonda Patrick who was a big fan of VSL3 for the biome. So anything aside from you said Visium, by the way, for everybody listening in, I'll make show notes and I'll put them at BenGreenfieldFitness.com IBDpodcast that's BenGreenpuffDentist.com IBDpodcast so I'll make sure I get the spelling right and put it on there for you guys. Any other, like, specific probiotics?

There's a couple of specific strains. There's actually a form of E. Coli called E. Coli Nissle that might have some positive evidence in ibd, but it's very hard to, you know, get, you know, Bacillus coagulans, certain subspecies of that maybe promote fecal bacterium Prausnitzi. Again, I would just say it's probably a better idea to just get your probiotics from sauerkraut or from kimchi or something fermented until we really understand what the fuck is going on.

What about like swallowable poop pills or fecal microbiota transplants? Like actually getting the stool from a healthy donor up your backside or. Because I've heard that this can be as effective like using like an oral capsule capsulated fecal from a healthy donor.

Amy, do you remember that time that I was just super sick and I was like, baby, will you give me your poop? Can we try that.

On a date?

What A date? It's definitely still too early to tell. I think the importance of it being a very healthy host is really key here because like you could.

Well duh.

Yeah, but like what does healthy mean?

Yeah, that's true.

Does healthy for you mean something different than for my body? Yeah, I don't have ibd, so yeah.

It'S kind of play with. I've always thought of it like CRISPR gene editing. It's like, I don't know. We really don't know. All the downstream implications of somebody else's entire biome replacing or getting added to yours. Right.

There does appear to be super donors. Right. There's these super donors that have way better of an effect than everyone else. And that's what the studies are sort of showing. So it's. But we don't know how to identify those super donors. The only way is to start testing them. So I mean I think if we were going to really pursue.

That'd be awesome if you actually knew, look at the shape of their butt. They're a super donor for sure.

We need like an Olympic training program for these people, you know what I mean? Like they need to be like microbiome Olympic athletes, you know what I mean? And then they also need to be tested in practice and see how their shit affects people with ibd. Because it does appear that some people just have a better, some sort of better composition. They just tend to higher percentage of the time we see a positive correlation impact.

I could totally see that happening. Like us actually having facilities where super duper healthy people live or identify. But you go to them for your sperm, for your poop, for your fecal matter.

Imagine if you paid like 750 bucks every time you went poop. How cool would that be?

Oh man.

I mean the important thing though, a toilet can bend on me, it can scan it too for the like quality.

They actually are making smart toilets now that can, that can Analyze your stool.

That makes sense. Yeah, that tracks. But some of the early evidence that we are seeing with people with IBD is that people with ulcerative colitis would be in the population that would have slightly more chances of success, success, whatever you call that, than with Crohn's disease.

Okay, got it. So we stop the inflammation, then we rebuild the microbiome using a lot of these bacteria and prebiotic type of strategies that you talked about. And then what's step three?

Step three is to repair the barrier, Ben. And this is the part that's just completely ignored by mainstream medicine. And yet all of the science says, hey, there's a barrier issue. The latest science from Mayo Clinic, the latest science from Stanford, from Harvard, all of this like, hey, there's a barrier issue. There's bacterial organisms that are leaking across the barrier. Okay, guys, so why are we not doing anything about this barrier? How can we give anything that's going to support this barrier? I think one really powerful compound to repair the barrier is called phosphylcholine. Actually made it to a phase three trial. Ulcerative colitis.

Phosphatidylcholine.

That's correct.

Cool. That's. You know, I take a lot of supplements. Not a lot, but I take some of the supplements from Quicksilver Scientific. Yeah, they're like liposomal formulations, but a lot of them like have phosphatidylcholine in them and they actually have actual phosphatidylcholine. And there's a. There's a doc, his name is Dr. Goodawai. He just wrote a book about treatment of Alzheimer's and dementia. And he has a test called a prodrome test that actually measures a lot of, I guess like the upstream building blocks for some of these cholines and other amino acids in the body, he calls them. I don't think it's proteoglycans, but something like that. Anyways, I did a test with him that showed some of like my levels were low for these so called plasmalogens. And so I actually supplemented with phosphatidylcholine for a while and then I retested and it kind of like gave me all the building blocks back.

That's beautiful. Yeah, I mean, I think in the studies it was done in a delayed release capsule or if you have ulcerative colitis or Crohn's colitis, meaning that it's in your colon, you could do it in enema form.

Phosphatidotic colon, you mean?

Yeah. Again, as part of a very comprehensive multi dimensional protocol that might be of extreme benefit, repairing the barrier. Just one example. Obviously, the most powerful way we can repair the barrier is to stop the inflammation, is to nourish the microbiome. I think all of your listeners probably know by now that certain carbohydrates feed the microbiome. Potentially. They are essentially transitioned, transformed into short chain fatty acids like butyrate that then feed colonocytes. And when those short chain fatty acids like but butyrate feed colonocytes or enterocytes, which are the cells of the small intestine, colonocytes are the cells of the large intestine, we see the barrier begin to repair. We see what we call deep mucosal healing.

Now, would that be better? Because I've always thought about this, like, if the issue is in the colon, like, would it be better to do an enema with like probiotics and butyric acid or butyrate, you know, capsules that you break open into that and then maybe some phosphatidylcholine or something like that and just basically mainstream it straight to where it's needed.

We have several clients right now and several members who are experimenting with enemas. There's a protocol for any, by the way.

I do a coffee enema once a week.

Yeah, you do.

Yeah, I like it. I feel amazing.

Probably not necessarily. I mean, I'm not against coffee for people with ibd. You saw me drinking a cup of coffee this morning, no problem. I mean, you saw me drinking a cup of coffee and eating some red meat that you gave me.

That's right, I gave you my leftover bell camp over the steak for breakfast.

You literally fed me breakfast. I was so appreciative.

I actually. Fed yourself.

So look, you know, again, I just, I just want to emphasize these enemas, these supplements, they, you know, we've talked about them. They are not panaceas, okay? They're not, you know, and people tend to look at them like that, okay, this supplement didn't work for me. Well, what's the relationship between that supplement and your other protocol? What's the context? What's the brand? What are the inactive ingredients in that supplement? What things could have disrupted the barrier? There's a lot of complexity here and there's a lot of contextual factors and it's too much for sick patients to do this all on their own. That's why we have this ecosystem that we're building that hopefully can be applied to a lot of different conditions. One day we're starting with ibd.

What about some of those other ones that people talk about a lot, particularly like glutamine, bone broth, glycine, and colostrum is another really popular one. Do you guys work in anything like that?

I'll comment on glutamine. Glutamine tends to be more helpful in Crohn's disease. Tends to be more helpful in the small intestine. I think colostrum not, you know, I'm still learning about that one, but again, just people who are sensitive to milk.

Right, Amy?

People who are sensitive to milk, we find that maybe that one is just a little bit more difficult for them to digest. But they could take one that Lucy Nailing often recommends called serum derived bovine immunoglobulin.

Oh, yeah.

SBI Protect, which is, I believe, which.

Has got a lot of the immunoglobulins that colostrum would have in it.

I found that to be a game changer.

Yeah, I think colostrum, people can tolerate it because I love it, you know, and I get a tricky gut sometimes. And colostrum is like my, like, number one thing I go to because it's got growth factors and it has lactoferrin and it has some things besides the immunoglobulins in it. However, I think that if people are cautious around dairy, they can just, like, try it and see if it works for them. Like, I don't do well with dairy at all unless it's fermented. I do fine with colostrum. I think it kind of depends, I guess, but. But, you know, coming full circle, you're basically healing the inflammation or shutting down the inflammation. You are feeding or restoring the microbiome, and then you are repairing the barrier. This begs the question about the stuff that might not be in the gut, particularly something you mentioned earlier, neuroplasticity. Like, what's this have to do with either the nervous system or the brain? Why do you talk about neuroplasticity?

Well, I mean, I think this. I'll give just a short amount of context that I was very lucky to grow up with my parents exploring places like the Esalen Institute in Big Sur, California, where the notion was that humans have an incredible potential and they can do a lot of things. That's in many places where the human potential movement was born.

Yeah, that was like a lot of, like, hippies, plant medicine and stuff like that.

Back in the day, sitting in hot springs, talking about how to make the world a better place. Probably doing some of the initial Psychedelic psychotherapy there. So naturally, I studied neuroscience and I became very interested in the foundations of the brain. And I think that is where one entrance point that is extraordinarily powerful for us to influence chronic health conditions is by helping to inspire people, helping to educate them, to teach them biology, and then give them the tools to actually design their own protocol in collaboration with their medical and health team. And that's all accomplished because their brain can change and that new synapses are being formed, some are being strengthened, some are being weakened, and new brain maps are being created. As learning takes place in different areas of the brain, as they learn about the different interventions and as they learn their own body, and as they go through a trial and error process to see what's working for them and what's not.

So many people come to us and the experience that they've had up to this point has been people telling them what to do, doctors telling them what to do, the Internet telling them what to do. And instead, by way of empowering them with the knowledge and empowering them with the belief that they do have an innate sense of healing within them and cultivating that, then they're able to be informed and make their own choices in collaboration with their medical team. But no longer are they sitting and waiting for something to happen to them. They can take action.

Do you guys actually do things as part of your coaching program to increase neuroplasticity? Like, are there actual, like, brain games or biofeedback programs or things like that that you're having people use?

I think we take a less literal approach to neuroplasticity. To that is that we know that this is just a huge concept and helping them to understand it. I wrote my thesis on how psychedelics potentially induce neuroplasticity, and I was actually with Jim Fadiman. I was one of the first persons.

Oh, yeah, he was on my podcast.

Yeah, we loved it. Jim's my mentor, one of them. And, you know, we proposed that these compounds activate neuroplasticity. And, you know, he's not a biologist, so I put the biological explanation there and we published a textbook chapter. Now it's been essentially proven that this happens.

You mean like the classic, like, use lion's mane and psilocybin to grow your brain, that type of thing?

Sure. Or even in a more powerful therapeutic experience. But what we realize here is that it's not the psychedelic that's causing the neuroplasticity. What's happening is that the psychedelic is lowering barriers of resistance to Allow changes in the brain to occur. And you don't even need the psychedelic, okay? You don't even need that. You need a transformative experience for people. You need a place where people feel loved and held and said, look, if you come and you join our community, we will never give up on you. We will literally keep working with you until you are healed. And we will not stop until we are done.

So your guys program is called IBD Coach. And how does it actually work?

People come to us and we get people from all ranges of their experience with their ibd. Some people who are newly diagnosed, some people who have been struggling with it for decades, but they come to us because they're ready to take action. And so we have a three part program that includes a educational experience getting people back to high school, learning their biology workshops that we host with experts in ibd, microbiome, diet, nutrition. We're starting one on like Women's health this month. And so building that community is that third part where a lot of people with IBD do not have someone else in their life. I mean, increasingly everyone I talk to seems to know somebody, but it is a really isolating disease. It's not something that you want to talk about at a party per se. We know that also that IBD is a lifetime condition. And so through these three arms of our program, by educating people, empowering them, building a community around them, but also giving them access to expertise, we find that people are able to achieve results that they weren't able to achieve on their own.

I want to throw you guys a few curveballs, but I always need to be respectful of my guests and their levels of fitness. And so are you willing to walk another loop with me and, and go through one more series of questions?

Let's do it.

All right. All right, cool. Everybody's got this. Upper Gatorade, a hydration station. Okay. All right, so what are, in your opinion, if you could name the biggest mistakes that you guys see people making when they're trying to manage their ibd, either fed by myths in the nutrition or health or diet industry, or just lack of knowledge or ignorance. Is there any big mistakes you see people making over and over again when they have ibd?

Yeah. So one of the biggest things that we do when folks come to us is when you have something like IBD or any type of gut condition. It's really common for, for food to become this really tenuous relationship. You know, I don't know if the thing I'm about to put in my body is Going to hurt me. So when I find something that kind of works for me that doesn't hurt me, I lean really hard into it.

Right. The cauliflower rice for breakfast, lunch, and dinner.

Always. Always. So we get folks who have really, really limited diets. And so a lot of what we do, actually, is on doing some of that, like, dietary trauma, frankly, and helping them open up. Because this extra vigilance and stress that comes with such a restricted diet is just compounding whatever else is going on in the gut. Because there's that direct relationship.

Yeah. That happens with a lot. A lot. A lot of gut issues. Because I talk to a lot of clients and they're just, like, afraid of food. They just don't know what to eat. And it gets super stressful. Just not even be able to go to parties and stuff without just being awkward and pulling your packet of whatever baby food out of your purse.

It's really hard to watch people go through that. So that's one thing. Andrew, do you have another?

Again, I think it's the kind of a. To jump off what Amy said. It's that they believe that piggyback is.

The word you're looking for.

That's correct. That's correct. That they. People think there's a silver bullet, that this one medication is going to work, this one supplement is going to work, this one diet's going to work. Oh, just. It's this. You've got to get out of this mindset that there is a silver bullet for this condition, and there's clearly not for most individuals. It takes a nuanced approach, it takes a complex approach, and it takes some trial and error. There is no allergy test that's gonna tell you what the optimum protocol is for this condition.

Now, what about the diet? Like, is there a diet that just, like, over and over again, seems to do really well for people who have ibd?

I love this question, because unfortunately for those who want that answer, there is not one. There are definitely strategies that tend to.

You're never going to make any money on a diet book.

Yeah. It turns out that the problem is a little bit more complex than that. So there are a few strategies that have good patterns throughout populations. But what we really do is think of food not just as food lists, but really the context of the food. Is your food cooked? What texture is it? What time of day are you eating it? How much of it are you eating in combination with what other factors? So, you know, gluten tends to be pretty aggravating for a lot of folks with IBD and without. But what if that gluten came with a giant pile of fruit? Then this proportionate damage that it would be causing would be potentially mitigated. And so being able to personalize that approach and really build an intuition around food, because there is no one diet.

Which diet is the closest? Which diet is the closest? Give us something.

Okay, so look, there's something going on with complex carbohydrates and ibd, almost certainly, and eliminating processed foods. So the first diet to kind of identify that is called the specific carbohydrate diet. Yes, I know that one.

Those are my friends Stephen Wright and Jordan. I forget his last name, but it's similar.

It's very similar to and ancestral diets. It's similar to aip. It's similar to other dietary interventions. But the reason why we don't really like to name certain ones is because people get caught up in these dogmas of that foods are legal and illegal. And Amy can even speak to that more because that's where she specializes.

Yeah, that food is not a moral situation. We really think that. I really think that the language that we use has a lot of impact on how we move through the world. And so calling something illegal is just not going to give your brain a good experience when you're confronted with the opportunity to make a choice about that food. So we don't call it cheating. We call it a food exploration or a food adventure.

Yeah, I think that to a certain extent, it becomes tricky because we have a very recent podcast guest of mine would have called a molecular herbalism approach to food, particularly plants, instead of an ancestral herbalism approach, meaning that taking into account the electromagnetic energy of that plant, its connection with. Now I'm going to get all woo. Your heart, your brain, your own electromagnetic field, how that plant is speaking to you when you hold it, and whether you know intuitively is something that you feel as though you should or could eat. The sacredness of food. You, you know, like I talked about in my talk, like, it's something people gather around. It's not just macronutrients like carbohydrates and fats and proteins. It's energy, it's life, it's tradition, it's how many photons of sunlight it carries. And so it's super duper important food is. And I would imagine it's a. It's a really tricky balancing act when you have ibd of kind of like breaking down food real scientifically into what's going to be good for you. And what's not, but also acknowledging kind of like the deep sacredness of food. It's not as though food isn't important, but I guess, you know, it's the type of importance that you place upon it. Does that make sense?

Yeah, that makes sense. I. I just read something a friend mentioned to me too recently of like, we don't have a tendency, we don't have a culturation to like smell our food before we eat it per se, and how much we're missing pieces of information that come through. Now we have hyper palatable foods and that is a whole other conversation. But like, Andrew has this almost sixth sense with food that he eats where he'll put it in his mouth within a few seconds of just holding in his mouth or smelling it, his body will tell him this is a fast food or this is a no food today.

You know, when I recorded a podcast with Paul Check about intuitive eating, I kind of added that into the way that I selected foods. And sometimes I will literally hold, in many cases it's packaged foods for this, but like I'll hold some supplement or some bottle or some can or some package of something and my body very, very quickly kind of tells me whether or not I should be taking that. Even if it's something I've been taking consistently for like the past week. I'll wake up one day and it's almost as though my heart is telling me, no, this is not for you today. Does that make sense ever happened to you guys?

I've definitely heard that a form of that intuition called like muscle testing and you know, call it what you want, but your body has an internal wisdom to it. It knows what it needs if we can tap into that.

I think the idea is to get IBD patients into remission and get them to live their f cking lives again and be able to eat what they're going to be able to eat, not worry about something causing them to go run to the bathroom 20 times a day. You know what I mean? Or setting off something. For example, I looked through your cookbook, Ben. I could eat every single thing. Yay.

Even the donuts.

Even the donuts. I specifically looked at the donuts and I was like, they're pretty damn good. So I'm stoked to make. I love cooking too, you know, and I'm stoked to make those. And that's what we want for every IBD ER in our program. To be able to just pick up a cookbook like yours, that's healthy, that has real beautiful gourmet food in it and be able to be like, you know, I can eat like 90% of what's in here or I can modify something very easily in order to make it it with my diet. But you know, I'll just say, look, I mean a lot of we, I think another piece of diet is the movement away from dogma, okay? It's just like, you know, people come in that they're fully vegan or plant based and we slowly help them to. We don't push it on them, but we help them incorporate animal products in a really responsible way if they're willing to do it. If someone really wants to be plant based, then we'll flow with it. It's there. You know, we work for them.

I think, I think the main problem is identifying with it and becoming attached to it, you know, you know, like a, like a crossfitter. The crossfitter vegan. That's their identity. I'm totally getting beat up by all my crossfitter friends now, so. But all my vegan friends because they're pacifist and loving and they'd never.

I love my vegan friends and I also love my carnivore friends.

I know I posted on Instagram recently, you know, me shooting my bow, getting ready for hunting season. But you know, I asked all of my vegan and plant based followers on what do you guys plan to forage this year, right? Like what mushrooms, what plants? It's, it's not as though there's not a real, you know, again, like a sacred appreciation for food and even like an adventurous and explorative aspect of food and especially like a well comprised plant based diet that hopefully includes some amount of foraging or at least a, a few farmers markets here and there.

You can find incredible foods right in your backyard. Amy and I lived in the Oakland hills and she and I brought back 24 pounds of oyster mushrooms this year just in our forest, just right there. Everyone ignored it, everyone walked past them, no one saw them. They were delicious.

Oh my gosh. Olive oil salt. Mushroom party at your house.

They contain beta glucans that are prebiotic anti inflammatory things. And actually there's actual data with beta glucans and ibd. So again, you can find a lot of the foods. You know, please be very careful with mushrooms. They can kill you. Please be very careful. But you know, a lot of these foods are available to us. The huckleberries that are growing near our house packed with anthocyanins and flavonoids. There are so many different Aspects that are just available to us even in semi urban environments.

There's something that you brought up earlier, and this might be the last little avenue that we explored. Explore. We, we've brought up stress a few times and how much an overacted sympathetic nervous system can drive digestive distress. We talked about the olfactory receptors and just smelling your food before you eat it. But, you know, one thing that we do at our house before we eat is we typically do anywhere from one to two minutes of breath work. Just deep in through the nose, out through the mouth, usually dwelling upon something that we're grateful for today, usually finishing with saying grace over the meal and essentially preparing the body to receive food is the way I often put it, but really it's kind of down regulating the sympathetic nervous system a little bit. And I think that for some people who are very stressed around food, it would be interesting to see how they might respond to some kind of biofeedback. Meaning there are devices you can wear that will tell you when your HRV is too low, your heart rate variability is too low, and then have some kind of a vibration or a cue that then it's usually tied into an app on your phone and it brings you through just like a short cycle of breath work to get your HRV back into rhythm. You know, I, I think that people with gut issues, if they just made a rule for themselves for the entire week that they were not going to eat food if their HRV was low, and actually determine using something like that, how to breathe themselves into a relaxed state before eating, I think that could be a really helpful tool.

Yeah, I'm gonna, I do agree, you know, with that. I think the larger issue here is just that there are just so many interventions, you know what I mean? And there's just so many things that people with chronic disease can do. And how do we help people to be in a mindset that they can take these overwhelming opinions that are all over the Internet, even at this conference, you know what I mean? Everyone has their own sort of thing that it's all Omega 6 or, you know, vitamin D is so crucial and, you know, all these things are so important, but they are.

Everybody has their hammer.

They're one piece of a puzzle, right? Of a complex puzzle. And how do we help patients with chronic conditions to accomplish that? And I'll let Amy comment on this and then I can tell you a little bit more about where we're going and how, you know, how we plan to accomplish that.

If you want anything to add in There, Amy.

Yeah, so, like, such an important piece of what we do is helping people who tend, like, it's interesting that there tends to be a personality overlap with this condition of, like, doerness and overachieverness. And I also am an overachiever, so I. I really have a lot of empathy for that.

Driven is the author of a book called Driven Doug Brackman, and describes it on my podcast, the Driven Personalities.

Yeah. And so there's a tendency, especially in such an area where there is so many things that people can be doing that when they're not feeling well, they're like, but I should be doing more. And a lot of should comes into that, like, self talk. And so helping people get a little bit more distance from it. Like, well, you know, IBD isn't something that you caused. It is what it is. And all that we can do is take one day at a time and then. And so, like, getting a little bit more inner peace with, you know, sometimes they're good days, sometimes there's not so good days. There is always more that you can do, so you can't do it all. Sorry.

Yep. Anything you were going to add in there? Andrew, you said you wanted to say something before. Turn it to Amy. Sure.

Yeah. This has been awesome, by the way. And Ben, I'm kind of a newer follower of yours, and I've just really appreciated all of your work. And your book is just like, oh, my God, this is just like a reference book.

Thanks. I'll send you a royalty check later.

I really appreciate it. Okay, so look, I mean, there's a huge problem right now in the United States and around the world, and it's unseen. Sure. We see Covid. We see environmental devastation. We have in California now. We have a fifth season. It's the smoke season. And, you know, it hasn't even hit yet. Luckily, we see these big problems in. One that I feel we don't see is the prolific rise of chronic health conditions. And we see it every day. This is an epidemic. People are being diagnosed with inflammatory bowel disease and other diseases at increasing rates every single day, every single month, every single year.

How it happened to one of my family members two years ago.

Absolutely. So how can we. Obviously, the legislative solution to our healthcare system has been stalled for a very long time, and that obviously needs to happen. But how can we, as private citizens, as business owners, entrepreneurs, as philanthropists, help this situation? And what we see is creating environments for people with chronic conditions to empower them, to teach them science, to give them the resources to allow them to build robust protocols that they can try on themselves, that they can act. We actually deepen the connections with mainstream GI doctors. We help patients follow doctors orders and we also help them to ask questions when they're just prescribed a medication out of the blue. And sometimes even most of the time the doctor says, hey, that's a really good question. You know, I didn't even think about that. Yeah, maybe I shouldn't prescribe this really powerful drug right now when all these other things are available right now. And you know, I was waiting for the pushback from our program from like mainstream GI doctors. It has not come. They are, you know, and they are historically have told their patients that diet doesn't matter. They've been very, very positive with us.

That's awesome. And your guy. It's called IBD Coach, right?

It's called IBD Coach. And I think, I think the direction that will go here is we want to really expand. We want to show that this works with people with this horrific condition and then branch out with this approach to other conditions. Build physical spaces, retreat centers. And the big goal here is to get this covered by world governments and by insurance companies. And everyone can win here. We have calculated that we have already saved insurance companies collectively over a million dollars in our program.

Wow.

So everyone can win here. Everyone can make money and we can save lives and we can transform people's lives. That's our message.

Well, I've got one more million dollar question for you. You get 20 seconds to reply. Max, you're shoving off to a desert island where you'll be for a year. What food are you going to bring Amy first?

No, I don't have an answer that quite yet.

You're stuffed. You're kicked off the island. You don't survive.

I'll figure it out when I get there.

I think I would bring a really amazing steak. And that's such a controversial thing to say with people with ibd, but I've.

Just been feeling the power nutrient dance. Had dinner with a friend last night at Bel Campo and he has a lot of gut issues. He started eating just meat like 10 weeks ago and he said he's never felt better. I think I would just probably bring some, some like worms to catch some fish with. I could always eat them one.

Ben Greenfield's gonna live longer than all of us on that island.

Well, for everybody listening in, what I'm gonna do is, is I'm gonna, I'm gonna link to Andrew and Amy's grams and websites and everything. Else that you need to stay in touch with them. I'm gonna put all the show notes@bengreenfieldfitness.com ibdpodcast where you can go and leave questions and comments and feedback. And a lot of times, the people I interview will sometimes jump in as well, which is fun. And I know this is a big issue for a lot of people. So Andrew and Amy, thank you for, for making the poster, for doing what you do, for doing IBD Coach, for filling people in, for going on the sunshine walk with me. Thank you for interviewing. It's been amazing making new friends.

It's such a pleasure to be here. Thank you so much.

All right, you guys, I'm Ben Greenfield signing out with Amy and Andrew from IBD Coach. Catch you on the flip side. Well, thanks for listening to today's show. You can grab all the show notes, the resources, pretty much everything that I mentioned over@BenGreenfieldFitness.com along with plenty of other goodies from me, including the highly helpful Ben Recommends page, which is a list of pretty much everything that I've ever, ever recommended for hormones, sleep digestion, fat loss, performance, and plenty more. Please also know that all the links, all the promo codes that I mentioned during this and every episode help to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. So when you listen in, be sure to use the links in the show notes, use the promo codes that I generate because that helps to float this thing and keep it coming to you each and every week.