The Root Cause Approach to Healing Chronic Gut Issues with Hannah Aylward

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I'm JJ Virgin, PhD dropout— sorry, Mom— turned 4-time New York Times bestselling author. I'm a certified nutrition specialist, Fitness Hall of Famer, and I speak at health conferences and trainings around the globe. But I'm driven most of all by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information that I uncover with as many people as I can. And that's where you come in. That's why I created the Well Beyond 40 Podcast, to synthesize and simplify the science of health into actionable strategies to help you thrive. In each episode, we'll talk about what's working in the world of wellness, from personalized nutrition and healing your metabolism to powerful aging and prescriptive fitness. Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out at 100. Don't miss an episode. Subscribe now at subscribe2jj.com to start unlocking your healthiest, most energetic self. Want to listen to the show ad-free? Head over to subscribe2jj.com and start your ad-free experience today. Hey, JJ Virgin here. Today we are going to go into gut health, dig into it a little bit, dive deep into it. We haven't done that in, gosh, quite a long time. So I thought, you know, it's time to start talking about small intestinal bacterial overgrowth, leaky gut, parasites. And I have a great guest with me today. It's Hannah Aylward, and she is a functional gut health practitioner and got into the business, which I would assume so many people who get into the gut health space get into the gut health space because they got gut problems. And she was similar to that, dug in deep, and now has an entire business with lots of gut practitioners working with her to help people figure out the root cause of the root cause. So quite often we talk in functional medicine about finding the root cause for something, but quite often in the gut health space, we still kind of skim the surface. So we're going to talk about what kind of lab testing you can do to really figure out what's going on, how awesome a stool test is. I just did a stool test with Vibrant Wellness and, uh, Vibrant Labs rather, and it was fantastic. And, uh, some of the things that you can do to heal your gut, things to look out for. She also has a great quiz that I will be sharing at jjvirgin.com/hannah, H-A-N-N-A-H, that will help you kind of identify what could potentially be the problem. So I will be right back with Hannah and to go into gut health and explore a lot of different issues, everything from microbiome diversity to oxalates and histamine intolerance. So stay with me.

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Hannah, welcome to the show.

Thank you so much for having me. I'm excited to dive in.

Me too. You know, it's interesting because I kind of spent years just talking about gut, and then I just stopped talking about gut. So I'm excited to bring it back to Well Beyond 40 because we haven't really dug into gut issues for a while. Um, first I'd love to just know how you got interested in them.

Yeah, absolutely. So, you know, I think a lot of us get into this work because we like had our own issues, and I, I am in that category as well. So I was someone who was really like struggling with chronic bloating, looking like 6 months pregnant after eating an apple or like a salad. I was eating very healthy, I was eating a very clean diet, and I was exercising. Like, I've been into health for like as long as I can remember, but I was still really struggling. And then I was dealing with constipation and lots of different food reactions. And things just weren't really like making sense. I was young, I was active, I was healthy, and things were not really lining up. And I did all of the elimination diets and I did all of the things and it would make me like— it would help me get a little bit better and then I would kind of fall back again. And so finally I just kind of started digging into the gut environment and the gut microbiome and digestion as a whole, really realizing that there's so much more to the topic and conversation other than just the food that we're eating.

So, right. Yeah. It's kind of endless, honestly. And I think the part that people miss with elimination diets is the other side of the elimination diet is actually healing. Healing the gut. It's like you got to do both of those things. When I was in college, I still remember because I was teaching aerobics, dating myself, in the '80s. And I remember I was walking back from teaching aerobics in a workout outfit and some woman stopped me. I was cutting through a department store and stopped me and asked me how many months pregnant I was. I understand that feeling. I was like, whoa.

Oh my gosh, yeah, a lot of our clients say that, you know. It's like sometimes they wake up bloated, or by the time they go— like, the day progresses, they have to unbutton their pants at the end of the day. And I know it. And, you know, the bloating is uncomfortable, but it's like everything that comes along with that, like canceling dinner plans and being afraid to travel and someone asking you how many months pregnant you are, you know, that really starts to leave its Well, I'm kind of trying to think because, you know, we do get into things because of our own stories, but it's like, it feels like gut problems are so prevalent, right?

Uh, and more so now than ever. So what do you think is going on?

Oh gosh, I feel like I could talk about this for 3 hours, just this. Um, I think so many things. I think of course our diet plays a role, you know, and we'll see some patterns. What's interesting is we run a lot of functional stool testing with our clients and we'll see patterns in people, and one of them is a decrease in bacterial diversity. And that can kind of reflect like the restrictive diets, or really maybe not restrictive, maybe that's not the right word, but more so the diets of like the same 5 foods, right? Like we used to have all of this diversity in the diet naturally, and we have much less of that now. I also think chronic stress. I mean, if we're— if there's one thing to kind of get a handle on, it's that. And And stress, I think, can be put in a lot of different buckets. I like to kind of section them out so people can better understand. So we've got physical stressors, overtraining, underfueling, blood sugar dysregulation, nutrient deficiencies. And then we've got mental and emotional stressors, being on your phone all the time, running from meeting to meeting, kind of just the chronic stress that we're all dealing with, the hyperconnectivity that we experience today too. We're always on. And I can check my email in my bed at 11:00 PM. This kind of— I hope you're not. I am like very much in process here. And then the environmental stressors, so things like mold exposure and heavy metals and chemicals and things in our water and our air. So I think like stress overall is contributing to some of these chronic, chronic digestive issues. And then you've got like antibiotic use and medication use and birth control use and all of that.

Yeah, just to frost the cake. Yes. It does seem— I don't know if we are just getting better at identifying mold because it just feels like it's such a big problem. Obviously a lot of these other toxins are kind of new in the last couple decades, but mold, um, it just feels like it's everywhere.

Yeah, totally. It was part of my story and I had no idea. I mean, I knew all about healthy eating and I knew all of that kind of stuff, and I was living in mold and I didn't know. And that was part of what was kind of playing a role in my story. And I felt like I had this like layer of like inflammatory weight I couldn't lose and my face was like, it almost looked like I was taking a steroid. Like if you look at my face now versus then, my eyes were sunken in, my face was kind of all puffy and my digestion, I mean, I was having like crazy reactions even to all of these healthy foods. So I agree, I like, I mean, I could really get up on my soapbox here about mold, but I do think it's a huge underlying root cause to like a lot of chronic symptoms. Symptoms that we can't really get a grasp on.

Yeah, one of the first things I was taught about looking at food sensitivity testing was when you had this hyperreactivity, it wasn't the foods. Yes. It was why are you reacting so much? What are the underlying toxins? But I will tell you, like when I started down all this path like 25 years ago, there was very little being taught about mold. I remember being in one mycotoxin lecture and everyone was like, oh my gosh. And I just, now I live in Florida. I used to think I was safe living in Palm Springs and I found out, no, you're not. But it's like, where would you possibly be with that you could be free from mold? I can't think of a place.

I know it's really hard. I'm from Florida. And so there's a lot of mold in Florida. I'm like born and raised there. Mm-hmm.

Mm-hmm. Mm-hmm. Mm-hmm.

You know? Yeah. The humidity there and then like the hurricane damage. I mean, my goodness.

Mm-hmm.

So I don't think, I don't think you can escape it all, right? I think it's more so like supporting your body's detox systems and maintaining like strength and health and minimizing stress as your baseline. And then just making sure we're not getting too much exposure, you know, through like leaks, like water damaged buildings. Always check your HVAC, especially in a place like Florida where there's just like, you know, the condensation is building on the HVAC. I was living in a place with a brand new HVAC. They were like, it couldn't possibly be the HVAC, we just replaced it. And then I opened up the closet and it was, it was growing all— oh no, I know. But it was, it's because it was so hot. Like, Florida gets so hot and then it's the, the AC system's like pumping out like on overload, um, and then it just grew on top of the HVAC. And then at that point it's being pushed through your whole house, you know. So it's— I try to find the line of like empowering people and educating them but not like just having people be afraid of every single thing because it's easy to be.

Yeah. Well, as far as the mold thing, I'm trying to remember the name of this kit that we did because it was a different type of mold. Like, I've done a bunch of mold tests in the house. I'll find it for the show notes, but it was a pretty interesting dust kit that we did all throughout the house to look. So far safe in Florida, which is amazing. That's great.

It may have been the ERMI, E-R-M-I. Was that the one?

No, that was not it. Okay. I'll have to, I'll find it. It, pretty sure it was called the DUST. It might have been called the DUST test.

Yeah.

Something unique like that. Anyhow. All right. So, so someone comes in, like I'd love to just kind of walk through how someone would look at this. Someone's got, and here's the other challenge with GI issues is so often we're not connecting those dots. Like, some of the obvious things like gas and bloating or constipation or diarrhea— oh, but you may not connect the dots between your joint pain or your skin issues. Um, first of all, before we go into like how you would look, look at all of this, what are some of the different things that a gut problem can, can cause beyond the obvious gut symptoms?

Yeah, I mean, you're right on the money there. Essentially everything. Of course I'm biased because this is like what we— what I do and what I've dedicated my life to, but brain fog, right? Really bad brain fog. It can contribute to heightened levels of anxiety or— and depression. We can see a lot of skin issues. So we have like— I have someone on my team who specializes in the gut-skin connection because we can get really like direct in that kind of work. And we'll see a lot of different gut infections, gut bacterial imbalances present in conditions like acne, eczema, psoriasis. Thyroid issues. So like anytime someone has hypothyroidism or Hashimoto's, I mean, we have to take a look at the gut because the gut influences the thyroid and then the thyroid influences the gut as well. Sometimes weight gain, you know, I would say like a little less that. That's not my first go-to, but if that— if the gut is influencing the thyroid, then we'll see the metabolic function, you know, slow down. So there's that. Those are probably some of the most consistent things that we see in conjunction with just the chronic GI issues and the, you know, quote-unquote IBS.

So someone coming in and they're— they want to go and look and say, okay, what could be going on? What would be the first thing that you would look at? Would it be a stool test?

Yeah, so, you know, I would say it kind of depends on where the client is at in their journey. We tend to see a lot of people who have like done a lot of stuff already, so our client is not someone that needs to like eat less processed food, right? Our client is like, they've done all of that. They're pretty advanced, they're well-educated, and then they're like, I don't know what's going on. So we— non-negotiable— we're running functional stool testing. I see it, it was a complete game changer in my personal journey. We run the GI Map by Diagnostic Solutions Lab. Um, truthfully, I think there's like ups and like positives and negatives to all of them. I think no test is perfect. I think you've really got to know how to, how to take a look at it and kind of where it falls flat. We've learned over the years because we've been running it for probably 5 or 6 years now. But that's going to show us tons of different microbial imbalances— bacterial, fungal, parasitic infections, bacterial infections— and also mal-digestion patterns. So are you actually digesting your food efficiently? Because that alone can cause chronic bloating and GI issues if you just don't have enough stomach acid or you're not producing adequate pancreatic enzymes or anything like that. So the stool test is going to give us a good kind of like bit of data to work with that can inform what we do next with the client.

You know, it really seems to me— and I just did one through Vibrant Labs. I'd always done the DSL GI map before, and I did the Vibrant Labs, which I thought was fantastic. Awesome. And it really strikes me that, you know, when we do physicals, like when someone goes to their doctor to get a physical, like, I look at it and go, I think we're doing the dumbest stuff. You know, like, what if you went to the doctor to get the physical and you had a body composition test, a handgrip test, a VO2 max, a stool test, and, you know, and then started to look at some other things too, and things like a fasting insulin and vitamin D. But like, you know, Hippocrates was right on everything starting in the gut. If your gut's not working right, nothing else is going to work right. So it's— I'm thinking of all the years of looking at stool tests, and I've never had someone do a stool test and have it look perfect, ever.

Exactly. Exactly, yeah, I mean, I agree with you there. And sometimes we get that question like, why isn't my doctor running this? Or my doctor doesn't even know what this is. And I'm like, I think, once again, I could get up on my soapbox, but there's a lot of reasons kind of why that could be happening. And we get, doctors will refer people to us, and then some people, some doctors don't think it's a joke. So it's really truly hit or miss. But I do think, yeah, I mean, we can always find There's always something that can be tweaked to help people feel a lot better.

Yeah, and I know the functional docs, they all, they look at these. So, you know, it's more the traditional, and it's not their fault. It's the fault of the educational system.

Yeah.

That this just hasn't caught up. There's that 20-year rule. So someone does a stool test and let's say that you find poor microbiome diversity, which I think is probably a pretty chronic issue out there. What are some of the things that you do to help? Why is that a problem, first of all? And then what are some of the things that you would do for that?

Yes, so, um, we can add in a lot of targeted nutrition support to support the gut microbiome and support that gut proliferation. This is a problem because you're— to put it simply, like, your good gut bacteria help to kind of weed out the bad gut bacteria and help to weed out the other microbes that can be present in the gut, things that are naturally occurring like fungi or yeast. Like archaea, like parasites. So your good gut bacteria, when they're kind of like taking up house, there's going to be less room for things like fungi to overgrow. And we know that when we have an overgrowth of yeast or Candida— most people would probably know it as Candida overgrowth— I mean, that can cause tons of symptoms for people. Recurring yeast infections, lots— we see it a lot and like very prominently in skin conditions, rashes, histamine stuff, chronic like diarrhea and bloating. Your gut bacteria kind of help to like maintain this ecosystem. The other thing is that certain gut microbes, you know, will help with gut motility. Certain gut microbes will help with metabolic function. Certain gut microbes like Akkermansia muciniphila, this is one that helps to maintain a strong mucosal barrier of the gut lining that helps to kind of then maintain that epithelial barrier of that gut lining. So that like cellular layer, basically like protecting us from things like leaky gut. So these gut microbes play so many different roles and even, you know, 20% or so of our thyroid hormone is converted in our gut microbiome. So we want a lot of these good gut microbes in, in the gut microbiome. Um, how we can help support these— yeah, lots of targeted nutrition, which is really fun and cool, and we can get a bit like specific with it depending on what you have. So when it comes to Akkermansia muciniphila, we see like very low levels of this very commonly. The research also shows that it's pretty prevalent to have low levels of this when it comes to different skin conditions like psoriasis or eczema. So once again, like, really cool, cool research that we can use. In order to bump up those levels, we can increase our intake of, like, polyphenol-rich foods. So think of foods that stain, things that you put on your cutting board and they leave a mark. So things like beets or raspberries. Increasing your intake of these foods can help to boost the levels of this good gut bacteria. So kind of depends on what's present, but we can bring in a lot of nutrition support here.

So what do you think of the, um, the 30 Plants a Week American Gut Project? Are you— do you think that will do it, or do we need more than that?

Yeah, it's a good question. Um, I think it's great. I think like that's kind of the biggest data source that we have, so it's, it's great to work with that. I would say a lot of our clients are too sensitive to eat a lot of these fibers. So when we've got a big bacterial overgrowth issue or fungal overgrowth or someone has SIBO, small intestinal bacterial overgrowth, they're gonna be really reactive to fibers. So they're gonna do better on a lower fiber diet only temporarily. I am a big fan of getting in enough fiber long term, but that's where people can get super confused, right? 'Cause they're like, I'm eating, I read this research, I'm eating all these different plants and I'm like, I'm more bloated than ever. Yeah, I'm more gassy than ever and I'm super uncomfortable. And that's just kind of a sign that there's like a deeper gut environment issue. But for most people, if you're— if you don't have a lot of these chronic digestive issues and you're just looking to like maintain good health and good gut health, then yeah, absolutely bring in a lot of plant diversity and just make sure you're getting in some good prebiotics as well.

And what are some of your favorite prebiotics?

Yeah, I love jicama because it's like really yummy. It's great to chop up and you can dip it in like guacamole and and it's really refreshing, I think. So that's a great one. We can also use like dandelion greens. We can also use sunchoke or Jerusalem artichoke. Sometimes it can be helpful to get them in through like a powder. So I try to get in like personally a very diverse diet, but I also will do a scoop of a good prebiotic powder in my coffee every morning. So that can be a nice way to just kind of make sure that you're getting it in. And then also resistant starches. So like cooked and cooled potatoes, oats can be great. Make sure to add in your protein to help support your blood sugar and different things like that.

Yeah, I think it's a good idea on the powder thing because you look at a lot of the prebiotic foods and you're like, mm, you know, just haven't seen the dandelion greens out there much on the menu. Whenever I see sunchokes though, if I'm out, they're always, they're always a yes. So Let's get into leaky gut and food sensitivities. This is one— it was interesting, um, I first ran across this because I was actually teaching for Metametrix back when there was Metametrix, and they had a food sensitivity test. And what I saw was that the foods that were most common for people to react to were not what the Elimination Diet— the Elimination Diet back then was a very complicated thing, and I'm like, I don't see anyone reacting to the foods on this elimination diet, they're reacting to these foods. So I redid it and simplified it, and that's— it was all based on what I was seeing with all of these people. And back then, literally, people would say to me, there is no such thing as leaky gut. I'm like, oh, all right, well, um, you know, I just know what I'm seeing here. So I'd love you to share, because you've already mentioned stress, which I think is the biggest culprit for leaky gut. Um, but what you're seeing with leaky gut, are you using an IgG4 test? Like, what are you doing to identify it? How are you healing the gut? What's your protocol there?

Yeah, great question. I would say, so when we run the GI Map, there is a marker, like, um, it's called zonulin, that you can run on the GI Map. But to be honest, we don't add it onto the GI Map very often. It's an extra cost to the client. And my kind of like assumption is if you've got a lot of dysbiosis we've got gut barrier issues. Like, we don't, we don't really need to test for it, you know. So also because of course the supports that we're gonna be adding in are not— they're unlikely to do like damage, right? They're not— we're not working with medications or anything like that. So, so yeah, I think we can obviously run into a lot of issues when we have that increased intestinal permeability. And what we see is a lot of dysbiosis, whether it's bacterial overgrowth, overgrowth of like histamine-producing bacteria. I feel like there's a big uprise in histamine issues right now that it's kind of like making the rounds.

And I don't think they're doing this— like, we'll go back over to this, but when I look at histamine, then people are like, well, you just have to eat a low histamine diet. I go, don't we need to figure out why you got a histamine problem?

Exactly, exactly. Yeah, I feel like I'm like screaming that from the rooftop these days because anytime something kind of like hits, hits the algorithm, then it's all over, and then people are asking, asking us about histamine stuff, and it's obviously it's very real and we just have to get into, you know, are you overproducing or can you not break it down efficiently or both? And usually it's a bit of both, you know, and that can contribute. The intestinal permeability can contribute to the histamine issues as well.

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Great. I want to talk histamines, oxalates, lectins, all that. But let's go back over to just the food sensitivity. So how are you looking at food sensitivity? Are you doing— and what type of testing are you doing, or are you doing testing?

Yeah, we don't run food sensitivity tests, which I know is like very different than what a lot of people's approach. Um, my goal is for clients to be able to tolerate as many foods as possible, and we don't want to strip foods out of the diet unless they're like actively reacting to the foods, because I think it's very quickly just a downward spiral of then people are afraid to eat pineapple, you know. And I'm just like, this is not— we don't need this. There's too much, you know, like I would rather you be eating healthy whole foods. Yes, we want to take out the ultra-processed stuff, of course. But when it comes to food sensitivities, you know, we're on the same page. We have to get down to the reason why you're reacting to the foods in the first place. And this is always a deeper gut environment issue. The gut lining plays a huge role in this. Also gut bacterial imbalances, you know, and also fungal imbalances, etc., parasitic infections. And then our digestive capacity. So, you know, digestive capacity and our ability to actually break down our foods is a bit more in the like food intolerance space, but to the client, people lump together food sensitivities and intolerances, and they're just like, I'm reacting to this food, so what do I do? And, you know, we can have a lot of reactions if we just can't break down the food very well. So for example, if someone feels like they're eating fats, they're eating like, you know, avocados and coconut oil and almond butter, and they are— feel quote-unquote sensitive to those foods, well, the underlying reason to that could be fat mal-digestion, and we've got to support liver function and bile flow. 'cause bile helps to break down those fats and absorb those fat-soluble nutrients. And this is what— like, we're seeing this very prevalently in our clients right now, like this fat maldigestion and liver picture.

Why do you think that is? 'Cause it feels like for, you know, protein digestive issues have been around for a long time. I think probably a big contributor to food sensitivities, but the fat one I think is a big deal that hasn't really been addressed.

Yeah.

Is it because people are like going keto and then recognizing it, or what's going on?

Yeah, that's a thought.

You know, keto's kind of past, right? You know how diet trends are. Maybe they're carnivore. I don't know.

I know, I know. And then people go carnivore and then they're like, I'm, I have diarrhea. And I'm like, it's because you're eating all this fat and you can't break it down, you know? But, um, if you want my honest, like my honest take is—

No, let's just make stuff up.

Yeah. Well, I think, I think that the birth control picture, like women being on birth control for a really long time is playing a role.

People still doing birth control pills?

I think so.

After all the stuff that's come out about it? Oh my goodness.

I know, I know. Well, and I always hold, I take the stance of like, listen, you gotta weigh the pros and cons with any medical intervention. You weigh the pros and cons, you do your research, and then you make your informed decision. I get really upset when people don't have, they can't make an informed decision 'cause they've been given no information, right? For some people, still gonna be worth it. For a lot of people, it won't be, you know? So, but, that use of birth control over time, I mean, that can cause some extra stress on the liver and gallbladder, and it can increase estrogen levels, which can also cause strain on the gallbladder. You know, women are at higher risk for gallbladder removals due to higher levels of estrogen. So I think that's playing a big role. I also think the fact that women are getting more exposure to chemicals through things like beauty products and skincare and all of that, I mean, our liver, it's just putting our liver under, you know, it's got to do a better job basically. Um, so I think there's quite a few reasons. Alcohol consumption, you know, all of these things can, can be playing a role. And whenever we have a gallbladder removal, we always have to ask, you know, what— how did this happen? And if you need your gallbladder removed, there was probably a liver issue that's been, you know, brewing in there for a little while that impacted the bile, because the liver is what actually, you know, creates the bile and produces it. So I think there's, yeah, many, many different reasons. And then stress. Yes, of course.

Yes. But it is interesting. I used to see a lot of people one-on-one. I never had any men with gallbladder issues. Never. Only women.

Yeah. Well, that estrogen component, you know, that estrogen component, and that can be— so many women, I mean, I'm kind of opening up a can of worms here, but so many women lean more estrogen dominant. We can also, my opinion, trace that back to stress because stress over time, increased cortisol, will contribute to lower progesterone levels, which will contribute to that estrogen dominance picture. So it all kind of makes sense when we trace it back.

Yeah, it definitely makes sense. So over to then the— with the leaky gut piece of it, what are some of the things that you like to put in place to help heal the gut back?

Yeah, the number one thing is we have to look at the microbiome piece and make sure that we're cleaning up the microbiome piece so we're not causing more irritation of that intestinal barrier. So bacterial overgrowths, infections, things like that. Then we can of course bring in targeted nutrient support. So sometimes L-glutamine is helpful. We can use things like zinc. Omega-3s can be great. Vitamin A can be great. Immunoglobulins are great for gut immune function. So those are some more kind of targeted strategies that we can bring in. And then of course supporting the, the regrowth of and the repopulation of those good gut bugs. Once again, going back to Akkermansia, like low levels of that can contribute to intestinal permeability. So we're— we take the approach of not just, oh, here, take this one leaky gut supplement, right? We're like, what is everything that's contributing to this breakdown in the intestinal barrier? Including the stress piece, because we know cortisol will poke holes in that mucosal layer of the gut lining. So it really takes like a whole comprehensive approach.

I do think that, um, part of the issue we have with GLP-1, like the whole GLP-1 phenomenon, I think part of it is because we aren't producing what we need to be producing because of leaky gut. Now I think there's some resistance too But I think that's part of it because you've just mentioned acromantia multiple times. So I think that is a piece of it. With, um, with SIBO, are you going and doing advanced testing with SIBO, or are you just able to see what you need to do off of a stool test?

Yeah, so the stool test is technically checking the large intestine, so we won't get like a positive or negative for SIBO in with that test. Um, the gold standard for diagnosing SIBO would be your breath test. Some of our clients have already gotten them. They'll come in with those from their doctor. Sometimes they'll go for them. We can— and I'm always, you know, this will probably get a little bit of eye roll, but we can see some suggestions of patterns on the GI Map that could be suggestive of an overgrowth in the small intestine. So if we see that your bacterial phyla that make up a huge portion of your gut microbiome are like really overgrown, we can, you know, kind of make the assumption like you've just got too much gut bacteria it's likely happening in the small intestine as well. But we, when we build out protocols, we're going to kind of address things in the small intestine and large intestine anyway. So sometimes it is like, and every client's a little different, honestly. Sometimes we want to send for a SIBO breath test, they go through their doctor, through their gastro, they get that done. And sometimes it's not fully, fully necessary.

I would imagine the symptoms are probably pretty clear too.

Yeah, yeah, yeah. I mean, that chronic like upper abdominal bloating, lots of reaction to fibers, I would say that's, you know, and Anyone that feels— if you try a low FODMAP diet and you do feel a lot better, I would say that's like a pretty clear sign that you've got some bacterial overgrowth.

Share with everybody, just in case someone doesn't know what a low FODMAP diet is, what, um, what this is and why someone would do this.

Yeah, yep. So FODMAPs are just fermentable carbohydrates. They're actually very good for a gut microbiome because they feed our gut bacteria. But we run into a lot of issues with them when we have an overgrowth of those gut bacteria, because we're kind of like, we're feeding those bacteria that we have too much of. And those bacteria eat up these fibers and ferment them, and then that's what's gonna give off gas that you'll feel as bloating and gas and pressure in your abdomen. So low FODMAP is very commonly given out by gastroenterologists or some like traditionally trained like dietitians. You know, you'll just say, they'll just say go on the low FODMAP diet. The idea is to bring them back into the diet eventually. A lot of people don't. Sometimes we see people that have been on low FODMAP for like 13 years, and I'm like, oh goodness gracious, because it's hard, right?

Well, important point here that I think is not said enough is that the diet that will heal you is not the diet that's going to sustain your health. So there are different things, like they're— that's when, when I look at something like the carnivore diet, if someone's super reactive, that could be a place you could go first However, and I'd love your input on that one, it's like, I look at that, let's go back to FODMAP, but then we can go to carnivore and talk gut microbiome, because I still can't wrap my brain around that that would be the right thing long term. Okay, back over to FODMAP.

Yeah, so really the low FODMAP diet is just a rest— like restricting or reducing the amount of fermentable carbohydrates that you're getting in. It gets a bit tricky.

Some examples.

Some examples. Yeah, apples, too much broccoli. Typically people will be really reactive to like onions and garlic. You're like, I cannot tolerate those at all. But the tricky thing is that it's a lot of healthy foods. So once again, we find ourselves not wanting to eat more than like a couple pieces of broccoli or, you know, a quarter of an avocado or something like that. And that's when, that's when you lose me, because once again, I know that that's not, it's not sustainable. So at the core, we have to address the intestinal, like, bacterial overgrowth that's contributing to the basically, like, need for the low FODMAP diet, but also what caused that. So we always take, like, I say we take a root cause approach to a root cause approach. So instead of going the SIBO's causing the need for low FODMAP diet and the bloating and the constipation and everything, we're going, well, what caused the SIBO? Motility issues. And, you know, the— it's not really a bacterial issue at its core, it's a gut motility issue. Why did we get the overgrowth in in the small intestine when the large majority of our gut bacteria are in the large intestine. So what kind of broke down to allow these bacteria to flourish and overgrow in the small intestine? It's our gut motility. And what caused that? Low stomach acid, chronic stress, low pancreatic enzyme secretion, maybe another gut infection like Helicobacter pylori. So we like to take it a couple layers back. But yeah, low FODMAP. I mean, if you trial it and you feel a lot better, we're probably looking at a bacterial overgrowth. I wouldn't say 100%, you know, testing's always gonna be best, but that's kind of what it is in a nutshell, just reducing some of those foods.

Now, for SIBO, are you able to get rid of SIBO without having to use antibiotics?

I would say yes. Yeah, so—

I've always seen everybody kind of kill it, scorch the earth with Xifaxan, so.

Yeah, and the research shows that, you know, it has about a 40 to 60% 40-60% success rate. That's, that's shown, right? So it doesn't work for everyone. Sometimes you need multiple rounds of it, and sometimes you get the— what we see consider is more rare— you get the rare case where it's like someone does one round of rifaximin and then they feel a lot better, and then that's it, they can move on with their life. That's just not who we see typically, um, because it doesn't address fungal overgrowth in the small intestine. It has a 40-60% success rate off the bat, and then sometimes these bacteria can become resistant resistant to different antibiotics too. So, you know, herbals can be great to utilize here.

Nice. So oxalates, histamine, lectins, you know, there's been books written about each of these things in a way that would scare the crap out of people. Yeah. What is your take on each of these things? Are these more a sign that you have a gut dysbiosis issue that needs to be addressed? Are there any issues with specific foods, especially things like lectins, that we should be aware of? What are your thoughts about all of these things?

Yes, I also want to know your thoughts on all of these things. Um, so this may not be popular, but, um, I'm not a big fan of this heavy restriction. I don't think that these foods are causing a lot of issues. It's just— it's honestly not what we're seeing in our clients. We're not seeing people pull foods and then everything gets a lot better. I do think it's typically a sign that something else is going on. So when it comes to oxalates, those that are, you know, more sensitive to oxalates, sometimes it's a mold thing. The, the mold toxicity is what's contributing to the sensitivity to oxalates. Um, when it comes to lectins, I think that there's a lot of ways to reduce that exposure too. So when it's like beans and grains, like soak them, you know, and then that reduces—

who's not soaking? Like, how would you eat that without Soaking it, right?

So I think it can be blown out of proportion a little bit, and I just am really— I really don't want people fearing healthy whole foods like black beans and quinoa and brown rice. I just don't think that's the reason for our nation's health crisis.

No, it's not. I will tell you, I mean, the way I've written every book is you go through a process to figure out which foods work for you and which foods don't. And, you know, I wrote Virgin Diet 2.0. I just was like, I didn't feel— I was like, I don't want to publish this. I want to do something else. However, that book was like, okay, and now here's what you need to do to heal your gut because that's the other side of it. It's like that book was identify what's causing an issue right now. It's not all of them. And then go heal your gut and see if you can get back to the point of eating all these things, which is the goal. Although I would say I don't think gluten, at least in the United 'cause it's a glyphosate, gluten, it's, you can't unpack, is it the glyphosate or the gluten? You know? So that's a different one. But I think we're on the same page with this, although it can be very exciting to demonize foods. Now I will demonize ultra-processed garbage things. There are some things like, I'm sorry, I don't believe in everything in moderation. No, I don't. So I'm not gonna go down that road. What about you?

Yeah, no, I, I agree. I, I don't think it's helpful to demonize these foods. Yes, of course, when I, when I say that, I mean healthy whole foods from the earth, right? So like beans and certain fruits and veggies and stuff like that. You know, you'll find these little sound bites on social, um, where it's like oxalates are the worst foods for you, and I'm just like, this is just absolutely not helping. And neither is oatmeal. Like, oatmeal is not the worst food that you could eat.

It's not a peasant food, people.

Fun, right? I'm just like, this is, this is not it. So I, I agree, and I think that's where it can— it's great that you brought that point up because it can feel very confusing for people because you do, like, in order to tolerate more of these foods, we do need to do some gut repairing. So it can be— I, I love the phrase that you use, like, what your— the diet that heals you may not be the diet that, like, sustains you. And I think sometimes people have a hard time, um, really, like, understanding that because It's more nuanced, but that is what we see to be the truth.

Yeah, I had a great nutrition mentor early on and he said, "The sicker you are, the farther back in your ancestry you need to go." The reality with that phrase is that, you know, I think for most of us, it's all of this ultra-processed, you know, and even the farming that's, you know, poor soil and all that kind of stuff. And so that's always made a ton sense to me. But the obvious goal is you shouldn't have to worry. Like, I want to have some resilience so that if I do go out somewhere and I do get a seed oil in my meal, I'm not like lying down with stomach cramps in a fetal position. So there's— that's the goal. And then the goal is to get a— I always say an A- on your diet. You know, it's like you don't need to get an A+, but you do need to get an A-. And there are— there are— I think there's a difference. One of the things I'm wish that we would be able to unpack better because I think it's so confusing for people is there's processing of food and there's ultra-processed food. And we really need to distinguish what makes something that's like dirty, ultra-processed, you know, not real food versus what just makes it convenient so that I can get my lentils. And I didn't— like last night I made this cauliflower. I love cauliflower pilaf. So I made this cauliflower lentil pilaf and I had these pre-steamed lentils. Easy peasy, you know, way easier than me having to deal with them. So like, you know, that was processed, but that's not like eating, you know, lentil chips made with some canola oil and some kind of weird sour cream fake thing on top, you know?

Yeah, exactly. And I think that is the goal. Like when I'm speaking to clients, I'm like, our goal is to get you to the point where you can tolerate more foods foods with less pain and you can live your life. You can go on the vacation and you can have some, you know, chips and guac or whatever and you can be okay. You know, you won't have to, you know, quote unquote pay for it for days afterwards. Like that's when we know and that's what I've experienced personally. I couldn't, I didn't touch gluten, I didn't touch dairy, I didn't touch any for like honestly a decade and I was struggling still. You know, it wasn't really doing the trick and now I can go out for a burger and fries. I don't go out for a burger and fries every day, you know, but I can— if it's a Friday night and it's a celebration or whatever, I can get a good quality burger and some fries and I can enjoy that and I can wake up the next day and I'm fine. And that's what I want for, you know, our clients.

I agree. I just also would love to figure out why it is I can go to Europe and eat whatever the heck I want and never have an issue. It's like, it's always the biggest, the biggest question. But I was the same, I couldn't touch dairy but I healed my gut back. So it's like, it was, it was like a whole world opened up. And that, that was what I kept trying to tell people. I go, this wasn't drop 7 foods forever. This was, you know, let's take a little break and start to heal back your gut. So I love your message. Now you have a quiz. Tell us about the quiz that you're going to give everyone to be able to take.

Yes, so I developed a root cause assessment quiz where basically you'll answer 20 questions, and it'll give you some information in regards to like what could be the root cause of your gut and digestive issues. Now of course, testing, working with someone, this is the best way to go. However, you'll get like a PDF download afterwards, and there are— there's a big breakdown of each and every root cause with education and best next steps there. So you can learn a lot. You can look at the signs that you have some of these underlying root causes, what to do next, what that kind of means for your health. I'm very big on education. I think it's really important for people to like understand what's going on and why and what to do about it. So this root cause assessment quiz, it's based off a digestive health assessment that we work with our clients with. So it's, it's good stuff. And I've— people have taken it and then messaged me being like, I then got tested and this was right. So, oh, how cool.

Yeah, well, you start to get a feeling like you can't explain it where once you hear it with somebody, you're like, I know what this is. Oh, I know what it is. So totally, you know, I just see the world where hopefully with AI we'll get to a point where we won't really have to do a stool test that often anymore because they're just— it's just not a fun thing. And it's especially hard to get a client. They're like, you know, but the information right now is amazing. And I don't really know any other great way to really see stuff you can find in a stool test.

Yeah, I just see it be like, it's a total game changer because then we're not guessing. You're not just buying probiotics and enzymes and all of this stuff hoping it will help.

It can just make you worse too. I can't tell you how many people would come into me. I had one poor gal who, you know, and you'll hear this and go, "Oh, I know what this is." Someone referred her to me and said, "She just needs cheerleader. I'm like, really? You're referring me to her and she needs a cheerleader? I'm like, I'm not that person. And she's like, yeah, I just, I just try not to eat at all anymore because every time I eat, the minute I eat, guess what happens? I get bloated. I'm like, I know what this is. And every doctor she would go to just kept giving her probiotics. You know, I'm like, well, that's just going to make it worse. So, you know, that's the thing that testing can really help you do is know that you're not crazy and probably help you heal a lot a lot faster instead of throwing a bunch of money in supplements that generally, if it's not targeted, could make you feel worse, not better, which is such a bummer.

Yeah, 100% agree. I mean, histamine issues, certain probiotics will flare you so bad. SIBO, certain probiotics will flare you. Fungal overgrowth, right? So there is a lot of nuance to it, and I wish I found it earlier on in my journey. Like, it would have saved me years of elimination diets that weren't really were even getting me feeling a lot better. So I do think it's— it can be, yeah, such a game changer and save a lot of time and money in the long run.

Yes, yes, agreed. All right, well, we will put that quiz at jjvirgin.com/hannah, and that is H-A-N-N-A-H, so the same both ways, right? Yep. So again, grab the quiz, jjvirgin.com/hannah. And Hannah, thank you so much. I'm I was very excited to do a big deep dive into gut because we haven't done one for a long while, and you were just absolutely fantastic with all of your information, so I appreciate it.

Thanks so much for having me. It was fun.

Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great and are built to last. Check me out on Instagram, Facebook, and my website, jjvirgin.com, and make sure to follow my podcast at subscribetojj.com so you don't miss a single episode. And hey, if you're loving what you hear, don't forget to leave a review. Your reviews make a big difference in helping me reach more incredible women just like you to spread the word about aging powerfully after 40. Thanks for tuning in, and I'll catch you on the next episode. Want to listen to this show ad-free? Head over to subscribetojj.com and start your ad-free experience today. Hey, JJ Virgin here, and just a reminder that the Well Beyond 40 podcast offers health, wellness, fitness, and nutritional information That's designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional. Make sure that you do not disregard, avoid, or delay obtaining medical or health-related advice from your healthcare professional because of something you may have heard on the show or read in our show notes. The use of any information provided on the show is solely at your own risk. Struggling with weight loss? ProLon's 5-Day Fasting Mimicking Diet is a clinically developed nutrition program designed to promote fat loss while protecting lean body mass. Developed at USC's Longevity Institute, it assists the body in entering a fasting-like state that helps reset metabolism and target visceral fat. In just 5 days, ProLon offers a science-backed approach to weight loss without extreme restriction or guesswork. Get 15% off plus a $40 bonus gift when you subscribe at ProLonLife.com/now.