Gut Testing, Gut Balancing, Hormones, Fertility and Genetics

Hi everyone and welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. Today's show is with Deborah Lee Smota, who is a functional medicine practitioner with acupuncture, Chinese medicine, and Ayurveda training, who's also studied under Aviva Romm, Chris Kresser, and Grace Liu, and she specializes in women's and gut health. But before we start the show, I was remiss in my duties and failed to announce the winner of the Biome Gut Test Giveaway, who was Sean from Nashville. And he said, I've wanted to do gut testing for a while now, so I'm very grateful and excited about winning this. I'm one of the millions with stomach issues that have gone through all the traditional testing only to be told it's IBS. I've recently started listening to your podcast, trying to educate myself as much as possible. Thanks for everything, and send you an update after having the test done. So congratulations to Sean, and I hope it helps you solve some of your gut problems. And as you guys can imagine, creating a podcast and taking the time to edit out all the ums, which I do for you so that it flows nicely and you don't, you know, I cut 2 minutes worth of wasted um audio out, and writing up show notes and all that takes a good bit of time. Plus there's the cost of hosting it on a podcast server. So I did decide to open up a Patreon page, which is where you can support me like a patron of the arts. So if you're a regular listener, I would really appreciate it if you would support me with a monthly donation on Patreon. There's a link in my show notes to my Patreon page or just check it out at patreon.com/theperfectstool. And at minimum, check out the gorgeous photos and names of bacteria that I named for the various support levels. So my first goal is just to have the monthly hosting costs of $15 covered. So just 3 $5 a month donors would do that. So if you love the show and you're getting some useful information from it to help your health, you would be my hero if you would help out on Patreon. So thank you so much for that. And also, if you love the show and listen on Apple Podcasts, will you give me a quick 5-star rating? You don't have to write anything, but just hit the stars. You just have to go to Library, Shows, and then choose the show and wait a couple seconds and scroll up and you'll find where to hit the stars there. And another announcement, if you're in the Tucson area, Tucson, Arizona, that is, we're putting out a paleo community dinner on October 25th with my friend Scout Noble from Noble Food RX. So do check that out on my website, highdeserthealthcoaching.com. And finally, my specialty is helping women lose weight without cutting calories or giving up any major food groups, so it's done in a healthy and sustainable way, and so the weight you lose stays off for life. So if you're needing some in that area, you can set up a free 1-hour discovery session with me to find out what's keeping you stuck and to learn about what health coaching can do for you. So there's a link in the show notes for that, or go to HighDesertHealthCoaching.com and you will find where to sign up. So thank you so much. And let's get onto the show.

Welcome, Deborah Lees.

Hi, I'm so excited to be here, Lindsey. Thank you so much.

Thanks so much for coming on.

Yay. So tell me about your practice and how you got started with women's fertility.

Yes, for sure. So I started off as an herbalist, and with that love of herbs, I just progressed into Chinese medicine and Ayurveda and nutrition. And then I found myself working in acupuncture and working with women in labor and fertility. And then as I progressed in my practice, I found myself in a birth center, which was so amazing. To be able to apply all my knowledge in real time with mamas who were trying to support their fertility in pregnancy, in labor, and postpartum. And I then advanced all my research and my studies into functional medicine, microbiome medicine, really supporting mamas with helping with their genetics and transferring their genetic blueprint, their microbiome blueprint, to their babies. So that's pretty much how I— how it's progressed over the last 20 years. And how I really got interested in it was I became a mama and had two home births and got inspired and fell in love with my midwife and all the midwives in the community and just started to really dive in.

Yeah, I wish I could have had a home birth. I had a hospital birth with equipment attached to me in every direction and ended up with a C-section as a result. And just, you know, the whole thing went not according to plan.

And that is a story for so many women. And my, my vision too is to support mamas post C-section, which is an amazing journey and to help them with breastfeeding and just supporting their microbiome. And also, you know, if there's trauma. Involved. And so, yeah, that's another part of my journey with, with mamas.

So do you encourage women to reseed their microbiome if they get— had a C-section?

Definitely.

Talk to, talk to the listeners about that practice because they may not be familiar with it.

Yes. And so one thing that I encourage, and I am in Boulder, just so you know, and Boulder's very open to a lot of these kind of crazy ideas, right? And so there's something called a vaginal swab. And if a a mama is scheduled for C-section, or let's say we can't find somebody who will do a breech birth with their baby, and so they need to get a C-section, I have the mama do a swab pre-labor, because as most women know, when you're in labor, you get very swollen down there, and it's very painful to do a swab at that time. So we do it, you know, before they go into labor and then store it in the refrigerator. And then after the C-section, most OBs and especially midwives are very open in the hospital to doing the swab all over the baby's face, in the mouth, and the eyes and the nose, because as you know, that vaginal microbiome is the fingerprint that then gets transferred to the baby. And so, yeah, that's what we do for that. And then in terms of reseeding, when a baby is born C-section, there is the unfortunate circumstances where they don't get that, that microbiome transfer. And so they actually get the— even the skin microbiome is influenced by what's in the hospital, whether it's Streptococcus or Staphylococcus. And so we then have the mama and the baby do what we call ancestral strains like Bifidobacterium infantis, and then also really promoting breastfeeding because that's where the oligosaccharides then help feed those good microbes and help build their immune system and their microbiota.

Yeah, and I've seen that there's actually bifidobacterium infantis is in the breast milk as well.

Yes.

Oh, there's— they're saying now, you know, over 1,000 microbes are in breast milk. It's incredible. It's so—

I don't know how with microscopes these things are new discoveries. I guess the DNA sequencing changed the picture.

That's what it was. Yeah, before we'd have to isolate the microbes and grow them. And so we were very limited of what we could see.

Right. So if they're anaerobic, then you wouldn't be able to grow them, right?

You totally got it. And the other cool thing about vaginal— I mean, with vaginal birth, the baby usually comes out and how it's facing is exposed to the mama's fecal matter. And that's the other way it's then introduced to the microbiota. And A great study showed that the vaginal microbiome is actually identical to the colon or the large intestine microbiome in the last trimester of pregnancy. And so all these microbes are growing at that time exponentially to prepare for this.

That's amazing what our bodies do, isn't it?

I know.

Oh, I love that stuff. It gives me, gives me goosebumps.

Me too.

So If a woman has strep B, or, you know, a history, but maybe not an active infection with, say, herpes or HPV, what would you do in that case? Would you need to just skip the reseeding?

Yes. So if they have Group Beta Strep, GBS, we can't do— well, we wouldn't skip reseeding. We would try, as the mama gets tested usually around 36 weeks for GBS, if they have a history of GBS, the midwives would usually work with me and we'd test early on and see if we could reverse it by the time the second test happened. But we would do things like, um, really shifting the microbiota with diet and doing herbal washes. We wouldn't do douches per se, because that's not super safe while they're pregnant, but just washes. And would also treat the partner because GBS can be interchanged if they're actively having intercourse.

And do you treat the partner with antibiotics, or is this with like probiotics and that sort of thing?

Yeah, no, we usually do probiotics. My favorite one is called Femdophilus. It's super inexpensive. It has GR-14 and RS-1, which actually help prevent and reverse GBS. And also there's a Chinese herbal wash called Yin Care that a mama could just do like in the shower or above the toilet and and, you know, just washing their labial area. And then the husband or the partner, if they're sexually active, will also wash himself with that. And we see if we can reverse it. And the other thing is BV. BV, you know, bacterial vaginosis, that can be very uncomfortable. And there's many different microbes that are involved with that. And then we would see if we could treat mamas with herbs and probiotics and prebiotics at that time. If they do not reverse and they are still positive, we just do everything to encourage, or I would, to encourage them to have a short labor. And that would be acupuncture and herbs and massage. And so then when they get to active labor, because once they arrive at the birth center, they get rounds of antibiotics, IV, but every 4 hours. And so the shorter the labor, the less exposure to the antibiotics. And then at that point, we definitely do everything we can to reseed, to support the good microbes, to re-flourish, because yes, any antibiotics is going to change the terrain. And now we've learned that even Pitocin will totally change the microbiome terrain, which is super fascinating. But then afterwards, we then We treat baby with really good bifido and probiotics and we treat mama and then hopefully we can reverse it for the next pregnancy.

And what do— do they know what pitocin leads to? Is there research that far? Is it just about what happens to the microbiome versus what then happens to the baby?

Yeah, it's just in terms of changing the terrain of the microbiome at this point.

Okay.

Yeah. Yeah. We're learning more and more every day. It's incredible.

Okay. So tell me about the typical profile of a woman who comes to see you.

So I started to really focus on fertility. You probably know the, the what's happening. There's a big shift right now, especially in the developed world, that women are having babies later and later in life. And it's because, you know, we are more career-driven and, you know, things are shifting and we have more opportunities. And so women are actually waiting later, you know, past 35, even into their 40s. And at that point, there can be issues with fertility. It's supernormal. And there's also more and more genetic mutations such as MTHFR that's on the rise. I see, I think probably about 50% of the mamas I work with have this genetic polymorphism.

Homozygous for it.

Homozygous or homozygous is definitely more detrimental. That's with two alleles. Heterozygous, it depends, you know, how well they're methylating. So I always check their homocysteine levels, you know, other inflammatory markers to see if they're methylating. And there's other ones like VDR, which means maybe they're having trouble with vitamin D, which is also very important for fertility. And why I decided to really focus on fertility is I'm trying to support that genetic and microbial blueprint to help them have a really healthy pregnancy without complications and without postpartum complications, and to really set their baby up to thrive because more and more women are having miscarriages or trouble conceiving, and it really has to do with all of the body burden that we're in. And so with that, I, I've come up with a protocol which I call the Weed, Seed, and Feed protocol, and I look at their microbial blueprint, whether it's through an organic acid test or through a stool test, and see what's going on in both their large intestine and small intestine, and then also looking at their genetic blueprint through like 23andMe, and then doing blood tests and just to check all the different markers to see if there's chronic infection. And at that point, we decide how we then, you know, either weed them, like weed out the microbes that are causing dysbiosis, or, or, you know, body burden, whether it's heavy metals. And then we seed the good microbes and then we feed them. And so for some women who are so depleted because maybe they have HPA axis dysfunction they're just very tired. We definitely—

can you explain a little bit about what that means?

Yes. Yeah, it used to be called adrenal fatigue, and adrenal fatigue now is— it's kind of a term that's not used as much anymore, especially in functional medicine. And it's really looking at the HPA axis, is what our body goes into fight or flight, right? So it's a sympathetic and parasympathetic nervous system, and a lot of us are stuck in the sympathetic nervous system, meaning that we're all always in fight or flight. And I explain this to my mamas that even if they're doing everything to relax their system— let's say they do yoga all the time, they meditate, they breathe— and they're still caught in this fight or flight, it's because they have a chronic infection that's always putting them in that. And so we need to get to the root of that to help them pull them into that parasympathetic and then their body can regulate the inflammation.

And so what do you find is at the root of that?

What's at the root? So there's so many different infections. Like, of course, you know, the big buzz in functional medicine is that everybody has Lyme disease, and maybe it's true, like, a lot of us do. But there's other things that I'm seeing more and more. Candida obviously is really high, and it's because if you think about it We have been introduced to antibiotics, which have been a saving grace. We've all had antibiotic exposure, but antibiotics really do increase Candida because obviously antibiotics were originally pulled from a fungus, right? And so we end up having fungal overgrowth, and we're seeing this more and more, not just SIBO, which you know is small intestine bacterial overgrowth, but SIFO, which is small intestine fungal overgrowth. And so I see more and more fungal infections and then trying to balance that out, not just bacterial, not just viral, but, you know, and we do see a lot of viral infections, a lot of whether it's herpes zoster that's been latent, whether it's strep. Strep is huge. You know, I've seen a huge rise in something called PANDAS, which is Pediatric Autoimmune Neurological Disorders Associated associated with strep. And but PANS means it's another acronym that has to do with neurological disorders associated with any infection, any bacteria, and that could be herpes zoster. And it causes anxiety, you know, that whole gut-brain connection that can cause anxiety. But it causes all sorts of issues. And you're just seeing this more and more in the children, in children, but also in adults. And I really, you know, I feel like people have diagnosed, like, for, for example, Tourette's syndrome. All this time that's been pandas because it's the same symptomology, it's the same tics, anxiety, having outbursts of anger. And so it's really just an infection. And so we are walking around with these chronic infections for years and that we just didn't know about them. And so root cause, I always see, it could be a a variety of either viral, bacterial, or fungal infections, and then we go specifically into what those are in the individual and then treat it accordingly.

So there's a lot of skepticism obviously out there in the traditional medicine world about Candida because it, you know, it became, oh, everybody's got Candida at some point. And so, so I, one of my prior episodes, I did a gut test with BIOM, B-I-O-M, that showed my Candida levels to be within the normal range. I subsequently did an oat test that shows I have an overgrowth of Candida. So how would you reconcile those two results?

Well, I'm curious, when you did the BIOM test, was that a stool test?

Oh yes, it's a, it's a DNA sequencing, uh, gut stool test. Yeah, not meant to be for diagnosis purposes per se, but you know, totally.

Well, my understanding is that when you do a stool test, you're really only getting the information that's in the colon. And so you could be getting a reading that your Candida— we all have Candida, of course, and it should be in healthy levels without a ton of biofilm formation, which we can get into the whole biofilm thing— but if that test was showing that your Candida was imbalanced in your colon, that probably meant that you had all these other wonderful microbes in your colon that were keeping it in check. If it was in your organic acid test, that's showing what's happening in your small intestine, because a urine test shows what's happening in your small intestine. And it's quite possible that the Candida had either come up from the bottom or somehow leaked in from the top. And so we see when, when there's SIBO or SIFO in your case it would be Candida, would be SIFO, that it would be from maybe the top, meaning that you had from the gut coming from the mouth, is that the stomach acid was very low. If you can imagine the stomach acid, your stomach as this cauldron that's burning up microbes that you ingest, but when it gets low and you're exposed to things from the mouth, which is a huge microbiome in itself, and it then leaks in and it goes into what should be a sterile environment in the top of your small intestine. And so there's different ways that Candida can kind of grow in the small intestine, and when it's coming— being pushed up from the bottom and, you know, kind of leaking through or, or bypassing the stomach acid, which is low. Does that make sense?

Yeah.

Yeah.

Okay, well, that's—

that makes sense.

I guess the other possibility too is just that it's a tiny little sample that you send, so it's hard to You know, it's hard to really get a good— yeah, totally. It's not like I mixed up with a blender all of the stool and pulled a representative sample. It was just, you know, so, uh, okay. So, you know, this is, this is a question I've sort of been pondering because of my own situation and just, and, and clients I see is, are there anti-mite or anti-herbals that kill Candida without killing bacteria?

Yes, and that's really my passion, is to bridge what I call ancestral medicine or original medicine, which is Chinese medicine and Ayurveda, with microbiome medicine, which is, you know, the advanced, new, cool medicine that we're discovering. And there are thousands of herbal protocols that can be super helpful for balancing out all sorts of microbial dysbiosis without affecting the other microbes. And it's just because we've been living in unison with plants for time immeasurable, right? And there is, according to the individual, we can decipher which plant could do what. There's a lot of overuse of berberines. You know, berberines are in goldenseal and Oregon grape and a lot of Chinese herbs, and those can become disruptive if you do too much of it. And I know that they've shown that it helps with regulating blood sugar, so everyone Everybody started getting on that. I know. So the issue is that some of them are really strong and we don't want to overdo it. But if you look traditionally at Chinese medicine and Ayurveda— and Ayurveda, if people don't know, is East Indian medicine, which is probably the oldest medicine known, about 5,000 years old— is that they always combined herbs. It wasn't just a single chemical constituent that people are taking. Berberine, you know, they're actually combining— it's like a symphony of chemical constituents that work together that then can support certain microbes. And, you know, they figured all this out. We don't know how, whether it was the Doctrine of Signatures. I don't know if you've heard that term, but that's when people would look at a plant and it would show what it was used for. Like if it was red, it would be for blood. And like Pomegranate, for example. We're learning pomegranate is really important for balancing hormones, for female health, for— if you do the pomegranate oil from the seed, it will induce labor. And it actually looks like an ovary. And so that is the doctrine of signatures. And they figured out thousands of years ago how things worked by experimenting and then seeing how that worked by what the plant showed. And so there is a huge pharmacopoeia. And in terms of looking at formulas, and that's where I really focus my practice on, because I think it's dangerous to just use one botanical and in high doses because that can disrupt everything as far as I'm concerned.

So, so do you make tinctures or do you put together different powders, or how do you do that?

Yes, I really lean more towards liquids, whether it's fluid extracts or tinctures. I know tinctures tend to be alcohol-based, which can be disrupting to the microbiome. I, if I use them, I use brandy because then there's no grains, it's not grain alcohol, and some people are really sensitive to grains. I'll have people put it in hot water to evaporate the alcohol if they need. I do use powders. I use instant teas, which are called granules, and the reason And the reason I do that over capsules is that there's something that's called rasa, which is taste, and it's super important according to ancestral or original medicine to taste the herbs. And as we're learning more, the microbiota of the mouth is super essential to triggering all of the microbiome health in our gut. And so tasting the herbs and taking them in either liquid or powder, I find it to be way more effective.

Interesting. So what— do you have a set of herbs you typically use for Candida, or does it depend on the person's stool test?

It depends, of course, yes.

But I will—

I'll blend according whether, you know, I do put in some— and of course there, there are plants that are endemic to certain areas which I think work even better for the person. So there's that idea that we adapt to an environment, and there are plants that grow that environment that will affect that person stronger. Like, for example, there's a Ligusticum, a Ligusticum porteri, which is Osha, that only grows in the Rocky Mountains. And there's Ligusticums all over Asia, and they are incredible for viruses, especially viruses that affect the lungs. And, you know, there's this whole thing with connection between the lungs and the large intestine, and so they definitely affect the large intestine western as well, but I choose to use herbs that are endemic to the area. And then ones that are endangered, you just want to be careful of how you use those just to make sure that the plants stay thriving. But yes, it is dependent. There are certain formulas that I use kind of across the board. One is a formula that's called Triphala, and if, you know, a person can tolerate it, it's such a gentle formula. It's an Ayurvedic formula of 3 herbs. It's called Bibhitaki. The herbs are Bibhitaki, Haritaki, and Amalaki. And what they do is they— and I'd like to see more studies on this in terms of the microbiota— but they strengthen the peristaltic muscles and they help move the stools. Because the one thing is transit time in terms of how healthy the biome is. And we have found that when people are very constipated, there can be issues with their microbiota. If people also have very fast transit time and, you know, diarrhea, there also could be issues. And what Triphala does is it regulates it so it's at a very good motility rate. And according to Ayurveda, it helps reduce what they call ama. And in my translation, ama to me is LPS, lipopolysaccharides, which are these endotoxins that invade our body and cause inflammation. And so Triphala is one of those formulas, according to my teachers, that people should do on a daily basis just to keep their gut healthy. And if you look at traditional medicines, way before Socrates, Ayurveda talks about how everything— 90% of their treatment protocols had to do with vata, which is gut health. Everything came back to the gut. So really, a lot of these formulas are really focused on gut health.

So it's Triphala, just gut health in general, not specifically to Candida, right?

Well, it does help with, they say, parasites and fungal overgrowth. So there is something there. I would love to see studies of what exact microbe these 3 herbs are affecting. But the beautiful thing about Triphala is it has all the tastes. And so there is something where when you have Candida, we crave sugar, right? We crave sweet. And in our diet, we are— we only we only really have two tastes in the standard American diet, and it's salty and sweet. And with triphala, it has all the flavors— the bitter, the sour, the pungent. And so really getting all of those flavors, it influences the microbes in the mouth, which then influences the whole microbiome. And so it will affect Candida because it's also triggering those other microbes that will keep keep Candida, which is craving the sugar, in check. Does that make sense?

Yeah. And is that a powder or a tincture or a tea?

Yeah, powder, tincture. Yep. I mean, I know it comes in tablet. A lot of people do it in tablet, but I usually recommend people to just kind of chew it just to get the taste. And it comes by— I of course get organic, like Organic India, Banyan. They're all organic. And so yeah, that's one that I feel very confident recommending it across the board. Otherwise, it's very individualized, of course, to see what's going on with them.

Okay, so talk to me about just the relationship between the gut and hormones.

Oh my goodness, yes. So what we're learning— and, you know, this is probably for the last 5 to 10 years— is we thought that hormones were regulated only in the endocrine system or in the liver. But what we're learning is that, like, for example, thyroid hormone is actually metabolized. And like, for example, the conversion of T4 to T3 actually mostly happens in the gut, which is super fascinating. And so, you know, the microbes are responsible not only for turning our human DNA polymorphisms, like our little switches and dials, off and on, which is super fascinating. But they actually metabolize hormones. And so one thing that I like to recommend people do is, when we're looking at really balancing hormones, is something called the Dutch test. It's a dried total hormone analysis where a woman will do a diurnal urine urine sample, meaning they do it 4 times, right? They, they pee on a strip and dry it, and it's in the afternoon, the evening, the early morning, and then late morning. And it will say not only what's happening with your basic hormones, like all 3 estrogens, your progesterone, testosterone, DHEA, melatonin, but it also does your stress hormones. And so your cortisol and cortisone. And what we have found too is that those stress hormones are a huge trigger for full hormone imbalance. And when we look at stress, we look at the sympathetic versus the parasympathetic, right? And the parasympathetic, the other term of it is rest and digest. And so when we're not digesting, when, when we're not digesting well, obviously it's because we're stuck in the sympathetic nervous system. And so one of the biggest hormone influences really is cortisol and cortisone. And so I always look at those, and that has everything to do with digestion and the microbiome. And so when I am balancing a woman's hormones and I'm working with hormones, I have to look at their gut health. I have to look at what their microbes are doing. And the other thing that— what we're learning too is that the microbes are responsible for not only producing vitamins but metabolizing vitamins. And so all our B vitamins, which is our nervous system, they need certain microbes. And like, for example, magnesium and calcium, they're all absorbed in the colon and produced in the colon, which is amazing to me. And so all of those are essential for hormone health. And so we need to make sure that the woman is assimilating and producing their own endogenous vitamins that will help regulate their hormones.

And if they aren't, what can you do?

So we then look at helping support the microbes. So we now know that just taking probiotics isn't the end-all, because when you take a probiotic, what we have found that if when you stop taking it, 2 weeks later it's all washed away. You have to see if you can feed it and help it hold. There— it was a Stanford study that found that when you stopped eating fiber, just pretty much had a very fiber-depleted diet, that it was only a matter of 4 weeks before certain microbes were extinct. I mean, that is frightening. And once they're extinct, I mean, you can't bring them back. And so, I mean, we keep thinking— unless you do a fecal transplant, which is a whole other, you know, story— but really, you can't bring them back with just taking probiotics. And so there are, though, certain ones that are super essential that we then like bifido, is very important for producing B vitamins and for our immune system. And so what we wanna do is feed those with the right fiber, whether it's GOS or FOS or, you know, different ones that then will bring them back from extinction. Of course, it's called resurrection. And what we're now doing is looking at resurrecting microbes that are just barely holding on in our bodies. And of course you can take probiotics, but that's not the end-all.

You—

otherwise you'd just be taking them every day, and that becomes a little tiresome. I want people to be able to have a microbiota that can sustain.

And so you're, you're talking about diet changes here, or are you talking about supplements?

Yes, I'm talking about diet changes, mostly doing it with certain fibers, certain fermented foods. Of course, there is a time for supplements. Like I do believe when you have to really kickstart something, of course. And all supplements aren't created equal. We find which ones work best. Some people are really— there's a woman who I met who's really into using phages, and phages are a different way that will exponentially grow microbes, and it's a microbe in itself. And so, and yeah, that's super fascinating. So we're, we're learning all the time, like how to support the microbiota, but I feel like food is obviously the most important. And we've just gotten— obviously, you know, the SAD diet, right? We've just lost a lot of our ability to eat the way our ancestors did. Like, they look at the Hadza, who are in Africa, who are nomadic, and they will eat a ton of bark and lots of fiber, and they have the most diverse ecosystem on the planet in their gut. And so those are, you know, I really feel like we're gonna get to the place where we start hoarding fecal transplants as the way to like save people's lives because as they become completely endangered, these microbes, we are going to have to just reinoculate people.

Well, in my— I have— let's say I was visiting my niece and I had her put a stool sample from her child in the freezer because I said if he has to go on antibiotics, you know, yeah, this is, this is your best insurance policy.

This is it. I know, it's wild.

Because I'm like, he's pure. He was born, you know, he was pure and perfect and in good health. And that's right there is the seed of all of it.

So yes, that's amazing. Wow, that's cool.

Now whether she's gonna— would be willing to go through with having to reintroduce it is another question, but at least she doesn't have to worry about, well, is it, is it, you know, unsafe because it's from someone else.

Yes, that's cool. What— you're really thinking outside the box.

Oh, I think all sorts of outside the box.

That's great.

So talk to me a little bit about estrogen dominance. I hear that a lot nowadays and think I suffer from it, so I'm really curious.

Yes, so we live in a very estrogenic world where there's what they call xenoestrogens from influence by phthalates from plastics, also, you know, pharmaceuticals. There's estrogens pretty much in our water, in our food, in our soil. And so we're constantly becoming estrogen dominant, which causes inflammation, right? It also reduces in women our progesterone, which is the anti-inflammatory, anti-anxiety, the, the hormone that helps us get pregnant and hold a pregnancy.

And so I'm just going to briefly say that I had to supplement with progesterone in order to become pregnant. That's the only reason I ever had a baby.

Exactly. And I am an advocate— I mean, not an advocate, but I'm super supportive of— if we had to do any hormonal support, it would be progesterone. And there's different ways to do it, and it's orally, vaginally, transdermally. And so meaning on the skin. So there's different ways to really support progesterone. Even there's an herb called Vitex that for some women can help them build endogenous progesterone if they take it long enough in, uh, usually in tincture form. And it's a quarter teaspoon in the morning, right when you wake up. And that will really help. It's helped a lot of my mamas. But yes, we live in a very estrogen dominant just because of the exogenous estrogens. Now, there are what they call phytoestrogens, and the interesting thing about phytoestrogens is that they can be supportive of the microbes and can be very helpful, like flaxseeds, um, when they're ground up. So they don't have the same kind of inflammatory effect. And so when people are saying, oh, I'm scared to do this is different from soy. Like, I wouldn't recommend doing tons of soy because how they traditionally did soy in Asia was fermented, and so that definitely changed it in terms of how it's bound to the estrogen receptors. But per se, phytoestrogens, besides processed soy, are not as dangerous as xenoestrogens. A lot of birth control. Like, when women are on birth control, obviously they can get very estrogen dominant, and that can just throw off their microbiota. It can lead to all sorts of things like SIBO and SIFO and tons of estrogen dominance. Now, when I look at reducing estrogen dominance, I usually have them work on their liver and their gut, obviously, but to help metabolize estrogen one is DIM, which is from brassicas, and that can help leach out that body burden of too much estrogens in our body.

Brassicas are like broccoli and cabbage?

Yeah, exactly. Yeah. And so, yes, I think, you know, we're seeing it even in men, like we're seeing estrogen dominance in men too. And, you know, that's— there's a fascinating thing that there's certain plants plants I'm gonna mention. There are certain plants that are very phytoestrogen-like on the higher scale, like hops in beer. And hops and marijuana are actually in the same full genus, which is weird to think about it. Like, a lot of people don't know that they're in the same family, but they both are very estrogenic. And we're using the estrogen— we're using the female buds to create these, you know, whether people smoke it or use it or drink it through hops, this— you're getting a ton of that female estrogenic quality of the plant, which then will influence male hormones if they partake in that.

So what you're saying, that's marijuana?

Marijuana and hops.

And hops, right? Okay, so they're drinking beer and they're smoking marijuana, they're basically making themselves estrogen dominant.

Exactly.

You got it. Okay. So the alternative would be, let's see, hops are what make beer bitter, right? Yes. Yes. So if you don't drink a very hoppy beer, then maybe you'll be better off. Yes. Okay.

I think that would be wiser. Exactly.

So let me just back up and ask if the birth control, you know, which are usually just estrogen, I guess, the ones that I was familiar with, although I know there are some with progesterone. Make women estrogen dominant. What do you recommend to someone for birth control instead of a pill?

I know, huh? Um, so there are women who do use IUDs, and they can do the non-hormonal, which is a possibility. It's the copper IUD if they're not sensitive to copper, and that is a possibility. There is a really good book called Taking Charge of Your Fertility that I really know it's Yes, I read it years ago and I know it's—

gave it to other people.

And yes, so good. And it just teaches women and empowers women to understand their cycle in terms of when are they most fertile. And so with knowing that, they can be very diligent about if they don't want to get pregnant, to make sure that they don't have intercourse during that, that short fertility window. And it can also—

which is when, of course, they're most wanting to have sex because that's when you're fertile and your body says have sex now.

Totally.

So basically take the best time of the month and throw it out, right? No, or use condoms, right? Exactly.

Yes. And of course condoms. Yes. That's the, the best way, of course, if you don't— in terms of not using the birth control pill. So, and I don't know, like there's talk about a male birth control pill. I don't know if it's going to happen, but they've been talking about it for a while.

Right. Yeah. Is there a gut bacteria that helps clear up extra estrogen in the gut?

Yes, I know that bifido is actually really helpful, and it's mostly— it also clears oxalates, it also clears inflammation. I think that one is one of the stronger ones in our body.

Just any kind of bifido? Not—

yes, any kind of like getting the maximum bifido quantity in your body, that would be my first choice. Choice for estrogen. And then also they're doing detoxes. If you were to do like a, a weeding process to help with estrogens, to do it at the change of the season, especially going into spring, and really working on the liver, because the liver does, according to Chinese medicine, Ayurveda, regulate hormones, and it has a big impact on estrogen and so doing a liver detox, whether it's bitters, whether it's glutathione, whether it's doing saunas to help produce glutathione in your body, but really supporting your liver to do its job in terms of reducing the body burden from estrogens.

So saunas help produce glutathione?

Yes.

I don't know a lot about saunas, but I hear about it now and then. I'm like, I don't have access to Asana, so I'm not gonna think about it, but I'm curious now.

Yes, yes, that's what they have shown, is that it actually helps your liver produce— because glutathione is your liver's strongest antioxidant, and it is actually produced in the liver, and your liver can produce it. The only time I've seen where there's a really difficult time with your liver producing glutathione is if you've had mold exposure or certain bodybuilding burden from, you know, certain fungal, which then blocks certain pathways. And so some people can take N-acetyl cysteine, and that seems to help their body.

Precursor to glutathione, right?

Exactly. And some people can't, you know, some people just need to detox the body burden through sauna, do a lot of bitters before they eat every meal.

And are you talking about like the actual supplement, or are you talking about like having bitter herbs or that sort of thing in your meal.

Bitter herbs? Well, the supplements are based on bitter herbs, right? Yeah, like dandelion and burdock and, yeah, and milk thistle. And not that milk thistle is super bitter, but it's a good one for the liver. And so, yeah, just doing a combination. And these are the things that grow in the spring, or that even our, our animal friends would dig up. Like bears would go and dig up these bitters just to detox their liver. When they woke up from their long slumber. And so that— this helps kickstart the liver to detox in the spring. And that's a really good time. Yeah, it's cool.

Animals used it. Yeah, it's sort of— it reminds me of, of the whole— I visited an organic dairy and they were talking about how the different herbs that come up, you know, the different grasses and the clover and things like that, that the horses will run towards it because they, they love that. And then it serves some, some purpose. Maybe it's a detox, I'm not sure. Oh yeah, you know, the whole process of feeding them the grass. It's like the man described himself, I'm a grass farmer, not, not that I'm a dairy, I run a grass farm basically because that's, that's what feeds the— what did I say, horses? I meant cows.

And I'm sure horses too, but yeah, right.

But the cows would go I get it.

It's so brilliant. Like, just watching nature around us, it's our greatest teacher, you know? Yeah. So, yeah, it's so awesome.

Okay, now I'm just trying to get my head around everything we've talked about in terms of— so if a woman comes in and she's suffering from infertility, what is your basic testing protocol?

So I like to— well, it depends on what they can invest in in terms of testing, because I'm always very conscientious of you know, how much people are— what funds they have to really invest in their health. But I do like to say I use the Biohack Attack Pack in terms of testing them, and it's— it has to do with blood. So full blood chemistry, including a full thyroid, possibly in terms— if their health history shows that they've had exposures to heavy metals, maybe a heavy metals test. Which one would you I like to use Quicksilver. They have a full one that's not just mercury but will do all the heavy metals, and that's blood. And you can do it through hair, blood as well through them. And then I do an organic acid test to see what's going on with their organic acids, which is a urine test. And then I like to do— if I have access and want to do— is a DNA test, which is through 23andMe. Is my preference, sometimes ancestral.com. But I get the raw data, and then I do a full analysis of their genetic blueprint. And then I also do—

hold on just a sec, let me, let me ask you about that. So would someone who was not an expert be able to do anything with the raw data, or would it be gobbledygook to them?

Yeah, the raw data just looks like a bunch of code. But they can— there's now programs where they can just plug it in. So if they did 20 free me, they just go to geneticgenie.org and they plug in their raw data and they do both their methylation profile and their detox profile. And the methylation profile shows, you know, their methylation markers like MTHFR, MTRR, VDR, you know, COMT, all of those. And then they're—

I'm sorry, back up. The methylation profile and the— what was the other?

Detox profile.

Detox profile.

Detox profile does the cytochrome P450s, which are— they called CYP CIPs, and those ones will show like how your body may or may not detox from certain pharmaceuticals or even nutrients. And so, you know, the body burden part, and I see a lot of SOD and NAT where people in the detox profile that are chemically sensitive—

what are SOD and NAT?

They're just CIPs, they're cytochrome P450s. And with those, we can see whether somebody might have trouble detoxing and how to support them. And with the methylation profile, we can see what we call nutrigenomics— what nutrients they might possibly have trouble assimilating and how to support that. It's kind of like a blueprint, and you can't treat these. This is their— this is their blueprint. We can't change it, right? We can support their body to work better with the blueprint they have. And so that's what I do with that. And yes, with the geneticgenie.org, they can see that. They won't get a full analysis, like I kind of write a full book for them. And so then they can go with that. But there's other nutrigenomic practitioners like myself that will really dive in deep. And but they can get that information from, you know, just a basic the actual what SNPs and SIPs they have through geneticgenie.org, which is free. It's a sister program to 23andMe. Okay, now the thing—

and wait, did you need to order a specific 23andMe test? Is there like the low-cost one and the more-cost one?

The low-cost one has the raw data.

Wow, okay.

A lot of people think they have to get the $199 and not the $99, and I've seen 23andMe at Target it. Like, they're all over the place. It's so wild.

You mean like they're taking samples?

No, the kits.

Oh, they're selling these kits.

Yeah. And so with that, you know, it's fascinating information. And then, you know, you can see your blueprint. And the thing is that 23andMe is starting to pull out certain markers. Like, they won't provide the BRCA. The BRCA, yeah, they stopped doing that. And then they started doing it again again.

So I heard.

So I don't know. And I think it's because they're scared to give people certain information and that the big medical industry, you know, the American Medical Association was like, no, we get to charge like $5,000 for that test. So exactly that, right? But I know it's kind of crazy, but they did take out one like the MAO, which is super frustrating to me. And the MAO gene is that warrior or warrior gene. And what we can see is that people who have that and they take certain antidepressants, it will trigger them to be more violent, for example. And they started to take it out because it was used in a court case in terms of somebody who murdered somebody said, oh, it's because I have this gene mutation. And so they're not allowing people to access it. At least that's what I understood, which is kind of crazy. But yeah, for that, I have people usually do the 23andMe even though they don't have all the polymorphisms, but I then plug it into some other programs that will show me things that are hidden in the raw data. Things that won't show up in the Genetic Genie. So there is access because the— if you look at your raw data, which you can figure out how to download it, just go to like Google 23andMe raw data and you go into your 23andMe account, and then it shows you how to grab it. You download it in a TXT file, a text file, and it just looks like a bunch of code. And with that, you can plug it into different programs. Some are free, some are not, and you can see what are all your methylation markers and detox markers. And so, and then the other test I'll have them do, if they're willing, would be a stool sample. I'm starting to use one that's called called Thrive. It's also a genetic test for stool where you just do a swab, like you don't have to send in the whole stool. Mm-hmm. You just take a Q-tip and you go along the toilet paper and then you mix it with the material that's in the kit and you send it in and then they show you your DNA from your microbes. And so then with that, I have a full concept of what's kind of going on with them. And then we come up with a plan.

And now, is that Thrive with a T-H-R-Y? Yeah. And do they give information on fungal overgrowth or parasites or anything else, or is it just gonna be bacteria?

Yeah, it's— it's— they don't do— they do some fungal markers, yes, but they don't do parasites. And with— if we're, you know, if people have traveled abroad, lived abroad, had lots of parasite infections, I definitely want to do a full stool test test. And that they can usually do through, if they have insurance, just get a parasitology test through, uh, a stool sample at the hospital. And that's the most accurate. So we can just get that analysis. But I think it's just variable on the person. And then we look at, in terms of treatment, it depends also on the person. It's like either 4 months, 6 months, and then we usually the first month or two is the most intensive, where they're really diving in and figuring things out and setting up protocols for themselves, whether it's weeding or seeding their microbiome. And then we start— then it becomes just the feeding, like just lifestyle. And then they just go from there, just empowering them.

Okay, so what kind of dietary changes will you ask people to make, say, if they're having to deal with, you know, SIFO or SIBO?

So I usually, in terms of dietary changes, I really want them to support their stomach acid. That's super important. And there's different ways to do it. Some people take H. pylori, but there's other ways that you could support it with apple cider vinegar or different things that will then support that And in terms of diet, like, I, I know that, you know, people do the low FODMAP. I get worried about doing that long-term. It's— I think it's kind of dangerous to do it for longer than even 2 weeks because it's not really feeding the good microbes. And as we've seen, that fiber is so important. So really what I do is I look at their— what their bodies, according to their DNA, according to their microbes, what their bodies need, whether it's B12, whether it's D, and then what foods will help them with that and what microbes will help them with that and support them with prebiotic foods. Just more inclusive. I, I really feel like we go on this kind of restricted diet thing, which can be very— like, there's this whole whole term orthorexia, where people just don't know what to eat and they become obsessed with foods that will do this or do that. And I really want to find a place where people are taking the food that they need with love, inclusive with love, and helping bring down their stress levels. And whether that's high fiber, whether that's fermented foods, whether they need to supplement here and there until they feel more balanced. That's what I do. I'm not really a big proponent. Like, I, I tried the ketogenic diet, I tried the paleo diet. Like, you know, we try everything, but we're now seeing that ketogenic diets, like too much fat, really disrupts the microbiota. It does, and for quite a long time, you know. And so in terms of SIBO SIFO, I usually include spices and herbs because I feel like they are the nutrient-dense— they're like the superheroes of food, and they can really balance out the microbes quicker than just regular food, I guess.

Are there specific spices that—

oh yeah, like totally, like turmeric and rosemary for some people, thyme like, yeah, there's so many different ones for really helping with the microbes.

Cool. And, and herbs, what are the herbs you like?

Oh my goodness. Oh, like medicinal herbs?

Oh no, just the edible ones that people—

edible one. Yeah, so those are the ones that I mentioned. So I mean, turmeric is one of my favorites, but you know, cardamom has been shown to be really helpful, and then cumin is amazing. For— it doesn't get enough press, but then of course garlic, but that's more of a food substance, but we use it as an herb. And so yeah, and some of those are really, really good for supporting microbes and actually staving off the dangerous microbes.

So, so with SIFO, would you have people go off sugar and go off grains, or, or more just sort of modulate a little bit?

Yeah, I, I'm I mean, sugar is very inflammatory, so yes. I mean, unless, you know, raw honey does have its benefits. And so I think it depends on the time of year. It depends on their specific situation, whether they should include honey. But yes, any type of processed sugar. In terms of grains, sometimes ancestral grains are important. And there are people who— there are actual microbes that need wheat. And so we can't just discount the wheat. And so that's another thing that, you know, that's a whole other series. That we can talk about.

But so I, I know you have a YouTube channel and digital courses. Tell me a little bit about all that.

Yes. So I started a YouTube channel as just my way to give back. I'm interviewing health heroes and thought leaders and really showcasing them to see if maybe they could support people in the public eye. You know, just who knows who will resonate with them. And I turn them into into superheroes with a caricature, which is fun. And then I also share a lot of information. It's called MedGeekTV. And yeah, I'm just having fun with that one. And then my digital courses, I am just starting to— I closed my brick and mortar. I see some people here and there, mostly in programs, but I am really showcasing digital courses where I'm educating people on the microbiota and the microbiome and creating a a platform where they can start from A to Z, right, to start a step-by-step program to really enhance their microbiome and their microbiota. And then I'm going to continue from there to do ones on hormone health and all sorts of things. So yeah, it's been, it's been really fun. I'm learning a lot.

I'll put links to all that in the show notes so people can find those.

That would be awesome. I really appreciate this. It's been so fun chatting with you.

Yeah, there's so much good information and I'm sure people will wanna follow up and check out some of your resources.

So thank you so much for coming on.

Thank you, Lindsey.

Great conversation.

I could have gone on for hours and I'm sorry if I left some of the terms undefined or unexplained, in particular the genetic stuff that we're talking about, like the MTHFR mutation. I know sometimes people in the functional medicine world assume everyone has already heard of these things, and I know everyone hasn't. I do try and stop my guests as much as possible, but I don't want to stop the flow of conversation. But I will try and have future podcasts that go into more detail on these topics. But in the meantime, you can Google the terms, as I'm sure Google can explain it much better than I can. And also, I wanted to mention that I do have a free resource on my website, which is an ebook on 5 healthier foods that may be keeping the weight on. So if you want to grab that, you can go to HighDesertHealthCoaching.com and check it out. You can also follow me on Facebook and Twitter or Instagram and now on Pinterest. So I'll put all those links in the show notes. And if you have any questions about my interviews or gut health or suggestions for guests, please write me at Lindsey@HighDesertHealthCoaching.com and be sure to include whether I can read your letter on the air. I love hearing from my listeners. And also don't forget about supporting the show through my Patreon page or my affiliate affiliations by going to HighDesertHealthCoaching.com and choosing supplements and lab tests. And incidentally, the lab I am affiliated with has a special on the Dutch test for hormones until the end of October that Deborah Lee's mentioned, and you can order it yourself. So I'll put a link to that in the show notes as well. Thanks for listening, and here's wishing you all the perfect stool.