Protecting and Restoring the Gut with Naturopath Dr. Joseph Klassen

Hi everyone, this is Lindsey Parsons, your host of The Perfect Stool: Understanding and Healing the Gut Microbiome. So before we get to this week's episode, I wanted to share a couple of listener emails. Actually, the first is from Reddit, where I post my episodes, and the first one's a bit long, so I'm going to pause between paragraphs and respond to the message. So it's from Krasicek8, says, "Hi Lindsey, I have been subscribed to your podcast channel and listened to most of your episodes. I'm afraid it's heading to where dozens of past microbiome podcasts have gone, which is a dead end." Ouch, that's me. I would say that that is not my experience of it. It's really just the beginning and Based on the growth in my listeners, it is not heading to a dead end. It is heading somewhere really exciting and positive.

Moving on.

Having a podcast with FMT testimonials and probiotic announcements is not useful when it's still so early in our understanding of the gut microbiota. The procedural aspects of FMT are not interesting because they can be learned from anywhere. Probiotics, like FMT, are also highly dependent on the individual, and they're often pushed in order to advertise them. Therefore, the primary focus should be about the science. What we need are interviews with scientists and scientifically literate people who can explain the studies in layperson terms. So I absolutely agree with that. And I have been trying to get scientists on, and I'm glad to announce that I just recorded a podcast today with a scientist. And so that won't be the next episode, but it will be the one after that. And I would love to talk to more scientists. So if you are a scientist listening to this, please reach out if you're willing to do an interview about your work and your research or about someone else's work and research or the field in general. But I have discovered that it is not very easy to get scientists on a podcast. If they're well known, I guess we're not quite made to the big leagues yet, so they're not interested in coming on this podcast at least. And if it's a matter of university policy, I find that some people, you know, there's, there's gatekeepers that don't allow them to come onto podcasts. I had one scientist, or the gatekeeper, say that they do not interact with podcasts, only with, with more traditional media. So that is absolutely my goal. And I'm going to keep— every time I see an interesting article, I reach out to the researcher, and I'm going to keep trying and try and get more and more scientists on here because that was my goal. Goal in starting the podcast was to have a combo of doctors, patients, and ti— scientists. In terms of the procedural aspects of FMT, it is interesting to me to at least hear from different people and how they do it, because different people have different methods, and some people are starting to do it over and over and over again, and they've found quick and easy ways. And I also just think that for someone who's considering it, to hear about someone else's experience and how they figured out how to do it it gives them the courage to maybe consider trying themselves if that's a direction they're going in. Okay, to continue his letter, he wrote, "With regard to the most recent episode involving Katrina, I think some comments about how poorly she went about finding her donor were warranted. She just chose her boyfriend/sex partner to donate his stool without screening and only minimal testing. It sounded like she was in a very desperate state, so any donor probably would have helped." But in most other circumstances in which FMT could be an option, people have to be extremely careful about choosing their donors since FMT can also make the recipient worse. FMT holds a lot of promise, but I feel that until we understand the relationships of our microbiome, genetics, and environment, we shouldn't reinforce the idea that people should just swap poop from someone if they feel they could benefit from it. So I did have a little bit of hesitation after reading this paragraph because I realized that I have put some FMT stories out there without in any way qualifying qualifying them with regard to testing and what is the appropriate protocol. I did do the podcast with Michael in which he talked about how small a portion of the population would be an ideal donor and how hard it was for him to find donors. So that sort of touched on the issue, but it is true that you want to test your donors thoroughly. Now, on the other hand, as someone who has been desperate about her health at times, I can also appreciate that some people are kind of at the end of their rope. They have tried literally everything, and they're willing to try something that is pretty extreme and that most people don't jump to casually. Like, people aren't just swapping out poop. In my experience, people are thinking about this for years. They're researching it thoroughly. And I would be surprised if anybody listened to my podcast and just grabbed someone else's poop and up it went. But if anybody is in that position, I would say that you should definitely look on the internet for— and you can look back on the show notes, especially for the episode with Michael who did the 9 FMTs, because he has a nice wiki, I think, that has a whole list of how you would search for a donor and the criteria. But you should definitely get as much testing as you possibly can and can afford. I do think, though, that when you're in a situation where you happen to have a partner who presumably you're having sex with, you already are sharing a heck of a lot of germs. And so in, you know, in my opinion, you're definitely— it's a lower risk. Let's put it that way. If you know the person's very healthy, you're already exchanging, you know, almost all your microbes anyway, then it's a lot lower risk proposal, especially if you've seen some serious consequences to your health, because maybe you pick up a parasite, but if you're going to the bathroom 7 times a day and can't leave the house, a parasite is, you know, potentially a small price to pay for that. But I do know, and I, and I would love to have someone on the show who's had a very negative experience from FMT, and I think that if you're in really fragile health, that you should go about do-it-yourself FMT very carefully. So that's just some of my personal opinions on that. Okay, let me finish out his letter. If someone is in relatively good health with a sufficiently diverse microbiome, maintaining or gradually improving your gut is already so straightforward and does not require anyone to buy anything aside from food. I have to disagree with that because if it were that straightforward, we wouldn't have so many people suffering from IBS. We wouldn't have doctors saying, I don't know what can help you. People that I've talked to and interviewed have tried literally everything from every possible probiotic to every possible diet change or restriction or elimination. So I don't think it is that straightforward, or people maybe just need more guidance and help in doing things like elimination diets in a systematic way because it is very straining to go for an extended period of time without eating certain foods, and inevitably you end up cheating, and then you sort of, you know, muddy the waters with regard to your results. So that's something that I, you know, I often help clients go through elimination diets and help them do it in a strict manner so that they can actually get actionable results from them. Anyway, last sentence of his letter was, "Nonetheless, I do appreciate your interviews and thank you for spreading awareness about the gut microbiota." Well, thank you for writing because those are good food for thought, and I appreciate you sharing it. So the second letter writer asked to be anonymous, but he wrote, "My suggestion for your podcast is how to bring Akkermansia muciniphila back into the gut." My reading shows that we get Akkermansia muciniphila from breastfeeding and possibly raw or pasteurized organic dairy products. Got to be organic for the cows to get Akkermansia muciniphila from the soil. Now, like you, I have no Akkermansia muciniphila after 2 tests and eating all the right foods such as navy beans, grapeseed extract, pomegranate extract, ground flaxseed, and walnuts. Given there are no supplements available, a show on how to bring this back would be good with some success stories. I'm starting to try the milk option now and will try raw goat's milk, etc., soon. Thanks for your show, like it lots. Well, thank you so much for writing in, and I totally agree, I'm completely fascinated with Akkermansia municiphila, and good news is I reached out to a scientist who is an expert in that area, and he did say contact me back in June when I'm— when classes are out, and hopefully he will come on the podcast then and talk to us more about it. But in the meantime, I would love to hear how your raw milk and goat's milk experiment goes and whether that brings it back to your gut. If you're not usually a milk drinker, I'll especially be interested because I don't normally do dairy, and that may be why I don't have it in my gut, if that's where it comes from. In today's episode, I talk with naturopath Dr. Joseph Klassen, who works at Fish Creek Naturopathic Medicine in Calgary in Alberta, Canada. He's been in practice for 14 years and he focuses on digestion, hormones, and colon hydrotherapy. And he also works part-time as a clinician consultant for Rocky Mountain Analytical Lab. So let's get to the episode and don't forget to press subscribe so you won't miss future episodes.

Hi, Dr. Joe, and welcome to the show.

Hi, Lindsey Parsons, thanks for having me. This is pretty exciting.

Yeah, I'm really pleased to have you on. So tell me about your clinic and your practice.

Well, I am a naturopathic doctor. I practice here in Calgary, Alberta. So as a naturopathic doctor, we, we try to pride ourselves on treating the underlying cause, harnessing the healing power of nature, and treating our patients as a whole rather than just targeting this or that particular illness or complaint, but looking at the patient, they say, as a rational whole. And we get good results. I really enjoy it. I think that we help our patients because we take such a different approach to it. I don't want to sound arrogant on that end. It's just, it's really a lot of fun taking the time to review the entire story with your patients. So I enjoy my job very much.

Yeah, helping people solve medical problems is one of my favorite things to do as well. So what areas do you focus on at your clinic?

I guess my primary focus, or maybe my talent as it were, is digestion. I find that fascinating. And digestion is the, you know, the unglamorous stepchild in medicine of all sorts. If you don't have celiac disease or an ulcer or a cancer, you have IBS, and please go home, and, and that's your fate. And I just encounter so many people who are frustrated that they don't feel well, and it's the functional part of, of this conversation about digestion is just a lost art in family practice and, and in the specialty of GI, right? Right. So it's fun to teach people that, you know, look, I ask this question all the time because I do presentations and teaching to doctors, MDs and NDs and chiros, on behalf of the laboratory. And I always open in the room with, where does digestion start? And what do you say? They say in the mouth. And I tell them that they're wrong. It starts in the brain. When you anticipate that meal, you, you, you can smell it, you can taste it, you're going to the room where you tend to eat. Your body has these Pavlovian responses, and you stimulate digestion. And you have to start there. And if people don't get that, or, you know, that I think they're failing their patients. So I start right at the top.

Yeah, well, that's exactly what we were taught in my health coaching practice. It starts with the, with the nose and the the anticipation and all that.

Exactly. And there's all these things going on. Yeah. And sure, I talk about, you know, oh, I smell the turkey, I'm salivating. Sure. But there's all these other digestive processes that we're not really aware of, like production of stomach acid and stimulating things to move along and releasing digestive enzymes, releasing bile. I know your focus is on the microbiome, and bile is a huge part of the healthy microbiome. Again, it's the least glamorous part of digestion. Nobody wants to talk about bile, and yet it really matters to understand how that plays a role. Bile can be very antimicrobial against the least desirable microorganisms, and it's not harmful against the most beneficial microorganisms.

So, so educate us about bile then. Tell me about, you know, where does it come from, what does it do, All that.

Sure. You know, if you're— again, you look in the classic book, what is bile? Bile is an emulsifier. It's a detergent. It allows the dietary fats and oils to be mixable with the water-based soup that's moving through from, from gum to bum. I'll say it, it's a great cliché, but right from the start. And it allows that oil to now become emulsified in the water-based soup. As we evolved, we adapted over time. We've become very efficient at absorbing those fat calories because they're good calories, and, and historically people have been challenged to be adequately fed. We, we don't suffer from that anymore. We get too much fat and too much sugar, but the bile is really efficiently absorbed at the end of the small intestine. Now, a certain amount of bile should hopefully get trapped in the fiber in the food that's passing through arrive in the, in the bowel, and, and provided it's not parked there for too long, it will stay attached to that and, and come out with the stool. So it's very cleansing. A lot of people are not aware that that is a significant route of release for steroid hormones that have been conjugated, right, that have been marked for, for excretion. But if they don't release in the bile, then one of the major routes of elimination is, is down, that heavy metals can be transported out of the body via the bile. So it is really important to have good bile function. And the biliary tree is all these canals in the liver that accumulate and bring the bile to the storage point, which is the gallbladder, and then the ducts release the, the bile into the small intestine as a bolus with the meal.

So the liver produces the bile and it's stored in the gallbladder?

That's correct.

Okay. And so if somebody were contemplating gallbladder surgery, what would you say to them? Because they've got stones, presumably.

Well, gallbladder is a tough conversation because by the time they get to where that's the option, I'm not sure how easy it is to salvage it. It's, you know, it's years and years of it being irritated that, that's problematic. That being said, taking in bile from an outside source, you know, supplements and healthy oils and lots of water, has been shown to help dissolve those gallstones. But if you're at the acute point where the gallbladder is, uh, totally not functioning, I, I don't want to sound like there's no hope, but yet I hear time and again from people who say, I avoided that surgery, I waited too long, and after I had it Although this isn't an ideal state, it's the first time I've felt good in 20 years. And so, you know, my common sense has to temper with that, but all is not lost. If you've lost your gallbladder, there's still that storage network, that biliary tree. It does have— it is covered with circular smooth muscle, so it will still contract and release a smaller bolus. You just have to watch the, the, uh, the threshold of, of oil or fat with any given meal, you know, to stay within what the bile you release has. Taking supplemental bile can really help.

Do you have a product that you like to recommend to people who have no gallbladder?

Well, yeah, it's, uh, there's a number of products on the market. I use one from a company called Biotics, uh, the product name is Beta Plus. Or I'll use from the Genestra company, Icoll Plus. They both work really well. They do contain bile that has been harvested from the gallbladders of an organic pork or sheep herd. So I always mention that to my, my, you know, patients who can't do pork or who won't do animals in general, right?

Right.

Well, you can use lecithin, you can use sunflower or soy lecithin. It helps somewhat, but it's not directly bile.

And there's ox bile too, right? I see that as a common supplement.

Yeah, but it was funny, you'll see on the label ox bile and then in brackets porcine, right? Comes from—

okay, so ox is just a euphemism.

Yeah, yeah, yeah, it's, it's sort of the the, the brand name, or, or, you know what I mean, the generic name.

I see.

Okay, great.

So, uh, did you have more to say about the biliary tree, or—

well, just that it's so important. The, the, what I call the biliary reservoir, the reservoir of bile in your body, in fact has a ton of hormones in it. And as a reservoir, every enzyme pathway, every biochemical process in your body is replicated by 1 or maybe 100 of the different bacteria in your gut. And so that reservoir of hormones can be reactivated and brought back and absorbed back into circulation under different circumstances in the gut. So it has a really protective feature, but also that could be problematic if we, we did something that changed how our bile is processed in the gut, like an infection of some sort of pathogenic microorganisms, right?

And is there something that people should be doing to be protecting their gallbladders or just their bile?

For sure. Eating healthy oils, getting your omega-3s. We, we have a lot of— I call them thick or sludgy oils. And a lot of people tend to be dehydrated, and that's, that's hard on this biliary reservoir. So taking in healthy omega-3s from plant-based or some fish oils is really helpful. I do a lab test called the fatty acid profile on patients, and so we see all the different omega-3s, omega-6s, omega-9s, saturated, trans fats, etc., and look at the balance. And even on my healthiest of patients, rarely does anybody have adequate EPA and DHA, the most anti-inflammatory and helpful of our omega-3s, because they get a ton of omega-9s. They get olive oil, right? And olive oil is a good choice, but you need to get some hemp oil and some fish oil or borage oil or flax oil in your diet. Perhaps take hemp oil and include that, use that as your salad oil instead of olive oil once in a while or quite often, and enhance the omega-3 content in your diet.

So I see a lot of stuff against canola oil, but if it's expeller-pressed and organic, it's very high in omega-3s. What do you think about that?

Well, you know, it's not one that people bring up a lot because, you know, and here I'm a Canadian, my family are grain farmers in Saskatchewan, you know, we grow canola for sure. That's what, that's what canola is, is the Canadian oil seed. It would have to be organic, and I think that's the concern with a lot of the grains. There's so many chemicals used, and the current farming techniques mean that they're trying to kill— they call desiccate, dry out the grains early. And so they're covered in herbicides right just before harvest, which didn't used to be the case. And, and that scares me.

Right. So obviously avoiding the, the GMO and the, and the pesticide-ridden oils.

That's right.

Yeah. Okay. So I guess one of the biggest challenges with, with the omega-3 oils as part of your diet is that they're so sensitive to heat. So I mean, all of those hemp oil, well, fish oil usually take, that's not a, that's not a dietary oil, right? Or borage and flax. I know flax is temperature sensitive. Is hemp as well?

No, hemp is super stable. That's the beauty of it.

Oh, so you could cook with it?

It's light, light, and, you know, temperature stable. Yeah, it has a smoke point that's, uh, 300 degrees-ish, somewhere in there, 175 Celsius.

Some light sautéing in that.

That's right, you can, you certainly can, and you can bake with it. No, it's, it's a fine choice.

Yeah, I'm always torn about what to— I make homemade popcorn in a pan, and I'm always torn about which oil, and I you know, I've moved, I, I, I'm stuck at avocado at this point because I need something.

Well, I was just gonna say, in our home, avocado has just seemed to work.

Yeah. Okay. So I've made a good choice. I, at one point I was doing coconut, but I'm like, no, it's gotta, it's, I can tell it's smoking. It's got a too low smoke point.

Speaking of which, just on a side note, we got an induction stove here last summer.

Mm-hmm.

Have you ever seen one, used one?

Yes, I have. And I realize that you have to have like a weighted pan or it doesn't go on. So I was very frustrated with one at a time.

The pans have to contain iron molecules is what it is. They have to be ferric. But nonetheless, oh my goodness, you can put 4 quarts of water into your pot, put it on the burner, you turn it on because you're going to want it to boil. You know, we're used to that takes 5 or 8 minutes, whatever, right?

Yeah.

It's boiling in, in 30, 40 seconds. It is unbelievable how much heat you can drive into it. So if you're using oils, that's why I bring it up, in the pan, you put them in the oil, you have an induction range, careful because you are going to smoke your oil, and that's not good.

That's not good to know.

Good to know.

Okay, so on to another subject. Talk to me about food sensitivities.

What, what are the most common ones you're seeing in your practice?

Oh, great. I'm— are your listeners aware of the difference between allergy, sensitivity, and intolerance? Have you featured that?

We haven't featured that. So briefly, because my listeners are probably more, you know, well, in a podcast you got to be somewhat into the gut stuff.

When I say allergy, that looks like hay fever or bee sting. It's moderated by histamine, right? You know what that looks like. A sensitivity is an allergy. It is a type 3 hypersensitivity, but it does not involve the type 1 histamine-releasing antibodies. It involves a type G antibody.

It's IgA versus the IgG.

Yeah, so the type 1 is IgE, IgE sensitivities is IgG, and that is delayed sensitivity. It could take up to 6 days to hit its stride. Those antibody complexes, they have a half-life greater than 21 days, perhaps as long as 90 days, and so this The sensitivity can be very hard for even the intelligent observer to put together. The intolerance is not involving the immune system. Lactose intolerance— you fail to digest the sugar, it feeds a bunch of yeast in the bowel that causes explosive gas, produces some proteins that give you diarrhea. It's uncomfortable, but it does not involve the immune system.

So tell me, I'm lactose intolerant, so I know, I know exactly what that's like.

Yeah, so I, I do a lot of work with food sensitivities. I do a lot of the the blood test for food sensitivities. It's the best way to test. The skin scratch test does not measure it at all. And you look for antibodies in the bloodstream, say, hey, you, you're having an inflammatory response to this food. And so to your question directly, dairy is number 1, eggs is number 2, wheat is number 3, other grains and seeds are number 4. So the legumes, the seeds, And all of these, what they have in common is that they have proteins in them that are very hard to digest, right? The, the gluten in, in wheat and other— did you know that as much as 20% of the protein in a grain of wheat is albumin, just like you find in the egg? It's really interesting. They can be cross-reactive, but these proteins are super stable. They don't break down easily. Therefore, they are the single hardest to digest molecules we encounter. They make it farther down our GI tract undigested or, you know, not fully disintegrated into singular amino acids. And so our immune system, which is the richest in the last few feet of the small intestine, lights up because these fragments, peptides if you want to call them that, fragments of these proteins are identified by our immune system. So it makes people very uncomfortable, and it causes systemic inflammation. It causes specific ailments. So in my case, eczema, asthma. My patients, it makes their PMS worse. Think about where the small intestine is located in the bottom of the abdomen, right? If the small— end of the small intestine is angry and inflamed, what's it touching? Ovaries, uterus, vagina, rectum, bladder. It's why people have so many issues down low there. And so it has other systemic effects. So finding out a food sensitivity to me is almost a key to how I start most of my patient visits. I like to say, hey, let's figure out what else is causing inflammation. So that affects the microbiome.

Are you doing a blood test then?

Yeah, I do a blood test. I take the samples in my clinic, we send them to the private laboratory, the Rocky Mountain Analytical Lab, and They got a great test. It works well, and I've used it very well for a lot of years.

Okay, so I have a friend who got tested. I'm not sure where, and every single possible food other than meat came back as sensitive. Is that probably a case of leaky gut at that point?

That's exactly the right description. I kind of hate the term leaky gut, but it works so well for what's going on.

It's, it's caught on.

And here's what happens, and it can happen at any point in life when you think about it. So something happens that causes the integrity of the small intestine, especially at the end, to diminish. So now all those tight junctions that are held together real closely, don't let anything through, right? That's the whole point. That becomes hyperpermeable, leaky, and now these fragments of food, especially when the GI tract is already inflamed and ill, food doesn't fully break down, and at that point it's that much easier for Mr. Food Particle to meet Mrs. Immune Cell, right, in your body. And now, having created that reaction, you are now sensitized to that foodstuff, right?

For good?

No, you can develop a tolerance. And especially though, you'll have to avoid it for a while. Now, this— your friend is a different story, we'll talk about that in a sec. But if there's specific foods that came up, you, you would want to minimize those foods. If not, avoid them. And then get that level of circulating antibodies down to a low point over time. With dairy, it may not diminish over time. You may not be able to go back. But most of the other foods— and gluten not so much, but the wheat itself, if it's not a gluten-based issue— they can tend to go back. But they've got to stay under that threshold, right? Don't, don't poke the bear. So 1 or 2 portions, you know, not too frequently, you know, 1 or 2 portions a week for a while. Once they've avoided the food, usually they can survive that. Taking a digestive enzyme with the meals when they have their reactive foods is certainly going to diminish that damage. And we deal with humans, you know, some people, oh, 3 weeks, I am happy as a bug in a rug. Other people struggle for 6 months, right? It's It's hard to determine that timeline. Your friend though, when it's leaky gut and everything shows up, then you don't have to worry about the specific foods so much. Maybe look if some are still traveling ahead of the herd in terms of their values. But what you have to do now is improve their digestion, the quality of digestion. That's what the story is about at this point. So yeah, you have to get back to right where we started our conversation. Right? Meal hygiene. They need to take the time to chew their food. That chewing stimulates the parasympathetic nervous system. Smell their food. Enjoy their food, right? Think of how many people don't prepare their own food, so they don't go through that process of anticipating it. They buy what I call one-handers, right? That's why hamburgers are so popular. You can throw them in one hand and continue driving or continue talking on the phone or typing or doing whatever the heck it is you do. And that's why they're good. The bread, you don't have to chew it. As long as you can get it down your gullet, it'll disintegrate in water. It's gonna disintegrate really fast into— the amylopectin is gonna digest into glucose instantly, right? It's rocket fuel. That's why a hamburger is desirable. You don't have to chew the meat, right? Nobody buys a solid piece of steak in the middle of a burger bun because then you'd have to chew it, chew it, chew it. They want stuff you just got to force it down the gullet, get a bit of water to dissolve it, and you're good to go. So they don't get the parasympathetic stimulation of smelling it because they went to a, you know, drive-through, right? The food's right in front of them this instant to eat. They didn't go through that time. They weren't at home where you take the time before a meal to give the blessing. Think about how that has a practical aspect. I think that's really interesting how, you know, my grandparents would have always taken the time to give thanks before a meal. I'm like, oh yeah, that was good for digestion. Because, you know, priming the, the system.

Yeah, priming the pump. Okay, so let me back up a little bit about the food sensitivities. What do you think about an elimination diet versus a blood test?

I would love to say that the elimination diet is a great effort, but it just doesn't pan out for my patients. It just doesn't. I've tried it and tried it for years. It is so hard to be compliant for people who who aren't in the middle of this world about being gluten-free and dairy-free and egg-free, and they have no clue. They're not preparing their own foods, so the chances of contamination tend to run at about 100%. You know, and then they even, they try, they do some reading, and 2 months or 2 weeks in, whatever, then they're like, "Oh, I didn't realize that the main ingredient for soy sauce was actually wheat." right? So it's, it's just too hard to do a good elimination diet if you are not already existing in this world and understand, you know, this alternative world that we live in. Yeah, where they, where they know how to be gluten-free, they know how to cook their, their beans well, they know how to, um, otherwise, you know, they can't buy anything at a restaurant doing elimination diet. And, and most homes The, the cost of the test is far less than the hassle of trying to do the elimination diet.

And now for the, the testing, do you have to have been eating the foods regularly that you're testing for?

Yes indeed, eating them or foods that are similar because there are cross-reactions. There are proteins that might be common in several things. And again, for example, this protein might be found in walnuts and And so although you never eat walnuts, the fact that you eat pistachios quite regularly means that your body found that protein via the pistachios. And so now, no, the walnut's not going to work for you. I hope that made some sense. But otherwise, yes, if you go perfectly gluten-free for a year and your body has not seen that, the level of circulating antibodies will diminish. And if the people say, well, then I guess I need to go on those foods if I'm going to do the test, Joe. Like, no, you don't. Because if you're avoiding gluten and you have issues right now and you know that when you went off of gluten, you felt better, you know that it's not something you want and it's not good for you. You don't have to go back on it. You already know that. So we test you today as you are. And we will see what it is that is currently causing your grief. So if I challenge the gluten, it might make the whole picture look worse, like your friend, and then I don't know what is relevant to what's been causing you grief for the last 6 weeks. That's what I want to know by testing you today.

So I was listening to another podcast about someone, uh, well, the doctor was a specialist in celiac, and she was— her contention was that it's better to have people go back on gluten and get tested for celiac because only in the US at least, only 15% of the known celiac cases are— have been discovered, which means that there's all these people out there who are probably avoiding gluten in a sort of half-assed way to put it. Yeah, because they don't realize they're celiac. Do you think there's some value then in maybe getting that proper diagnosis so you really avoid it hardcore?

Well, for some people that might be, yes. Others, they know, you know. I, I think that the, the problem with doing that is that you then you really need to keep having that gluten, that wheat, for long enough to make sure that the symptoms are very apparent. You know, they say, oh, you know, have it twice a week for 2 weeks. No, that is not good enough. If you wanna say, let's make this gold standard, I want 6 weeks of wheat every day, different forms, cereal for breakfast and bread for lunch. Yeah.

Okay.

So you really have to go hardcore on it.

Okay.

And, and the other part is, you know, why do you need the, the diagnosis? I guess, like you said, to, to enhance compliance.

Well, yes, it would be like the level of, but I mean, think about the level of, I, so I, I don't, I don't do gluten because I have Hashimoto's. But, you know, I'm not going to be destroyed when I eat gluten. I'm not going to have like severe— I mean, I'm going to have bloating, but not super severe reactions. So, I mean, my family eats gluten and I use the same toaster and the same cutting boards. And people who are celiac, they don't do that. Like, there's not a grain of gluten getting in.

Yeah. And in Canada, there's an added bonus to the diagnosis of you get some tax preferential treatment, right?

Really?

It's a disability. You have to go and buy expensive foods.

Wow. What is the— what is the nature of the tax preferential treatment? What do they get? Just a credit?

They could write off their gluten-free purchases.

Wow. That's revolutionary. I'm dumbfounded.

Most people don't find it's worth the paper— that keeping track of that receipt from the grocery store yesterday where I bought the gluten-free loaf. They— most people say they don't bother.

It's just— Oh, I love that, though. That's revolutionary. Okay, so, so you're not big on the elimination diets. Okay. Talk to me.

Well, I'm a fan of elimination diets.

It's just they're so hard to do. Lack of compliance, right? Yeah. Right. Yeah. No. So as a health coach, I work with people week after week, so it's a lot easier to kind of follow them through an elimination diet. And I know when people are kind of, if they're not really doing it, then I'm like, listen, let's just cut out the pretend elimination diet. Cuz you can't just have like a once a week gluten and call that an elimination diet. Yeah, exactly.

Yeah.

Okay, so talk to me about the interaction between food sensitivities and autoimmune diseases.

Well, the, the nature of the food sensitivity is that that IgG antibody sees its perfect antigen. When they bind irreversibly, there is now stimulated the release of certain inflammatory chemicals. They, they come from the omega-6 fat family, and they're eicosanoids, leukotrienes, prostaglandins. And there's the generic or systemic inflammation, so it's, it's just raised overall inflammation because these chemicals are more plentiful. Then there may be an additional problem because that antibody-antigen complex settles in a particular tissue and invites inflammation there. And that's exactly the mechanism in celiac. For some reason, that antigen complex only settles in the last few feet of the small intestine. It will not settle in your kidney. It does not settle in your nose. There, to gluten, and then invites destruction of the small intestine. In my case, my weak link is my skin. I get a form of eczema. In some people, it's their asthma. In your case, Hashimoto's thyroiditis. Fans the flames of any other inflammatory or immune process that is coexisting. And so it's a great imitator in that that food sensitivity did not necessarily cause your thyroiditis, but it fans the flames. So fanning the flames of any autoimmune processes is also realistic too. To include in your conversation.

But you were saying that you see people heal from food sensitivities other than perhaps the big ones like the wheat and the dairy.

Absolutely. It, it's a game changer for a lot of people who've struggled to find a way around their eczema. I'll use that example because I have just some amazing cases. This 4-year-old boy was brought into the clinic last fall by his grandmother. The boy's mother has died from a recent fentanyl overdose. The father's on the streets. She's got this boy with— as he sat in the chair, the eczema was oozing and dripping. You know, we had to dabble his chin. It was just awful because one nipple was about— you're American folks, but it was an inch and a half in diameter. And it was elevated 3/4 of an inch off of his chest. It was like a, you know, a marshmallow cookie. And on the bottom, it was black. It was necrotic. It had bled and excoriated so badly. And so we did the food sensitivity test. We pulled him off his foods. And at his 7-week visit, it was shocking. This nipple had diminished a bunch. His skin on his face was closed. He, you know, was looking a lot better, still had some evidence, of course. And then we did a stool test. We, we looked for— and we found that there was some yeasts going on and a few other things, and no production of short-chain fatty acids. So we, we worked on that. And at 16 weeks, that nipple had gone back to pretty much normal. Well, normal. And, and his skin was awesome. He had that week been exposed to some wheat again, and he got a a dotty rash called dermatitis herpetiformis. It's a kind of eczema on his leg, but it didn't make the whole thing blow up on that one exposure. So, you know, it's just that it's a life changer for a 4-year-old to be able to sleep and not be teased and bullied. They wouldn't let him into any daycare.

Oh, I'm sure they thought it was—

his skin looks so bad—

contagious.

That's just— then that's, you know, life is cruel when you have that kind of deformity, right?

Yeah. So I'm curious what his allergens were because I can only imagine that if he was a typical 4-year-old, his diet consisted of like chicken nuggets and, you know, well, yeah, absolutely. All wheat-based things and like, you know. That's right.

That's exactly what he wanted. That's— and he wanted that and that only. But, you know, grandma can do things that mom can't sometimes, right? You know, and she did. She's done a wonderful job.

So was it just wheat?

It was, nope, wheat and dairy.

Oh, yeah, no, that's killer. I tried to take my son off wheat for a while and it just didn't work.

I mean, he just wouldn't comply. You know what? He's real good because he feels good. He knows. He knows.

Yeah. Well, when it's that concrete, I think it's a lot easier.

Yeah, he knows that a cookie is his, it will make him uncomfortable. It's his poison. And Grandma, you know, bless her, she comes from modest means. Um, you know, these aren't people who have, you know, a lot of education or, or finances. But she, bless her, man, she is doing great. But I went to, you know, here's a nice story. I went to the 3 main supplement vendors from my clinic, and I called them all and said, this kid needs your stuff and can't afford it. So, you know, since I'm over, one of my vendors was there within 2 hours. This fellow brought a bunch of stuff— probiotics, healthy oils, digestive enzymes, right? It was within 2 hours. He said, oh, I was just in the neighborhood. I'm like, you are lying. He said, yes, I am. I know, I just— I had to help this kid. Great.

That's awesome.

Everybody has stepped up and they're doing nice.

So talk to me about how you worked on his short-chain fatty acids. And let's just talk about that in general. Why was that a problem?

For sure. Uh, you know, the number one issue for me is butyrate. So the short-chain fatty acid called butyrate, to me, if you only got to analyze one thing in the stool about digestion, it would be butyrate because it is the most important short-chain fatty acid of restoring colonic health. The epithelia of the colon use butyrate as their main food source, and the colon needs to be oxygen deficient. Most of our— if all of our healthy bacteria are obligate anaerobes, they do not function in the presence of oxygen. There's some of the commensals, you know, they're not really pathogens, but if they're too plentiful, that they could crowd out the good guys. And those— many of those are facultative anaerobes. They can adapt and function in a presence of oxygen, but they're fine in the anaerobic state, which we normally have. And then there's the aerobes, and most of the pathogens are in that aerobe world and the facultative anaerobes. And so here's the question: how do you take the oxygen out of the bowel? I, I had never thought about this before. And a wonderful microbiome researcher, he's at the University of California Davis, his name is Andreas Baumler, and, and he said, think about it. I'm like, my God, I've never thought about how do we make it oxygen deficient. Well, a butyrate takes an oxygen molecule with it and travels into the colonic epithelia as they're a main food source. So if you're not producing butyrate, you're going to have oxygen. If you have oxygen, you can't get back to the healthy gut bugs, and you're stuck in that circle until something disrupts it. That's why I think butyrate is so, so important. Feeding the short-chain fatty acids is— feeding all the microbiome is something that nobody really knows specifically how to do it. Oh, raise this by eating this one food. What we do know is that in the microbiome, when we analyze in the gut, there's not one perfect enterotype, one balance of these different genera or families that makes perfect, and everybody should look like this and you'll be great. People look great, you know, with this pattern, and then the next person is the same pattern and their gut is awful. So it's what your gut is doing not who was there. So since I'm Canadian, I use the hockey analogy. It does not matter which of my players are on the ice at the moment or were on the ice yesterday. It matters how many goals they've put on the scoreboard right now. That's butyrate. That's your, that's your short-chain fatty acids. So how do you build gut flora? How do you build diversity? And that's the key. It's the diversity of the gut bacteria that's is truly important. And you get that by having a variety of plant matter. And I talk to so many, you know, I mean, who visits me at a naturopathic clinic? Mostly these are people who are probably a little healthier than average, a little more engaged than average in eating well and being fit and being healthy, right? Lots of, lots of, you know, people saying that I eat lots of plants, I'm nearly vegetarian. I'm vegetarian, I'm vegan. And yet when I look at the list of what they eat, it's 8 vegetables long, right? They, they say they get a lot of fiber, and they might, but they're not getting a ton of variety within that fiber. So I tell them, go stand in the produce section every time you go to the grocery store. Stand in the produce section and look around, and the first thing you see that you don't remember the last time you ate it, or that you can't even say or spell it, you need to buy that thing this week. And each week, each trip to the grocery store, buy one new— I'm winking as I'm saying that— one new vegetable to you. And people look at me still, they're like, I get lots of stuff, Joe. I'm like, okay, when's the last time you had an okra, a kohlrabi, or a jicama? Then they go, well, I guess never. Right. And so that's the key, is you have to get lots of fiber, but you have to get a variety across it over time. And I really believe strongly that it is not as simple as just taking a bunch of supplemental fiber. That'll help, sure, sure it will, but all of these microorganisms have different food needs, and so variety is really important.

Okay. Good diet advice. So talk to me about— because I know you do colon hydrotherapy in your clinic.

Yeah.

When is that indicated? And doesn't that wipe out good bacteria when you're cleaning out everything?

Well, sure, it wipes out a lot of stuff, but the colon hydrotherapy— I know people, you know, I mean, the thought you have when you hear, oh gosh, they're going to pressure wash my innards, and that's not really the case. We introduce a small amount of water into the bottom of the bowel, right? So there's a small tube that goes in your, in your bottom, and, and there's a freshwater inlet, and we have water that's filtered and sterilized before going in. And then that tube that's holding, what I say, the other sphincter, the gate open, is connected by a hose to the sewer. En route, we have a valve we stop, so then we trickle in some water. And only enough not to make your eyes bulge, but enough to stimulate the defecation reflex, right? Oh, hey, I need to get somewhere socially and hygienically acceptable to drop a bomb. And, and so we, we fill and release and fill and release. And so you get the repeated stimulation of that peristalsis, right? And that repeating it, not unlike taking your biceps to the gym you need to repeat the bicep curl, and you need to attend the gym several times. What you get is not just an increased strength of contraction, but an increased resting muscle tone that enhances transit through the bowel. So at the time you're doing the, the cleanse, it's not that— the tube only goes an inch into the rectum, that's it. It's only the water would travel beyond there. And so you're never going to put a ton of water all the way up to the ileocecal valve. We're coaxing your bowel to bring all of that fecal matter to us.

Got it. And so, but is this for someone who's constipated?

Typically, I love it for constipation, especially to reawaken the defecation reflex. I love it for cleansing. I love it as an annual event for people come in and do 4 or 5 sessions in a few-week period and just enhance your bowel. It's very hydrating. Think of people who are constipated, right? The lining of the bowel is as dry as that poop that's coming out. So putting the water in really helps rehydrate the whole epithelia along the way. Parasites hate the raw water, so we'll see worms and other parasites, a lot of mucus release as well, some icky stuff. And, and so at the same time we're doing this, we are also guiding them to eat fermented foods, to take a probiotic supplement. And it is not the case that we have washed out every last ounce of stool from the very top of the bowel. And, and that's the appendix's job, is to store a small amount of stool that always serves to reseed, right? Gives the, the healthy bugs the competitive advantage. But the probiotics and healthy fermented foods while you're doing colon hydrotherapy really enhances finishing the series of treatments with a great microbiome.

So the appendix stores stool and reinoculates the gut.

That's its job. It is not vestigial, right?

Wow. I love that because for the longest time they were saying, oh, this is this useless thing. You don't need it.

Yeah. No. Gosh. Just like, hey, no matter if you pray to God or Gaia, we don't have things that have no purpose.

Yeah, I think there was another thing like that that I recall. It was about, they called it all this junk DNA that's not necessary for anything. And then I can't recall what the use was, but they found a use for it.

Oh yeah, yeah. And, you know, think of simple things. Take a some dead animal and leave it out in the sun for a good week or two till it bursts open. Is there anybody who doesn't find that smell revolting?

Vultures, right?

But humans, right? There's the right— put a whole bunch of poop somewhere, we're going to walk away from it. Why? That's what that junk DNA, I believe, is. Instinct. We know. Smell that? Stay away, because something died and it might be contagious. You know, it might spread bad germs. And that's why it's so ingrained in us that these are icky things. And we have that reflex. You know, think about when you get near that rotten meat, you want to puke. You want to spew. Why? Well, so that in case you had eaten some of it, when you smell that stuff, you'll get rid of it. It's why we avoid it. It's why we walk around it. And that's what you talk about, that junk DNA. I think that codes for common sense and instinct.

Yeah. Okay, back to the colonics. Um, does it go into the small intestine or—

or no, no, no, no, no, we're not doing anything that aggressive. Okay, it's really stimulating that defecation reflex. That's, that's the key to a good colon hydrotherapy session.

Okay, and what about people who are dealing with diarrhea and that sort of thing, or Same thing, restoring healthy microbiome.

Uh, you know, we won't do it, uh, on somebody who's got any GI cancers, who's got any bleeding at the moment, uh, just in general bloody stools. If you have hemorrhoids, internal hemorrhoids that are flaring, obviously we wouldn't want to irritate those.

But you would, you would use it on someone with diarrhea?

Oh yeah, yeah. And we would also not use it for active diverticulitis.

Right. Okay. So, so the fundamental purpose though is just to sort of tone that, that muscle of the intestines and reactivate the peristalsis.

And if we feel that there's a dysbiotic, you know, stool in there, if we can get a lot of it out, that just helps the reseeding go better.

Mm-hmm.

Okay.

So talk to me about a typical patient you might see where you, where they, other doctors haven't been able to help them and you've been able to help them.

Oh, so I had a great case. It was last summer, a lovely young lady. She'd been in her sort of early to mid-20s and had chronic constipation. And she had traveled to India about a year prior and, and had some stuff going on. And then they gave her some antibiotics for it and things returned to normal for her. And then over the course of roughly the better part of a year, she just became increasingly constipated. And so we did a stool test for her, the GutWell Stool Test, and on the parasites came up with Blastocystis hominis, which is something that is associated with causing constipation. But she, it it was not responding to the pharmaceutical antimicrobials. And so we use the herbal antimicrobials, and they work really well. And you do a staged process where you do the one herbal combination for 2 to 3 weeks, and then you do the second different herbal combination for another few weeks, and sometimes you repeat the first one again. And, and that just, it made all the difference. Well, we did the colon hydrotherapy and we did talk about foods and fiber, and she just got to a whole new place. And, you know, a year of working with her doc, she did not see that.

And so for the herbal, you said you use a few things in combination, and then are you, are you buying a combination product, or is she buying a combination product, or are just providing each of those, or do you mix them up? All the above.

I have combinations from different vendors that I use. You know, I'll use a— tend to, tend to be the— some of the— where the active ingredient is an oil-based product. And so that comes from, you know, Wormwood and cloves and oregano and a few other herbs. And then the second formula is more of a water-soluble herbs like the berberines and pau d'arco. And then I have— I keep 105 different liquid herbs in bulk in my clinic dispensary, and we custom formulate. And pau d'arco, pericress, I might use Thuja, and we might use myrrh, goldenseal, and Oregon grape, and all your classics. And, you know, sometimes throwing some antivirals like licorice and and lemon balm, uh, if we feel there's some overlapping concerns. So yeah, I use what, what's going to work for this patient.

So you were saying first you use an oil-soluble set followed by a water-soluble set?

That's right, just so that we have a different mechanism. So if I gave you that product for 2 to 3 weeks Well, any of the organisms that we were targeting that have survived that, even if most of them died off, but if a few seem to be able to escape that product, they're not gonna be eradicated by using that product for another 3 weeks. So then we switch products that use a different mechanism and that catches those, those survivors.

Got it.

Because, you know, after 2 to 3 weeks, they've adapted to that first product.

So say you've, you finished your, your 4 to 6 weeks, then what's your process for rebuilding the gut?

All the way along, we've been doing antimicrobials by day, probiotics at night, and fermented foods.

Okay. And are there—

and fibers and variety of plant matter.

And what kind of probiotics do you like?

Multi-strains, as long as they've got a variety. I, I use one from a company called NFH, and I use from the Genestra company, and I use from Metagenics.

And in that, that's— we're talking about parasite here. So say you were, you were dealing with somebody who had something, well, like Candida, for example. Same thing, same protocol.

Yeah, and that's the, the elegance of of the— this kind of a strategy. I've done some stool tests where we get a— what would we call— a culture and sensitivity on these other bad bacteria. And, oh, we grew them in the dish and we put on some, you know, the pharmaceutical antibiotics, and we put on some herbals. And this one, you know, this— they had a Klebsiella and it was susceptible to caprylic acid, right? Okay. Oh, Nobody ever goes and just treats that with caprylic acid. We use a formula of caprylic acid and other things, and we probably do the stage thing. That's, it's the most common approach for people using herbs. But what we found is that that's what we could culture, but we can't culture 98% of the bugs in everybody's gut. So those obligate anaerobes are hard to find. They're hard to culture. So even if we've got this dysbiosis, we use the product to target what we did find, but then in fact there's the innocent bystander effect. We're getting rid of a lot of our, uh, non-anaerobic bacterias. So there might be other ones that we couldn't measure and see and test, but that the herbal approach is so, so such a wide net. It, it gets the parasites, it gets the yeasts, and it gets the undesirable bacterias.

Mm-hmm.

And, and so it's really wonderful that way.

And it's not, you're not in danger of killing off the anaerobic ones that are so hard to replace since we can't just—

That's right.

Take 'em.

Well, and so almost all the herbs that I've listed there and that, you know, you would find in these products, let's think about oregano, rosemary, and thyme and garlic. And clove. Sound familiar? Got them in your kitchen.

Yeah.

Here's the reason why we call them herbs. You know, my 30th generation ago grandmother did not use these foods, these herbs in her foods, because she wanted everybody to know it tasted better. They were poor. They subsisted. It's because it gave their food longer shelf time. It made their food safer. That's why they used them. That's why they call them herbs, not poison. They do not tend, in reasonable quantities, to hurt the beneficial bacteria, but they definitely have an effect on the bad bacteria. It's the same reason the Japanese use wasabi and pickled ginger, right? It's not to make their, their fish taste better. It's because they're anti-parasitics. They work very well. And they knew that in the way that they were preserving their fish, they're at risk of getting the parasites. So they always ate it with these, what we call, condiments. That was a safety issue. It was common sense. But people did not, 1,000 years ago, the average person, spend much time, "Oh, I am going to dust a little parsley on top of the spaghetti sauce for my kids," right? There's a practical reason these made their way into our community diet.

How interesting. I had no idea, but it makes sense since I think, how in the world does that pesto stay good in my fridge for months when every other food, you know, yeah, goes bad in a week, right? And I'm talking about homemade pesto too. Maybe it doesn't last months, but it lasts a couple months for sure. Oh, for sure. Yes. How interesting.

And it's amazing how much longer your food lasts in your fridge If you don't lick the spoon and put it in there, but if when you cook it you don't lick the spoon when, you know, eat out of it and then put it back in the fridge, just that little bit of bacteria from the spoon will make it go bad so much faster than if you just, you know, leave it more pristine in terms of bacterial exposure, right?

Note to self: don't lick the spoon.

Well, you lick the spoon, but don't put it back in, right?

Right. Okay. So tell me about how hormones interact with the gut microbiome.

Ah, well, you know, that's a great, great section. One of the things that we forget is, again, that whole what— how much hormone is in the bile? Because the building block for to make any bile molecule is a steroid. Mostly cholesterol and sex steroids, right? There you are. So they're in the gut. And so you get something like flaxseed. People say, oh, it can be estrogenic, right? Well, it is not in and of itself estrogenic. It has to be acted on by particular bacterias in order to turn into estrogen. And in that case, it does become bioidentical estradiol. It is. But it's only about 40% of women actually have that bug in their guts.

Which bug is that?

I don't know the name of it.

Okay.

I know the enzyme that it produces, but it's, you know, but anyhow, it deconjugates that in terms of the microbiome. These bugs deconjugate that steroid from the bile and allow it to be reabsorbed. There's this phenomenon, you know, where some— maybe let's take 4 sisters who have the same genetic predisposition to something, right? Hormone-wise. And you can say, "Yeah, but how come, you know, 3 sisters don't have this issue and one does?" In terms of the disease presenting. And it's because in the other girls, there's a bacteria that's covering the gap for them, 'cause, you know, genetically they don't make this particular enzyme. But if you have bacteria in your gut that's making that enzyme, No harm, no foul. That's the beauty of a healthy microbiome. It, it's more than just healthy bugs for digestion. It covers your bases on what your genome may be missing.

So if you're dealing with someone then who has just wiped out their whole microbiome, they've taken, you know, they've had Lyme disease and taken 8 weeks of antibiotics or something like that. Yes. What do you recommend?

I, I, that's exactly what we talked about before. Getting the fermented foods, getting your probiotics, alternating each time you buy a probiotic by a different brand, a different combination next time. But getting, you know, eating some dirt is a great start.

Yeah, I assume you don't mean to like go ahead and take a teaspoon of it, more like just don't wash your stuff too well.

Well, actually, you know what they're saying is that just the amount that you get in the dust by playing in the garden or by hiking in the forests is actually helpful.

Like that you're breathing in your nose? Yeah.

Okay.

Yeah. So I find that really fascinating, but I certainly wouldn't hesitate to pull a carrot out of a garden that's had healthy, healthy composting going on. Right. You know, don't just pour cow poop straight onto it. It needs to age for 2 years so you don't have the E. coli.

Right.

And but with healthy composting, you're going to have great soil probiotics.. So yeah, just pull the carrot out, maybe wipe off the largest chunks of dirt and rocks, but eat it dirty. That is gonna help.

And what about those soil-based probiotics? What do you think about those?

Well, there is no such thing as perfect probiotics, right? That would be fecal matter transplant.

Mm-hmm.

And so the, I think that the difference between a lot of the various probiotics, there's, there's good arguments. I'm not, I'm not disparaging them, but in terms of actual effect in the patients, it probably makes more difference to the marketing department than it does to the med sci department.

So you can't go too far wrong, just alternate them and—

That's right. And I do like some of the premium products. I don't want to say that they're worthless. That's not my point. But you still— there's no one perfect thing and you need to get a variety. And you need to feed the bugs. That's— and that's what most people miss in the conversation. They are not feeding their bugs.

The prebiotics.

Yep. Yeah.

Okay. Okay. Actually, one last question, which was, is there anybody you would recommend that I have on the podcast? And I'll tell you, in particular, I'm really looking for scientists who want to talk about their research. If you have any connections like that, you know what I would do?

If you go to the— you can probably still find it on the internet, but the Keystone Symposiums, symposia, all the speakers they had last— was it March, last March or last May in Banff, Alberta? There's going to be another one coming up in San Diego, I think, in the fall. Look for the speakers list there.

It's a good idea.

You know, I mean, what I did last time, I went to the thing and I just did a bunch of quick Facebook Live interviews of the people I thought were most interesting.

Okay, great. Anybody you know in particular that you would recommend?

Well, Andreas Baumler. I thought he was just awesome.

Okay, could you connect us?

Nope, I don't know the man other than I heard him speak and he changed my life by teaching me about butyrate.

Okay, awesome.

Well, I will look him up and see if I can get him on.

Well, thank you so much for being on. I really appreciate your time.

Thanks for having me over. Yeah, and call, you know, if you want to interview me again some point down the road, give me a shout.

Okay, awesome.

Thanks so much. Thanks for listening. If you love the show, can I ask a huge favor? Could you go on iTunes and leave a rating so that other people can find us? And also make sure you're subscribed in your podcasting app. And if you or someone you know is struggling with weight gain or autoimmune or thyroid issues, please reach out. I coach clients over the phone or through video chats from anywhere, and I help clients lose weight without ever cutting calories or going hungry by learning new eating habits that will help them take the weight off and keep it off for life. And also, I would love to hear from my listeners why you're interested in the show, what you liked, what you didn't like, what you'd like more or less of. So please email me at Lindsey@HighDesertHealthCoaching.com. That's Lindsey with an E-Y. Or follow and write me on Facebook at my High Desert Health page and tell me what you think. And be sure to include whether I can read your letter on the air. So thanks so much, and here's wishing you all the perfect stool.