GI Health with Dr. Cheryl Burdette, NP, Co-Founder at Dunwoody Labs

In this episode of the Root Cause Medicine Podcast, we will be discussing Gastrointestinal Health with Dr. Cheryl Burdett.

Microbiome is not about our own cells, but about this bacteria that's in us. And if we were to boil humans down, we would find we'd be 9, 10 bacterial DNA and only 1 10th human DNA.

Welcome to the Root Cause Medic Podcast. Each episode focuses on giving you the information you need to understand the root cause symptoms and treatments available for specific medical conditions. In each episode, we'll meet renowned medical experts, specialists and pioneers who've influenced the way certain conditions and diseases are understood and treated. I'm your host, Dr. Anthony Profassi. Welcome to today's episode of the Root Cause Medicine Podcast. Today we have a very interesting guest. Her name is Dr. Cheryl Burdett. Dr. Burdette has a very extensive and fascinating background. She is the co founder of Precision Point Diagnostics, a functional laboratory with a focus in gut based health. She's also the founder of Personalogix Health Academy, an educational initiative, among many other things. Dr. Burdette is the Director of Education and the Naturopathic Residency program at Progressive Medical. She's on the Board of advisors for Zymogen. She also completed her residency at Cancer Treatment Centers of America and the Family Health and Wellness Center. And while practicing in Atlanta, Georgia, she worked at a laboratory that specializes in nutritional and metabolic testing. Dr. Burdett's passion is teaching around the practices of integrated and naturopathic medicine to increase awareness of evidence based natural therapies. She's also helped formulate a new educational piece for Zymogen on igy, which is a powerful tool for gut based inflammatory conditions. So, without further ado, it's my pleasure to introduce Dr. Burdette. Thank you so much for joining us on today's podcast. And in case I missed anything, please tell us a little bit about yourself and fill in those gaps for our listeners.

Well, I think you got the highlights there. I'm also a mom of two kids and three dogs and wife, and so that keeps me busy.

That's amazing. I mean, come on, you got multiple full time jobs here, Dr. Burdette. So give a round of applause for you and all the moms out there listening, because that's a big time thing. So thank you for doing such a great job there today, Dr. Burdette. We really want to discuss the GI and Digestive and gut health because so many people are suffering with this around the world. So many people are wondering what is going on. And so there's Just so many Americans especially, that are really, really dealing with this on a daily basis. And we're. What we want to know is, why do you think this is happening? Why do you think this is going on?

I think that the assault to our GI system has continued to grow and grow. And this can be. It's a lot of things that have come together all at once to really create the perfect storm. So what we used to think is that when you eat food, the GI tract, that it's a barrier, and this is where we absorb things. And that's absolutely still the case. But what we realize now is that it's so much more than that, in fact, inside your GI tract. And so that means all the way from your mouth, esophagus, stomach, small intestine, large intestine, and out throughout that house. That's where 85% of our immune function happens. It's where we make enzymes, it's where we make neurotransmitters. And they don't just stay locally there either. And so, so much is going on in terms of function. And then we look at how eating habits have changed, and we're all aware that while probably, I mean, Even in the 50s, there were a more fruits and vegetables, a lot more prepared foods at home, and we've seen a shift towards things that are more processed. And when they're more processed, of course, they tend to have higher sugar and more salt, and they remove a lot of the nutrients. Like, I always laugh at something called Wonder Bread because it says it's enriched, and you actually take out more nutrients than you ever put back in. And so all of these things have come together to start an assault on our GI tract. And then you add to that the fact that even if you're trying, most of us can't eat organic food all the time. You go out, maybe you're at a really nice restaurant, but that steak still isn't necessarily organic. And so add to that the antibiotics that are in the food supply, that really changes our bacteria. And we're learning more and more about this microbiome and how really how we age is not about our own cells, but about this bacteria that's in us. And if we were to boil humans down, we would find we'd be 910 bacterial DNA and only 110 human DNA. And so that piece of it, and then just to kind of finish it off, we are also under a lot more stress than we ever used to be. And stress creates less blood flow to the gut. And the reason for that is because when you're in a state of stress and you are in the part of the nervous system called fight or flight, get away from the bear, you're not in the part called rest and digest, that parasympathetic. And so you decrease the blood flow to the gut. And this really changes what's happening there as well. So processed food, lots of sugar, lots of stress, and all of that, added antibiotics in the food supply, all of that adds up to really change what's happening in our GI tract.

That's so interesting, Dr. Bedet. Thank you. And it's no wonder, talking about Wonder Bread, why so many people are suffering with all these things. So you hear about people traveling overseas from the United States to countries and places like Europe where they can eat pasta and bread, and it's a completely different compound, as far as I know, over there, versus in the United States, where everything's so processed and it's not very natural. So it sounds like here we are on the Root Cause Medicine podcast, trying to understand the root causes of some of these things. So thank you for diving a little bit deeper into that. It's really, really fascinating.

And I think it's such an interesting issue, because for so long, I would have had patients, for example, that can't tolerate wheat or gluten when they're here. And then they go on that vacation to Italy and they're like, but I could eat the pasta there, I could eat the bread there. And so I would think, well, maybe it's that you're on vacation, maybe you're less stressed, maybe that glass of wine, you're just feeling a little better with it, whatever. And I think all of that can play a role. But also, you're quite right. We've hybridized our grains here, and we've changed them here. And so one of the things that is different is that in Italy, for example, they use more durum wheat. And that durum wheat has a. Well, an enzyme in it, a decapeptide. And that enzyme breaks down the allergic or the antigenic part of the wheat, something called gliadin. And so by the time it gets presented in the GI tract, there's less of the irritant there than there is on some of that we tend to utilize more of here. So there absolutely is a difference in terms of what we choose to grow and therefore how our bodies react to it.

So fascinating. I know there's so many people dealing with even the wheat sensitivities and allergies nowadays, so. Absolutely true. So when you're looking at the root causes of GI gut health, digestive issues with your patients and when you're teaching them, what are some of these further common things or sources that you're usually finding that, well, why are they presenting to you?

Yeah, so a number of things could be going on there. Like we mentioned, there could be prolonged stress and that causes a decreased blood flow to the gut. They could have had a history of using a lot of antibiotics and that changes the floor in the gut as well. And really not just antibiotics, but many medications have the ability to do that. They can alter ph, or they can have different dyes and colors on the outside that can change what's happening in a gastrointestinal front. People can become over reliant on the same foods, which eventually can cause some irritation to the gut lining. And we can end up with low level infections in the gut, bacteria, yeast or even parasites. And many people think, oh well, if I had an infection in my gut I would know and maybe you would and maybe you wouldn't. And kind of check in if you experience a lot of gas or bloating, if you tend to not have well formed stools. And yeah, you probably do have a low grade infection there, but you can have a low grade infection in your gut and not even have GI symptoms. In fact, there's a lot of literature that talks about inflammation in the gut being a reason for things like depression. And so, so many people would think, well, I can eat whatever and it doesn't really bother me, therefore it's not related, but not always, because that inflammation that starts in the gut will affect some people the most there, will affect some people moderately there, and some people won't feel it there at all. They'll feel it more systemically in the rest of their body. Things like joint pain, depression and various other chronic conditions.

It's so interesting. So you can have so many different types of diagnoses and also symptoms, but have no GI or gut symptoms. And then you don't think anything's wrong with your digestive tract.

Absolutely. It's because like I mentioned, 85% of the immune system is in the GI tract. And so what happens is when you become inflamed in the GI tract, some of us are just more resistant, more robust. That's just not our weak spot. But that inflammation that's created there, those signals don't stay there. So it will create signals, things called like IL6 and TNF Alpha and IL8 and they'll move throughout the body and then they can trigger More inflammation in whatever your genetic weak spot is. So for example, when we are inflamed in the gut and we make more of this IL6, it sends a signal to the liver to make something called C reactive protein. And C reactive protein is an inflammatory marker, but it's commonly looked at for cardiovascular disease and measured for things like rheumatoid arthritis. It's not typically used as a gut based marker. And so it makes that point that what starts in the gut doesn't stay in the gut and can create inflammation elsewhere through sending signals to the liver or out in circulation in general.

So fascinating. And like you're saying, it sounds like people are going to their doctors with certain symptoms and, and they're checking for these markers but then not relating it back to the gut where it can all be starting from the, from the first place.

Exactly. And the other problem with that is that if we're not really treating the root cause, then people get stuck on medications and of course they're going to be treating the symptom. But if that gut based inflammation is not addressed, then you're going to be on that antidepressant more long term because that inflammation that's occurring isn't changing. And, and it sounds somewhat far removed, but we can get right down into these little nitty gritty pathways and biochemistry that really illustrate this point. So for example, in terms of depression, there's an amino acid known as tryptophan and it's what's high in turkey and it's what makes you sleepy on Thanksgiving. And if all is going well, your body takes that tryptophan and it converts it into serotonin, the neurotransmitter that makes us feel good. But if you've got a lot of this IL6 floating around from leaky gut, like I mentioned, it completely blocks that pathway. And now that tryptophan doesn't make serotonin, it makes these other neurotransmitters that make us ache and make us not feel well and totally changes what that nutrition would have done in our body. And so you can take an SSRI and feel better from that, something that increases serotonin and feel better from that. But you're going to continue to need that support unless you get rid of the root cause, why the serotonin was lower in the first place, and it can be traced right back to gut based inflammation.

So important, obviously, always wanting to get to the root issue. Otherwise, as you're saying, these symptoms will fester and fester until one Day it gets so bad that the point of no return becomes present. So, Dr. Burnett, you've mentioned this term leaky gut, and I think some people have heard about it, but it's such a funny term. Can you break this down for everybody? So we kind of know what you're talking about?

Absolutely. And it does. It strikes you as odd. And I can remember exactly where I was sitting in school the first time I heard about it, who was talking about it. And I remember thinking, that sounds made up to me. I'm going to go to the research. I'm at a place called pubmed where all the peer reviewed medical research is. And I was like, I'm going to look this up. And unless I find something on there that I know that this isn't a real thing. And at that time, which was a few years ago, at least, you did not find anything referring to leaky gut on PubMed. Now, if I did the same thing today, we'd find hundreds, even thousands of publications around that leaky gut. And maybe one of the ways that it really became quite apparent overall is that what we learned was that you could actually measure things that modulated it, for example, and it's a marker that we do at Precision Point Labs. There's something called Zonulin that you can measure in your blood. Alicia Fasano, a researcher who's now at Harvard, he popularized this idea. And so Zonulin is a molecule that tells. They're called tight junctions and they hold your GI cells together. I always think about Lincoln Logs when zonulin goes up, it tells these tight junctions to open. And these tight junctions are held together at what are called kissing points. I like that too, because it sounds attractive. Zonulin comes into the picture. Your tight junctions open up and now your fortress wall is no longer intact. You're permeable. So we could call this permeability too, if we wanted to add some syllables in there, but the same thing. So the gut becomes permeable. And now instead of being this barrier that decides you stay out and this comes in, things begin to leak through and they leak through intact. And so larger pieces of food, larger bits of bacteria, and when this comes into our body, our body goes, whoa, that is not something I am used to. That is foreign. I'm going to treat it like a pathogen. And so we start to mount this attack to it. We increase inflammation. Our white blood cells get going, they make more of this Interleukin 6 and Interleukin 8, and it creates this inflammatory process. And so Leaky gut. It explains why the gut can become such a source of inflammation for the rest of the body. And let me kind of just say it a slightly different way. It means when we treat the gut successfully, it's one of the best ways to calm down inflammation in the system. And so that inflammation might be causing depression or joint pain, that inflammation might be flaring your lupus or your rheumatoid arthritis. Sure, it's nonspecific, it will reduce inflammation in general, but that can. Inflammation can be the fire behind so many different pathologies out there. And so it's a natural way of decreasing inflammation in the body. And it's something that doesn't have side effects. When we think about some of the medications that might do this, glucocorticoids, they are successful. They just also come with a pile of side effects as well. And so if there's an inflammatory component, working on gut based health can be part of calming that inflammation down and helping people feel better.

Absolutely. And I think, just to remind all the viewers, when you're saying the inflammation, we're talking about this chronic silent inflammation that breeds from bruise for years and years until one day you develop symptoms. And that's why so many people are only looking at symptoms. And when this has been going on for a very long time. And Dr. Brett, you were talking a little bit about the testing for leaky gut. Can you kind of dive a little bit deeper into that for us?

Yeah. So this was a real breakthrough moment when Alicia Fasano, Dr. Fasano, helped us that you could measure something like zonulin and that that was telling the gut to open up because it really validated this as a concept. For years and years and years, those of us in integrative medicine and functional medicine had talked about this concept. And then you would go to maybe some other doc and they'd say, well, because it does. It sounds funny, that's not a real thing. You know, let's get you on this antidepressant. Let's get you on this anti inflammatory. Let's approach this from more of a pharmaceutical type of approach. First of all, there's nothing to say that we can't both use a pharmaceutical approach and treating root cause at the same time. The idea is that you need less and less of a medication and often you're able to wean off. But so this was a great breakthrough moment when we learned, oh my goodness, there's a biomarker, there's something that we can measure in the blood that correlates with pain with leaky gut throughout the body. And so when that went up, the gut became more leaky. Another really fascinating thing about zonulin is what Alicio Pisano's research showed us is that that goes up in the blood before the onset of various autoimmune conditions. So we aren't born with lupus, we aren't born with rheumatoid arthritis. So it's not entirely genetic. Of course, there can be genetic tendencies, but there's some type of trigger that sets that off. What his research showed us was this marker, zonulin, as it goes up, tells the gut to become more leaky. And that's the trigger that causes those genetics to express itself. We can measure this phenomenon now. And zonulin opens up those tight junctions, and it's one way we become leaky. We can also become leaky because you just wear down the gut lining. You just eating things that are not very helpful or you're taking maybe NSAIDs. And we know that if someone takes too many NSAIDs, you can wear down the gut lining so much you ulcerate and you bleed. That's a very leaky gut, but it's not mediated by Zonulin. I tell people, think of that more like just the sledgehammer. So the first way, Zonulin, that's the elegant way. That's the key. I put my key in the keyhole and I open up the tight junctions. That's one way to get in there. The less elegant way is I just show up with my sledgehammer and I start beating at those tight junctions, and eventually they wear down and open up. And so that's atrophy. And so another way that we can look at that, some testing markers that help us do that, are to look at things that we make in the gut lining. An example of that is an enzyme called diamine oxidase. And this enzyme, we make it right there in the gut lining. And so as it goes down, what we know is that our gut lining is wearing down too. The second thing that happens, first you get leaky. And now, second, that enzyme has a function of its own. It's the enzyme that degrades histamine. So as we wear this away, you have less and less of that enzyme, so you can't break down histamine anymore. So histamine happens when we're around pollen or ragweed and we have allergies. But there's also histamine in food you eat. If you drink a glass of red wine, that has Histamine. If you drink champagne that has histamine, that's part of the hangover on New Year's. But if you eat a tomato or a strawberry or an avocado, those things also have histamine. And so you no longer can tolerate histamine, as most people do. And so you present kind of, you react to all different kinds of things. You take foods out, you may get a little better, but you don't get completely better, because unless you're on a low histamine diet, then we would expect symptoms to still be there. And then there's still a third category of way to get leaky, and that is from certain bacteria. And these bacteria shed something called lipopolysaccharides or bacterial endotoxin. And that toxin is now like dumping acid all over the lock in the door. It will erode it, too, and it will open that way. And so the endotoxin from bacteria can cause these tight junctions to not work. Well, I kind of think like bent up puzzle pieces, they don't fit like they should anymore. And LPS is sneaky. It can come through the cell as well. But so those are three different ways that we can become leaky. And when you become leaky, it sets off that inflammatory cascade. And like you mentioned, you don't always feel it. So that CRP that I mentioned is a marker that we look at in the blood. It's an inflammatory marker. It's associated with cardiovascular disease. You may feel fine, but your CRP is high. It's a marker of inflammation. But your joints don't ache or your belly doesn't ache. Homocysteine is another cardiovascular marker. It's a marker of inflammation. You don't feel it, but we know inflammation is going on that will affect the heart. So it depends on where your inflammation is occurring, whether or not it's sending that nerve signal that you feel or not. Inflammation can cause many different things in different areas there.

Yeah, it's so important. And I think some of these markers you're discussing are often on general annual lab visits and wellness exams, but often are not related back to these root issues of potentially autoimmune conditions, which I think over 50 million plus Americans are suffering with, or any other digestive issues. And so I really love your analogies of the different types and reasons why leaky gut can occur. So hopefully everybody understands a little bit more. But I think what most people want to know is if you get leaky gut, can you fix it? What do you need to do to.

Fix it, yes, absolutely. And so I work with a number of different tests. Some of those things that I mentioned, I'll measure those. I'll look at foods that can be wearing a gut lining down. I'll look at stool testing that tells me, do you have nice, healthy protective bacteria there? And the reason we look at these things, in fact, is not to take foods away for forever. In fact, the idea is take them away for a period of time, calm down that inflammation, build the gut lining back again, and now you should be able to bring them back in. And the idea is that over time you should actually be able to eat more foods without inflammation, not less. Now, some people will have to keep a couple foods out more lifelong, but that is a rarity and more of an exception than the rule. Most of us, if we figure out the root cause of why the inflammation is there and then treat it, there are lots of things we can do to build the gut lining back. There are various amino acids. Glutamine is a great example. It's the preferred fuel for enterocytes for gut based cells. So using higher doses of glutamine, probiotics are another thing that help build back the gut based lining. I'm a big fan of immunoglobulins, like you mentioned in my bio, something called IG26. It's a great immunoglobulin. And that immunoglobulin actually blocks zonulin from binding to that receptor. So we don't open up tight junctions that way as well. It will also help to normalize some of that immune response. So there are all kinds of therapies and I could just go on and on and on and I could list 20 therapies, 40 therapies, 60 therapies, but that becomes not realistic. We don't want anyone to have to take 60 therapies. So this is why the testing can be so useful, because it really directs. What's the problem? Is it a problem in terms of a bacteria? Is it a problem in terms of a food? Is it a problem? And those are basically your two big categories of why you start to wear down the gut. Some outside of maybe stress, but even some of the more sweeter processed foods would show up in that area. But basically, if we're trying to conceptualize it, two basic ways that the gut becomes leaky, eating foods that aren't the best for you, and these, sometimes these are very healthy foods. Like just the food test that I helped to develop at Precision Point Diagnostic Labs, my partner just ran into a Patient at the clinic in parking lot, and they ran up and said, oh, I just want to tell you how much better I'm doing. And she was having migraines and feeling fatigued. And the thing that came back positive for her was broccoli. And so I would have never told her to take broccoli out of her diet. I would have told her to eat more broccoli because it's so good for you. So sometimes we can be eating healthy foods, and those can be a trigger, and that's why the testing can be useful there. But I just say that to say, in general, your two big categories of why your gut got leaky, a food that you're eating or an imbalance of the bacteria in your gut. So two tests that will often be useful are food sensitivity testing and looking at a stool test, and then sometimes some of those other markers of leaky gut that I mentioned.

It's so amazing. And you brought up some really good points because as you're saying, these tests and the testing that you can utilize for digestive health and overall wellness health are so important. And people, once you get the testing, many people get so many answers to why they've been suffering for years and years and years, and then they're able to finally take the steps necessary to regain their health. So really, really important point.

And it's manageable. And if I measure Zonulin and I know it's high, and then somebody says to me, well, how long do I need to stay on these things? Well, now we have a real benchmark to be able to gauge that until Zonulin's back in normal range. Because now I know that those tight junctions have come closed and your gut lining is back in place. And so rather than just kind of guessing at it, we have a very specific roadmap of what to do, what to do next if you're not responding, like I think you should, looking at those things again, oh, Zonulin hasn't come down at all. Let's change these therapies up. And so you're just not shooting in the dark as much.

So true. There's that old saying of what you measure, you can monitor. So we always want to stick by that because it's really, really important for these chronic health issues. And you were talking a little bit about gut imbalances. And, you know, a lot of people have heard of the term microbiome, but can you explain this for everybody? So everybody understands this a little bit more, like, what does it mean? Why is it important for us to know about the microbiome.

Yeah. So simply put, your microbiome are bugs that are in the GI tract and we want these there. And like I mentioned, there's more bacteria in your gut than there are stars in the Milky Way. And so we are largely made up of bacteria, but in your gut and friendly bacteria that really help us out a lot. Like there are certain vitamins that friendly bacteria make. Fiber gets really converted into some very powerful phytonutrients in the place of this bacteria. This bacteria can help determine whether or not we're going to lose weight or gain weight. But it turns out it's not just bacteria. There can also be healthy yeast and even healthy viruses there that we're learning more and more about. So it's that ecology that's inside our gut and it's the study of looking at the things that should be there, the foreign invaders and then things that are just out of balance as well. And so when we measure that, that's typically measured through doing some stool testing. And you can get a picture of all of this bacteria and these various pathogens and really be able to tell, okay, is this a reason that someone's not feeling well? And right back to that example of depression which we often. You think that's here, not here. But it turns out some of that same healthy bacteria, Lactobacillus, makes serotonin, Bifidobacter makes gaba. And while we used to think that just stayed in the gut and didn't affect anything here, we now know that you absorb it. And when it goes past this area, the blood brain barrier, there can be some diffusion back and forth. There's some transport mechanisms there. So we aren't these static, divided compartments. All of these things interact. And even if that seems far fetched to you, the neurotransmitters we make in the gut, I mentioned one called gaba. That's our inhibitory neurotransmitter. It helps with rest and relax. It calms the brain down, stops racing thoughts, helps us focus. If you were to take different anxiety medications, they work on those same receptors that GABA works on. And the GABA in our gut will send a signal through something called the vagus nerve to our brain and say, everything's okay down here, we can feel better here as well. So there are multiple ways that the gut communicates with the brain. And so the neurotransmitters that are in the gut that don't merely affect the gut, they affect the rest of the body as well.

So fascinating.

And that's our microbiome.

Yeah, that's the microbiome. Okay, there we go. So. And you were discussing some of the stool testing. But there's so many stool tests on the market today, we see them all over now. Can you dive a little bit deeper for that? Like, what makes each one of them different and which ones you think might be the best and why?

Yeah, there are a lot of great ones out there. There is GI Maps and there are some other diagnostics out there. I use a lot of the GI360, and the reason that I have landed on that is because we were back and forth with this debate about what is the best way to do it. Should we culture it out and grow it, or should we do PCR and look at the genetics? And so on one hand, you go, oh, wow. Looking at the genetics will allow us to capture so much more more, and we'll see things that we might have missed otherwise. Because when you grow it out, the strongest ones are the ones that are going to survive. And certain things don't grow as easily on media. But if you do grow it out, culture, as that's called now, not only can you culture, but you can get a specific sensitivity. So I grow it out, and then I put antibiotics next to it, and I put natural subnatural antibiotics next to it, and I see what kills it the most. If I'm just looking at DNA, I haven't grown it, so I can't put anything next to it to see what kills it the most. If you see sensitivities done with DNA testing, they're just saying, in general, this bug usually responds to that, whereas this is this bug specifically in your body. This is how it's reacting to things. So on one hand, probably one captures more of the microbiome. On the other hand, the other would give us more of a picture of what we can use to treat Most specifically the GI360. Combine both these technologies, they do both PCR and culture. I think that that gives us a balanced perspective. Culture's come a long way. People tend to think of back to their microbiology class and where they streak the agar plate and then watch what grows. That's a very rudimentary culture. But what's being done in terms of GI360 is more blasting down to bits of RNA and then running those through some profiling to look at so much more sophisticated than just what we did in microbiology 101.

Interesting. Interesting. Yeah. So there's lots of different kinds of Tests. But I think the bottom line is for many of these tests that you're talking about, you're able to find things like parasites and yeast and worms and bacteria. Is that correct?

And that is correct. Another part of doing both the culture and sensitivity is that if you're only doing PCR testing, then one of the things that gets. You don't get some of the other pieces. And there are many tests that will do these things together. But on a stool test, yes, it will show me the microbiome, but I like to see not just the microbiome, but something called secretory IGA. That's that 80% of the immune system I've been mentioning. And we can tell if that's worn down, your gut lining is worn down. If that's worn down, your immune defenses are worn down. If that's sky high, your immune system's reacting to some type of infection. So it gives us some great information. If we're just doing genetic testing, you're not getting a picture of short chain fatty acids. And those are breakdown products from fiber, and they're associated with things like decreased colon cancer. They're associated with things like decreased cardiovascular disease, decreased autoimmunity. Those short chain fatty acids also can be absorbed and send some signals to our brain. So there's some brain communication there as well. And if you're just doing genetic testing of the bugs, you don't see that. Other things I like to look for on a stool test, the digestive enzymes are another piece of that, and then some of the inflammatory markers as well. And there are many out there that will cover both the gut bugs as well as kind of the state of health. The short chain fatty acids, the immune system, the inflammatory markers. So look for kind of those things together to get the most complete picture.

That's so important because, you know, the standard stool test used to be the ova and parasite. Correct. Can you kind of dive down that difference between the stool test that you're kind of discussing now and that standard ONP test that, you know, someone might get 20 years ago, say, or something like that?

Yeah. Even today. Because if you were to travel abroad and go to many clinicians, you travel abroad, you ate something and you haven't felt right since then. And so you come back and someone goes, okay, maybe that's a parasite. And what's still routinely going to be done is an O and P. And the other part of that name, and that stands for ova, the eggs, P the parasite, and it's an O and P times Three. That's what they call it. And it means they do it three times. And why do they do it three times? Because it's notoriously bad at picking up parasites. So they say, well, we'll at least do this three times, so we'll increase our chances of seeing it. In addition to that, it depends on what you look for. So most of those tests are only going to look for a handful of parasites. Now, this is a place where the genetic testing really shines, because the reason the OMP is so difficult, difficult is because bacteria, that's easy. Put a little bowel next to something and it's very easy for that bacteria to grow. But there's not really an easy medium to. Once we're down to eggs of parasites, there's not some very easy medium to put that next to that causes it to divide and grow. That's very hard to do. So you're looking at it under a microscope to see if you see it. And so you can see how that would be difficult. But now with the GI 360 and some of the other genetic tests that are out there, they'll look for genetic pieces of these parasites. And so they pick up a whole bunch more than some of these conventional measures. And I always think, well, just your name tells you it's not that great a test because it says you got to do it three times to even have some chance of capturing something. So if you fall into that category, you're somebody who traveled somewhere and never felt the same afterwards. And you go, yeah, but I did a stool test, probably not one like this. Those that you might have done maybe looked for some parasites, probably didn't look at bacteria, certainly didn't look at viruses or yeast, and even more so, didn't look at literally thousands of those all at once. In addition to that, what you're experiencing now might not even be the bacteria or the pathogen anymore, but it might be that it eroded your own healthy flora. And your healthy flora make these things called mucins that coat the gut and make us feel better. So if it knocked down your good guys and they're still not back to where they should be, you could still be feeling off and infection's not going to show up and guarantee that nobody. These tests do not look at your own healthy natural flora. All of those are reasons that you could hurt. And so if you've done something very basic and it didn't give you the answers, now it's time for a more extensive workup. And it's a shame that These aren't more routinely done because not just you traveled and you felt bad, but this, what's called dysbiotic bacteria or bad bacteria, can be connected to things like cardiovascular disease, diabetes, and many other chronic conditions. And so if you're not looking for them, you're never going to know to treat them.

Yeah, that's so important. So, I mean, this, we could call it the old school stool test versus the, this new school stool test, tongue twister there, where the old school is really just. It's a more of a limited amount of markers and that the newer tests with the DNA PCR methodology, it's really able to not only identify your ova and parasites, but bacteria and a number of these other immune markers that are so important to identify in the body. So if someone does find that they have parasites, yeast or worms in this DNA new school type of testing, what are some of the steps that you take to help resolve them, and how long does that process usually take?

So we can use various pharmaceuticals, we can use various botanicals, and we can use those even in combination or one or the other. But the good news is, is that this is something that you treat and can go away. A patient that I was working with, her diagnosis was ulcerative colitis. I said, based on some of the other things I'm seeing on your lab work, it looks like you had an infection when you went to the hospital and they told you ulcerative colitis, let's do the stool test. Let's see what we see. And so we do it. There's an infection. We began to treat it with different botanicals, compounds from garlic, compounds from things like goldenseal and different berberines that are antimicrobial. We eradicate it and her symptoms go away. And she says, well, do I have ulcerative colitis? Because that's what they told me I had. And they said I would have that forever. Well, that's a very interesting question. How about someone who had diabetes, but they got their blood sugar down and their insulin down, do they still have diabetes? And so I think that the way we look at this is that she probably always will have a tendency towards a weaker gut, something that could get out of balance. But does she constantly cramp and bleed and have symptoms from this? No. And so sticking to care would say, we don't know what causes ulcerative colitis, and now you'll just take anti inflammatories lifelong to manage that. Whereas we were able to see what was the cause of the ulcerative Colitis. It was a bug that wasn't looked for. And they ran some cultures on her in the hospital, but just, you know, just a handful, and they missed it. And so we run a bigger profile. We identify the cause, we treat it. And I like to talk about permanent remission.

I like that word, permanent remission. It is possible to put something into permanent remission. Absolutely. Especially if you're able to identify and search for the root issues of the problem. So important. So, Dr. Burdette, you talked about some really great information that you can get, aside from knowing whether there's bacteria, fungi, yeast, parasites in these stool tests, like overall immune health. So based on some of these additional markers that you can get and information you get from the stool test, why would you think someone or everyone could benefit from getting one of these on, say, a yearly basis as part of their annual wellness or yearly exam and testing?

Yeah, because not only can it be related to pathology, but the major thing that determines our rate of aging is. And if it were like a multiple choice now, and I said, is it cellular health and the mitochondria, the powerhouse that makes energy? Is it the cell membrane? I could see good rationalizations for picking those answers. But actually, what they've tied to our aging, even more so than our own cells, is what is happening with the bacteria in our gut, that microbiome. And as that microbiome begins to decline, as we lose diversity, as the number of species are not as strong anymore, that's one of the major things that drives aging in our own system. These signals say, okay, we're wrapping up here. And another way to look at that is when they did studies and they looked at people from various areas, from Spain and Ireland and Portugal and the US Et cetera. The hypothesis of this study was that where you are from will dictate your bacteria. If I eat the same tomato you eat, there's the soil, and the bacteria from that will have similar flora, will have a similar microbiome. And while that was true, where you were did help to determine similarity, it wasn't the thing that was most predictive. The thing that was most predictive was your state of health. If I were frail and sickly and 18 years old, frail and sickly and 81 years old, our flora looked a lot alike. But if I were healthy and robust in 18 years old, but healthy and robust and 81 years old, those people's flora looked a lot alike. And so what they learned was, as your flora declines, as your microbiome declines, so do we. And so if we could look at this once a year, we'd have such an opportunity for prevention and wellness. Like Fasano's work taught us, what happens first is the leaky gut, then the onset of pathology. So if we could stop that in its tracks, we could stop pathology in its tracks. And that's exactly what he says. He says if we remove the environmental trigger, we are no longer sitting around destined to have these conditions that our mom or our grandma had. If we can remove the environmental trigger, we can stop the assault to the cells so they don't express these genetics that result in various pathology.

So interesting. The transformations and the advances in technology today in science and health are so vast. And as you're talking, it's so important for us to again identify those root issues. And so with the future of GI health, there's many different types of treatments now, everything from obviously stool testing to fecal transplants that are now people can undergo. So what do you think the future looks like though in terms of uncovering the root causes and as a whole for digestive health patients?

Much better. Because if we were having this conversation even five or ten years ago, some of the PCR technology wasn't quite where it's at. Think about kind of a computer from the 50s that took up an entire room compared to something like computer like this that we just carry around in our hand or a phone. And the same is true for being able to look at organisms in the gut and understanding a relationship to pathology. Our knowledge of that has just really exploded. Not only has our knowledge exploded, but the technologies that you utilize to do that, like technology always, the price continues to come down. And so instead of being thousands and thousands and thousands of dollars, we're talking hundreds of dollars, which is a much more realistic price point for looking at these things on a regular basis. And there are more people that are looking at it and there's more data and there's more evidence about that. And so what that means is it's more likely to be an option presented to a patient. Not as often as it should be quite yet, but if we're having this conversation, 20 years ago, these bugs would be harder to identify. People wouldn't be as aware of them. And so there'd be much more push just to say, well stay on your prednisone, that's your anti inflammatory and that's what you're going to need to do to keep this ulcerative colitis in partial remission.

So, so important for the future of GI health to continue to Monitor those things. As you're mentioning again, what we can measure, we can monitor. So getting the proper testing is the first, I think, ultimate step there, as you've been explaining. Dr. Burdette, I have one final question for you today. If you could give one or a couple tips to someone listening with GI health issues, what would it be?

Find someone who is going to listen and who's going to keep looking. So if you have gone to someone and you've tried something and you're still having symptoms six months out, a year out, it's time to look for a different approach. And so I think the message is hopeful, actually, because there's a reason these things are happening in your body. There's this term in medicine called idiopathic, and it means we have no idea. And so this is what they would say about things like irritable bowel syndrome or ulcerative colitis or even some depressions. They're idiopathic. Well, I think we're, as we are learning more and more and as technologies improve, we're learning, oh, no, there are more causes to these things. So what I would say is keep looking. You are the expert on yourself, and if it doesn't feel right to you, then you need to keep asking the questions and find a practitioner that will work with you to help you ask the questions and find the answers to them as well.

That's so important. Thank you so much, Dr. Burdette, for coming on today. It was such a pleasure to have you here. I really enjoyed your different analogies for leaky gut, helping us understand the reasons why that can occur, as well as the other imbalances that occur in the microbiome. So people get a little bit more of a foundation understanding of what it is that is going on inside the body and how it can impact other areas that you might not think are related to the gut, but it is the direct result of overall gut health. So I think that's really going to help our listeners, and hopefully they learned a lot from this. So thank you again.

My pleasure. And if we can touch one person, then it's a job well done.

Agreed. Likewise. Well, we look forward to seeing you next time.

Take care.

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