S1 Ep 1: 'The Immune System in your Gut' featuring Cheryl Burdette, N.D.

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So hi, I'm Kirsten Chick, nutritional therapist and author, and I'd like to welcome you to series one of the ICANN Magazine podcasts. On today's episode, I'm talking with Dr. Cheryl Burdett, naturopathic doctor and educator on the theme of the immune system in your gut. Hi, thanks for joining me on the new ICANN Magazine podcast.

So much for having me.

Pleasure. So, Shel, you've achieved an extraordinary amount in your time. So you founded your own laboratory. You do some incredible education and training programs that you run and teach on around integrative medicine. So first of all, where are you active most at the moment and what's led you here? Tell us a little bit about your story.

Yeah, so as you mentioned, I co founded a lab called Precision Point Diagnostics, and that's probably where a large part of my focus is right now. And so I really love the research space. I love developing and refining diagnostic tools that help us both to rule in and rule out things that are otherwise in question. Because in the integrative medicine space, the idea and the philosophy behind it is that it's not one reason that somebody is sick. There's not a single pill or a single fix, but that it's multifactorial, it's epigenetic, and it can encompass so many things. Nutritional deficiencies, toxic body burden, mental emotional stress, inflammation, free radicals. And so really developing testing that helps us to understand the process behind the condition so people can get to the root cause of what's going on. But as you mentioned, I also love the education piece and I'm also involved with a group called Origins Incubator, in which I'm the director of the clinical curriculum. This is a group engaged in helping practitioners get started in integrative medicine, because many times practitioners know that they want to do more, more of this style of medicine, they want to look at root cause, but they're unsure how to shift their focus in that direction. And I find that's one of the rate limiting steps of integrative medicine right now, is just having enough practitioners to, to help people who are in need.

Fantastic. So really at the heart of it all there. So gut health, that's always been a key focus of nutrition, hasn't it? And naturopathic medicine has always been there. But we've been lear a lot more in recent years about the relationship between gut health and the immune system. And that's really what I wanted to focus on most today. So we tend to think about the immune system as white blood cells and antibodies and things like that, but there's so much more to it. So let's have like a brief talk through what the immune system actually is to begin with, because first of all, we have all of these barriers, don't we? Like the skin.

Absolutely.

Explain a little bit about that and how the microbiome, the gut microbiome in particular, fits in with those barriers, please.

Yeah, absolutely. So like you alluded to, most people think of their immune system or something floating around in the blood and they think of getting a blood draw and looking at a white blood cell count. And that certainly is part of it. But what most people are probably not as aware of is that 85% of the immune system is actually in the gut. And how the rest of the immune system responds in our bloodstream is often primed by what starts in the gut, but certainly doesn't stop in the gut. So when we eat something, when we take something in, maybe some bacteria on the outside of the food, it turns out that our gut lining is exposed to more potential invaders in a single day, more antigen exposure in a single day than the rest of that immune system will see in our entire lifetime. So it's very important to be thinking about this gut based health and how to augment the immune system there. The first component of that is something called secretory iga. And if you can visualize, kind of think about aligning over the gut, maybe a first wall defense, maybe the first line of your army that's all standing alert, hopefully ready to protect when possible. And so there are many things that we can do to help the secretory IGA to stay robust and strong. Certain nutrients will help to do that. But also a very important connection that you mentioned, our microbiome. So in when we. The microbiome is of course bacteria and obviously microscopic. But again, a large Part of who we are. If I were to boil down a human being, if I boil myself down, I'm actually 10 times more bacterial DNA than I am human DNA. And so this secretory IGA, this first line defense, think of it, it as a good rich soil and really helping the garden to grow. And the flowers in this analogy or the fruits and vegetables in this analogy are that microbiome. So they work hand in hand. You've got to have the right soil for your fruits to flourish like they should. And so when we think about immune priming and where we can go to get the immune system to fight more appropriately, or when the immune system is overly excited as in an autoimmune condition, how we can get more immune balance, going back to gut based health is very fundamental to how the whole process is primed.

So we have this ecosystem, we're part, we are this ecosystem and that's a major part of it. Of course you know that 10 times more DNA. That's a really lovely way of putting it because often there's kind of similar ways of describing it that makes us think what there's so much more bacteria than human cells and why can't we see it all? But they're teeny tiny, aren't they? About the.

Absolutely, yeah. And so this, that's a, it's, it's an interesting point because many people when they are having GI distress and let me just bracket that for a minute because you can have symptoms that are caused by gut based inflammation and not even feel it in your gut. And we'll get to that in a minute. But the obvious is when maybe somebody is having a GI issue, maybe lots of diarrhea or constipation or ulcerative colitis, maybe they've been diagnosed already and they might go and do called a colonoscopy. And that is a very good thing to do. And that screening saves thousands of lives in terms of early detection for colon cancer. But it's important to recognize that if you do have a GI issue and you do a colonoscopy and nothing's found, what's being looked for is their cameras. You're looking macroscopically, you're not looking at the microscopic part, you're not looking at the microbiome. Now let me also say that sometimes there will be biopsies will be done and they'll look, look a little bit more. But even, even at that moment it's a handful of pathogens or bad bacteria that's looked for. It's not a measurement of your good healthy flora. It's not a measurement of really the thousands of bad bacteria that could be out there. So with this understanding of being able to sequence our genome and look at DNA, we've also been able to do that for bacteria in the gut as well. And as we do that, we realize there's so much more there than we ever knew. And so we're really gaining more of an understanding about how it's not just the bad guys and it's not just a handful of bad guys, but it's equally as important for your own microbiome to be intact. It does things like we mentioned, supporting that 85% of the immune system. It also does things like priming our systemic immune system. It also does things like create molecules that are anti inflammatory, inflammatory. So when we find ourselves in a, say a, with a disease that has an inflammatory component to it, we don't only have the option for reaching for anti inflammatories in terms of pharmaceuticals that are out there, but if we can help our own microbiome to thrive, it will create anti inflammatory compounds that help to calm down the immune system and put us back in balance.

Wonderful. So it does so so many jobs, doesn't it? And that the anti inflammatory role is really key, isn't it? It's involved in, I can't think of a disease or a condition off the top of my head that doesn't have inflammation as part of its makeup.

So and that's really, that's really key. So that might sound confusing maybe to people out there that are thinking, well, I have depression or I have anxiety. But when we drill down on that, and this is fascinating as well, it turns out that that same microbiome that creates anti inflammatory compounds also makes neurotransmitters, things like serotonin or gaba. So there's a type of bacteria called Bifidobacter that helps reduce our allergies and our autoimmunity. We don't have much of it when we come onto the planet. And breastfeeding helps for that Bifidobacter to take over. Well, that Bifidobacter also makes something called gaba. And GABA is an inhibitory neurotransmitter. It helps with rest and relaxation, it helps us fall asleep at night and it helps us to feel good and not feel anxious. And that effect in the gut isn't localized to the gut. So when we have the right microbiome, when we're making enough of this gaba, it sends a signal along A nerve, the vagus nerve, that essentially sends communication from the gut to the brain. And it says, okay, everything's okay down here. In the gut, we're doing okay. So the brain can calm down. And the reason for this, evolutionarily speaking, is that if we dial the clock back hundreds of years ago, we didn't live long enough to get autoimmune conditions or arthritis or chronic, these chronic conditions that we see now, we died at earlier ages. And we are much more likely to die from things like dysentery. Getting a bacteria that caused so much watery diarrhea, you eventually were just so worn out from that that your body gives up a fight. We're more likely to die from infection. And so when the infection hits our body, there are these communications to the brain to say, we are not okay, we do not need to infect the rest of the tribe. Go to the back of the cave, withdraw yourself. And so those signals make us feel, well, depressed. They make us withdraw from evolutionary wired for that. So now fast forward to today. You're not gonna, you're not likely to die of dysentery. Antibiotics help us with that. But there are many things that put the microbiome out of balance besides just infections. So if I'm eating lots of processed food, that can change my microbiome. If I'm eating a very sugary diet, that changes my microbiome. If I'm eating meat that's treated with antibiotics, that changes my microbiome. Even the day to day stress puts me in a state called fight or flight and I'm not in rest and digest. And so that too changes our microbiome. So all these things in our westernized world will change the microbiome and that can result in the signals to the brain that make us feel like we want to withdraw, we want to just stay on the sofa, we don't want to go out, we don't feel good. And so again, not only just boosting the immune system, but boosting our, our cognitive health can get traced right back to what's happening in the gut. So, so important to think about what we're eating and, and nourishing our, our, our friends within us.

There's a few things that I want to unpack there, there's so much in what you've just said that's really juicy. One of those things that I'm really intrigued about is how it, it's not just about our own individual immunity, it's the immunity of the tribe that we're looking at.

Yeah, absolutely. Yeah, we're wired that way. And so sometimes it can be, you know, you pick up the, you hear the news and shooting has happened or something horrific has happened and it can really feel like oh no, what's happening to the human population. But I would like to give a shout out in terms of something optimistic about people and I'll turn to a study with serial killers to do this. And in this study they looked at serial killers, killers from different prisons across the US and what they found was high amounts of toxicity in, in this population. Not all in the same location either. And so I like to use that somehow optimistically to say I don't think that people have become more messed up. I think our environment has become more messed up and it's, it's harder for our brain chemistry and to, to feel more settled and. But the glass half full side of that is that more inte medicine works at things in terms of lowering toxic body burden, which helps our microbiome, which helps our whole system to feel more relaxed and better. And again, these aren't treatment strategies merely for serial killers. That's an extreme example. But whenever we're feeling a little agitated or a little more off, it doesn't mean our only choice is a pharmaceutical. Those can be very good choices and they can help us get out of crisis. But for many of us, we would like to also know what can I do to back to normal, get back to myself without an outside support. And so there are things that we can do to address our own internal environment, our microbiome. And I generally think that there are these broad strokes. If we can improve our nutrition, if we can decrease toxicity, if we can decrease free radicals, and if we can decrease mental emotional stress and if we can decrease inflammation, that's often gut based because if I stretch out your gut, it's the size of a tennis court. So it has this literally huge opportunity to interface with, with everything as it comes into our system. And it's the place that decides are we going to react to this or are we going to assimilate this? Are we going to pull in nutrients or are we going to create inflammation? Are we going to make lovely levels of neurotransmitters? I mean it's fascinating. We make 400 times the amount of melatonin, the one that helps us sleep in our gut versus our brain. And so quite literally this enormous opportunity to interface with the outside world in either way that helps us to accept it or reject it. And when we get back to things like changing our diet and Looking at foods and looking at our microbiome, it really gives us a lot of opportunity to move things in a positive direction.

Amazing. And there's a few things you've talked about already in terms of how the microbiome is really dynamic. It has dynamic relationships with other parts of the body. So you've talked a lot about neurotransmitters and the impact that they have on the rest of our body. Are there any other ways that the microbiome is really dynamic in its activity?

Yeah, absolutely. So the microbiome is going to help nourish that gut lining. So increasing that 85% of our immune system when it nourishes the gut lining, that is a place where we make what are called brush border enzymes. Yes, we make some acid in our stomach and then pancreatic enzymes, but they're in the lining. This is also involved in absorbing our nutrients. So whether or not we're able to extract nutrition from food comes down to the microbiome. If I have a healthy microbiome, it interfaces with this food. First of all, let's just talk about fiber. Something that might sound quite boring, but it turns out when our microbiome gets, gets enough fiber, it turns it into these compounds called short chain fatty acids. And those are things like butyrate that decrease our risk of colon cancer. But we're now finding out that you absorb these short chain fatty acids and within the body, in the brain, they can create a calming effect. Or how about this right there at the gate to the brain, and we call it the blood brain barrier. And so you can have a leaky blood brain barrier. And if that's the case, it's easier for toxins to get into the brain. In fact, one of the things that they've isolated with COVID long haul in the population that has brain fog. So let's say after an experience with COVID you know, maybe you were more fatigued, okay, that's a different population. Or maybe you had more clotting issues. That's a different population. But if your predominant symptom was brain fog, what they found is there's a connection to the gut with that. And so the inflammation from COVID and especially if you had gut based symptoms during that time, which many people do do, creates an increase of a signal called zonulin. And zonulin tells the gut to open up. And so why would it do that? Well, it wants immune cells to flood into the gut and try to fight what's going on. But if you have this long haul presentation, then that goes on too long, you absorb that zonulin and it tells that blood brain barrier to become leaky as well. And so they saw that the people who had more brain fog long term versus those who didn't had higher zonulin and leaky blood brain barrier, which started in the gut. But if you get that microbiome working for you, again, short chain fatty acids that they make compete with zonulin. And so they were able to compete with zonulin at the blood brain barrier, make the blood brain barrier less leaky. And that helped to resolve brain fog. So normally when we think about brain fog, we might think about amino acids that make more neurotransmitters that help us focus, or different botanicals that increase that, or different drugs that increase that. But it turns out just regulating another barrier, the one to the brain, is a part of decreasing brain fog. And the way that help happens is back it up. Your microbiome chews up fiber, makes these short chain fatty acids that just have profound effects throughout the body, from lowering colon cancer to helping us think better.

Wow, that's fascinating. I hadn't heard that about long Covid, but it makes complete sense. And the way you've described it has been, it's really clear you've really clarified that. So thank you for that. And one of my questions was that, you know, there's been so much interest in the microbiome in recent years. It's a real one of those areas where there's been an explosion in how we can look at it, how we interpret what we're looking at. Of all of those breakthroughs, what have been real game changers changes for you?

Yeah, so I mentioned zonulin and I think that this one was one that I really appreciated seeing come out in the research because if we, if we move back maybe 20 years ago and, and talk about our conversations around the microbiome and so if the microbiome wears down, then that gut lining wears down. And if the gut lining wears down, it becomes more permeable. Or an easy way of saying that is it becomes leaky, it's good wall of defense anymore. And if your gut lining becomes leaky now, things get into the body that shouldn't. Little bits of bacteria, little bits of food that should have been broken down by the gut lining. And this confuses our immune system. Our immune system says, oh my gosh, I'm under attack. We start to make antibodies and this creates a lot of inflammation in the body. It can be the root cause for autoimmunity but that inflammation even blocks our ability to make certain neurotransmitters in the brain, like serotonin, that helps us with depress and anxiety. So we need a good, strong barrier. And for years we would talk to patients about this concept of leaky gut. And we would work on changing diet and things that build the gut lining. And they go, oh, my depression is so much better. I sleep better. And they might go out to other, maybe family members or other practitioners, and they'd say, leaky gut's not a real thing. That's not in the research, that's made up. And they said, but I feel better from doing this. Well, that's spontaneous recovery kind of thing. Well, Zonulin was popularized by Dr. Alicia Fasano and one of those breakthroughs in, in natural medicine that I really champion. And so he was at Boston at the time, but now at Harvard, and he found this molecule called Zonulin. And you can measure it. You can measure it in the stool, you can measure it in the blood, and it tells what are called tight junctions. So the, the, the locking points of our gut cells. It tells them to open up. And so it governs this concept of leaky gut. So now with you could measure this molecule, you could track what was going on. And his research went on to say zonulin goes up before the onset of autoimmunity. And that's really fascinating as well, because what it tells us is, you know, you're not your mom, you're not your dad, you're not just sitting there waiting to get the lupus they had and sitting there waiting to get the rheumatoid arthritis they had, that there's something that triggers the genetics to express themselves. And that makes sense. We're not born with rheumatoid arthritis, we're not born with lupus. So something changes that causes that expression. Well, his research showed that as zonulin goes up, the gut becomes leaky and it creates this flood of reactive oxygen species or free radicals that cause genetics to express themselves and are associated with the onset of autoimmunity. And again, he too likes to speak that glass half full message, like I do as well, because he goes on to say, but if we can lower Zonulin, we can put the genie back in the bottle. We can remove the environmental trigger that caused genetics express themselves, and we have a way to calm things back down again. So he was very much in the research of leaky gut. His research started with celiac disease, which is a condition in which people can't tolerate wheat or gluten. And. But then he began to find this molecule, zonulin, that goes up in that condition, goes up in other autoimmune conditions as well. And it really validated this concept of leaky gut.

I remember following that whole or from my perspective as a nutritional therapist, I remember when zonulin was first available and it was all to do with celiac disease. But actually now it seems to be taking center stage in a lot of testing. So it's there or you can have zonulin add ons quite easily. So I guess that brings us quite naturally to the whole area of testing. So currently, what are the key things that you're looking out for when testing in terms of gut health and immune health?

Yeah. So I think if we think about practitioners that have been very successful in terms of helping people get their health back and we looked at the similarities and what they are doing, we would probably have to recognize that people in the integrative space that have a lot of success and patients who have a lot of success have probably all this in common, that they have made significant dietary changes. And so I, I earlier said how the gut is the size of a tennis court. And so if we're eating a food that inflames us, we are creating a lot of inflammation in the body. I also said that that inflammation doesn't have to be a gut symptom. If you're listening to this, instead of even saying, I get headaches but my stomach never hurts, that doesn't mean that you don't have a gut based source of inflammation because that inflammation that starts in the, doesn't stop there. And so it can trigger certain cytokines or certain white blood cells that create these signals called cytokines that put our immune system in a state of inflammation. And I mentioned the neurotransmitter piece. So we make serotonin from an amino acid called tryptophan. That's the one that's high in Turkey. And here in the US we have Thanksgiving where we all eat turkey and then we're all sleepy afterwards because serotonin goes on to make melatonin. And so that sleepy thing kicks in. Kicks in. But if you're inflamed, even from the gut, it creates these cytokines that block your body's ability to turn that amino acid into the right neurotransmitter and you turn it into other neurotransmitters, things like kynuric acid, quinolinic acid that make Us ache and feel not well. So inflammation that starts in the gut doesn't stop in the gut and it has a tendency to express itself and kind of whatever our genetic area of weakness is. So just because you don't have gas or bloating or, or diarrhea, doesn't mean that your condition doesn't have some gut based association. So if we can change the diet and move people to some, to a healthier diet, then this is really foundational to everything else. And that just makes sense. I mean, if your gut is inflamed, you don't absorb other things as well, whether or not that's a medication or a nutraceutical or the nutrients from foods that we need. So it just is a logical starting place. And so then the next question is, well, what should I eat? And you know, you read 10 different books, they say 10 different things. It's confusing using. All right, you know, or we do have some consensus out there. We're getting, we consistently see data in terms of something like a Mediterranean diet having benefit. But people could switch to more of a Mediterranean diet and still notice I'm still not feeling optimal. And unfortunately that is because if there's gut based inflammation, leaky gut, if there's a worn down microbiome and we don't have that proper immune signaling in place anymore, then our immune system can get confused. Like I mentioned, when it becomes leaky, larger molecules of food leak in, it looks weird to the immune system and we start to mount a response. So this can happen even to healthy foods. I've seen people where the trigger for them was chicken or cantaloupe or even broccoli. Can you imagine? You think you're doing everything right. I'm increasing broccoli in my diet and that's a trigger for you. So at Precision Point Diagnostics, the laboratory that I co founded, we really, really thought, okay, how can we get the best picture of what's happening with diet to create the least inflammatory diet possible? So what we figured out, and from the research, you know, large bodies of research that says this, I wouldn't say we singularly figured it out. We read the data that was out there. But in terms of allergies that people are familiar with, when you have a reaction to a food, only 50% of the time is it a classic allergy. So what does that mean? That means 50% of the time you're having a reaction to food. That is me. That's something else. It's not an allergy. And what we know is that allergies are an immediate reaction and they're governed by an antibody called IgE. Well, there's this whole other part of food reactions that are sensitivities, not allergies. They don't kill you. You're not going to need an EpiPen, you don't get shortness of breath. But these sensitivities, they create inflammation. That word we've been talking about, that drives, as you said, you got hard to think of a condition, condition that doesn't have inflammation attached to it. And this can happen 3 to 72 hours after you eat the food. And so you have a bad day, you think, what did I have for breakfast? And it's really what you had for breakfast either the day before or the day before that. So it can get very confusing. So we put together a test that yes, looks at allergies, but also looks at sensitivity, so we could get a complete picture of what's happening in terms of food reactions. But then as science advances, we also realized there's more to it than even these two big categories. Categories. There are things that fine tune what's going on within those major pieces of the immune system. So what we learned is that this IgG sensitivity is actually has a whole class of antibodies. There's IgG subtype 1, 2, 3 and 4, and, and, and it turns out that they don't all behave in the same way. Sub substance subtype 1, 2 and 3 create a lot of inflammation. They bind to something called complement that really signals the arrest of the immune system. And they seem to be largely responsible for these sensitivities. But IgG4 seems to be very different. And IgG4 is this tiny little antibody that will either sit in the IGE receptor and block it from binding. Well, if you block IGE from binding, that's how the release of histamine occurs. So it blocks the release of histamine. Or IgG4 can bind to IGE and keep it from being able to fit in the receptor. And so igg4 is this very different type. Realized that we needed to tease that out because it would confound the results otherwise and because it gave us very good clinical information, it blocks ige. It's the way we become tolerant. If you've ever met someone who said, oh yeah, I had a dairy allergy as a kiddo, but I grew out of it, yes, your immune system grows out of things. We can eventually become tolerant. So like, okay, let's look at allergies, let's look at tolerance to allergies let's look at sensitivities. And then we found out that there's this thing called complement that binds to IgG and that amplifies those reactions. So let's look at that as well. So we developed this test that looks at four different ways your immune system can respond to food. So we could really get a complete picture. And I remind patients that this is much like if I were looking at your Cardiovascular risk factors 60 years ago, I'd be happy measuring cholesterol. That's what we had. But now we know there's HDL cholesterol, and there's LDL cholesterol, and there's triglycerides, and there's all these fine points of better predictors of. Of your risk. And that's not even getting into particle s and buoyancy and oxidized ldl. But. But. So as we learn more, we can have more predictive biomarkers. So this is what we figured out around foods. As we've learned more, we know there's more ways the immune system reacts. And so a test that looks at multiple mechanisms can really help to change the diet. And I want to just say one more thing about that because. Because for patients, it can often seem daunting and scary. I don't want to give up a bunch of foods for the rest of my life. But the whole point of this testing is not to take away foods forever. It is to do it for a period of time and build the microbiome back, build the gut lining back. But then the idea is you'll be able to reintroduce these foods without that immune confusion, without that leaky gut putting the immune system back on track. And so the point of testing like this is, yes, to take out foods for a period of time, but ultimately to have a broader diet that's less reactive and less inflamed and a good source of nutrition from all types of foods.

The temporary means to an end rather than this is how you have to live for the rest of your life.

Yeah, exactly. Exactly. Now, that.

That test, to me, is fascinating. So there's so much going on in there, and I've so. And it kind of. It totally explains why in the past, food sensitivity testing has been so hit and miss because you've got that little. I call it a rogue itg, but actually it's a very lovable rogue. From that, can you pinpoint foods that are actually beneficial to include in your diet to bind up ige?

Ah, yes, absolutely. And. Or strategies to make to get to that tolerance. So what we know is, for example, if you know you were able to breastfeed as a baby, that that's good, that reduces allergies, autoimmunity. They're are very real reasons why, you know, sometimes people don't have that opportunity. So no, no shame or fault here. But we do know that if you get to breastfeed that that helps to balance out immune function, less allergies and long term less autoimmunity. Well, why is that the case? It's because it nurtures this microbiome and that microbiome helps us to become less reactive to these foods as we're first exposed to them. Well, there are other things that we can do to nurture that microbiome. Probably one that seems to people listening are probiotics. And in fact taking probiotics do improve tolerance. A beautiful example of this was done with kids who were deathly allergic to peanuts and they went on to do desensitization through injections. One group got a probiotic at the same time, the other group did not. They all did relatively well in terms of desensitization initially. But at four years years out, only 4% of the desensitization group could tolerate peanut. At four years out, if you got desensitization plus probiotic, 84% of that group could still tolerate peanut. So we know there are other things that we can do to increase this IgG4 to improve tolerance. Your microbiome is one. So probiotics help there also. Omega 3s help there as well. They turn on a cell signaling mechanism, something called IL10. In fact, IL10 is high in breast milk and IL10 says calm down immune system, don't be overreactive. So probiotics, some fish oils alongside removal can be some things that really help to retrain our immune system, increasing that IgG4 so we become less allergic.

Wonderful. One more question and I was going to say quick question, I don't think it is, but if you can answer it briefly about testing. Are we at the stage yet where we, we can test somebody's gut bacteria and then prescribe specific probiotics in response to that?

I think yes and no. I think that like I mentioned, now we can look at stool testing that breaks down things even to the DNA of the bacteria that's there. It's given us a much broader picture of what's going on. But when you do it it that way compared to what was done previously, which is a culture. A culture means just that, you culture it, you grow it out and when you grow it out, then you can put things next to what you've grown and see which ones kill it. Antibiotics, natural, conventional, otherwise. And so there are some tests out there that blend those together and these move us a big step forward. But I don't think that we have it absolutely nailed down in terms of this bacteria, this outcome. And in fact that will again, that's that westernized thinking, one bug for one ill. And it'll probably will, it'll probably never be that simple. It's how multiple bacteria influence each other, it's how they influence the immune system, it's how they keep pathogens at bay. And so quick answer, yes and no. But I do think we've made large strides forward. And absolutely people that have gone in and had go, please get your standard workup, let's make sure you don't have colon cancer, let's do the colonoscopies, let's do the right medical approach. But then you're still having issues. That's a great time to step in and look at maybe a test that says are there foods that you're sensitive to? Because I like to say, you know, it probably gets down to two things. Irritating the gut. It's either a bug or it's a food. And those aren't looked at in a comprehensive way within a standard of care workup. And so at that point go look, see is there a food that's irritating? You go look, do a more comprehensive stool analysis. Because the ones that in hospital look at about five bugs, not thousands of bugs. And they, like I said, they don't look at your microbiome. And so now go find out is there something else going on and those things are treatable and many people will see a large amount of improvement when they take that next diagnostic step.

Marvelous, thank you. So is there anyone out there right now or anything right there out there in the nutrition world that's particularly getting you excited at the moment?

Yeah. So I mentioned Alicia Fasano and I'm absolutely a fan. I think he's been a great champion of our work. And then then another thing that we're seeing that we've learned from the microbiome, so is this idea around peptides and peptides are cell signaling mechanisms. And so not only so identifying what the microbiome does and how it influences the rest of the body and we're drawing on these peptides for things like new medications for diabetes, but even things like weight loss and other anti inflammatory tools and a lesser known but not not any less great. A good friend, friend and colleague, Dr. David Hossey, and he is pioneering something called plasma electrophoresis. And what he does is in one way it sounds very eclectic and old school. We used to think about botanicals that clean the blood. He uses this. Well, he draws out blood and cleans it of particles that are there and then when you inject the blood back in, you removed these age particles. And he's really made some great str in terms of decreasing cognitive decline, really helping in that dementia realm as well. But he does this alongside good gut based strategies because he too recognizes the importance of that interconnection between the gut brain axis.

Wow. There's so much intriguing stuff out there, isn't there? And it's been really fascinating talking to you. You've got such a wealth of knowledge and experience and understanding and the way that you put it it all. But what do you love most about what you do?

I love that we give people more hope because many times the, the standard tools that are out there will help many people, but there's a subset of the population that don't respond and they think that that's all that can be done and they're left feeling very disempowered. But when we get to talk to people about things like dietary change that they can do themselves, it puts the power back in their own hands to seek more wellness. And I don't think that we're all out there trying to eat a perfect diet to win the trophy to say I ate more greens than anybody else. I think we do this because it allows us to live our passion. And so when you feel horrible, you can't live your passion. And so by being able to talk to people about these somewhat simple things that are often overlooked, we put the power back in people's hands to have more tools to feel better and to ultimately be to able, able to live and, and do what they feel passionate about. And when we're able to do what we feel passionate about, this is what gives us possibly more life, but certainly better quality of life for us and.

For our communities as well. We're back to that, aren't we?

Yeah, we're our greatest resource humans. And so the more we can get humans back out there not toxed out and doing what we love, the better off we all are.

Thanks Cheryl. That was amazing. So that was naturopathic doctor Cheryl Burdett Chatt with me. Kirsten Chick. I hope you enjoyed listening and gained some really useful insights about the immune system in your gut.

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