236 Dr. Michael Ruscio: Healing The Second Brain

We're just going to run a series of experiments and we're going to figure out what works, we're going to carry that forward and we're going to abandon what doesn't work. That's really the process, right? That's, that's really what the process is. But that's incumbent upon someone trusting their own body. If you can do those two things, learn to trust your body and kind of surrender to the process and do one thing at a time, you improve. And so I'm happy that people are now, you know, having more of a dissemination of that message.

That's Dr. Michael Ruscio, and this is episode 236 of Wellness Force Radio. What's up, my friend? It's your host, Josh Trent. And welcome back to another episode for your weekly access to global experts in all things wellness as we discover the physical and emotional intelligence we need to live life well. In this episode we're talking with Dr. Michael Ruscio, the four Pete, one of the coolest and most knowledgeable men that I know. When it comes to the enteric nervous system, not just the gut microbiome and gut health, we're going way deeper. We're going literally to the bottom of the truth basement. Today, live from Lake Tahoe to talk about the enteric nervous system. This is a fascinating part of the body which I've just stumbled upon and I'm so stoked for you to learn about it too, because it's called the second brain. Because, because this system, it actually operates separately from the autonomic nervous system. You know, we talk about sympathetic and parasympathetic on the show. This ens, the enteric nervous system, this gut and brain talk to each other through nerve signals, stress hormones. But the ENS has hundreds of millions of neurons, more than all the nerves in the spinal cord. It's capable of reflexes, gut feelings. You know that feeling you get when you're meeting somebody and you're like, you know, I just really like that girl or I like that guy. They're super cool. It's because your gut is actually giving your brain a message within, makes you feel something in your chest and that's how you call it, a gut feeling. But what if this, what if our gut feeling could actually lead us astray? And I've been thinking a lot about this, you know, the health of our gut and the decisiveness of our decision making faculty when it comes to intuition, you know, sharpening the intuition of the sword. We're talking about this so much today on the podcast with Dr. Ruscio healing this second brain. How do we do this? How do we heal the enteric nervous system, starting with the tight junctions in our gut. And we'll talk about probiotics. We're also going to talk about microbes, how microbes in our gut talk to our nervous system through chemical pathways. And also some of the research and findings about dysbiosis and. And a lot of other things that are very fresh on the bleeding edge of research. For Dr. Ruscio himself, it was super cool. I got to. I wish you could have been there. We were in this huge mansion. It was overlooking the valley in Squaw. I was there for the Spartan race, the world championships. This is the second year. But what I really loved the most about sitting with Dr. Ruscio was being able to understand really what he believes to be true based on clinical experience and also what's coming down the pike when it comes to this brain to gut connection. This second brain. I can't help but wonder with the focus right now on suicide prevention and depression and anxiety, and you and I both know we've had people in our lives, maybe ourselves, that have suffered and struggled with depression or anxiety or mood swings. The question remains, this enteric nervous system, what is its relationship to depression, anxiety, and also people who choose, unfortunately, to take their own life. How much of this, this is my de question. How much of this could be actually prevented? And how higher of a quality of life could we all have collectively if we understood this enteric nervous system? This second brain. Shownotes from today are@wellnessforce.com 236 make sure you dig into the show notes. There's gonna be a lot in this one. I'm super stoked to hear your thoughts on what this episode brought up for you. What did you feel? What are you curious about? Can you share this with somebody that you think gets to hear this message, Somebody that can really benefit from this message? Let us know what you think. We're across the entire Internet. Elness Force on social, on Instagram and in the private Facebook group. Now let's hear Dr. Ruscio's take on how to actually heal the second brain. Now, last year, I remember I met you in the kitchen here.

Kitchen paleo effects.

PaleoFX.

Awesome house.

These events bleed together, dude.

Totally.

How many podcasts have you done this trip already?

I think this will be five.

Okay. Have you talked about the enteric nervous system yet?

No.

Okay. Now this is something I know you're a specialist in. This is really cool, by the way. Fourth time on Wellness Force. Dude, you, you win. You're officially. Hashtag win for Dr. Michael Ruscio. Awesome. People already know you, man, but you are a doctor. You're a clinical researcher. You're obviously this brand new best selling author. How's the book doing?

Doing great.

How many copies have been sold so far?

I don't know. I get a monthly report. I should actually we should add to our tracking sheet a lifetime. So that's one of the first things I'm gonna do as soon as we're done. Okay. I'm gonna add that to our Excel tracking sheet. I actually don't know, but we've been skirting in and out of number one in two different categories in Amazon since we've launched Digestive Health and Gastroenterology, which has been really cool to see. And the other thing that's been really, I mean, awesome. I guess for lack of a better term, there have been people sending in their, you know, I guess their, their compliments via Instagram and Facebook and Twitter who've literally been working with functional medicine doctors and haven't been able to get well and then did the book Protocol and they feel great now.

Yep.

So that to me is just a huge testament to the power of the book. And I don't mean to toot my own horn, but it's deep. But it's been really cool to see. I interviewed this, this guy. So what we're doing now is we're interviewing a few of these people just to kind of showcase what the book can do for people who maybe don't know me or my work. And they're like, well, is this just like another book? How can I parse through if this is legit or not? We've been interviewing some of the people and this last guy I interviewed, he had read like five diet books and seen a functional medicine doctor and was not getting any results or getting part just partial results, but he felt like he was just getting a snippet here, a snippet there. And then he went through the book protocol and he finally feel like he had everything laid out in front of him and an easy step wise process to go through. And he was like, dude, I can't thank you enough. I'm feeling so much better. And that to me was worth the three years, you know, three days a week for three years just writing a book.

We didn't talk about this last time. We just had a podcast when the book came out. Did your health suffer at all when you were actually going through the process of creating the book. Because sometimes, like, creating something can be a toll on your own health.

I think that my health suffered a bit just because I took on way too many things at the same time. The clinic, as soon as the clinic started getting to a point where it was self sufficient, I wanted to start a website and a podcast, but I didn't really realize to have the kind of website that guys like us have, it's a lot. It's like a business. Right. It's a business in and of itself with a legit team behind it.

Yeah.

And so I remember there were days where I just had to get up and like go for a walk. And I'm talking like I was working at like 10:00pm because you'd be. I'd be working till like 11 or 12.

A lot of nights I would get your email. Sometimes Saturdays at like 5pm I'm like, what?

Yeah, yeah. I would work way too much, but I'd be working. And I'm so frustrated with trying to integrate, you know, how do we build this team? How do we get everything working the right way? I'd have to go for a walk around the block at like 10:15pm on a Tuesday night and then I'd finish working by like 11:30. So there was that. And then there was also the book, which at its inception was just intended to be an ebook. And then when I started writing it, I just started realizing how many half truths propagate and circulate.

Yeah.

In the space. And I really wanted to try to tackle those and give people a good resource. And as you know, I try not to say anything that I haven't really researched or if I haven't researched it, I'll just say like, disclaimer, this is not my area. So to do that with the whole book takes quite a bit of time. And so it was building the website and writing the book at the same time. That was just a lot to take on.

Yeah.

So yeah, for a little while I was, I was, I was never like eating McDonald's and drinking five nights a week, but I think I wasn't exercising as much as hard. I wasn't eating quite as well and I was probably a little bit too amped up, like a little bit too intense because you're always go, go, go. And just recently, over the past literally month, I've been working less and I've been kind of chilling out. And it's, it's great feeling. It's a fantastic feeling.

Well, you seem relaxed, but you also seem Grounded. And I've always had this trust element with you. This is our fourth time doing a podcast, so the reality is, man, so many people have already heard you before, but yet we haven't talked about. And this is why I'm so stoked we haven't talked about this second brain. You know, we've talked about gut health and all the things from probiotics to feeding the gut microbiota and all these different aspects of gut health. But this second brain, I was fascinated to learn about it just recently, and we had so many people. Actually, someone tagged you in the Wellness force group, said Dr. Ruscio is my go to guy on this. And I want to tell people what this is because I just found out about it as well. The ens. So we know about the autonomic, right? We're, we're parasympathetic, we're sympathetic. But the ens, this is like this mesh like system of neurons that governs the function of the gastrointestinal tract. The ENS is also called the second brain. And I saw this video on Facebook that I sent you, actually cool video. It was like 20 million views or something. For people that don't know, man, like, there's so much nuance about the second brain, about the ens, what is the ENS from your perspective? Like, what actually does it do for us?

Boy? Well, there's a deep question. I mean, it's been, you know, once you start studying the gut, you learn fairly early on. And actually, in my book, I create this side by side of how the intestines kind of look like the brain. And if you think about it, right, if you look at an intestinal diagram, there's these squiggly tissue lines, and it's not that dissimilar to how the brain looks. So, yeah, I mean, we've known about the enteric nervous system for a while, and so much happens in the gut. This is why the gut is so important. This is why we see your gut being able to affect joint pain, skin, brain fog, mood, metabolism, thyroid, what have you. Because it's such a complicated interface. It's literally how we get all of the nutrition into our body. So it would make sense that it wouldn't just be some kind of rudimentary border. It would be highly complex. You have to regulate circulation, immune function, repair, and I mean, essentially the enteric nervous system is. I mean, the best way to put it is it's literally like your second brain. It's a neural network as comp. I don't Know, if we could say as complicated as your brain, I don't know if anyone has done the comparison, but it's definitely highly, highly complicated. And I think what makes this maybe on par in terms of complexity with the brain is that the brain is probably more complex neurologically. The enteric nervous system is probably less complex neurologically, but it also has to govern much more immune function and absorptive capacity and circulation, and it has to be kind of select. You know, you have the selectively permeable membrane, which is partially mediated by nervous system activity, but also by immune function. So essentially, it's just this complicated network of neurons that help make sure that stuff that should not get in doesn't get in, and things that you want to absorb are absorbed. And that sounds really simple, but sometimes this involves these little junctions, these tight junctions contracting together or loosening up. As an example, you have these series of little doorways and then changes in circulation also. So sometimes the enteric nervous system is saying, boy, there's this old Woody Allen movie I think it's called what Happens During Intercourse. Have you ever seen it?

No, but tell us about it.

So we'll have to. Once we've done recording, I have to look it up. It's an old Woody Allen skit with Burt Reynolds also, and it's called, you know, what Happens During Intercourse? And it cuts to a guy and a girl in a car, and you see the girl from, like, the first person. So, like, you see, you're like, you're the guy looking at the girl, and she says, kiss me, baby. And they start making out. And then it cuts to the brain center, and there's like 10 guys in this control room, like, prepare for intercourse, right? And everyone starts, like, ramping up. And, like, you know, they talk about, you know, diverting circulation to. He's trying to get an erection. Like, we need more pressure. Yeah, yeah. So that kind of thing happens in the gut also, where if your muscles are pumping, if you're exercising, you divert blood flow from the gut to the muscles, and part of that is enterically mediated. So, yeah, I mean, there's. There's a thousand little tangents we could go down. But it's a. It's a super important part of your anatomy.

One of the things that fascinated me, I was doing some research. There's hundreds of millions of neurons, more nerves in the ENS than in the spinal cord, all these afferent and efferent signals that are going back and forth that are connected to the health of our gut. So there's almost like a little. In that video I saw, it had like, almost like a radiator or like a potentiometer that said, hey, if this is coming in, we're going to send this signal to the brain. This I believe, and I'd love your opinion on this. From a clinical perspective, this is where we get brain poisoning, brain maladjustment from the signals that are going on from dysbiosis in the gut. So can you talk about that a little bit?

Yeah, I mean, I'm not sure where to elaborate specifically because it comes down to kind of a, I think a handful of simple pathways where we know that when there is disturbances in the gut, you will see that manifest. Not always, but you will. Or you can see manifestations aren't logically. This is why I think the last time that I was on, we discussed that study that recently found that those with ibs, irritable bowel syndrome, gas, bloating, constipation, diarrhea, abdominal pain, have a higher predilection of anxiety, depression and fatigue. Because there is this connection between the two. And some people have probably noticed I eat a meal that doesn't agree with me. I feel a little bit bloated and I feel foggy in the head. And that can be almost instantaneous.

For me, it's pizza. If I eat pizza, I'm done.

That's too bad. What about gluten free pizza? Can you.

I mean, I haven't really played around with it, but I just know like, if I'm gonna eat the pizza, I'm just gonna be okay with like going to be knowing that I'm foggy.

Right.

But anyways, continue. Yeah, right.

Yeah. So, you know, part of this is mediated by nervous activity. Some of it may be mediated by lymphatic activity. There's recently a discovery that there's a direct channel between your gut lymphatics to your brain lymphatics. And then part of it is likely inflammatory and immune. And what likely happens here is one interesting thing where that that gut barrier tends to function in concert with other barriers of the body. And so there's a kidney barrier, there's a bladder barrier, there's a blood brain barrier. And those barriers to a greater or lesser extent tend to function together. So if one's leaky, they're all leaky. And this may be why, for example, we see more environmental and skin allergies when people have gut problems. And this is why some research is showing that probiotics can help with seasonal allergy.

What Kind of skin issues. Would you see if there is that issue going on?

Well, it can vary. And I. I don't profess to be great at being able to diagnose all these by visual inspection. Okay. But one of the conditions is known as atopic dermatitis, which is essentially, for lack of a better term, kind of like pimples. You also see rashing with histamine intolerance, which can emanate from the gut. And then some people, even myself, if I have a meal that really irritates me sometimes, I'll notice I get a few pimples. Right. The next. I mean, I'm sure other people. Have you noticed that yourself where.

Yeah.

If your gut flares, then if I.

Eat dairy, I'll get like a zit here and there, right?

Exactly.

It's specifically pasteurized dairy. But raw dairy, I don't. I don't feel like it does that.

Okay. So the enzymes in the raw dairy, possibly. Yeah, yeah. So, I mean, it's. So all these barriers tend to function together, one of which includes the. The blood brain barrier. And what may happen is when there's permeability in the gut, part of which may be mediated by the enteric nervous system, then you have that. This leaky phenomenon. You have inflammatory compounds released, and some of that in circulation, in the body, may work its way up into the brain. And I believe it was Michael Mays who published a paper showing that people with depression had gastrointestinal dysbiosis that was also causing permeability at the blood brain barrier, and that correlated with increased inflammation or inflammatory compounds in the brain. When they treated the dysbiosis in the gut, the information in the brain went down and the depression cleared. And Michael Mays has been doing a lot of research kind of with this inflammatory aspect of the brain, and decent amount of it ties to the gut.

I wonder if we tested some of these people that commit heinous atrocities, if we were able to actually test their gut function and see if they have extreme dysbiosis, do you think? I know it's speculation. You're not going to be quoted, like, across media here, but do you think there would be a corollary? Because I think a lot of people that commit insane things, they have something going on. There's some switches that are flipped in the brain, and then that's obviously connect to gut.

Yeah, I think that'd be. I think that'd be a really reasonable correlation to expect to see. I mean, we already know that those with IBS have A higher predilection towards anxiety, depression and fatigue. So it's not to say that these people have ibs, but oftentimes you see, you see different pathologies clump together. Right. So like, people who have rheumatoid arthritis may be more prone to having ibs, as an example, or those who have celiac people have probably heard are more likely to have. Or people who just have one autoimmune condition are more prone to have another autoimmune condition. So that would make sense. And knowing the impact, I mean, knowing that there have been patients who've been through my clinic or people who've gone through the book protocol who have been on bipolar medication, fix their guts, and now they're off it and feeling better, it's not a huge stretch. I would expect to see a correlation there.

So the mechanism between, if there is dysbiosis, can you walk us through how that actually connects to the brain function itself? What does that communication look like from one to the other?

Well, I mean, it could be multifold. It could be the leaky gut, leaky brain like we talked about. And that may be undergirded by inflammation. That may be one of the main things that causes that. Mace has also discussed your serotonin precursors. So your tyrosine, your tryptophan, rather, can be diverted from instead becoming serotonin, which is needed for mood down another pathway called the kina urinase pathway, which is an inflammatory pathway. So instead of making serotonin, which would make you happy, you make this inflammatory protein. And so some of this may be metabolic or, you know, it's a byproduct of. Of inflammation that influences your metabolism of neurotransmitters. And so you end up with this low serotonin syndrome secondary to the fact that you have inflammation.

My curiosity too is, is everybody knows about C reactive protein. It's like, you know, the primary marker for inflammation, right? If we had a communica, a communication pathway that was messed up between the enteric nervous system and the brain, would that show up as C reactive protein being high, or would that not be associated?

I haven't always found C reactive protein correlates with a patient presentation that looks clinically inflamed. And it may be because C reactive protein is a post hepatic or after liver inflammatory marker. And so looking at various interleukins may be a better way to ensure that you don't have an inflamed person, but you miss an inflammatory marker in them. And some people do advanced interleukin testing.

You gotta tell us what an interleukin is because I don't know. Oh, sorry.

Sorry. No, it's all right. So interleukins are essentially signaling molecules, some of which are anti inflammatory, some of which are pro inflammatory, but they're signaling molecules. I believe the predominant function is via the immune system. Yeah, it's via predominantly. There may be other systems that also use interleukins, but it's a way that the immune system communicates inflammation because. And we should probably cover this. If you picture your immune cells like these little cops and they have these little guns, they would be shooting inflammation as their bullets. Does that make sense?

Yeah.

So the, the tool of the immune system in part is inflammation to, you know, clean things up that it doesn't want there. And interleukins help communicate inflammation and they can either be pro inflammatory or anti inflammatory. But some of that I think is too speculative. It gets a little bit too into the weeds for me. And so I haven't really gotten too pulled into. I'm open on it. I can't say I've done a super deep dive, but once you start getting into the realm of the immune system. If you want to talk about complicated, the immune system is just bafflingly complicated. It is amazingly complex. And so I think it's very difficult to look at 15 inflammatory markers and try to get a read on what's happening.

And we have the autonomic nervous system, we have, you know, the immune system, and then we have the enteric nervous system and they're all talking to each other. There's this like ancient language, Mike, this ancient language about like, hey, here's how I'm doing. How are you guys doing? The main thing that can get in the way of that, that we all know about, is the improper diet. I mean, improper diet can just cause havoc with these systems. It's almost like, you know, if you have relatives and you talk to each other, imagine if all the phone lines were cut and you couldn't talk to your relatives anymore. They're never going to be able to check up on you. So you coming from an Italian background, like, you know this, right?

That would be pret detrimental.

There'd be no communication.

My mother would go nuts, I can tell you that.

So in these systems, the way that they communicate to each other. One other interesting thing I was learning about the ens it's capable of autonomous functions like the coordination of reflexes, but it also receives considerable innervation from the ans it can and does operate independently of the brain and spinal cord, so if it had no connection, it would still be doing its job. What fascinates you the most about the ENS specifically?

Uh, well, I. I mean, I really think everything that. That we've talked about, and to tell you the truth, I haven't really thought a ton about the ENS specifically before our conversation. So some of these things I'm. I. I haven't really given much thought prior to. But, yeah, I mean, I. I would say the. The thing that I find most striking about the enteric nervous system is literally that you have this neural network in your gut that's almost as complicated as your brain. And we don't really give that enough credit. But I think. And it's another reason why it's so important to really optimize your gut health, because if you. If you want to have a good brain, you have to have a good gut. Right. And so that's. That's, to me, what I think is most fascinating, knowing that someone can come in littered with depression and brain fog, and they can have gone to a psychologist or a psychiatrist and tried talk therapy or tried to, you know, Wellbutrin or Adderall or whatever it is, and still they don't feel like they're getting any better.

Yeah.

And they find a way of healing their gut, like, six years later. So they've been dealing with this for six years of their life. They've been suffering. They've been taking Wellbutrin, but it's killing their sex drive. So they go off it, and then they're brain foggy again, so they go back on it, and then they don't have any libido, so they go back on it again. And they've been literally suffering with this for years. And then in, like, two months, they heal their gut and their brain fog and their cognition is great. That's what is amazing about the enteric nervous system and wrapping in the whole gut with that.

Why do you think now there's such a focus in academia and I guess you could say the health and wellness industry. It seems like everywhere I go, and maybe it's selective because, like, you know, you buy a new car and you see the same car everywhere. But I feel like since I've been trying to understand more and unpack this enteric second brain, I feel like I'm seeing more and more and more research on the ENs specifically, especially in that video that I sent you. Are you seeing this, too? I mean, did you. Did you have that in your thought process. When you wrote Healthy gut healthy you.

Well, the ENS specifically. No, the. The gut as a general topic. Yes. And we're definitely seeing a boom in research.

I mean, I'm glad people are caring.

Yeah, I am too.

Yeah.

Because seven, eight years ago, when I was first starting the clinical practice and, and seeing these cases where people come in and they've been depressed and not feeling well or they have joint pain or chronic skin issues or whatever it is, and we improve their gut health, no symptoms go away. And I'm saying to myself, why don't more people know about this? And there were some times where I would literally get angry, where I would go to a seminar about improving your brain health and there wasn't one word about the gut. And there was many a seminar where I left and I. And this is maybe why I have a little bit of a jaded perspective as it pertains to functional medicine. But there were a lot of big names in functional medicine. And I don't mean to be taking a knock here, but I don't know how to articulate this point without. Without maybe making it look like that, where these people were so revered for being so smart in functional medicine. And I'd leave there and I'd say, how. How are you talking about this cognitive model and these 15 supplements that you can take, yet you haven't even talked on the gut or your gut recommendation was a gluten free diet. So I am really happy that we're seeing more research develop in this area because, I mean, as a clinician, I've been just watching so many people flounder, and then when they finally improve their gut health, they improve. And so I'm happy that people are now having more of a dissemination of that message.

I saw a gentleman on your Facebook page where you walk through his discovery of like actually gluten and adding carbs in made him.

Yeah, yeah.

Can you talk about that? That was a fascinating video. We'll link that in the show.

Notes. Yeah, Randy's case study was a really interesting one. And this is, you know, this is part of the reason why I'm not dogmatic on gluten. And I'm trying. I try not to be dogmatic on anything. I don't think anyone tries to be dogmatic by choice.

The only thing I think you're dogmatic on is people that lead with testing. Like, I don't think you're about that. I got that from you last time. That's the only dogmatism I Could see.

Yeah. Well, I mean, over testing and, you know, so I have a friend who is. Who was raised a Mormon, and now he's an atheist. And we have conversations about theism versus atheism. And I'm kind of in the middle ground where I was raised Catholic. I. I kind of drifted away from religion when I was in college, and. And now I'm. I'm kind of seeing the merit in religion, but also seeing some of the holes in religion. So I kind of see both sides. So I'm pretty moderate, but in conversations with my friend, his name is Preston, I'm always arguing the side that's pro religion because he's so anti religion. And so the functional medicine field has gone so pro testing that it makes me relatively look anti testing. But I really think what I'm advocating is a really reasonable moderate position. But coming back to Randy's case study, Randy, when he came in, I was saying this is either a metabolic issue or, you know, this guy may have, like, a serious heart complication, and we may need to get him to his primary care, like, right away, because he could barely even walk up a flight of stairs without getting winded. Right. So one of the things you're thinking there is that could be cardiovascular. That could be a major, you know, or not a major, but a partial occlusion that's really impacting his cardiovascular output. But we decided to increase his carb intake because he had been doing essentially ketogenic for a while. And one of the challenges with Randy was that when he ate carbs, he would have a bad symptomatic reaction. And what you sometimes see is, metabolically, someone will do better if they up their carb intake, but gastrointestinally, they can't handle that until they heal their gut. Right. So in just a couple months, we were able to get Randy's gut pretty tucked away. And all of his gut symptoms were gone, but these metabolic system symptoms persisted. And so we increased his carbs, and he was able to tolerate the carbs because his gut was healthier. And literally a month later, from a guy who could barely walk up a flight of stairs, he had stained his deck and power washed his house the weekend before our visit. And he said, my God, I feel so much better increasing carbs. And I said, if you have to eat gluten, have some gluten. I said, I'm not advocating that you make it a staple per se, but if you're between a rock and a hard place, it's more important that you eat adequate carb intake than try to eat gluten free. And so he was having some gluten. He wasn't having gluten five times a day. But it was a really powerful example of one of the things that I advocate, which is trying to find each individual's relationship to gluten and not just having this across the board. Everyone needs to avoid it all the time. And when Randy reintroduced gluten, he didn't feel any worse. In fact, he felt better. Now, was the gluten helping him? I mean, it probably wasn't helping him, but it's just he needed more carbs in the system and gluten containing grains was one way of achieving that.

Yeah. So with him, it was like the opposite of what the ketogenic and even the low carb advocates preach, which is, hey, carbohydrates, they're bad. They're not bad. They're just optimal for some people and not optimal for others. The discovery process of that, though, isn't it about the elimination process? You talk about this in the book a lot. Eliminating certain things and then giving yourself a breath so you can see how you damn feel.

Right.

That's really the starting point for everyone, right?

Exactly, exactly. Eliminate, see how you feel, and then eventually reintroduce some things and see where your boundaries are. It's not that complicated. And I don't know why gluten free crusaders or ketogenic dogmatic types have a hard time with that concept. And, and I got a fair amount of flack at a low carb conference when I discussed one of these case studies. And people look, some people.

What kind of flak did you get?

Some people's jaws dropped, like I was telling this guy to drink battery acid or something. It was just. And, and I remain open. And I think some of the people in the community made some good comments which were, you know, was he eating enough protein? Was he eating enough fat, Was he consuming enough salt? I think those are all salient things to consider because. And I do think you want to make sure that you're doing a well executed ketogenic diet if you are doing a ketogenic diet. So I agree with that. But to think that everyone has to be on a ketogenic diet, I just, it baffles me. I don't know how you can think that. And it's funny because usually I'm the guy defending low carb from the gut perspective.

Right.

I'm the guy who's. Who's been saying for a while you don't have to eat lots of fiber. You don't have to eat lots of prebiotics. You can eat lower carbon, have a healthy gut. And then I'm at a certain keto conference and all of a sudden I look like a high carb zealot because I just wasn't low carb enough for them.

Because you're going against the common denominator, which is like, hey, we're all going to eat this way because this is how people should eat. I don't think there's a necessarily word for should. Should. Should not be around dieting. Correct. There's no should or should not.

Agreed. And that's why in the book I try to lay out, you know, here's a couple different diets and let's help you navigate and figure out which one's going to work best for you. Because if, if we're being intellectually honest, we can find literature showing benefit on various types of diets. And it probably has to do with the fact that we're not all the same.

Yeah, right.

Africans have different. And we've. I think we talked about this last.

Time I was on somewhat like 23andMe almost through the lens of ancestry.

Well, that Africans have different gut microbiotas and different lifestyles and different diets. And some of the bacteria that seem to help African hunter gatherers could actually be really detrimental for those in the West. And methano, Brevibacter smithii is one of those where it essentially helps Africans because it slows down the transit of their highly fibrous diet. Because if something's highly fibrous, you need more time to digest it. This is why cows have more than one stomach.

Yeah.

Because they need more time to digest all that fiber. So this methano brother, Brevibacter smithii, slows down transit of the African hunter gatherer diet, allowing them to extract more calories out of that diet because they're eating a lower calorie diet. Highly fibrous diet, when that overgrows in Westerners, we see constipation and weight gain. So do you see how you can't just say, well, African hunter gatherers are this model of health and they have like no autoimmunity. Is one example true. Right. But what do you want to totally replicate what they have going on in their system for those of us in the West?

You actually sent me a study recently. It's fascinating. It's on PubMed. We'll link in the show notes evaluation of fecal dysbiosis tests for IRRITABLE bowel syndrome in subjects with and without obesity. Yeah, this is a really interesting study because the corollary at the end was dysbiosis was statistically significant associated with morbid obesity, but not ibs.

And so, so what's the cutoff there? So we've, we've had a kind of a back and forth about some of these tests that map the microbiota, and I caution people not to use these for clinical purposes. If they want to support some of these companies for amassing research, I think that's great, go ahead and do it. But if you're someone on a budget and you're trying to get healthy and you only have limited funds, which is the majority of people, so then do not spend 5, 6, 7, $800 on one of these tests because they really don't deliver on the promise that they're making. And it's unfortunate that I have to be blowing the whistle here where, you know, I'd like these companies not to be making these, these pretty, pretty lofty health claims when there's not really the data to support them. This test that I sent you, the, the PubMed abstract on is the GA map and it's out of this research group in Norway. This is probably the test that's the closest to being clinically relevant in terms of a gut mapping assay that has shown correlation to both IBS and ibd. And it's almost to the point where I think we can act on it clinically.

What's the GA map? What does that mean?

It's just the name of the test.

Okay.

Yeah.

Just the specificity of tests.

Yeah, There's a different test in the States, which I, I think is a decent test. It's the GI map. So it's not to be confused. These are two different tests. This GA MAP is out of a group, I believe, lead researcher's last name is Casey, I believe. But they're the closest to being clinically relevant. And their most recent study found that they did not show a correlation to their mapping profile and dysbiosis. So that, and that's the point I was trying to make. This is the most proximal to being clinically ready. And even this one, they're still working out some of the bugs, but, but they did, to your point, show a correlation to obesity. And where you see other correlation data is with methane predominant small intestinal bacterial overgrowth and weight gain, high cholesterol and high blood sugar. And some of the initial intervention trials have shown treating SIBO can decrease Blood sugar and cholesterol. I don't know that anything's been published that has shown that SIBO treatment can improve body composition, but I've definitely seen that in the clinic, so I think it can happen.

The fascinating part about this, too, is I know that we've talked about fecal transplants before, but this fecal dysbiosis test for ibs, I think of how many people have a baseline of health where it's very suboptimal and people aren't actually healthy, but they think that that baseline that's actually very low level of health is the normal for most people. Have you had a conversation with a patient where they've come in and they'll say, yeah, I feel great. But then you'll actually go through somewhat of a clinical observation, and you'll feel like. And you'll see from your observation, wow, this person's operating at a suboptimal level, but they feel like they're healthy.

So you mean that they have biomarkers that are suggestive of not being healthy?

Biomarkers and. Or specific tests. Basically, they feel like they're okay, but they're coming to you because of symptomatic things like, oh, you know, I can't have stools that are healthy, but I guess I feel okay. Does that ever happen where symptoms and feelings are totally different?

Good question. There is a degree of disconnect with some people where. And this kind of answers your question, but I'm kind of changing the question a little bit, so. Pardon?

Change away, man.

Yeah. Where some people will come in and they may not feel like their energy is optimal, so they're not feeling great, but they're also pooping twice a week, but they don't even mention the fact that they're only pooping twice a week. All they mention is that they're a little bit fatigued. And luckily, you know, I've learned to ask specific questions in our intake paperwork because I've noticed that sometimes people don't tell you everything.

Poop can be kind of a weird topic.

Yeah, no, I. I get it. I guess. I guess I'm a little bit desensitized for you.

It's like, totally normal.

But, yeah, they'll be pooping twice a week, and they're wondering why they're fatigued. And. And is there always a correlation? No. But, yeah, you sometimes do see people having things that aren't normal, but they become so accustomed to them that they think that they're normal.

Yeah. What about treating disorders like psychological disorders? Have you ever, in tandem worked with a psychiatrist or a psychologist where you have a patient come in, they're getting care for their mental health, and the psychologist is actually savvy enough to know to send them to you?

Good question. I can't say that I've experienced that, although I do think that you're seeing more training start to connect the gut and the brain. So I'm hoping that that will start happening at some point where psychologists and psychiatrists will start making the referral and the other way. It works for me in the other direction, where if someone has had pretty traumatic experiences in their life prior and they seem to have lifestyle imbalances around stress, I will make a referral for them because. And I think you've done a good job discussing this, as has Kevin Geary, that just like if you pulled your hamstring in college, you may have to periodically do some rehab or some stretching because that may be a pain point for you.

Yeah.

If you had psychological, emotional trauma in your past, you may have to occasionally kind of tend to that. You may have to work a little bit harder. And so if someone's not doing anything for those things, then that can kind of be the thorn in their side that thwarts their complete recovery.

We'll get right back with Dr. Ruscio, but I want to talk to you about something I just found out was in the green juice. This gently dried superfood powder from Organifi we're talking about organic prebiotic vegetable fiber is going to be something that is going to nurture the digestive capacity of our gut, the microbiome, and all the communications that Dr. Ruscio and I are talking about today. This green juice is not only filled with some of this organization, organic prebiotic vegetable fiber, but it also has a ton of other adaptogens like ashwagandha, red beetroot, turmeric. These are the types of things that give the body the signal for general health and wellness. Just an overall feeling of being better. Well, in our lives, which is the whole point of this podcast, this discovery process of the physical and the emotional. We can't think straight if we have brain fog and we can't have a clear mind if we have a gut that's in dysbiosis giving us the wrong message to the brain. So let's clear it all up. Let's take it one step at a time together and let's start getting in these organic prebiotic vegetable fibers from Organifi in the green juice. You can get this@organifi.com WellnessForce you just need to use code WellnessForce. You get 20% off not only the green, but the red and the gold. And the gold's got really nice lemon balm so you can sleep soundly like a little baby at night. Well, actually, if you're a baby, I think you wake up and cry so it'll make you sleep like a baby who's really tired. Go to organifi.com wellnessforce get this green juice powder today. Don't wait any longer and save some money too. Wellnessforce 20% off is the code@organifi.com Wellnessforce let's dive back in with Dr. Ruscio to healing the second brain. I want to ask you a question, man. Have you ever done any deep work when it comes to emotional stress on the gut? Have you ever had anything, like you said, tend to. Have you ever attended to anything specific in your garden?

So some things I have been doing, I guess there are definitely things that I've done for my own personal upkeep. One is working less. Being on my phone less has been really impactful. I've been listening to less podcasts. I'm sorry for people in my audience, I've been responding much less on social media, and I've been having other people on our team help me out. And the way I rationalized that to myself because I didn't feel good about it was I can either read research studies and stay abreast of what's happening, or I can respond to comments. And I just felt like the greater good for me to serve would be to get a better handle on what's happening in the research and report back to our audience with that, rather than just answering questions like, you know, can I take the probiotics on an empty stomach or with food? I get that's an important question for the person who's asking it. But there are resources out there or there are other people on our team who can kind of answer that for them. But being on my phone less because I'm responding in part less of social media and listening to less podcasts or lectures or whatever, that's been really helpful. And just creating an empty space or maybe like listening to some kind of comedy. Like, I've been listening to a lot of Bill Byrd lately. I find him to be just so abrasively hilarious. And being from the east coast near Boston, he really strikes a chord with me. Meditation, I have been meditating, and I feel like that's really helped kind of slow me down. And I've Been getting more back into music. I'm learning Fur Elise in the piano right now, which I won't be able to play the whole thing. If you know the third measure for Elise, it's where Beethoven just goes nuts. So I'm probably a long ways away before I can learn that. But just, just playing classical music on the piano and kind of getting back into that has been super helpful. And I'm also putting performance back on the menu of things that I'm trying to achieve. Like my mind used to always go round and round around about work. Right. I'd be in the shower, I'd be in the steam room and I'd be thinking, well, you know, be much easier for people if in our store they could do xyz.

Yeah.

Or that research study, you know, we should do investigation into this or that. And I'd literally get out of the steam room, go to my locker, take up my phone, send myself an email note. And so my mind was just always going on work related stuff.

Sounds like my mind right now.

Right, right. But as I've started to pull some of these things back, my mind is, it's still going, but I'm thinking more about, hmm, you know, I wonder if I started training one more day a week and I shifted my macros in this way if I'd see better performance in the gym. And so it's cool just to start seeing, I guess, my mind giving some attention back to myself.

Yeah.

And I think that for anyone you have to get yourself at optimum performance because that's when you're going to be able to do the most for the people you're trying to help. And I think I was able to go a number of years where I was kind of sacrificing myself a bit, but it started to kind of catch up to me. And then I started noticing my mental performance started to wane. And now I see those things getting better as I'm putting more time and focus back into myself.

That's real, man. Because I think I'm in a phase that you've previously been in right now. And I'll raise my hand and say, one of the newsletters that got the most responses I got, 60 people that wrote back to me was when I said, hey guys, I'm raising my hand. I've been sacrificing my health for business.

Right.

You know, this is the most I think I have on my body as far as lipid storage in 10 years since I let go of my weight. And so my current journey that I'm being open and honest and just sharing because why the hell not we're all on this path together is that I'm in the process of readjusting my lifestyle and my work habits and things like this. And I think about people that are listening that have mental health issues, you know, and I, I, I asked you the question before. Would you ever would, as a clinician specializing in gut health, work in tandem with a mental health professional, what do you think has to happen in our industry for functional medicine and psychiatry to join arms, to truly link up together? Would it be funding from government? Would it be something else? I mean, I think that's a recipe that's missing right now.

Yeah, that's a great question. Well, I think communication between the two sides will help. And whether it's from the top down or the bottom up, I'm much more inclined to think it would be more of a bottom up kind of endeavor. The understanding about the connection between the gut and the brain I think will create the environment from which that, that conversation can then grow. But you know, and, and I don't mean to sound like a broken record on this. If functional medicine does not clean up some of its overzealous crap, no one is going to take the field seriously. And so if you're a psychologist and you refer someone or psychiatrist and you refer someone to a functional medicine practitioner and they come back and the patient says, yeah, that guy had me do $3,000 worth of testing, scared the crap out of me, told me I can never eat gluten again and gave me 15 supplements, that Dr. Or that clinician is never going to refer to functional medicine again. And so, you know, I don't, again, I don't mean to keep beating that same drum, but it will hold the communication with other fields back and that will ultimately hurt the profession itself and hurt the public that both professions or both spheres of medicine are trying to help.

So what's blocking a potential partnership from growing would be overzealous amounts of testing and also prescribing supplementation.

Just overzealousness in general. Right? In general, trying to find the minimal effective dose and trying to be conservative. I think, and I think that's one thing that medicine does well. And, and there are many things that medicine doesn't do well. But I also think that's when you ask medicine to do something that medicine is not trying to do. Medicine is not trying to be necessarily this great preventative field that looks at mind, body, diet and everything else, but for what medicine does do. I think it does it pretty well. And we could learn from medicine in the vein of trying to be evidence guided and conservative and not overzealous. And I think it really emanates from a psychology. It's because the data is there. If you look at, if you look at the data, it doesn't lead you to a dogmatic or an overzealous paradigm. So I think it's a psychology that one just has this feeling that things have to be extreme. Right. Like they have a problem not thinking in absolutist mentalities, where if gluten is bad and you've learned about gluten being bad, then now gluten has to be taken out of the diet for everyone. And that bit of nuance is left out. And that's where I think the problem is, because the science is there. You can read my book and you can see I go through certain issues and I say, here are the studies that are the point and here are the studies that are the counterpoint and how do we interpret this? And it leads you very easily to a kind of measured, conservative conclusion. So the data is there, but for some reason, I think people have a tendency to cherry pick data.

We talked about this with Dan Pardee, the episode we called the Sneaky State of Food Science. And he's had many people on Humanos radio. And I don't know if you've been on his show, if not, you get to go on there where they've talked about this. There is such a financial incentive for people to pull out the research that benefits them and their cohorts rather than, you know, the, the media and the public at large. Do you feel like that's just as present now as it was when you started as a clinician?

I do, yeah. And I mean, I even talk about that in the book also where information can be used as marketing. And so if a supplement company is trying to sell you a supplement, they are going to only cite the studies that show that supplement work.

Yeah.

And they're not going to cite the ones that don't that show a difference. It doesn't work. Or a lab company, the same thing. And you know, this is not a dig on supplement companies or lab companies. They're doing one thing right and they are trying to find a way to produce dietary supplements or lab tests at the cheapest cost. And I think there's a good capitalistic driver for that. And the cost of these things are coming down and the quality is getting better. It's not incumbent upon the car manufacturer to teach you how to drive a car. Do you know what I mean?

Yep.

So if you buy a Ferrari and kill yourself, it's not really on the Ferrari manufacturer. So I'm not trying to make that same, you know, levy that same criticism, but someone has to be. And that's where I think the clinicians need to do a better job. And I think, I think one thing that would be really helpful to this endpoint was if any clinician learning from another clinician started to be suspicious when they were learning from someone who seemed to have a very one size fits all or absolutist sort of recommendation.

Yeah.

Because if you can do that, you'll weed out a lot of the people who are, who are just dogmatic.

I want to go practical here too, man, because there are people that have, you know, maybe 30, 40 pounds of weight that they're carrying that they don't need. They're experiencing GI symptoms, their mental health is affected. I mean, all this stuff is so dependent on one another and its function and in its disease. So I think about the way that a starting point for people could be, obviously, yeah, read Healthy Gut Healthy. You. I think it's probably the most user friendly guide I've ever seen. And I've interviewed a bunch of people about gut health and about, you know, I think about Dr. Susan Blum and what she's doing with autoimmune research and things like this. But the actual practical steps, I'm curious from a non food perspective, you know, I do float tanks. I love that stuff. I do breath work. It's in our M21 guide that we have for the audience. Like, I know the power of breath. For me, it's even tattooed on my arm in Italian. Se poso respirare poso schehere. Which means if I can breathe, I can choose. It's like our breath unlocks everything. And I think about when we breathe deeply, it shifts our nervous system to parasympathetic, which allows everything else to blend and move nicely. Do you do anything from a non food, non supplementation perspective with either yourself or patients, like breath work or floating?

Well, meditation would be a way of getting at breath work. And so for patients, and so I meditate myself. And then for patients who, when they seem like their life is a little bit imbalanced, then I'll recommend something like headspace or I've actually been doing Sam Harris has a 9 minute and a 26 minute guided practice.

I heard about this. Do you like that?

I mean, this is the first time in my life when I've been consistent with meditation. But the key question there is, have I finally gotten to a point where enough things are tucked away or actually have the time to meditate? Or is it that Harris's meditation was just so simple, practical and short that it got me to. It's probably combination of the two, to be honest with you. But I've been liking it. And what I typically do on a day where I have less free time, I'll do Harris's nine minute meditation. And then, you know, the first, like three minutes, you're kind of like thinking about all this, like, oh, I should have put this on the counter because I don't want to forget it when I leave mine. But once I get to about the four or five minute mark, then I just kind of level out and there's just this open space of empty, and it feels great. When his meditation ends, I typically sit there for another five minutes just because I'm just so happy in that space. And I'll do some visualization, some gratitude, and also just kind of wallow in the emptiness for a while. So I think the hardest part is just getting past that few minutes.

What are you the most grateful for right now?

Well, I mean, I oftentimes try to start from my family out. So I'm grateful for my family, my friends, and also just everything that I've been given because I think I've been given a lot. And I try to really honor that by working hard and doing a lot. But I also try to be grateful for the tools that I've been given and then the things that I've achieved. It's easy to get wrapped up in reaching for what you want and forgetting. Like, man, eight years ago I was just opening up this clinical space and there wasn't one appointment in the calendar. And now, you know, it's months and months of being booked out solid.

Yeah.

And sometimes you just get so accustomed to where you currently are, you don't appreciate where you were and how far you've come relative to there.

That's huge. I think people get scared of concepts that aren't quantifiable. You know, they're like, how do I quantify meditation? How do I actually know that's going to improve my gut health or my overall wellness? It's like, well, there's tons of research on it. Have you seen anything else besides meditation specifically, though, breathing or sensory deprivation? Have you ever experimented with that?

Personally, I haven't. I want to. I've been doing for the past two weeks cryotherapy paired with red light therapy.

Do you wear the little mittens when you go in the tube?

Well, so mine's not a tube, it's a whole chamber.

Oh.

And I've done both. And so for people listening, you can do cryo chamber, like, I'm sorry, cryotherapy in this tube where, like, your head sticks out the top.

I've seen that. Like, everybody has that on Instagram. Look at me in the cryotherapy booth again.

Or you can. So I'm glad I didn't. I'm glad I never posted that. I thought about it. Yeah. Or there. It's like. It's like a freezer. I mean, you feel like you're like.

How cold is it?

It's a negative 180 degrees. And you feel like you're in like some Russian freezer where they're trying. The Russian mafia is trying to just kill you by leaving you in there. Negative 180 degrees. It's total body, you know, so total body is submerged. And that's. It's intense. And. And we have someone lined up to come on our podcast to talk about what the research says on that because I'm really interested. And then I pair that afterward. So I go to US cryotherapy in Walnut Creek, shout out. And then I pair that afterward with red light therapy with the joov light. And I've read a couple studies showing pretty interesting findings and I have a book on it. And I'm also going to have the author of that book, Ari Whitten, on the podcast because I know he's looked very much so at the merits of red light therapy from an evidence based perspective.

I love talking about these corollary things because, yes, in your book there's an outline for this pathway of healing for the gut, but also there's these tertiary things that can help release stress, which then relates to a healthier gut. What about cannabinoids and CBD and hemp? We had the guys from Ned on the show. I've been taking the product. I'm a fan. Honestly. I just like how I feel scientifically. No, I'm not an expert. I don't know exactly.

What do you notice?

I notice that I'm just calmer. And I also have this kind of not like tingly feeling in my stomach, but just like a soothing feeling in my stomach. And I deal with anxiety. Everybody knows this. Like, I've had anxiety my whole life, which is why I'm so fascinated with the second brain. Because I'm like, huh, there's some lessons in there. But I'm curious if you've, I know you had someone on cannabis on the show. Have you done any research or what's your thoughts on CBD and the cannabinoids for overall health and, and maybe how that relates to the gut as well.

So there's a handful of clinical trials looking at cannabinoids. The challenge is, is that at least from, from what I've been able to take away from some of the review papers is that I don't know if any of these studies have used just CBD in isolation. So I think there's kind of a theoretical that we could just use CBD or non psychoactive cannabinoids and derive some of the benefit that's been seen in some of these clinical TR of which clinical trials have shown for inflammatory bowel disease some benefit and also for different neurodegenerative diseases some benefit. I think those are the, if my memory served me correctly, inflammatory disorders of the bowel and neurocognitive disorders have shown the two highest benefits. I mean also for appetite, for people undergoing chemotherapy. That's a pretty selective group. So I'm really curious to see if we'll see that same amount of utility clinically with just a CBD or just a non psychoactive mixture of cannabinoids. One of the things that I've been talking with a supplement company about is trying to do, it's known as a retrospective chart review where we would just treat 10 recalcitrant IBS patients with one of these cannabinoid formulas and do a pre post IBS symptom score and see if we were able to document appreciable.

Improvement in their IBS symptoms without telling them anything. Right. You just give them.

Yeah, you don't, you don't, you try to be as, as minimally biased as.

Possible because placebo can kick in.

It can't. So another way of doing this would, would be a placebo control trial.

Okay.

It's just, I like starting off with a retrospective chart review because you don't have to go through the same amount of, of rigorous bells and whistles and applications to get a retroactive chart review rolling. And so if you, if you see the positive impact in the rcr, then a clinical trial I think is a next good step. So I would like to, I would kind of like to do that study. We have one cannabinoid blend, non psychoactive, that I'm going to start experimenting With. With some patients. But I have seen patients enough who've said one of the only things that mellows my stomach out is some cannabis.

It's really interesting. And I've never. I'm not a big weed guy. Like, I don't care if people are. I think it's cool. It's just not my plant. Other plants are my plants. And I think that when I take the cbd, how I feel is my biggest report card, which is really. I don't you think that should be everyone's biggest report card? Like, I know data and markers are a second one. Do you think that when this farm bill passes, it's gonna. I know it's gonna pass. I have this feeling hemp's gonna be legalized. And when that happens, we're going to start to see, I think, in a way, like an explosion and then also some regulation, because things are going to get out of hand. It's the wild, wild west in cannabinoids and cbd. Do you think that there's a potential for a deeper healing aspect if you did some of these tests you're talking about that it would ever scale to be in actual medical doctors offices?

Well, I believe there's some work. Sal was telling me yesterday that a certain pharmaceutical company has patented or is trying to patent a certain CBD formula.

Why does that make me upset? I mean, if it's going to heal people, it doesn't matter how I feel.

Yeah, I mean, I mean, I just.

Kind of don't like that.

So I think I have an answer for that question because I've been grappling with why. So I have a lot of gastroenterologist cohorts, conventional gastroenterologists. I mean, guys I like, I've lectured with, and we shoot PubMed abstracts back and forth to each other on different things. But. But I noticed that some of them just have a really hard time with probiotics. They'll recommend, like, one probiotic, which is a prescription and not anything else. And I've been thinking, like, there's so much data on these other probiotics. What is the trepidation all about? I think a lot of medical doctors are just so used to prescriptions that that's a safe space for them. Right. And so they feel much more comfortable if something is a prescription, they're thinking that it's probably clean, it's probably safe, it's probably, you know, it's probably gone through certain degrees of rigor to get it here. So it may not be a bad Thing if you have a cannabis prescription, because that may get you over the hump of getting it endorsed or used in the office of a conventional doctor. So that might be a more positive way to kind of frame it.

Yeah. And then on top of cannabis, there's all these other plants that are medicinal. Are there any other plants besides cannabis or even cannabinoids focused that also help to heal the gut? Do you like certain plants? Whether it be rhodiola is like a stress calmer, but I don't know if that impacts the gut at all.

Do you go to the doctor? It does. So I also talk about this in Healthy Gut Healthy U, where certain adrenal adaptogens have been shown to actually attenuate the stress response and help to prevent stress induced skewing of the microbiota. So yes, some of these adrenal adaptogens through or at least partially through their role of mantra and the stress response, because the stress response negatively impacts your gut microbiota. So if they can partially attenuate the stress response, they can prevent those negative shifts in your microbiota. And there's a couple other plants. But just back to cannabis for one second. One of the things I'm curious to evaluate is, is any potential detriment of the immunosuppressive effects of the cannabinoids. And I wonder if we're going to see people start overusing these and then they're plagued by chronic upper respiratory tract infections or chronic other infections in the gut. Which is why I think it's important to always be looking for the minimal effective dose. Because you do see this reported in the cannabis literature, is that that an unintended side effect of the anti inflammatory and immunosuppressive nature of cannabis, like many other anti inflammatory treatments, can be immunosuppression if the dose is too long or the duration. I'm sorry, if the dose is too high, the duration is too long. So that's just one thing that I think people should just keep their feelers out for. And you know, and yourself included, if you're feeling good on this cannabis product, great. At some point I would try to scale down your dose and see if you can discover what your minimal effective dose is. Because you may not need that that forever.

Yeah, and as I said, mine's not really cannabis focused, it's more hemp oil. So for me that's what I'm feeling. But I'll, you know, my dad actually texted me and you know, something's mainstream when your parents are talking about it. My dad was like, yeah, I'm doing CBD now. I'm doing CBD oil. And I'm thinking to myself, this is probably a good sign that it's in the common, like, nomenclature of just every person. What are some of the things that people get wrong about this, though? Like, you know, we look at this equation of ultimo gut health. What do people get wrong about? How do I treat that first step? You know, is it. Is it really. Is it really just addressing stress, or is it diet? Should you just choose one? What if you can't do two at the same time? Sometimes people can adjust their life and they only can adjust their food.

I think the biggest thing I see people grapple with is they make things more complicated than they need to be. And I mean that in any sense you can apply it, right? So you have a simple protocol that you can follow in the book. And then people will say, but I've read, if I have sibo, I shouldn't take probiotics. I address that in the book. Right, but sometimes people, they overcomplicate things, right? Or you say to do this fast for three days, but. But I can only do it for two, I think, okay, then do it for two. Right? People are overcomplicating things because they hear other tidbits, and so they have a hard time just following one lead. Or they overcomplicate things in the sense of they think that to follow this protocol, you have to do everything perfectly. And so I think the biggest thing people can do is just find a simple system like the one I lay out in the book, and then just kind of chill out and do your best to go through it, because that's really. I mean, if someone pays the money to come see me and we're going to go through some of these, oh, you can't fast for three days. Okay, do it for two. Not a big deal, right? Yes. It's as simple as that. You know, it's. It's. These things are not that complicated, but there's so much information out there that I think it makes people think that they're more complicated than they are.

Don't you think it boils down to trust? If somebody doesn't trust themselves that they have to have a perfect template, a perfect PDF, they can only trust you if they know everything that you know. Rather than breathing and surrendering and just working with someone like a clinician or a very talented functional medicine doctor and just surrendering. I think surrendering to the healing process is a big Part of the process beyond just, you know, following whatever the protocol is.

And I think to build upon that and offer another insight. If people can just take one step at a time, isolate one variable and just do that and give that a shake, and then end that trial and then reevaluate and then move on to the next, I can tell you that there are patients who've come to my office who've been to some of the best functional practices, functional medicine practitioners in the world. And the one thing that we did differently was we just slowed our roll and we did one thing at a time. And you will learn so much from doing that. We've published two case studies in our clinicians newsletter of patients who had chronic abdominal pain and diarrhea. And they couldn't figure out why. And they had seen a couple different people, and they were never able to figure it out. And in two of these cases, it was a reaction to the bile supplement that these people were taking. That's all it was. Now, the only way that we were able to discern that was by doing one thing at a time. Okay, step one. Come off everything. Right? You're taking all this stuff. Let's just clear the deck. Let's clear the variables. Come off everything. Oh, I'm feeling better.

Great.

Then we'll start with a few dietary changes. I'm feeling even better. Awesome. Then we'll add in some probiotics. Oh, I'm feeling the best I felt in five years. Fantastic. Okay, now let's add in some enzyme support and bile. My diarrhea is back. Try the bile alone. Try the enzymes alone. Just the bile caused my diarrhea. Okay.

Yeah.

Congratulations. There's your diagnosis. There's your problem, and you're now good. But why that's so important is because if you don't do that, you can get pulled into this black hole of. Well, it could be. Okay, your SIBO test is negative. So it could be hydrogen sulfide SiBO. Or maybe it's Lyme. And sometimes you have to do that. Yes. Right. But you don't want to put the cart before the horse. So I would say slow down, do one thing at a time, and realize that to learn from your body what it needs, you can't do seven things at once. Right? Do one thing. You don't have to do that one thing for eight months. Sometimes you only need a few weeks, and then do the next thing. And then learn to listen to your body and trust what your body says. Right. So if you're someone that does do well, keto, even though we've kind of been knocking keto a little bit, it.

Works for some people.

Yeah. So then say, okay, I'm someone who does better on keto, and I'm going to be okay with that. If you can do those two things, learn to trust your body and kind of surrender to the process and do one thing at a time and learn from those, those occurrences, I would recommend taking some notes because sometimes what will happen is people using the same patient, two years later, she goes back on bile because she forgot about bile being the problem and her diarrhea comes back. Well, if you have a little short summary of experiments you've done and observations you've taken away from those experiments, then that can be good to kind of jog your memory.

This has been so radical to be able to sit with you and go over these concepts because Skype is great. But I've felt something from you today that I haven't felt on any other interview. And it's this calm confidence that I couldn't get through Skype. And I know, I know people are feeling that too, man. So thank you so much for being on the show. People can pick up a copy of the book, obviously, but as parting guidance, what does a day look like for you? You know, for a clinician like yourself, who I'm sure gut health is in your top five priorities for you knowing, you know, seeing firsthand what happens to people. Tell us, like, what's Dr. Ruschio's day?

Well, there, there's two kinds of days. There's clinic days and there's non clinic days. So I'll give you each really, really quick because they're definitely different. On a clinic day, I typically will wake up, you do your whole things, you pee, you brush your teeth, you shower, whatever, and I'll make breakfast, but I won't eat breakfast. I'll then go and do a meditation for nine minutes, and then as soon as I'm done with my meditation, I'll eat breakfast and then I'm into the clinic and then the clinic is. Clinic is great. It's just we're booked back to back to back to back, so there's no downtime. But it's awesome just seeing. And it's really kind of a cool experience seeing person after person after person who is not feeling well, complaining about something, struggling with something, and then you see them visit after visit and those conditions and symptoms fade away. And it's a really cool feeling knowing that the majority of people, you can take their suffering and make it go away. It's such a. I don't think I appreciate that enough sometimes because I've had things that even recently where I feel like I'm more mellowed out. And it's so great having that no longer be part of me. So just having that one little thing taken off my plate, I can't imagine if I. Well, I can, actually, because this happened to me about 15 years ago, but having chronic insomnia and brain fog and just what a gift it is to have that taken away. So, anyway, those are clinic days. I come home for lunch, try to get at least 20 minutes out in the sun, and then what do you have for lunch? So breakfast I oftentimes will do if I'm eating lower carb, which I'm not anymore. But I love doing three eggs kind of over easy. And I think it's Casa de Chica salsa from Whole Foods. I. I put a couple of scoops. That salsa is just awesome.

Wow. That's a free plug for casados.

Yeah. I mean, their. Their salsa, it's just the best sauce I've ever had, like, bar none. I love it so much. So free plug for them. And then I'll do half an avocado and a couple scoops of that. And then sometimes I. I kind of lightly wilt some, mix spring and greens in along with that. And that's a really easy. You can make that in five minutes. Easy, clean, healthy. And then for lunch, typically what I do is I have a frozen chicken breast in the oven, and I have the oven on delay start. And sometimes I'll do this olive oil, pepper, turmeric, where I'll just kind of really douse it in that. And if you bake it, and then when it comes out, if you cut it up into small pieces, mix it all together and put it back in for another couple minutes. Then the chicken really kind of imbues all of that flavor. That's really good. If you do that with curcumin or turmeric, that's smart.

You put your oven on auto time. Yeah, that's really sticking in there.

It's really helpful.

Yeah.

Because I was having a hard time. If I would come home and then have to bake something, I would be eating right before I went back in. I just didn't want to be that rushed. So the delay timer function is really helpful. And then I usually do a lot of steamed vegetables, so maybe I'll do steamed broccoli with that. Lately I've been doing more carbs, so lots of potatoes, sweet potatoes, regular white potatoes as well. Yeah.

Do you try to time that based on your activity load?

Not yet. Um, I'm trying to eat 3,000 calories a day right now. I don't think I've been eating. I may not have been eating enough calories and I may not have been eating enough carbs. So I'm trying to eat 3,000 calories a day, which feels like a ton of food and on training days at least 200 grams of carbs, which feels like a ton of carbs to me. But I may have just been in this territory where I was chronically under eating a little bit and under my carb needs. So I think that's helping. It's also hard to say because I'm also working a little bit less at the same time, but I do think that even when I was working, you know, so if I have like a four day vacation when I was, you know, still in crazy work mode, yeah I didn't have this level of mental clarity, spark and even driving the gym. So I do think I was a little bit too low calorie and a little bit too low carb. And this is actually something that I'm, I'm thinking about putting together not right now, but in the future like a life after healthy gut healthy you. Which is all like optimization strategies because this kind of stuff is my personal hobby anyway. I just. This personal hobby has been covered in about a inch of dust up until recently. But I would like to share some of these things with people. But so that, that's kind of like your, your first half of the clinic day and then typically after the clinic those are my non workout days because clinic days are really cerebral and oftentimes what I'll do is I'll do a sauna and then I'll come home, maybe I'll read PubMed abstracts and then play some piano, maybe listen to a Sam Harris Jordan Peterson debate or something like that.

Those are good.

Yeah, yeah. And then on my non clinic days kind of similar start where I'll, you know, get some stuff ready in the morning, I'll cook, I'll meditate, and then after I meditate I'll either call someone on the phone and go for a walk around the block or walk down to my local coffee shop and get a coffee. But I've been drinking less coffee lately, also less caffeine, which has been another thing I think has been really helpful. I think I was drinking too much caffeine also kind of, it's a slippery slope. Isn't it this theme of overstimulation?

Yeah, it's like, I've dealt with that myself too. Like, I'm. I'm drinking a Focus Aid and I'm like, I'm not gonna have any more caffeine today. Like, that's enough.

Right.

But it can be, you know, depending on, I think, and I don't know if you can extrapolate on this. Depending on what somebody's dealing with, their load of responsibility, caffeine can be this little devil that, like, creeps up on your shoulder and says, drink me, do it, do it. Drink me, damn it. Have you. How did you deal with that specifically?

Well, I think part of the reason why I was, I guess, a bit caffeine dependent. I wouldn't say dependent, but I just. I felt like I would have better mental energy when I had it, so I could function without it, but I would just feel like I was a bit too slow. I think a part of that reason or part of why I was in that position was potentially not eating enough and not eating enough carbs. And you combine that with working probably too much. And I think, I think eating that lower calorie calorie, lower carb worked for me up until a few years ago. But I think as my workload kept going up, up, up, up, up, and I didn't change those things. That little bit of a lower calorie, lower carb diet, it's a stressor. Right. And if. If everything else was less stressful, then you could overcome that stressor and have a positive hormonic effect. But because now I think the. The workload became too excessive, I think that stressor I couldn't recover from. And then I need caffeine to stimulate me to a level of performance that I would need. So I think the biggest thing that helped me get off caffeine was a little bit more rest, a little bit less training, more calories, more carbs. This is the exact same thing that I've been telling patients for years, Right. When I would see this kind of my own presentation come in. Yeah, I would scale back their training by like, 30%. I would have them increase their carbohydrate intake, eat every three to five hours, and try to really reduce their caffeine. I would never say come off caffeine completely because that gives people more stress.

Sometimes and headaches usually.

Yeah. But I'd say, you know, try to cut your caffeine by 50%. If you can do more, great. But we just want to start reducing your stress Load. And that's another thing I think that's helpful for people is a recommendation. There are very few recommendations in my mind that are set in stone. It's just a recommendation is a principle trying to move you in a direction that's going to be beneficial for you. So if a clinician says come off caffeine, you can probably have some caffeine, right? It's not that like if you have caffeine, there's this magical thing the clinician's trying to do that you don't know what it is. And if you have any caffeine, that magical thing is going to be ruined. It's just, hey, we're trying to reduce your stress load of caffeine. So if you have a little bit, that's okay. And the reason I share this is because sometimes I think people don't trust themselves enough to make that adjudication. And they think that if they have any caffeine they failed. They get stressed about it, that stress isn't good for them. And some people, then they go, well, you know, screw it. If I already had one and I wasn't supposed to have any, I'm not going to bother anymore. I'll reset after my next visit. Right? And that's such a huge mistake. It's just trying to move you in that direction. So I had some caffeine, I slept terribly. I think there was mold in the place I'm staying, I was telling you earlier. So I slept terrible the first night and the morning after that I just needed some caffeine to like jack me out of that because I had to be here at 8 o' clock and do an interview. So, you know, sometimes you gotta roll with it.

I love, I love your honesty, man. Because yeah, there is recommendations, but a recommendation isn't like a life sentence. It's not something that there has to be a template that your life fits into forever. Because man, you know, the man that you were when you went through your symptoms 15 plus years ago, the man that you are now, it's like you have more experience under your belt. So why not all of us, I think, take this experience that we're learning what works, learning what doesn't, and leave the rest. It's like, I think Bruce Lee is really famous for saying, yes, yes, you know, learn as much as you can, but only take what you need that you really feel applies to you. And I think he said something way different.

But I kind of like, no, I think you, you nailed on the head and, and it's Funny. That's a lot of what I recommend people do in my clinic and in the book. We're just going to run a series of experiments and we're going to figure out what works, we're going to carry that forward and we're going to abandon what doesn't work. That's really the process. That's really what the process is. But that's incumbent upon someone trusting their.

Own body to end the show. Man. I always ask about wellness, but you've answered that question before. So let's end the show with something different. And it's when we really address and think about that second brain that we started with. Healing. This healing aspect, healing the human, this is what you do. And a lot of people that listen to this podcast, we're all healing something at some point. But specifically that second brain, what's parting guidance for just maybe sparking a curiosity or more attention focused on healing that second brain?

Well, because so much of your automatic nervous system affects your enteric nervous system and we're kind of in this theme of de stressing also. So I would challenge anyone who's not meditating for one week to look up Sam Harris's nine minute meditation.

Right.

Because that's just an easy one. It's what I've been doing. Do that for one week. Do it in the morning. Because I find that as the day goes on, it's harder and harder to sneak it in. So just, I mean, nine minutes, right? If you take a poop, it's probably about nine minutes, right? So it's not like this is a huge commitment that you can't, you know, surrender to. And that should have a nice impact on multiple things, your true brain and also your enteric brain. And I'd say that that would be a good thing to implement if people haven't made meditation a practice yet.

Drrucio.com is the website.

Yep.

And they can also go get the book at a specific URL as well.

Healthyguthealthyoubook.com Healthy gut, healthy you book.

So great to do this with you, man. Thank you so much.

It's been a pleasure. Thank you.

Thanks, Mike. Hey, my friend, thank you for hanging out and growing with me on today's show. Remember to hit subscribe share this podcast with somebody you care about that you think gets to hear this message. Support the show by leaving a five star review for the podcast right now simply by tapping on your show artwork. On your iPhone, click that purple link that says review this podcast. It helps the show reach more conscious and smart people like you and your voice will attract more world class guests that want to come on the show. So let them hear your voice. For all the downloads, videos, links and free resources mentioned on the episode go to wellnessforce.com radio. And while you're at my house on the web, join us in the Wellness Force Community newsletter on that page and I'll send you four free guides around staying healthy with your eating, moving and sleeping while you travel. But don't let this conversation stop here. Join a group of people like you over at the Wellness Force Community Facebook page. This is where we talk about the things that really matter. We share our wins, inspirations, struggles and a lot more. So join us. Tap on the show artwork on your phone and hit that purple link that says join the Facebook group and I will welcome you at the door. Okay, now you get to go out into your world and create impact for the people that you care about. So until I see you again real soon, I'm wishing you love and wellness.