Balance Candida and Improve Your Gut Health, with Dr. Mahmoud Ghannoum

Candida tropicalis. When it is in our gut together with E. Coli and serratium or two bacteria, they come together and they form what we call biofilm. And when they do that, they become resistant to antibiotics, they become resistant to our immune cells and then they start to cause trouble to our gut lining and that's where it could lead to leaky gut.

If you want to live like you matter, ditch the pills, look great and feel freaking amazing. You're in the right place. I'm Dr. Wendy Trubo. And I'm Dr. Ed Levitan. Welcome to the Feel Freaking Amazing podcast where we empower you to live a vibrant and healthy life by optimizing your structural, chemical, emotional, social and spiritual lives. Hold on to your hats. Hello and welcome to this episode of the five Journeys Feel Freaking Amazing podcast. Ed got pulled into another meeting, so I'm on my own. And he's missing a really cool interview because we have Dr. Mahmoud Ghanoum. He is a microbiome scientist known for naming the microbiome and he's co founder of Biome. He's dedicated the last 40 years to microbiome research, publishing over 500 peer reviewed papers. He's been cited into over 29,000 scientific papers and he discovered more than 100 native species of fungi in the oral cavity. So brace yourselves because this is going to be really fun and cool. Dr. Kunum, welcome. I'm so excited to have you here. This is a really cool topic.

Oh, thank you very much for having me. I'm really looking forward to it. And as you said, we are going to have fun.

We totally are. First off, maybe tell people what's the microbiome. Sure.

Mycology is the study of fungus. And that's why when we were talking about fungi or fungus that grow in our gut, in our skin, I thought it would be good way to name the community. Michael. Biome. So it is the community of fungi that lives in our body. And as you know, Candida is a very well known fungus. People know it about thrush and you know, oral thrush as well as vaginal thrush. And then when a person takes an antibiotic, for example tetracycline, if a woman takes a tetracycline, they develop thrush. So what you are doing, you are killing the good bacteria that keeps Candida under control. And that's why to me, when I started thinking about the microbiome, I said, oh, we should really start thinking not only about bacteria only, but also about other communities that live in our body. And of course this include fungus, viruses, archaea and parasites. So that's where I really, my interest peaked and start looking into the effect of the microbiome and different communities in our health.

This is so interesting to me, Mahmoud, because you think about it, I'm in clinical practice and I say to my patients, if I'm giving you an antibiotic, the candida in your body are doing a happy dance because they are no longer inhibited by the good bacteria because you're going to scorch the earth and wipe them out. And the bacteria are dancing, the candida are dancing. They're so happy and they're going to grow because I always say, think of your gut like a garden and if you don't plant good, good plants, you're going to get weeds. I think of the candida like a weed. But let's say a little bit more technically, like we're talking about the things in our body, but technically for the listeners, your mouth to your anus is actually outside your body. Even though it's inside the cavity, it's not in your body. And so these candida in theory are living in, in the tube that goes from our mouth to our anus. Right. So they're not, they shouldn't be in our bloodstream. Hopefully they're really isolated to. In the gut or from the mouth to the anus, that tube.

Absolutely, absolutely. You know, like I tell you I did when I was many, many years ago when I was teaching, I told my students, listen, can you give me a swab to see if you carry Candida in your mouth in the oral cavity? And lo and behold, I collected samples from them and guess what? 50% of these healthy young students have Candida. 60, 60% of them. You know, so really, people carry Candida normally in their mouth. And the same applies to our gut. If we go down the tube, as you say, we have also Candida living there. Happily, you know, you. Not only. Actually, actually, this is one thing I want to clarify. Candida, when it is living in our gut at low level or low abundance, it helps us, it's a good guy, because it can breaks down some carbohydrates which give byproducts for the bacteria to live on.

So more symbiosis, right?

Exactly, more symbiosis. But then as you pointed out, you go and take a broad spectrum antibiotic and guess what happens? It's scorched earth. You kill not only the bacteria that causing us an infection, but also the good guys like Tobacillus bifidobacterium And then when you do that, these are the policemen that keep Candida under control. When the police goes, guess what? Candida overgrow and start causing issues.

So is it a broad brushstroke that, okay, all Candida has the potential to be a bad guy, or it could be beneficial, depending on the amount, the concentration, and what's holding it in check. Is that a fair brushstroke?

I think. I think Candida in general, when you talk about brush, broad brush, you are talking about the genus, you know, like anything under different species. Under Candida, like, to me, there are top different Candida species that we are concerned about, especially in the gut. We have Candida albicans, Candida tropicalis, and Candida glabrata. These are the top ones that could be in the gut and cause issue. Okay? The others could be there, but even if they are there, they are not as pathogenic. In other words, they don't cause as much disease. They are not as resistant, okay? And that's where the difference. So I wouldn't say broad brush. All Candida are bad because some of them are. Are good, you know, and so these are the ones we need to focus on, the Albicans glabrata and tropicalis, as far as our gut is concerned.

So Candida is not necessarily a bad guy, but it needs boundaries and rules and oversight so that it doesn't become disruptive. It's like a toddler. Okay? So Candida is essentially a toddler in our gut. And it needs like clear lanes and boundaries so that it doesn't.

I like this. I really like this. The truth, you know, if you keep it under the control and listen like toddlers, don't give them too much sugar because you eat too much sugar. Guess what? Candida loves it. And that's why I tell people, please, let's cut refined sugar because you are going to encourage this bad character there, which is the Candida, because then it overgrowth and causes problem.

We were chatting about this in our practice because we were at a provider meeting and there was a. We got some samples of bars from. It's very clean, right? It's clean, but it had 10 or 11 grams of sugar in the bar. And I was like, you know what? That. That for me crosses a line. I don't. I try not to eat sugar just as a rule. So that's too much sugar. I don't. I'd rather eat an apple with 25 grams of sugar than eat a bar that has 11 and then it's just too sweet. I don't know, it's different. So we were talking about added sugar versus innate sugar from the food that was added to the bar. And I was like, I don't really care. It's all sugar, right? And it's not coming with the fiber and the. And the. The micronutrients that you're getting from the live food. So. So what qualifies as too much sugar? Is it just added sugar or is it. I mean, I've had patients. I had a patient who's eating two bags of mandarins a day, and I was like, that's a lot of sugar, man. You know that when you think about how much maybe too little mandarins is about 18 grams of sugar and you're eating a whole two bags, like 10 pounds. That was. I was like, we got to back this down. So how much is too much? And is everybody different? Or are there some. Some guideposts that we can look at?

No, I think really this is what you are pointing out is the truth. Like, you go and buy orange juice or you have, as you say, Mandarin, and there is so much loaded sugar, like 30 grams, 40 grams in juices. Also, the fruits have a lot of sugar. So what is the key to all this is moderation. Look, you need to have some. Just take a little bit. Like for me, for example, I take an apple a day, which, as you know, keeps the doctor away, as they say. You know, there is some sugar, but it is not really purified sugar. So refined sugar also, which is added to the bar, is different from the sugar, which could be complex carb, which could be beneficial as well. So it's moderation. And what type of sugar you are having is really the critical point.

Okay, so tell me if this language is accurate, because I say this to my patients and I'm like, oh, I need a gut check here. Gut check. I didn't mean to make a joke. Okay, so when I. When my patients say to me, I am craving sugar, I'm like, oh, you probably have Candida because it needs to eat, and it is going to cause you to crave what it needs to eat because it doesn't have control over its food. Is that an accurate way of thinking about Candida in the system?

You know, if you think about it like along these lines, if Candida is, as we said, the normal level, not too high, it's fine. But as Candida grows, guess what it does? It keeps the bacteria, which keeps it under control, like Lactobacillus, down. So, yes, if Candida is overgrowth, it Needs more sugar so that it can keep. Be the dominant factor. It's as you say, the weed in the garden, okay. Instead of having it at low level, where the good guys, you know, the beneficial probiotic strains can take care of it. So definitely when you have an imbalance or dysbiosis in your microbiome, you are going to be affected to what you like to eat, what they not to. Yes, this is a really good way of thinking about it.

Okay, so. So it sounds like the ability to have a healthy level of microbiome and yeast. Microbiome and yeast depends on the health of the microbiome, that they're almost inextricably linked because these guys will keep these guys. I mean, this is essentially a bully, right? The microbiome is going to be a domineering toddler bully who hasn't slept.

And really, look, what you said at the beginning, the fact, like a garden, okay, the garden, now we are going into spring. We want the roses, we need the lovely flowers. So you need to give them fertilizers. You need to feed these good guys. At the same time, we need to keep the weeds, which is candida, one of them, E. Coli, for example, which is a bacteria, or serratium or which is a bacteria. We need to keep them down. Okay? So having this balance is really what helps us, not only in our gut, but also our other part of our body. So that's how I would like to have it. We strive to have a balanced diet. Microbiome, where we have good bacteria and good fungi, such as yeast, for example. Saccharomyces. Saccharomyces cervicia.

I was going to ask you about that. I'm so happy you brought that up.

No, you see, that's why people, when they think about fungus, a lot of people are afraid and this sort of thing. Look, there are good guys also in fungus. They help us, such as the Saccharomyces cervicia, as I mentioned.

Yeah. Okay. Do the fungi in our gut act the same way? And I don't know if you know the answer to this. Do they act the same way as. My kids are obsessed with mushrooms and we actually do go mushroom hunting and eat what we find. We come from. You know, my husband's Russian, and that's what they do. Like they go out and they actually pick mushrooms. I was brought up in Framingham. If we saw mushrooms, we just kicked them over. Like, we didn't eat them. We didn't go looking for them. So to the. The fungi in our Gut behave the same way as the fungi outside, where they have this amazing link of conn. That they can communicate with each other.

Oh, absolutely. Actually, we did studies where we showed that there is interaction between these organisms, not only between fungus. Fungus, but also between fungus and bacteria.

In one person or in one person.

In one person. It could be like in our gut if you have. We published a paper in Crohn's disease patients, and what we showed is that candida tropicalis, when it is in our gut, together with E. Coli and serratium are two bacteria. They come together and they form what we call biofilm. It's like the plaque in our teeth. And when they do that, guess what happens? They become resistant to antibiotics, they become resistant to our immune cells, and then they start to cause trouble to our gut lining, and that's where it could lead to leaky gut. So that's why it's very important we understand that these organisms in our gut and our skin as well, it's not like they are sitting there and they are each one in their own little house. They don't interact. No, it's a nice neighborhood, but we need to support this neighborhood where we have the good guys more than the bad guys so that you can enjoy it.

Okay, so we have potential bullies who then band together and make a gang with negative outcomes. I heard Candida tropicalis E. Coline. What was the third?

Serratia marcissens. Serratia. This is a pathogenic bacteria, you know.

Wow. Okay, so now we have a biofilm. So then the next question is, it seems like getting into that state might be an unconscious event, but once one has that event, where I think of it like they've magnetically put together and now there's a biofilm and they don't treat, I'm assuming they're causing dysfunction in the system.

Oh, yeah, yeah. You'll start to have some guest gastrointestinal symptoms, you know, issues. You start to have inflammation because remember, when you start, you increase the number of pathogenic microbes in your gut. Then our body want to respond to keep it under control. So you have inflammation, you start to have bloating, you start to have flatulence, abdominal pain, and sometimes diarrhea. So, yeah, not only they affect the structure of our gut, but they also start causing symptoms for us to tell us, you know, there is something wrong there. We need to take care of it.

So when that occurs, obviously. So I'm a huge fan of test. Don't guess. I love stool. My patients are probably not like, oh, yeah, give me a stool test. But when they do the stool test, the information is fantastic. So when you get the information that there's potentially this imbalance occurring, how do you then address it? Because they've made this, this resistance to antibiotics. So how do you break it up? What's the mechanism for that?

There are a couple of ways to do that. Number one, we again publish papers in mBio where we showed that we are able to break down this biofilm by using some probiotic strains and the enzyme amylase. These are good bacteria and good yeast, such as Saccharomyces boulardii, which is similar to Saccharomyces cerevisiae. They come together and then they break this plaque which is in our gut, digestive plaque. Once you break it, then clearly you are going to start to have less symptoms and then you need to support the beneficial ones. So you need to start eating the right diet. You need to start, I always say there is lifestyle options such as exercise. You have to exercise because all of this come together to help rebalance our, our gut. Okay, finally we really need to start thinking. You know, sometimes I have an upset stomach, you know, because I'm stressed, even though I'm eating great food. But you know what, I still don't feel well because I have imbalance in my microbiome, you know, so please do some meditation, do some yoga. So you really need to adjust this, as you can guess, have a holistic approach that includes using some good diet, reduce stress, have probiotic and enzyme in this regard to try to break down this biofilm. And then guess what? As you are eating the right food, you are encouraging the growth of the good guys, Bifidobacterium lactobacillus, which then can keep not only Candida and others under control, but also they help us by secreting some good metabolites, which are good small molecules compounds, okay, Such as short chain fatty acids. And these short chain fatty acids produced by these good guys, what they do, they help healing the gut lining and also they help our immune system. So you can see it's really a total approach.

It's really an ecosystem. I mean, it's fascinating. I'm just thinking about when the adrenal glands are under experiencing stress, like it's an on, off. Yes, a lion's going to eat me. And then the adrenals will say to the gut, like, okay guys, we really don't need to focus on digestion right now. Very interestingly, it's so interesting, I didn't think about the adrenal glands are in the body and the microbiome is outside the body, but truly symbiotic and getting signals from the adrenals and liver. But then more than that, if you're stressed, the good bacteria or even the regular bacteria are getting suppressed and the candida again are having a field day because they're not being inhibited by the other signals. Right. They're not dependent on the signals from the adrenals in the liver. They're like, yes, bring on stress. I'm happy.

Yes. You know why? Because this, you really brought us to a subject called gut brain access. So before we all the time think about, you know, the brain tell us everything. Now we know it is bidirectional communication. They talk together two way street so that if, if our gut is out of balance, it will affect our brain. But if we are stressed, guess what it affects also the production of serotonin, for example, which makes us happy. Okay, so it's two ways treat, which could affect each other. That's why, as people say, all things start in the gut. So if you balance your gut, you are going to have hopefully better mood, different neurotransmitters will be produced and you are going to be happier and less anxious.

They've shown this.

Sure.

Really, it's amazing. Dr. Kanum, thank you for being here. Where can people find out about you?

They can go biomehealth.com or we have a lot of information there. Also, I am professor at Case Western University and University Hospitals. If people like to reach out to me or through Biome, I'll be more than happy to help them in any way, shape or form.

Awesome. And we'll put all those links that you referenced in the show notes so people can just look at those. All right, y', all, thank you for joining us for another episode of the Feel Freaking Amazing podcast. My guest, our guest, even though my partner is not here, is Dr. Mahmoud Ghanum. He's an expert in the microbiome and is co founder of Biome Health. Thank you for being here. This, this. We said we would have fun and we had fun and this was great. So thank you very much for being here.

Thank you for having me.

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