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

Foreign. Hello and welcome to this episode of the Five Journeys Feel Freaking amazing podcast. Obviously I'm here alone today. 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 Ghanum. He is a microbiome scientist known for naming the microbiome Microbiome. Excuse me. 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. Kohnum, 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. All right, my first question is where do you hail from originally? Because you have a great accent.

I am originally from Beirut, Lebanon, the Mediterranean. And I've been in the US about 30 years and traveled all over the world. So I cannot get rid of my accent. But I think, I hope it is good.

Well, it's lovely to listen to so belatedly welcome to America, let's put it that way.

Way.

So how'd you, how'd you get interested in the microbiome first off, maybe tell people what's the microbiome? And then people, how did you get interested in it?

Sure. First of all, what is the microbiome? You know, mycology is the study of fungus. And that's why when we were talking about what fungi or fungus that grow in our gut, in our skin, I thought it would be good way to name the community Mycobiome. So it is the community of fungi that lives in our body.

Okay, so it's named the mycobiome. So how'd you get interested in the family of fungi and fungus? Was that just you woke up one day, you're like, I'm studying that.

Really? You know, this takes us back to over 40 years when I first went to England and then my summer project was, believe it or not, what's the effect of antibiotics and steroids on Candida? 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. So that's where I first met the fungus. And then after I finished my summer project, my mentor There they said, you know what? You should do your doctorate on this topic. So I was working with fungus for the last. Oh, my goodness, all my academic life.

Yeah.

You know, and then, you know what happened? It's interesting because as you said, just to relate it back to the microbiome or the microbiome, you know, when you, when a person takes an antibiotic, what happens, 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 really start. 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. Sorry, the. 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 I want to dive into that. Like, maybe it's not, 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 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, 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, so 60% of them. 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, in fact, it helps us. It's a good guy because it can break down some carbohydrates, which give byproducts for the bacteria to live on.

You know, 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 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, don't 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 overgrows and causes problems.

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 a. 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 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 two 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 guideposts that we can look at?

No, I think really this is what you are pointing out is the truth. 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, exactly what you said. I take an apple a day, you know, 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 is. 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.

You reminded me of something that I wanted to say and then I forgot, which is killing me. But let me go back to when we're talking about Candida. Are there strains of Candida? 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 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 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.

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. 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 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 cerevisia, 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 fungi in our gut behave the same way as the fungi outside, where they have this amazing link of connection 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. Okay. 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 they 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? Yeah, I haven't heard this one. I haven't heard of.

So, okay, this is a pathogenic bacteria.

Okay, 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. People will know, right? People think, oh, I'm not right?

Oh, yeah, yeah. You start have some 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 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 published papers, you know, in mBio, where we showed that we are able to break down this biofilm by using some probiotic strains and the enzyme amylase. You know, see, these are good bacteria and good yeast, such as Saccharomyces boulardi, 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 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. 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. 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, but truly symbiotic and getting, 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, they're not dependent on the signals from the adrenals in the liver. Right? 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 bi directional communication. They talk together, two way street. So 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, better, different neurotransmitters will be produced and you are going to be happier and less anxious.

I mean they've shown this.

Sure.

It's amazing. Okay, let's go back to prebiotics. Because I think people understand probiotics, right? Like lactobacillus strains. It's easy to think about when you think about prebiotics. I think there's often a lot of just lack of knowledge or unsurity or confusion even. So can you talk more about prebiotics? And I'm personally a huge fan of eat your way to health. That's actually a program we made called eat your way to health, because that's what you could do. So can you talk about prebiotics as a group and certainly a pill form, but also, what are the ways we know we're getting it in the way we're eating? If we say, okay, focus on these five to 10 foods, what would they be?

Okay, first of all, let's define what is prebiotic. Prebiotic is basically, as you said, it's food, okay? It's this food that can feed our good bacteria and our good yeast. And because when we feed them, as you, as we said, they will start doing good things to us. Keep the bad guys down, produce these small molecules, and they help us. So basically, the prebiotic, unlike the probiotic, which is live organisms, live bacteria and live fungus, these are food, food ingredients. And this includes fibers, for example. And in this regard, like I tell people, you know, the best thing to do is start to eat, like oatmeal, for example, eat lentils. It has a lot of fibers. You know, beans are also great. So this type of food, we as humans in the intestine, we don't break it down. Who breaks it down are these microorganisms that live in our gut. They are the ones that break it down. And by breaking it down, it really is helping us. So as we said, bananas, for example, towards the unripened side of bananas also is very good. You need to eat good proteins. Of course, this could come from chicken, from salmon, fish, for example, is fantastic. So all of this you need to take together, in addition to some, you know, herbs and some spices, Turmeric, for example, garlic, I love garlic. You know, and you laugh, you laugh at that because, you know, I'm from the Middle east and we eat Mediterranean food, you know, Mediterranean food, a lot of garlic, lemon, and guess what, the oil, you know, olive oil. It's fantastic. So all of this should give you an idea how we should really eat, I hope.

Okay, let me ask you something, because I talk on glyphosate and I know that glyphosate preferentially impacts actually E. Coli and beneficial bacteria in the gut. It's not Impacting salmonella and other pathologic strains. I was thinking about, you didn't mention artichokes. And I always think of artichokes as a really good source of prebiotic fibers, but it's very difficult to get them organic. They often come conventionally grown. So now I'm thinking, okay, I'm getting my prebiotic fiber, but I'm getting a dose of glyphosate if I'm eating that. So how do you advise people to navigate doing good for their body? But is the glyphosate negating the impact of the prebiotics because of the impact it has on the bacteria in the gut?

You know, this is really very, very interesting topic because now everybody talk about organic stuff and this sort of thing. I really understand and I think it's good. The problem is the availability of these products, the expense of it. They are very expensive. And also sometimes we are seeing even reports now about some organic. Even though they define them organic, they are not really organic. So you have to go back to the source, make sure what they are. So to me, look, it's very difficult to avoid all of these things by going toward organic. Having said that, we can use the regular, the regular, you know, vegetables, the regular stuff, as long as again, you are more mindful. Like if there is some, something locally grown, for example, you know, it's much better than who knows where it comes from, you know the source. So you need to be judicious in what you select. If you can afford it and you know it is good organic, yes, that's great to have. But look, as long as you are going towards more healthy type of plants, you know, asparagus, you know, the mushrooms, as you mentioned before, provided you don't pick it up if you don't know about it, all of these things will help you and to avoid the side effects that you may have because of preservatives and other other components.

I think this is a good place to put a plug in for your local community supported agriculture which has shares that you can buy and you get a box of vegetables every week and that's often organically leaning or regeneratively grown and is going to be good for the earth and good for you and local, which means it didn't have to travel. I live in Massachusetts, so a lot of our veggies come from California, which means it has to be shipped across the country, which means it has to be picked at a time before it's ripe and then it has to ripen on the way. So, you know, I think there's a lot of. There's a lot of ways to make an impact here. Tell me about banana skins. When someone just said to me that they actually take unripe bananas and throw the whole thing in their smoothie. And I was like, wait, I always peel my bananas, but should we be washing and then using the skin? Because that seems like it'll blend up.

You know, I really, I really, I personally, I'll go with unlipened banana. Like peel it and use the inside. I mean, a lot of the time people talk about even apples, the apples. The skin in the apple is really very good. Lemon, for example, if you, you know, I remember when I was a young kid, we used to have, you know, you have a lot of orange groves and lemon groves. We take it. But. And then we used to sort of get rid of the yellow part and then you can eat it. So, you know, there are ways you can eat the skin of stuff. I really did not experience the banana skin. I think I would go towards banana before it start to have these brown spots. Then you are going to have a lot of complex carbs there and you will get the benefit. And if you want to eat skin, listen, other fruits with the skin, such as, again, we go back into apple is really good idea. You know.

Got it. All right, so we've covered a lot here. Is there anything that we haven't talked about that would benefit the listeners when they're listening? And okay, we've talked about prebiotics, probiotics. Are there any other things to help people improve their gut? Because we've talked about minimizing complex carbs, espolardi, cervice, anything else?

I think I really, in addition to these approaches, I really encourage people to start doing some lifestyle changes as well. For example, you don't have to exercise so aggressively and so intense. Just half an hour, three times a week will be plenty. And then you can build it up. So exercise is very, very important. It's important to watch when you eat. Sometimes people say, okay, I'm eating all salad, for example, but the amount of salad is huge with everything and be moderate. Like when you go sometimes travel abroad in Europe and whatever you can be, the portion of meal is smaller, so try to cut it down a little bit. And I tell you, I personally, I'm eating and I love the food I'm eating and say, oh, I have to stop now. So you have to talk to yourself. In addition, I really think, again, stress is very important. So I Would go diet. If you need supplements, it's good to have some vitamins. For example, vitamin D3 in particular is very good because what it does, it reduces the proportion or the level of protobacteria, which is pro inflammatory, it causes inflammation. Also cut the sugar down. As I said, for Candida. For Candida, studies have shown that if you are deficient in vitamin B and C, then really you will be more likely to have some gastrointestinal issue because of that. So take your multivitamins as well. So all in all, if you look at it like this and oh, one last thing I always love to tell people to do is to eat nuts. You know, I love pistachio, for example. You laugh at me, look what I have here. This is my bag of nuts. So especially at 10 o', clock, 11 o' clock during the day, because I have breakfast early, I get hungry so I have some of these nuts. These have been shown to be great for your microbiome and will help you really balance the gut.

So, so it's so funny you talk about pistachios. I love pistachios and pistachios and peanuts are really high in mold levels. So what do you tell people who are trying to balance their microbiome with their hunger? You know, I always say to people, you know, peanut butter is like my least favorite snack because it's so moldy and it's often very sugary. So what do you tell people? Like, what's the girl to do?

You know what I do? Usually I buy. Of course you have to look because you worry about mold and fungus. You know, as long as look, you can see all the time. I say look at the product, get it fresh and if you store it a lot of the time, sometimes we leave it in the cupboard for the, you know, weeks. And you say, oh, I have not. That's not a good idea. Try to eat small, get small portions, you eat and finish it quickly. And also make sure it is not highly salted. You know, I, I try to get it not salted or even lightly salted is fine, but the benefit of them is really very, very huge, provided you watch. I mean, especially you, you hit a subject which, you know, I, I like, I, I can't tell myself I'm a fungi. So I love fungus, you know.

Right.

But, but with fungus, like when you are having fruits, for example, we all buy fruits and you see sometimes there is a little bit of fungus growing, so people come and cut the piece and say, no, if you see a fruit with A little bit of fungus, just throw it away. The same with respect to the nuts and this sort of thing. Because even though you don't see it in the other parts, it could have already penetrated. Okay. So, you know, just try to get fresh. Fresh stuff. Watch it, don't have it forever and come back. And I know some people, sometimes it's like me, I remember my mom telling me, you have to eat everything. You know, you have to finish everything. And sometimes say, no, no, I don't have to finish everything. Also because it's been in the cupboard for long. Don't have it. It's not worth it. Try to get smaller portion. Buy smaller portions so that you eat them, and then when you need more, you can get more.

Yeah, I'm a huge. I'm very. What's the word? Vigilant around rancid foods. I have a particular nose for them. So they'll cut. The kids will come to me like, is this good? I'm like, oh, my God, no, don't eat that because the oil is rancid. And that's even worse for you.

Yeah.

So let's talk about supplements a little bit, because I know you. You co founded Biome, which is a supplement company. So tell me about the supplements that you have and how. How they've made a difference and what. What are you focusing on?

Yeah, what we did, we started to think of supplements when we did our study in Crohn's disease patients. And we found that there is the imbalance in Candida as well as the bacteria, you know? So my son Hafeev, he told me, dad, we have to start a company because so many people are contacting you to ask you, what do we do? What do we do? Especially when they realize we are talking about fungus as well. So we started a company called, as you said, Biome Health. And in it, we really designed a probiotic. Our first product. Designed a probiotic so that it can keep bacteria and fungus under control. So we did what you call correlation analysis. And we found which microorganisms good guys can keep the bad guys down. And we came out with four different probiotic strains. And we tested them, and remember I told you that when they form biofilm, so we tested them against can they break down this biofilm or the plaque? And lo and behold, they were able to do it. And we added an enzyme, amylase, which have been shown to do that as well. And the good news is, when you come with a formulation, then you need to validate it. Really? Do you have scientific Support. So we did what you call preclinical in vitro stuff in the test tube and we showed, we break biofilm, then we did in animal models to make sure that they really do it in humans. Because sometimes when you do a test in the test tube, it may give you good results, but you are not sure. But really, most importantly, we did two clinical trials which we showed we are able to reduce these organisms and reduce Candida in particular, you know, and that's one study. In the other study, we looked at the gut symptoms and we really reduce bloating, flatulence, abdominal discomfort, you know, as a primary endpoint. So we were very happy with that data and we are now, you know, we have that probiotic Biome effects in the market. And there are other products which we have remembered, we talked about we need to have the right minerals, we need to have the right vitamins. So we have also different products. So to answer your question, really, Biome is a science based company. When we want to come out with a product, we need to validate it. We need to show the data that it works and then everybody is happy. You know, I am a professor and I all the time in my life I help other companies develop their drugs and you know, you have to have evidence. Sometimes it's so funny, you know, some companies you don't, you know, you do a test and it doesn't work. You say, look, I'm sorry, it doesn't work, you know, and of course they got upset. But what can you do? We need scientific, that's the fact, you know, And I'm sorry, I know, I love that the product could have worked, but if it doesn't work, it doesn't work. So that's where you have a science based company that can develop nutritional supplements based on the evidence. And that's what Biome does best. In addition, we started a gut testing where people send us stool sample. We look at not only bacteria but also at the fungus. And we look at, is your gut imbalanced? If you are imbalanced, we say that's great. We have nutritionists that can basically help you recommend what it is, they guide you. And really, if you are imbalanced, that's great, keep going what you are doing. If not, we look at, okay, what sort of things based on your questionnaire, okay, cut the sugar, do a little bit exercise, stress, the things which we talked about. And really this is what is allowing us to collect so much data. And now we are using this data to come out of the new product. It's really exciting time.

It's really cool. So I know what something that my patients ask me a lot, which is, do I have to stay on this forever? Because. And I'm. I'm always like, well, if it. I can argue it both ways, right? If you're low in something, that indicates that you should just be taking it. And then there are some things that I think is an opinion. This is my opinion. So this is not fact. This is opinion that things like fish oil and vitamin D are staples for people that, especially in the Northeast, where we're not getting the sun and then we're putting on sunscreen, we're not getting the vitamin D that we need, and that those are staples, like take them and maybe a B, B complex. But do you need to take this forever? Do you take it until you feel better and then you stop? Or is it. Is it like a detox? We do it once a quarter. How does it work?

This is really very, very good question. Thank you for asking it to me. When we, when we talk about nutritional supplement, it's supplementary situation, we are trying to improve. But really once you have your gut symptoms back to normal, you feel good and this sort of thing, I don't think you need to continue to do it. But if you take antibiotic, for example, you know, you are killing the good guys. So this is a good time to take it after you finish your probiotic. But then to me, the most important thing is try to have the right diet after that. The diet, the exercise, the lifestyle, once you have this, then you don't have to do it. So to me, I don't think we should use it forever. But you need to take it when you need it. And when you are in good balance, try to, you know, to. You don't have to take it, but then you can come back to it if you feel, you know what, I need a little bit of support. You know, I'm down, I'm stressed a little bit, I need to do this. So that's the way I look at it.

I think that's the biggest challenge is because when someone gets to a point of a diagnosis where, okay, I've got this. I've got this trifecta of terrible bacteria that have made the, made the biofilm. And you treat that, you still have the underlying issues that led to the problem. So it's really important, like fix the way you're eating because that led to the problem. Manage your stress because that led to the problem. Ensure you sleep and move your body because those Led to the. So. So you can't. And I always say to people like the best supplements in the world are not going to fix a terrible lifestyle. You know, maybe it'll help a little bit, but you have to fix the way that you've created the problem. And that's not to blame you. It's just the way you live contributes to how you feel.

I really. You put it beautifully. Honestly, like this is what it is. Look, we are all responsible for our health, okay? We need to adjust it. But again, it's in our hand. If I'm not eating well, like I personally, even though I come from eating Mediterranean diet, I changed my diet now and towards to get like I adding more nuts even though I used to eat some before, but now I have it more regular. I do more, I do exercise more, you know, so you are absolutely right. Sometimes we need to take responsibility ourselves. Say, okay, look, you know what? I am using this supplement. It's helping me. Let me change a little bit. And you don't have to have drastic change slowly. Take your time, you know, and then you will be successful and you are going to be healthy.

I hope we're totally on the same page. I love this. I should have someone on who I totally disagree with to see how I can get the common ground. Is there anything. I didn't ask you that you want to make sure that we tell people? Is there anything missing from what we talked about?

I think honestly you did a great job in the question and I think we answered. But to me, to finish, I am an optimistic person. I think we are coming into a great time always where we are starting to understand more and more about our gut health. And I think this is great because if we take care of this, guess what? We are going to have a better life and we prevent a lot of diseases down the line. I hope so. It's exciting times and I am an optimistic person. And just take care of yourself and you'll be great. Good.

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 mycobiome 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 and I'm sure our paths will cross in the future. Thank you.

I hope so. Have a great day.

You too.

Thank you for having me.

It.