Heal the Gut-Brain Connection, with Dr. Will Cole

It's easier and more prescriptive for me to say, focus on these foods. They've been shown to support detox. Don't have these. It's more linear. It is more complex and big to unpack to things like, okay, don't have shame, don't have stress, don't have unresolved trauma. You just can't drop that like a cupcake.

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I'm Dr. Ed Levitan. Welcome to the Five Journeys podcast where.

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Welcome to this episode of the Five Journeys podcast. I'm Dr. Wendy Trubo. Ed Levitan can't be here today, so I'm soloing for one of the first times. Our guest is Dr. Will Cole. He's the New York Times best selling author of Intuitive Fasting Ketoterian the Inflammation Spectrum in the brand new book Gut Feelings Healing the shame Fueled relationship between what you eat and how you feel. He's a leading functional medicine expert dealing with thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, brain problems, and more. Will, welcome to the show. I'm so psyched to be interviewing today. I know Ed's really bummed he couldn't be here.

I know. I'll try not to take it personally he's not here, but I'm glad you're here.

Not personal. He's double booked with patients and we try never to cancel them. So here we are.

Yeah, I'm the same way with patients. They come first.

Patients, patients take over everything. So can you talk to the listeners who may not be as familiar with the gut brain connection and why it's important?

Yeah, sure. So the gut and brain are formed, and when I say gut, I mean the stomach, the large intestines, and the small intestines. So it's the gut and brain are formed from that same fetal tissue. And so when babies are growing in their mother's womb, the gut and brain are formed from that same fetal tissue and they are inextricably linked for the rest of our life through what's known as the gut brain axis, or the connection between the gut and the brain. There's many reasons why. That's one of the reasons why the gut is known in the scientific literature as the second brain. If you Think about it, even physically, the intestines even resemble the brain somewhat. 95% of serotonin is made in the gut or happy neurotransmitter. 50% of dopamine, or pleasure neurotransmitter, is made in the gut. So there are many reasons why the gut's known as the second brain. And these neurotransmitters that are made and produced in the gut work upon the vagus nerve. The vagus nerve is the largest cranial nerve in the body. It gets its name, translates from the root word, which translates as wandering. It's this wandering cranial nerve that impacts our audit. Aspect of our autonomic nervous system is the aspect of the parasympathetic, the resting digesting that is gut hormone balanced nervous system regulated state. Because most people in the west are in varying degrees of nervous system dysregulation. And what's happening is there's dysfunction or suboptimal function of the neuroimmuno endocrine axis, the intersection between our nervous system, our immune system, that is chronic inflammation, and our endocrine system, that is hormones. So it's really, that's what's going on. The vagus nerve is a major part of that and it's a major connection between the gut and the brain. But there's, there's far reaching implications even beyond that. I mean, if you, even if you look at the microbiome, which is technically separate, right from our own, it's its own separate entity that lives within us and are on us, on our skin. But we have our gut microbiome, the skin microbiome, which, that influences a lot of these neurotransmitters that the metabolites, these bacteria produce actually work upon the vagus nerve in this crosstalk between the gut and the brain. So, and they are also, we know from studies that I talk about in gut feelings that these certain colonies of bacteria, depending on different bacterial overgrowths or deficiencies of beneficial bacteria, are associated with things like anxiety and depression and fatigue and other neurological issues. So there are many connections between the gut and its influence on the brain and vice versa.

You just said like a year's worth of unpacking here, Will.

Right. It's hard to boil it down, right?

Yeah, well, you did boil it down, but then there's a ton in this, right? You've touched on the microbiome, you've touched on the, you call the gut the second brain. I know that's what it's called in literature, but I really Feel like it's the first brain and we just think of this as the first brain. But the gut really runs the show. And then you've talked about the vagus nerve and all of the things that influence our mood. And when you talk about shame formation, are you talking about essentially internalizing the shoulds? But when we're not doing, you know, I, I should, I, I always joke with my patients that this is like the confessional booth except there's no, there's no penance involved with me. Right. You're never in trouble and I'm not going to yell at you but like, bless me doctor, I didn't do what I should. I'm like, oh my God, there's a lot to unpack here. Like we don't use the word should in my practice because it's to me, should is, is just a shame inviting word. Like you didn't do what you should. Shame on you. Right. So, so how do people untangle that?

Yeah, it's, it's, it's unpacking, it's starting to relearn what wellness looks like, what foods look like, how do you use, what's your relationship with food and wellness in your body? It's a healing process and healing your relationship with food just as is you're using food to heal your body and that takes time and it certainly is non linear. But yeah, shameflammation is my made up word concept about the research of the mind body connection and the research of chronic stress and its impact on physical health. The research on shame and its impact on physical health and the things that cause shame like unresolved trauma and chronic stress and body shame and food shame, like orthorexia, like disordered eating around healthy foods, all of these things are part of that shame inflammation spiral that many people can find themselves in. That is shame and inflammation. The impact that shame and other emotions like that will impact our biochemistry because our body is a cellular library and our thoughts and our words, our emotions, our experiences will influence our biochemistry just as much as a food that doesn't love us back. So it's really these things and how do start there, it's these, what I call in the book, metaphysical meals. It's not just about what you're feeding your body with breakfast, lunch and dinner, but what are you serving your head and your heart. Like how can you really look at from even from a mindful eating standpoint, like starting with intentionally being focused and taking in your meals, not be on your phone scrolling, not be standing running around, do Everything you can to be supportive of that parasympathetic grounded present moment awareness, eating, to be congruent with the parasympathetic while you're eating. And then it's beyond that. I talk about the science around breathwork and around somatic practices and therapies like EMDR and these things that are really very supportive at metabolizing stored trauma and stress and shame that impact things like inflammation and that neuroimmuno endocrine axis that I talked about earlier.

I want to go back to when you're talking about, I'm going to call it mindset, right? When you have a mindset that disempowers you and you behave inconsistently with that mindset, you create a state of inflammation and I'll call it dissonance or dysfunction. And what I'd love to draw the line between is because I think because our listeners are really into detox. And so when you think about you're creating a state of stress and a state of a state of dysfunction that trickles down into what happens in your liver and what happens in your gut. Because if you're in a state of fight, flight or freeze, which is essentially a state of stress, you're not going to detox and you're not going to poop properly and the microbiome is thrown off and then your toxins are all a mess because you're wondering like, why am I such a mess? Why am I gaining weight? Why am I losing hair? Why aren't I sleeping? Well, some of it tracks back to the thoughts you're having serve as their own source of stress. And the beliefs you hold can serve as your own source of stress and toxins. They serve as a toxin unto themselves.

Yeah, absolutely. And when the body's in that dysregulated state, when that neuroimmuno endocrine axis is dysregulated and in a hypervigilant state that is absolutely, like you said, it's a. It's the antithesis of the body congruently supportive of these detoxification pathways. So everything's going to be more sluggish, everything's going to be impaired or has a potential to be impaired. And you will see that reflected on labs. You'll see that reflected on different inflammation markers. Many times you will see impacted in some people, higher liver enzymes and other signs of detoxification impairments. So it's absolutely you. If somebody's interested in detoxification, there's a whole section on detox in gut feelings because of that, when your body is in that hyper vigilant state, it's really going to impair any quote unquote detox export, supporting detox in a positive way because the body is in, not in an optimal state. Everything's going to be more impaired and sluggish. So it is, it starts, but it's, it's a lot more, I understand these are complex things. It's easier and more prescriptive for me to say, all right, focus on these foods. They've been shown to support detox. Don't have these. It's more linear, it is more complex and big to unpack to things like, okay, don't have shame, don't have stress, don't have unresolved trauma. You just can't drop that like that. You can, you know, as a cupcake or something that's going to cause some that doesn't love you back so much. So you're going to have to really cultivate these practices, these metaphysical meals to start to nourish your body. Because just like you would want to eat a food that's been shown to support detoxification pathways or a certain herb or something in a nutritional standpoint, these practice metaphysical meals will support the proverbial metabolism or detoxification of stored trauma or stored thoughts that are living in your body that are impairing the physical detoxification. Because I see people that have all the food reactions you can think of, right? They have all these food sensitivities, all, all these food reactive reactions. They have the methylation impairments, they have all the things that they know physiologically that make them more hyper sensitive to certain things. And they know they don't detox very well. But when they start dealing with the head and the heart stuff, the feeling stuff, the methylation gene variants don't matter as much. The food sensitivities calm down, everything's a lot more congruent because they're emptying that proverbial bucket with things that are filling up that they have never dealt with. So it's very, very important to deal with the mental, emotional, spiritual stuff. So the physical stuff can happen more unimpededly.

Right? I mean the emotional pathways for detox absolutely impact the physical. Tell me something. You just were referencing the labs. Tell me more about someone who hasn't done the labs. What are they experiencing if they're in a state of dysautonomia or dysregulation? How will someone know without the labs if they're just sort of listening and they're like, oh, that's me. Can you describe who they are?

Sure. So if we're talking about a dysregulated neuroimmuno endocrine axis off of how you feel. Well, it can be. A lot of people explain it as feeling wired and tired, they're anxious and exhausted, they have fatigue a lot of times, you know, it'll be lumped in many people that have quote unquote adrenal fatigue, which is a brain based issue. It's the hypothalamic pituitary adrenal axis. That's the brain adrenal axis. That's a large part of that, that adrenal fatigue is part of that neuroimmuno endocrine axis dysfunction. Because it doesn't. It's not really an adrenal problem per se. It's not Addison's disease. It's a brain based issue that's impacting what cortisol is doing. Cortisol is not inherently bad. It's an endogenous immunosuppressant. It's a natural anti inflammatory. So typically inflammation levels are high. The body's trying to attenuate that inflammation. And like you said earlier, like there's physiological stressors and then psychological stressors. There's like underlying gut problems, nutrient deficiencies, chronic infections. We see a lot of mold toxicity and environmental toxins like glyphosate. That's going to stress the body out just as much as like a stressful work event or like a toxic relationship or unhealthy boundaries with people. Both the physiological and psychological impact, how they feel anyways. So they feel wired and tired, anxious, exhausted. They can have things like brain fog, fatigue, digestive issues, IBS C and D could be sluggish, GI motility, lucifer stools or vacillating between the two, uncomfortable bloating that can happen throughout the day. A lot of times they will have dysbiosis or sibo, small intestinal bacterial overgrowth because there's a decrease of the migrating motor complex that mmc the gut brain communication where the gut, the nervous system is not innervated appropriately. So you have suboptimal communication between the gut and the brain. So the bacterial overgrowth. And just like people can have SIFO or small intestinal fungal overgrowth where you'll find this even without labs, they will have symptoms like bloating, ibs, food sensitivities, these type of issues. Food sensitivities like histamine intolerance is something that I see a lot Clinically too, with these cases. And skin flare ups can happen for some people, but it exists on a spectrum. Dysautonomia is the end part of that, where they're perpetually stuck in a hyper vigilant state. And that's associated with certain autoimmune issues. Chronic fatigue syndrome, fibromyalgia, panic disorders, anxiety disorders, things like that, but that there's everything in between. Sometimes that they're not diagnosable, but they're feeling that background anxiety, that digestive problem, bloating, uncomfortable, things like that. So those are some telltale signs that something the body's telling you something. There's a check engine light that we want to see what it is. And there's a lot of possibilities what are the pieces to that health puzzle. But those are some signs that your nervous system is not optimal.

Yeah, I love how you were talking about this because the thing that I'm present to as you're talking about is that the body will let you know that there's something to look at and if you ignore it, it's going to get louder. Right. So it's almost for me, not even like check engine light or not because essentially when the, by the time the check engine light comes on, we really have a problem. It's the clunk that you ignored. It's really what's happening before you get to crisis state. Then I'm really interested in altering the trajectory of that so that people, I mean I wound up with an autoimm disease. I never, I say to people like on my watch, you should not be getting an autoimmune disease. We should be reversing your autoimmune disease, not developing. So I'm always interested in how do you, how do you recognize that moment before it's what I'll call bad enough. You know, how does it get bad enough before it's bad enough and you're really debilitated. And I'm always curious about that. And I think it sounds like a lot of the shameflammation comes from our past. Yes. Like the way we were brought up, the modeling we had, the experiences we had. So how do you start breaking that open and altering the future and changing the narrative? Where does that come from?

Well, and it's going to be a bit of both for some, for many people it's the past trauma, it's the current stress all contributing to that shameful amation. For some people it is predominantly in the past where you'll talk to them and they'll say these are things that people would say. They'll say to me, well, my life is great. Like, there's nothing wrong with my life now. I just know I have a great relationship. I have great friends and family. My job isn't stressful, but I feel like this anxiety. I feel this dread, I feel this fatigue. And I don't know why I'm feeling anxiety. I have nothing to be anxious about. Those people, there's physiological issues going on certainly that need to be addressed. It could be mold toxins that are causing these symptoms. It could be chronic Lyme for some people. It could be underlying gut problems. It could be environmental toxins that are contributing to that. But part of that potential is not just the physiological stressors. It's the psychological stressors from their past that's playing out in their life today as if it's still going on.

Right. It's not actually the past. Right. It's. It's present.

Yeah. It's present in their bodies. Yeah, exactly. It's. It's replaying. Yeah. So one of the things we look at in functional medicine, as, you know, but for people that are. That are new to our approach, is we look at adverse childhood events or experiences when we measure what's called an ACE score. And we're talking about things like, was there physical abuse growing up? Was there psychological verbal abuse growing up? Was there sexual abuse growing up? Was there substance abuse in the home growing up? And the researchers show. The research shows that the higher the ACE score, you're more likely to have different autoimmune problems, metabolic issues, trouble losing weight, chronic fatigue syndrome, hypervigilant nervous system, things like anxiety and depression later on in life. So it's not the only ingredient. There could be. It could be the mold toxins that set over the edge, or it could be the. The virus that set it over the ed. But oftentimes there's. Contributing to that bucket overflow are these mental, emotional, spiritual things that haven't been resolved or unresolved trauma. So, and many people will say, well, they'll almost like gaslight themselves and say, well, it wasn't that bad. Or they'll look at somebody that, like, went through something worse and they'll say, well, they're fine. So therefore, like, it can't be that bad. And that's what they're talking to themselves about these things, and they're gaslighting themselves. But the research shows it's not the experience by itself. But what is your bio individual? How did your body receive that experience, that trauma? So it's it's, it is so bio individual as far as like what's considered a trauma, right. This is an experience that's impacting your body today on, even on a cellular mitochondrial level. You may not even know it. That practices and therapies like breath work and somatic practices in EMDR I've seen be tremendous. And people think yeah, my A score, they're score was relatively not even that high. But it wasn't until they started doing these practices that really are vagal nerve exercises. Right. They are vagal nerve strengtheners that the feeling side of gut feelings, they really move them past that plateau where they were stuck at on their healing journey. So that's what you do. You do things that are strengthening the parasympathetic. Now nutrition supporting gut health, supporting detox pathways are all supportive of the parasympathetic certainly. But the feeling side needs to be dealt with. And it's something that is not linear. It's a little bit more nebulous in the sense of, you know, it seems like woo woo, like you tell me to breathe and like do meditation. But these practices are very good on a quite a physiological level to tone that vagus nerve to allow the nervous system to be more regulated. So the sympathetic, the fight or flight stress state is not so overactive. You can start to strengthen that weak part of your nervous system. The parasympathetic.

Well, it's all about retraining. I think when you think about, I don't, I don't know if the listeners know, okay. If you're in fight, flight or freeze sympathetic, you're going to be running from a lion. Guess what? You're not digesting, you're not detoxing, you are not sleeping. So when you breathe out longer than in, when you do EMDR tapping, when you're doing things that are essentially cutting the trauma lines, you're increasing parasympathetic which does increase rest, relaxation, digestion, absorption, detox. And so you, I always think of it like am I tipping the scales towards sympathetic or parasympathetic? And if you know me personally, you know that I run a mile, mile a minute. And so I always have to work on, you know, quieting that down and increasing the parasympathetic because that's where the magic is. So talk to me about ketamine. Do you, do you have patients on it? Do you recommend it? Do do it. My partner Ed, who's not here two weeks ago came back from a ketamine conference and did ketamine and had an amazing experience. And now it's like now we're going to start it up in our practice.

Yeah. I mean there's so much evolving. I talk about psychedelics in the book and the research around it of it really metabolizing these stored things in the body and working upon the nervous system, working on inflammation in many ways the pathways are, you know, we don't even fully understand the pathways and how it's metabolizing, but we know the outcomes and we see the dramatic improvements in so many people. So yeah, it's a tool within many of our patients. Toolbox. Not all of them. And it doesn't have to be, you know, ketamine assisted psychotherapy therapy. It could be microdosing for some people and stacking like pairing microdosing with other nutrients that are supportive like neurotropics and adaptogens for example, and really supportive of that hypothalamic, pituitary, endocrine axis and nervous system regulation between the parasympathetic and sympathetic. So yeah, it is the ketamine is one of those ones that, that because it's an anesthesia, it doesn't work for everybody just like any psychedelic. Like it's not a magic cure all for everything and should be done with. The doctor should be assisted. You should be a good candidate for it. So I wouldn't recommend going and picking up some random psychedelics. Some shirts.

Please don't do that.

No, no, no.

You need to be supervised.

Supervised with the doctor that's trained in this. So look at MAPS as a great resource as far as the research of psychedelic psychedelics. Dr. Will sue is another amazing psychiatrist that's doing a lot of research in this space and he facilitates ketamine clinically and is a part of MAPS in the research too, beyond ketamine, but psilocybin as well.

Yep. I want to pivot to something. You have a 21 day gut feeling plan. What is that designed to do for people? What would people expect to get out of that?

So it's a introduction, it's a leaning into. It's a game plan to. To experiment with that vagal nerve toning that every day. There's a gut and a feelings tool. There's a physiological and a mental emotional, spiritual tool to serve that strengthen that weak hypo function of hypotonic action of the vagus nerve. The fact that they have, if they have poor vagal tone, how do we strengthen it? Well, on a physiological. We can talk about supporting gut health and we talk about Things like the GAPS protocol. In one day we talk about the gut and psychology syndrome or gut and physiology syndrome depending on how we're using it clinically. But it's using things like soups and stews to be nourishing to the gut, to allow the gut to. It's like a proverbial siesta for your gut so your gut can be less taxed and stressed. The vagus nerve can start being supported and on a feelings it could be a breath work for a day or the next day. I talk about the research of forest bathing of Shinran Yoku, the research out of Japan and South Korea of using nature as a medicine and meditation to support the vagus nerve and support that neuroimmuno endocrine axis. Or another day could be, it could be breathwork. I mentioned meditation, just different meditation practices. In breath work I talk about holotropic breath work. We talked about psychedelics earlier. The holotropic breath work, man, it's born out of psychedelic research of a way to tap into the same parts of the brain that the psych psychedelics seem to be working upon. The holotropic breath work has similar mechanisms of action as far as having these psychedelic experiences and allowing the body to clear things out and clear out these toxic thoughts, these toxic experiences that live in our body. So that's an interesting section of the book. Is holotropic breath work a kind of psychedelic breath if you will. And then I talk about this, the research out of Japan of Ruikatsu, which translates as tear seeking. It's of cathartic crying and releasing and allowing tears and the opiate releases that are released endogenously when you cry and allow stored stress and trauma to be leaving your body through crying. There's so many free, accessible, interesting science backed ways to support vagal nerve tone and that's what each day, each day you get to experiment with something new.

I think that's fantastic. Well, so the first comment I'll have is people should go get the book Gut Feelings Healing the shame infused relationship between what you ate and what you feel, how you feel. Is that on Amazon? Is that at Barnes and Noble? Where can people get that?

Yeah, all the, all the places. Amazon, Barnes and Noble, Target, independent bookstores, all the places. Yeah, but the links are@drwillcool.com too.

Perfect. That was my next question is where can people find you and how can they engage with you and participate? What's your favorite venues?

Yeah, everything's@drwillcool.com, the links to the Telehealth center are there. I have a podcast called the Art of Being well that is a new episode every week. I'd love to have you on. I can't wait for you to come on. Yeah. So and everything's, everything's there. I'm on social media. I'm on probably Instagram the most at Dr. Will Cole but Facebook, Twitter, TikTok, trying to talk out all the places.

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