Episode 204: How The Microbiome Impacts Your health, Immune System, and Thyroid Physiology

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Eric Balcavage (00:23):
Hey everybody, it's Dr Eric Balcavage, we're
back for another edition of theThyroid Answers Podcast and with
me is Kara Seidman. She is aregistered dietitian and she's
Certified Diabetes Care andEducation Specialist. She'll

(00:44):
tell us what the heck thatmeans, but one of the things
that she is really into and veryknowledgeable about is the
microbiome. And we're going toget into a discussion of the
microbiome. We'll kind of talkabout how this relates to our
overall health physiology, andof course, we'll talk about the
impact on thyroid physiology. SoKara, welcome to the thyroid

(01:04):
Answers podcast.

Kara Siedman (01:05):
Yeah. Thank you so much for having me.

Kara, I gotta be honest to the audience, this is
not our first conversationtogether, is it?

No, we're old friends.

So just so everybody knows, we had a
fantastic conversation about aweek ago, loaded with fantastic
content, and then when wefinished, somebody didn't have
the record button on, that wouldbe me, and so we are back. We're
going to have her back again. Ipromise. We'll do just as good

(01:40):
of a job as we did the firsttime, but yeah, we had a
fantastic conversation, andthere was no way I was going to
let this conversation gounheard. So Kara, welcome back.
Can you just give everybody anidea who the heck Kara is and
why we should listen to her.

I love that question. So yeah, you said I'm
a registered dietitian, and beenpracticing and in this space for
over 15 years now, and camethrough very conventionally. You
know, I, as most dietitians do,worked in the hospital and, you
know, really kind of fed my lovefor just medicine and healthcare
and acute care. But of course,that translated, I've always

(02:17):
been, into more natural medicinetranslated into more counseling.
Really wanted to help peoplewith more long term
sustainability, and found myselfworking in various demographics.
I started a diabetes program,and then made my way to Colorado
and got connected with a verylarge gastroenterology practice
that, you know, very allopathic,conventional scoping. And kind

(02:38):
of didn't know what dietitianswould do. And here I come, and
sort of started this functional,Integrative Nutrition Program
for them, and was with them foralmost eight years. And that's
really what I think.
I've always had this interest inthe microbiome. I'm a food
fermenter. Got into that veryearly on in my college days, but
just sort of fed my love forworking within the GI tract, the

(02:59):
world within which is ourmicrobes, and we know that this
has such a valuable impact andsuch an incredible impact on our
overall health. And so I used totell the doctors I worked with,
you know, you guys know the GItract, and then I work with the
bugs within. And so it was anice relationship, and that kind
of propelled me into themicrobiome space, working for
various companies, biotechcompanies, and really just my

(03:22):
love for science, and sciencespecifically related to the
microbiome, which is such anevolving field and continues to

So why did they hire you for the first I mean,
because if you have atraditional gastro office, how
often are they going, huh? Maybewe should be working with this
person's nutrition.

It's a great question. One that I asked them
in my interviews. They, I reallyso they were, you know, as a
privately owned practice withmultiple offices, and, you know,
kind of on the business side,wanted to bring everything in
house, but I think they reallyonly wanted me for educating on
celiac disease and a gluten freediet. And lo and behold, here I

(04:09):
come, you know, being like,well, I can do so much more. So
I put in a lot of education. Iwould sit with all the doctors.
I would do weekly, monthlyeducation sessions on what we
can do as dietitians, beyondeven just the nutrition space,
but what we can do to helppatients not just feel better,
but can even overcome some ofthe things that they were
dealing with. And so it took awhile, I would say. It took a

(04:30):
good year of not just workingwith patients, but really
building that trust. And then itit really grew. I had, you know,
four other dietitians that Itrained and mentored, bringing
in supplements and integrativetherapies, bringing in other
sort of functional lab testing.I still don't think they really
knew all that we did, but thepatients were feeling better,

(04:51):
and people were, you know,gaining back so much of their
quality of life that they werelike, Okay, this is working.

So did they understand? And especially from
a functional medicineperspective, when we look at gi
testing, they're looking atpathology, right? What am I?
What do I have to cut out? Whatdo I have to medicate? Versus in
functional medicine, we're oftenlooking at, is there dysfunction
in here first, right? And we maysee somebody who come, they may

(05:21):
see somebody who comes in withgas, bloating, constipation,
diarrhea. They do theirendoscopy, the colonoscopy, they
do their testing, and they go,there's no pathology here.

Yep, structurally, biochemically, you're okay,
right?

They may even know there's some erythema and
inflammation, but essentiallynormal, right? So how open to
they? Were they to this ideathat maybe there is that the
disease is coming from longerterm altered function or
dysfunction, long before thepathology actually shows up.

(05:59):
Were they real open to that, ordid that take some work?

Some were and understood that process. But I
think there's a big differencebetween a gastroenterologist
that's looking at structuralissues right looking at things
that you can see. And that's whyI love the relationship everyone
coming to me I knew they didn'thave, or they did have, you
know, IBD or celiac. You know,we got a lot of that
differential diagnosis ruledout. And then I think, you know,

(06:25):
there's definitely a disconnect,I think, between the sort of
conventional gastroenterologyworld and then the microbiome
space. And I think we're gonnasoon see that you're gonna have
gastroenterologists and you'regonna have microbiome doctors,
because they are very different.So I do, I think there was a
disconnect. I think wheneducating on the research, there
were people who are, you know,especially some of the
physicians that were comingaround to, yes, there's

(06:47):
something happening that'sdriving this. And even more so
these sort of traditional,conventional organizations like
the Rome Foundation, haveredefined the term functional gi
disorders and have even renamedthem to disorders of gut, brain
interaction. So this, I thinkthe conventional sort of
allopathic world lags behind thesort of functional space. You

(07:09):
know, the functional,integrative space of has always
looked beyond just the systemthat's being impacted, but we
still have a long way to go, andI think that's why we have
various practitioners. It was awonderful relationship and being
able to make sure that some ofthese biggies and the big things
were ruled out. But thenpatients that would come to me,

(07:29):
my clients, would come to me,and they're disappointed. I
mean, that was one of the mostinteresting things working in
the GI space, is how upsetpatients were that they didn't
have a diagnosis. I just saw apatient the other day that said
that to me, I'm frustrated andupset that I'm I was almost
hoping for something to show up.I mean, that's so twisted,
right, like that, they want adiagnosis. And I think that

(07:49):
that's really leaning into whatwe do in the integrative and
functional space, and where sortof the microbiome space has
taken us, and that, no, there isactually something wrong. We
just can't see it to the nakedeye, but there is something
there, and we understand

that, yeah, I think it's because we all grew
up watching TV, right? And sobecause we all grew up watching
TV and commercials, we feel thatwe need a diagnosis to treat
right? And if you don't have adiagnosis, then insurance
doesn't cover it. There'snothing wrong with you, but it's

(08:22):
different from a functionalmedicine standpoint. I mean, you
often hear people saying, from afunctional medicine space, we
don't diagnose, right? Thereality is, everybody diagnosis
to some degree, right? We'resaying, Hey, you have low
stomach acid, yep, but the butit's a, it's it is a, it is a
different model, typically froma functional perspective, from

(08:44):
what they're doing, but

I like to say it's integrated, right? Like, yeah,
we're looking at how each systemimpacts other systems, and
that's what I love about themicrobiome. You know, I work for
a company that's really workingin microbiome research. We call
it the gut x axis, in this sortof understanding of at the
foundational level, how are eachof these systems, and
specifically the microbiome, buthow are each of these systems

(09:11):
impacting beyond and I think asintegrative functional
practitioners, we're looking atthe entire system. We're not
just looking at the heart, thelungs, the liver, right? And I
think that that's an importantpiece, because we all, we know
everything is interconnected.And I often think of the
microbiome kind of as that hub,as that foundation. Yeah,

let's talk about what the microbiome is, because
some people may not knowactually what you're even
talking about when you're sayingthe microbiome. What is the
microbiome?

So we'll often hear two different terms,
microbiota and microbiome, andthese are often used
interchangeably, but there aresome subtle differences. So I'll
first say the microbiota, thisrefers to the collection of
microorganisms, from bacteria tofungi to viruses, that all live
within a specific environment.So we'll think of microbiota
that live. Are on the skinmicrobiota that live within the

(10:02):
gut. And so then the microbiomeencompasses not only those
microorganisms, like bacteriathemselves, but their genomes,
their genes, the surroundingenvironment. And so I think of
the microbiota as like theindividual residents. And then
the microbiome is theneighborhood. So you have a gut
microbiome, you have a skinmicrobiome, we have an eye

(10:25):
microbiome. I mean, we'reessentially finding these
various microbiomes in all partsof the body. We really blood,
urine, like all these areas thatwe thought were sterile, the
lungs, which has really beenkind of at the forefront of some
of the newer microbiomeresearch, is that we have these
unique and individualmicrobiomes, and there's this
cross talk that exists betweenall of them. And the gut

(10:47):
microbiome is that largestneighborhood. It's the biggest
neighborhood. It contains themost bacteria. And so when we
talk about the microbiome, weare often talking about the gut
microbiome.

And they're all interconnected to some degree,
right? Connected, yeah, for thelistener, like, it is believed
that, you know, so she do it fora mom during pregnancy, like,
how do we get how does thatchild develop a microbiome,
right? Well, because some ofthat, and you can correct me if

(11:19):
I'm wrong, but some of thatFlora gets transport, and it's
to some degree, it's our ownimmune cells that are helping
transport the bacteria or themicro or some of these
microorganisms into the vaginalarea to colonize it, right? So
it is not that these aredisconnected systems. They are

(11:40):
all interconnected,

All interconnected. And exactly the
the sort of first seating thattakes place from mother to child
is through that vaginal canal.And so, you know, there's an
incredible influence. And eachof these microbiomes have now
really been relayed back to,especially the gut microbiome,
to almost all chronicconditions. There is not a
condition now that doesn't havesome sort of cross talk or

(12:06):
conversation that's occurringbetween the gut and these other
organ systems.

Yeah, so I think it was maybe a decade or so ago
I heard Mark Houston, who's acardiovascular doctor, say, to
become a good cardiovascularsurgeon, I had to become a
gastroenterologist, right?Because he fully realized the
impact of Gi based issues havingan impact on the cardiovascular

(12:37):
system, creating inflammation,creating damage to the
cardiovascular system, which iswas amazing to hear from a
traditionally allopathic surgeonto tie these two different
systems together and go, Hey,these, this is a big piece. So
pretty important. And now today,I mean, you could see a lot of
clinical research where you say,you look at somebody's micro

(13:02):
microbiota in their in their GItract, and you can look at
literature and see, okay, thesein certain conditions, we often
see these types of bacteria highor low, yep, right.

I think that's exciting in the microbiome space
is really understanding these,what we call profiles, or
microbial signatures that arevery common with specific
conditions, so we can't diagnosebased on microbes, but this is
potentially an insight and a newfrontier when it comes to well,

(13:36):
people that have COPD have thissort of microbial signature
profile. People that are obeseor suffer from type two diabetes
have this type of microbialsignature. And I think this is
the movement of the future. Andwhen we start to get into
precision medicine or precisionconversations, we have to start
to consider the microbiota, andwith advancements in DNA

(13:58):
technology, we're getting thereand better understanding these
microbes that are more prevalentor common when it comes to
certain conditions. And so Ithink it's a cool space. I think
MD might change down the road,and it might be a microbiome
doctor now, but I think youcan't really specialize in one
area and not have anunderstanding of how the gut and

(14:19):
the gut microbiome is impactingit.

So we're gonna, this is gonna be a two part
question. We'll take them one ata time when we get them both out
the same point, have weestablished what a healthy
microbiome even is? And two, howdo we go about evaluating the
microbiome appropriately?

Yeah, great question. And there was some
newer research that came outlast year of like this very
question, what is a healthy gutmicrobiome? And there really
isn't this perfect consortium ofbacteria or or understanding of
you must have this, or you musthave that. There are
characteristics, and so I kindof take us through those
characteristics. And one, one.Of those characteristics being
diversity. You know, we talkabout diversity both in quantity

(15:06):
of bacteria, and we're going totalk about bacteria primarily,
just because that's the largest,you know, microbiota that
inhabit the microbiome, the gutmicrobiome, but you've got
quantity, and then you have thequality. And there's definitely
some varying opinions on that.But when we look at sort of
indigenous tribes, when we lookat, you know, various indigenous

(15:30):
tribes that we sort of use as amarker, they've got lots of
different species. They canhave, sometimes upwards to, you
know, 500 to 1000 differentspecies of bacteria. And as
we've industrialized, as we'vemoved into our sort of modern
world, that number has gonedown. And when we see with
different sort of microbiometests in clinical research, also
what's available commercially,I'll see patients and people

(15:51):
that have 12 species, 50species, so that sheer number
has just gone down. And that'skind of an understanding of
like, okay, something's changed.But more specifically, we're
losing the diversity of our goodbugs, the good bacteria, your
health promoting bacteria, orwhat we call these keystone
species, that really have aninfluential impact on the

(16:12):
overall health, primarily yourshort chain fatty acid producing
bacteria. Short chain fattyacids being those very important
metabolites or chemical signalsthat really impact just about
every aspect of the body, play ahuge role in reducing
inflammation, supporting immuneresponses, brain, heart, lungs,
all of that. I'm sure we'll getmore into short chain fatty
acids, but as we start to losethat abundance, so a healthy

(16:35):
microbiome is going to havediversity of these health
promoting species, a healthymicrobiome, is also going to
have a supportive gut barrier.And so when we talk about the
gut barrier, or the mucosalbarrier, we'll hear that term a
lot. I simplify it to say it'syour security perimeter, it's
your fence. I always look at mybackyard because I have a fence,

(16:56):
and so I keep everything insidemy fence that I want in there,
like my dog or my garden, butthose individual fence posts, or
what we call those tightjunctions, that keeps everything
sort of tight, we want to makesure that we have well formed
tight junctions, that they're inplace, because that protects
your immune system. And so ifyou have a supportive gut

(17:18):
barrier, if you have thissupportive fence, then what's in
the microbiome can stay in themicrobiome, and it's it's
porous, right? So nutrients cancome through that we need to,
but it's keeping out the thingsthat we don't want to get into
our immune system. So when wethink of a healthy microbiome,
we're having those key pieces inplace. We don't have a lot of
pathogenic bacteria or bacteriathat can promote inflammatory

(17:39):
responses, and we're reallysupporting that gut barrier.
Whereas an unhealthy microbiome,you start to see that change,
right? You start to see thatloss of diversity, you lose
those key health promotingspecies, you start to see their
fence posts get knocked out, andthen that's where unwanted
bacteria or components ofbacteria can then get into

(18:02):
systemic circulation, or yourbloodstream, and start to drive
changes throughout the body,which we'll talk about. So
that's kind of like in the senseI think of it as more of these
sort of characteristics, but weare getting closer to
understanding more of that sortof population of what we really
want to inhabit or exist withinthe microbiome,

So do we? Because there's so many food
religions today, and a lot ofpeople swear that when they
change their diet, that theirhealth got so much better. Have
we established that a health andhealthy vegan diet is going to

(18:47):
have this type of a biome versusa carnivore diet that's a
healthy person with a on acarnivore diet is going to have
this type of biome, the personon a healthy, and I keep saying
healthy, because you can haveunhealthy of all of these,
right? A person on a healthyketogenic diet is going to have
this type of kind of profile. Dowe know any of that yet, or is

(19:11):
it too early? So

there is some really good quality research
that's coming out around diet, Ithink diet is and there are some
big sort of microbiomeresearchers that are really
trying to figure this out ofkind of the personalized diet,
like, Can we eat for ourmicrobiome? And I think that's a
movement of the future. I hopeto be alive when that gets
figured out, but we have seenwhat some of these dietary

(19:35):
changes can do to themicrobiome. Now, the microbiome
is is malleable, right? It canchange very quickly, but long
term, sustainable change takestime. So you can eat really well
during the week, go hog wild onthe weekend, and have a
different looking microbiome,but then it can sort of bounce
back to whatever your sort ofstable state is. So to create

(19:56):
meaningful change, we need tohave, you know, I would say,
minimum eight weeks. Takes butlonger to really start to see
that shift, especially dependingon how you know, damaged or
dysbiotic or imbalanced our gutmicrobiome is. But we have seen
research, so I'll give anexample, right? And I just was
like listening to a video of ofthe person who started the

(20:16):
carnivore diet. This is not adiet, you know, that I
personally prescribe to and nordo I see people that come in and
are like, I eat this way and Ifeel amazing. I'm not working
with people that feel amazing.Unfortunately, I wish right our
job would be a lot easier. Butthere has been some some
interesting things that havecome out. And actually, the
person who started the carnivorediet stopped, he doesn't

(20:38):
prescribe to it because hestarted developing all these
symptoms, from fatigue tohormone imbalance to, you know,
gut issues, all this stuff. Andso what we do see is there are
certain types of foods andcertain components of foods that
nourish and feed our gutmicrobiome, and specifically our
fiber, our complexcarbohydrates, your prebiotic

(21:00):
fibers. So when you strip thediet of these very important
components, and you startloading up with a lot of
protein, which is essential, wehave three macronutrient groups,
I say protein, fat and carbs.They're all needed. So when we
go on these sort of extremeplans, we start to remove those
substrates or the food that ourbacteria prefer, and that can

(21:22):
start to shift the abundance ofthe types of bacteria. And so
people that have a lot ofpathogenic bacteria more
dysbiosis, or just an imbalancebetween your beneficial buzz,
right? Everyone's competing fornutrients. Well, when you have a
lot of protein, that'sessentially what's going to get
fermented or broken down by youryour bacteria, and it can
actually produce byproducts thatcan be more harmful and be more

(21:42):
toxic, or even like, I loveusing the sort of understanding
around saturated fat. There's alot of conversation in the
nutrition realm around saturatedfat, and specifically coconut
oil. You know, I remember whenit was like, Oh, you broke your
arm, put some coconut oil on it,and you'll magically feel
better. But this actuallyinduces more, sort of what we
call endotoxemia, or more ofthese sort of unhealthy

(22:06):
components, specificallylipopolysaccharides, to get into
circulation, it has a moreendotoxemic effect. So I really
look at the individual right?What do you have going on? What
are your issues? We can sort ofthink of the microbiome, of how
we have to start to createbalance, especially with the
diet that someone's coming in onalready, and so I think balance
is key. As a dietitian, I verymuch promote that, but I am a

(22:29):
huge proponent, and the researchpoints to this is that we have
to make sure that we'reincluding a robust amount of our
beneficial fibers, our prebioticfibers, because we know that
feeds your beneficial bacteria.We know that's how we can
encourage the survival and thethriving of your commensal
species.

Yeah. And we'll get into that in a little bit in
more detail, because that part'simportant. And we'll talk about
the barrier and the analogy ofthe fence posts and those things
is really good. You know, Ialmost kind of think about it
too. And I guess I'm datingmyself here when I say it
sometimes that there's almostlike a D the DMZ, if you know

(23:10):
what, the demilitarized zone is,right between these cells and
the and the gut lumen, we've gotthis kind of mucal layer there
that's like, Hey, don't come in.Yeah, don't come in here. So we
can get into that in a littlebit. But so we know that
there's, you know, food canchange definitely has an impact
on the microbiome. What else hasthe science shown us? Really can

(23:35):
change the microbiome for goodor bad, and maybe take the good
first, or start with the badperson and with the good,

start with the bad, because it can be kind of
depressing, right? When we thinkabout and actually it's a term.
It's called the exposome, whichI think is a cool term, because
it's not a good thing, right?It's all these external or in
the cardiovascular we call itmodifiable risk factors, right?
Or dysbiosis risk factors, Icall them the earthquakes and
hurricanes and bomb cyclonesthat you know, disrupt your

(24:04):
foundation, since I think of themicrobiome as the foundation to
a home,

I just had, like, the visual of a whole
bunch of people dressed up likefurries, going to some like
Comic Con or something, when yousaid extra, when you said it, I
was like, Huh, okay, but goahead,

exactly right. You can envision all this, but
basically all of these externalfactors that we know are
creating imbalance or dysbiosisor damage to the gut microbiome,
and so obviously diet being oneUltra processed foods, right,
not consuming these beneficialfoods that we know are really
important for the microbiome,and there's been a lot of

(24:40):
research that has come outaround Ultra processed foods,
actually, in the last year ortwo, that talks a lot about the
combination of these differentemulsifiers and preservatives
and how it actually knocks yourfence posts out and breaks down
that mucosal or that gut barriermedications, right? Antibiotics.
That's probably the number onething. When you look at the
research and what's beenstudied, antibiotics just kind
of decimate, right? They're likea nuclear bomb when it comes to

(25:02):
the microbiome, and it's they'reneeded. The problem is, is we
throw antibiotics at everything,and that's a very common
practice. We don't know what'swrong. Take an antibiotic.
There's been a lot of researchto show that you know certain
number of antibiotics before theage of two, you have an
exponential increase inallergies and obesity and so
antibiotics are a big part ofthis. Certain medications like

(25:28):
proton pump inhibitors, which weknow many people take for things
like reflux and Barrett's, thatsuppress and really stop your
parietal the cells in yourstomach to produce stomach acid,
we need stomach acid. Itneutralizes pathogenic bacteria.
It helps with the breakdown offood. So that's another sort of
medication. Chronic stress. AndI say that, you know, with a lot

(25:48):
of empathy, because who doesn'thave stress, right? And I always
kind of cringed when I'd heareven the providers that I worked
with that's like, Oh, you justgot to get rid of the stress.
Well, you know, everyone hasstress. It's the way the stress
impacts us, how we deal with it,how we let it sort of marinate
into all aspects of our livesand our body, that it really
creates a lot of dysfunction.Even travel. I travel a lot for

(26:14):
work. Those changes in yourcircadian rhythm can impact the
microbiome. And so, you know, westart environmental toxins. So
all these things that are comingin that are around us that are
starting to create sort of thischange in this imbalance, where
we start to see this sort ofdownstream effect, and not to be
all like doom and gloom, becausewe do live in a modern world,

(26:34):
but small changes can actuallyhave very significant impact.
And from changes to theenvironment, you know, getting
rid of some of thoseenvironmental toxins, to the
types of foods that we choose.We know that even, you know, I
this is a whole notherconversation that we could
probably have a whole notherpodcast on organic versus non
organic, but there's been a lotof studies now looking at the

(26:56):
impact of glyphosate, and evenmore, not even just glyphosate,
but Roundup, which is primarilyused, and the damage that that
does to the gut microbiome,right? So, you know, from a
nutritional quality, there's notthat really necessarily much
difference, but in terms of whatthose chemicals and those
environmental factors or thoseenvironmental impact inputs are
doing, and so I think we canmake some of these small

(27:18):
changes. I kind of look at mylife and say, Well, this is
something I can't quite changenow. So what could be something
that's easier for me to removeor replace for something that's
beneficial? And I think thatthat's a way to not make it so
depressing.

So you before we get into the goods, right? The
good stuff, I think. And I'vejust, I haven't delved into this
too much, but you may know alittle bit more about this. I
totally agree that it'simportant, like what we often
spray on our food as a as a wayto have nicer looking crops,

(27:55):
right? And they grow better, canhave a negative impact on our
our our gut based physiology,because of the way those
chemicals impact us. You weretalking about glyphosate, and we
were told for you know, decades,that glyphosate doesn't create a
problem because we don't have ashikimate pathway, and only the
bacteria do. But our bacteriahave a shikimate pathway, right?

(28:15):
So you can destroy our gutflora. And maybe this was a
bigger trigger for things likeceliac disease and gluten
reactivity than the actual wheatitself that we've potentially
been eating for 1000s of years.And so we there's this big push,
and especially right now, andI've got concern when we start
to look at this from whatthey're pushing for is these

(28:38):
more toxic chemicals that we puton the food and saying, Hey, we
need organic stuff. But I have aconcern about some of the things
that we're saying are organicmay not be very healthy for us
either. And this kind of goes tothe Oh, BPA, like plastics are
bad, so we're going to changeit. And there's still BPA, like

(29:00):
plastics, we just changed thename. So are you seeing in your
literature? I think you'vealready alluded to the fact that
some of the things that we sprayon our foods can create some
problems for the gut biome thatare maybe not organic. But are
you seeing things that we sprayon the food and people think,
Oh, this is organic because theyuse organic pesticides and
organic fertilizer. So it mustbe good for me and my biome. Are

(29:24):
you seeing information thatmaybe some of these are organic
things aren't very healthy forour gut flora?

Absolutely. I think this is, like such a
complicated topic, and I justwant to first say, like, yes,
these, these sort of chemicals,and you know what we're
spraying. We know can damage thegut microbiome, but does eating
that, then whole grain and that,you know, Berry, sort of

(29:50):
counteract some of that damagepotentially. So, so it's, I
mean, I think we can become veryfearful around food. As a
dietitian, I've definitelyexperienced this. I live in
Colorado. Boulder is whereorthorexia, you know, sort of
got coined in this sort of, youknow, overly healthy or this
sort of fear of eating unhealthyfood. And I think we have to
take it kind of from a largerperspective that we know when it

(30:13):
comes to good nutrition, whichis the most important thing when
it comes to the microbiomeoutside of like probiotics and
all the other stuff and noiseout there, your diet is the
number one sort of modifier orimpact from a good and a bad
perspective. So I don't reallyencourage organic this or
organic that. I might say, hey,certain things that we know are

(30:35):
more highly sprayed, you mightwant to choose, but it is more
important that we're consumingthese fiber rich foods, it's
more important that we'reconsuming these prebiotics,
because organic or not, we knowthose have a beneficial impact.
And so I think that's a way to,like, just kind of, you know,
again, we're speaking from aneducational from a science
perspective, and this is whatthe research is looking at. But

(30:57):
time and time again, and all theall the current research coming
out around diet and themicrobiome. It's not looking at
organic versus not. It's lookingat the types of foods we're
choosing and how we're feedingour microbes, right? So it's not
about, you know, feeding thegut, you're feeding your whole
body. And so I just, I alwayswant to say that, because diet,
to me, is kind of one of theeasiest things that we can start

(31:18):
to make some of thosesubstitutions and changes that
has probably one of the mostprofound impacts on your gut
health.

Yeah. And I, I bring that up not to create more
stress and fear in somebody'slife, but I agree with you,
there's a lot of food fear goingon. Like, yeah, I can only eat
this. I can only eat that, I canonly eat this. Like, it has to
be organic. Like, yeah, no, youdon't have any proof, and
somebody said to me, Well, Iknow it's organic. It's better

(31:46):
for me. I'm like, You don't knowthat that's organic? You're
like, Yes, I do, because it'sgot a it's in the organic
section that is such BS justbecause there's a sticker on it
or it's in that section. I and Iknow people in the industry. Or,
like, when we don't have organicsticker sticker, right? And
you'd be like, well, that's notright. And they're like, nobody

And I remember I was working in the hospital, and
knows.
I was speaking to thisstrawberry farmer, and he's
like, you know, strawberrieshave taken a hit. I created this
sort of organic strawberry plot,you know, goes through. It takes

(32:27):
certain amount of years tochange the soil, but then other
areas surrounding, you know,we're not and what do you do
when you water and there'sirrigation? And so that's why
I've always said, like, if itmakes you feel better, like we
can use the sort of, you know,clean 15, Dirty Dozen lists. But
ultimately, I care about thetypes of foods you're choosing,
the quality of your foods. Andprobably, in my opinion, one of

(32:50):
the biggest things is reducingthe number of preservatives. I
think that is, you know, theterm processed foods gets thrown
around. Pretty much everythingwe eat is processed, but it's
those emulsifiers, it's thoseadditives, and especially the
combinations of those that we'reseeing drive microbiome
dysfunction, but more so evenmetabolic health and other areas
of health. And so that's kind ofwhat I teach. And there's a step

(33:12):
wise process, because ultimatelyI want people to be on the diet
that makes them feel the best.And so if there are people who
can't consume, say, enoughfiber, or enough prebiotic
fiber, then we have really goodquality supplements as a way to
people who can't consume enoughprotein for whatever reason.
Great. We've got protein, youknow, drinks and things of good

(33:32):
quality now that we can do. Andthat's where I think of the word
supplement. And I used to tell,you know, providers and patients
this the term supplement has twodefinitions. You can replace
things that are missing in thediet because we can't get it,
vitamin D, right, things that wejust don't get sufficient
amounts of, or we're taking asupplement to achieve
therapeutic or higher levelsthat we're trying to get, you

(33:52):
know, a different function from.And so I think no matter what we
do, we work on the diet to thebest of our ability to what you
feel you can do, and because ifit's not sustainable, then it
doesn't mean anything, right?Yeah, it's the long term impact
of diet that we really want tofocus on.

And because we don't know everything, and
because we know food changes alot of different things, I think
the foundationally, I say thisall the time, I have it my book,
like for me, a whole food baseddiet is probably the best place
to be, minimal amount ofingredients on it. Try and eat
locally and seasonally as muchas you can, because it's like

(34:33):
less likely that that pepperthat you got from the farmer
down the street was probablygrown in that farm. It's got,
it's not grown some twocountries away, and then force
ripen somewhere right where itpotentially that's the whole
argument against plants, is thatthey're more toxic. Well, I
don't think when they're attheir ripened state, they're at

(34:54):
their most toxic level. There'sa little bit of anti nutrients
in there that are needed for.Healthy gut function. But I
think for most people, you know,when you're struggling with
chronic health issues and isjust get back to the basics,
whole food based diet, plants,fruit, yes, meat is good and

(35:17):
it's okay, right? Fish, allthese things in and just and
lots of variety, but whole foodbased

And variety, I think, is key. I think, you
know, and that's one of thehardest things I have, like, a
thing on my refrigerator,especially because I have a
three year old who I'm, youknow, trying to get to eat lots
of variety. But I think about,like, Can I, can I add five new
types of fiber this week. Youknow, before I do my grocery

(35:43):
shop like, I start to create, Ikind of gamify things to be
like, How can I create morediversity? Because we do. We get
stuck in our rut and, and, andthe other point I want to make,
too with diet is there's alsodiets out there that we use,
restrictive diets, eliminationdiets, because we are so
symptomatic, and those can bebeneficial in the short term. So
I'll use, like the FODMAP diet,which is a very well known diet.

(36:05):
It's been studied. It'sclinically backed. I've used it
with patients. These arefermentable carbohydrates, and
essentially, you know,fermentation creates gas,
creates boat bloating, and sofor people that have this
imbalance, that have this sortof dysfunctional gut, removing
those foods can actually relievetheir symptoms, but long term,
use of those diet, ofspecifically a FODMAP diet, has

(36:26):
been shown to decrease thediversity and start to create
more damage in the gutmicrobiome. So I think it's just
this. There's almost likedifferent aspects of sort of the
food fear, but diet, ultimately,is the thing that's going to
improve it, although we mighthave to take certain steps and
stages to get to that diversediet. So I think that's why it's

(36:49):
so important to work withfunctional practitioners, people
who are knowledgeable on this,because, like, I would have
people come to me that areeating two things and still
symptomatic, and it is then muchharder to start to increase that
diversity. It takes a lot longerand a lot more work to do that.

Yeah, I think that's fair. So like I and I'm
not saying that any of thesedietary strategies, carnivore,
keto, vegan, vegetarian, paleo,AIP, that they can't change
somebody's physiology. I agree,these are tools to help create a
change, especially a quickchange, in somebody that may
give them some symptomaticrelief, but I don't think that

(37:23):
any of those are great long termstrategies. I think we you, you
can use them as a tool, thenstart reintroducing and you want
to be whole food based, lots asmuch variety as you can, and
potentially eating seasonally,if possible.
How do we How does somebodyrealize that they have a problem

(37:48):
with their microbiome, and thenwe'll tail it, will jump back
into that like, how do weevaluate it? Yep, because I
don't think we answered that onebefore. So what might be
indications to somebody thatthey have a imbalance or a
problem with their microbiome,and not like someone would say,
Well, I don't have a problemwith my microbiome. I don't even
know what it is. I just havereflux. I don't have a problem
with my microbiome. I just haveirritable bowel syndrome. I
don't have a problem with mymicrobiome. I just have eczema,

(38:17):
right? So what are, what are theindications that somebody might
have problems with theirmicrobiome.

Well, I think you just kind of hit the nail on the
head. It's not just aboutdigestion, although digestive
distress, bloating, gas changesto your bowel movements, right?
Constipation, diarrhea areoftentimes those first signals
that something is wrong. Somethings change. Something's
imbalanced within the gutmicrobiome. But that's not
always the case. I have so manypeople that are like, I have a,

(38:47):
you know, stomach of steel, andmy guts amazing, but they can't
sleep. They're dealing withmaybe thyroid pain, yeah,
chronic leg pain, or eventhyroid issues, thyroid issues,
or skin issues, or sleep,exactly. And I think that goes
back to sort of this gut x axis.Is that the microbiome is seen
as foundational to every systemof the body. But you don't have

(39:11):
to have gut distress. You don'thave to have gut dysfunction to
have a microbiome problem.

You don't have to perceive, right, right? I
would say you don't have toperceive it, right? And I think
that, and I think that wasthat's a huge issue, because
people are like, but I don'thave any GI pain. Even celiac
patients rarely have gi basedsymptoms. I think the statistics
less than, like, 30% of thepeople who get diagnosed with

(39:36):
celiac disease actually go inwith a complaint. It's usually
because their family member gotdiagnosed, and now they're
testing the rest, and they'relike, Oh, you have celiac.

Oh yeah, I experienced that all the time.
Even my niece, she has celiac,and oftentimes especially in
autoimmunity, we see this evenin, you know, thyroid autoimmune
issues that you will have, othersigns and symptoms start to pop
up because your immune systems,you. Are starting to kind of
like alert, all these signals.But my niece had like early

(40:05):
signs, of, like, all her teethwere cavities as a as a kid, and
she didn't get diagnosed untilshe was six years she was, yeah,
about eight years old, actually.So she had some of these sort of
early signs, extreme anxiety,you know, as a young child, that
were all before, and actuallyher GI symptoms were the very
last thing. That was finallywhen, like, you know, they

(40:26):
believed me. That was, like, yougot to take her in because their
mom has celiac. But, yeah,oftentimes we will get a lot of
these, you know, sort of otherchanges prior to even the
diagnosis of some of theseautoimmune conditions. So I
think that's really fascinating.It's why you know your your
history, your genetics, areimportant to know that because

(40:47):
that, because, again, that canbe that kind of like, Hey, I've
got a history of this, so when Istart to experience something
that's off, let's go down that,especially in the autoimmune
space. But yeah, you know, a lotof people I've worked with,
even, like, just think ofmetabolic disorder, right?
Obesity and diabetes and fattyliver disease, these are all
rooted back to dysfunction inthe gut microbiome. Yeah. I

(41:10):
think about like, you know,patients that are like, doing
things right, and exercising andeating well, but not seeing the
changes that they should. Ithink of the microbiome then,

yeah. I think almost everybody that comes to
see me looking evaluating theirGI physiology is critically
important, because everythinghas to go in through there.
Everything has to go out throughthere. So you bring everything
in. If it's not functioningwell, you're not getting the
micronutrients. If you're notbringing the right stuff in, it

(41:41):
creates, it can createinflammation and immune
activation, inflammatorysignals, it can trigger problems
with neurotransmitterphysiology. It's so important
and you can't detox through a GItract that's not healthy
appropriately. So it is soimportant that for the listener,
it really wouldn't matter to mewhat your diagnosis are or what
your symptoms are. In mostcases, I It's one of the first

(42:03):
places I'm thinking about as aproblem, especially for the
people who have immune drivendisorders already. And we could
talk about the impact that,especially from a thyroid
perspective, of how that is, butit is. It's like, to me, it's
the some of the first things wegot to think about you. I have
migraines, okay? We got toconsider what might be going on

(42:27):
in your gut. Well, no, no, Ihave a hormone issue, okay, but
we still need to be consideringwhat might be going on your GI
tract, but I don't have any GIsymptoms. But that doesn't mean
you don't have a GI problem,right? So in they may say what
I've been checked and I don'thave a gut based issue. Tell me
who checked you. I went to seethis gastroenterologist, and
they said, I don't have Crohn'sor colitis. You don't have
pathology, but that's you havedysfunction. And the tests they

(42:52):
ran are pathology based tests.They do pathology based care. We
do functional based tests andand try to restore function so
you don't have the pathology, soit's different. Yes, you can
still have a GI dysfunctionwithout a pathology, right? You
can have chaos in yourneighborhood without people

(43:14):
shooting each other, right? Itcould just be arguments, right,

Absolutely. And I think, to each practitioner
and tension,
themselves. But for me, andobviously I worked in GI but for
me, the microbiome was thatplace to start, because
oftentimes, if you can start tobuild resilience and start to
improve that resiliency, youwill see some of those other
symptoms. So I, instead of likechasing the symptom, I start

(43:37):
with the foundation and then seewhat needs improving. You know,
upstream from there, from, youknow, detoxification to, you
know, everything else, right?Digestion to brain health. And I
think that's where, you know,kind of bring it back to the
research. It's really excitingto see how the gut is connected
to the brain, how the gutsconnected to the thyroid and
vice versa, right? We have theseaxes. It's this bi directional

(43:58):
communication, where one thingthat's off, say in the brain,
say chronic anxiety or chronicdepression and anxiety can drive
gut dysbiosis. Same thing,right? Loss of thyroid function
can drive gut dispos gutdysbiosis. But dysbiosis and
changes in the gut can alsodrive dysfunction to these
specific organ systems and andso for me, I would take a lot of

(44:19):
these complicated patients thatI'm like, oh my goodness, you've
got polypharmacy, you're on amillion drugs, you're taking a
million supplements. You've seenevery practitioner like for me,
that first place was always themicrobiome, and that was just me
as the practitioner, because Iknew there was a lot we could
do, and you can actually createsome real clinical
meaningfulness with even somesmall changes,

right? So diet's important reducing the overall
stress load. And we talk aboutstress, we're not talking just
about emotional stress andmindset. We're talking about
sleep disruption. Can createchallenges. We can talk about
poor respiration and how thatalters and affects our
physiology. We could talk abouta. About, we talked about food,

(45:01):
alcohol. We can also consider,you know, we talked about
medications, how they can havean impact, but even things that
people think they're doingreally well, like, I exercise
every day, right? And I'm like,I can't tell you how many
endurance athletes you see thathave chronic GI issues.

I saw that all the time, especially here in
Colorado. I worked with a lot ofsort of ultra marathoners and
ultra athletes, I think, likeeverything. And I say this about
the diet, it's probably one ofthe hardest things to talk
about. And the microbiome isvery much like this. It's the
Goldilocks. It's all aboutbalance. And I mean, I would
work with patients that werejust diagnosed with, say, IBD,

(45:46):
like Crohn's or colitis, andrunning was their outlet, and
running was their thing thathelped them sort of mentally
feel better, but it was actuallydriving a lot of of chronic
physiological stress. And weknow, when it comes to this is
another sort of reallyinteresting and big area of
research is sort of this athletemicrobiome. We see a lot of
elite athletes that have, likeyou mentioned, gastrointestinal

(46:06):
disorder. They call it E gigs,right? Like, there's a term for
everything, but basically, sortof IBS associated, and it's
because longer duration, greaterintensity, actually drives
intestinal permeability, startsto knock out your fence posts.
And that's where then, you know,bacteria and bacterial
components can start to driveinflammation and immune
activation. So I really say,like, you know, exercise is

(46:29):
important. There's kind of this,like, sweet spot of, like,
what's the right amount ofexercise versus overdoing it.
And I think that can bepersonalized. I think we
underestimate the power ofwalking and how incredible that
is. But yeah, I mean, andthey've done now microbiome
assays to look at, you know,sort of the the everyday
exerciser compared to the eliteathlete. And they truly do have

(46:51):
a dysfunctional microbiomeanalysis. They don't have the
right types of bacteria there.They have this broken down
barrier. And so balance is key.And you know what makes you
happy and brings you enjoyment?Might always, might not always,
be the best thing, but how canwe lessen it or change it, where
you're still getting that samesatisfaction?

Yeah, I think we kind of think of health
sometimes by the look, right?Yeah, we look at the individual
and they, they're they'rephysically fit and jacked, and
we assume that their their bodyis actually healthy, but we
don't understand what it took toget that way. We see the ultra
endurance athlete or triathleteand assume that because they can
do this masterful thing from aphysical fitness standpoint,

(47:31):
that they have great metabolicfitness or healthy microbiome,
and that may be if very far fromthe truth, you often see elite
athletes getting by, but really,really unhealthy, and
especially, especially in thesituation where you have
athletes in the fight worldwhere or wrestling world where

(47:53):
they're they are training hard,and then have to cut Weight
massively to make a certainweight and the just the distress
it creates on their wholephysiology, but for sure, on
their overall gut physiology. Soit is. It's not about the look.
It's kind of like Instagram,like everything looks beautiful

(48:15):
and crazy. Look at that. That'sawesome, but you don't see
what's really going on behindthe scenes. And many times,
those people who post thesefantastic everything in their
life is fantastic are probablythe people who are just getting
ready to go through a divorceor, you know, doing something
else that's negative.

So let's talk about why I stay away from
social media, right? Yeah? Like,I take those rose colored
glasses off, yeah,

it's not a great place to live. Um, let's talk
about evaluation. So there'slots of tests on the market.
There's tests patients can orderfrom home. There's tests that
just measured the micro biome.There's tests that that have a
functional capacity to it, likedigestive capacity, intestinal

(48:59):
permeability markers, indicatorsof short chain fatty acid
production. So do we have a goodidea, a good sense of the best
way to measure the microbiome,and what are those types, and
what types of tests would thosebe?

Yeah, great question. There's a lot of
options out there now. And likeadvancements in cell phone
technology, we have advancementsin microbiome technology. And I
think microbiome testing, youknow, I will say it's a it's
data, right? They'recomplicated. I think as a
practitioner, you need to gothrough training to understand

(49:39):
the nuances. I think, you know,unfortunately, a lot of
microbiome testing is treatedvery similarly to traditional
diagnostic testing. You don'thave this, replace this, or you
have this, let's kill this. Icall it the point and shoot
method. It's much morecomplicated than that, right?

It's like genetic testing, right? Like,
oh, you have this mth of our.You need folate and B 12, right?
Methylated folate, and maybe,and maybe you don't.

Yeah, not, not an genetics is a whole nother area,
very complicated. But yes, Ithink it's a data point, right?
And I think what I love aboutmicrobiome testing is that it
can really give a baseline sortof snapshot. Now, yes, you can
do a microbiome test one day andanother day, and it looks
slightly different, but it doesgive you a baseline

(50:26):
understanding of what's going onin the microbiome. How much of
the you know, do you've got theneighbors in there that you want
to live next door to? Or do youhave some of those neighbors
that you're like and I wishyou'd move out right? And there
is more advanced technology,what's known as whole genome
sequencing, or shotgunmetabolomics, where it looks
deeper and can actually look atthe entire genome of bacteria,

(50:47):
meaning you can see deeper intowho's there, so down to sort of
that species strain. And I'llexplain what that is in a
second, but you can also seewhat they're doing. And so when
it comes to bacteria, and we seethis in the probiotic space.
Especially, you can take a veryhealthy bacteria, and let's say
lactobacillus acidophilus,right? Like that's a species, so

(51:13):
you'll, you'll take that, butwhen you get to that strain
level, active bacillusacidophilus, lla five, for an
example, right? You're betterable to determine that specific
function. So the analogy I useis think of like dogs, right?
They all come from the samegenus, from the same family, and
then you have your terriers,you've got your pit bulls,

(51:35):
you've got your chihuahuas,right? They act different, they
look different, or even Homosapiens, right? We're all Homo
sapiens, but we are verydifferent. So we are our own
individual strain, right?

The analogy I use is it's like, you marry, if
somebody told me they married.Joe Smith, Okay, which one?
That's like, I'm takinglactobacillus acidophilus. Okay,
yeah. But which one? Like, and,

and I, and that is like, I think one of the biggest
areas of like sort of myth andconversation, especially in the
probiotic spaces, you cannotextrapolate research on, say, a
chihuahua and transfer that tothe to the pit bull. They're
very different. And so wholegenome sequencing, or this sort

(52:19):
of shotgun sequencing, becausethey can look at the entire
genome, or the entire DNA of abacteria, that you can get more
specific down to that strainlevel. There are various
companies out there that areusing that type of technology.
And beyond that, beyond justseeing who is in the microbiome,
what kind of neighbors are youhave in your neighborhood, you
can see what they're doing. Andthat's a, that's a that is

(52:42):
another sort of complicatedpiece. But when we look at the
functions, are we producingenough, say, short chain fatty
acids, these metabolites, bileacids. Do you have the right
people there that are convertingyour primary bile acids to
secondary bile acids, tryptophanmetabolites? You know, all these
things that we consume that ourbacteria will actually break

(53:02):
down. Are they doing that theway they should? And that's
really when we look at themicrobiome, it's that functional
redundancy and capacity thatactually dictates a lot of the
health of the microbiome. Youcan have lots of bacteria there,
but are they not consuming thenutrients the way they should
and producing those compoundsthat we know are beneficial.

So I think that's the challenge. With some
of these direct to consumertests, they have the organisms
there and then make they andsay, Oh, because you have these
organisms, or you have lack ofreduction in these organisms,
therefore you're going to havenormal short chain fatty acid
production, or you're not goingto have normal short chain fatty

(53:41):
acid production, and that maynot be true. What they come up
with as a conclusion, like youhave these bacteria so you could
do this, or you shouldn't dothis. But when you run some of
the and these are tests for thelistener, you can run microbiome
tests that are connected tofunctional assessments as well,
and you can look at both,because you might just look at

(54:04):
the microbiome and say, Oh,because these species are low,
because you have lowbifidobacteria, you're going to
have low short chain fattyacids. And so you may make an
but if you had the test that hadboth the microbiome and the
functional markers, then youmight look at it. Okay, yeah, I
have normal Roseburia. I havenormal bifidobacter, but I I

(54:28):
still have low, short chainfatty acids, right? So you eat
the I think these direct toconsumer tests that don't have
that additional functionalmarker test, they can provide
some information, but I don'tthink most, I don't think it's
really in the best benefit ofmost patients for those and you

(54:48):
can, you may have a differentopinion on it, because it makes
some decisions to me. And yes,genetic testing is got, is a
whole nother can of worms, butit's the same thing from a
genetic standpoint. Point whensomebody gets a genetic report
from somebody and they becauseyou have this gene, you need
this supplement. Because youhave this gene, you need that
supplement. When you really readthrough what they say, they're

(55:09):
contradicting themselves all theway through this genetic report,
right? Just because you have agene gene polymorphism doesn't
necessarily you need a wholebunch of cofactors. And just
because you don't have a genepolymorphism doesn't mean you
don't have dysfunction with thatgene. So there's direct to
consumer, there's the typicallythe functional clinician kind of

(55:33):
functional stool test. Where doyou see a role for both of
those? Am I totally off base inwhat I'm saying from your
opinion?

So, and one thing I just really want to mention,
too, especially to the consumer,we can't diagnose based on
microbes. You're looking atpatterns, you're looking at kind
of an overview, but you're alsohave to think about, well, what
am I eating? What am I taking?What are all these other things
going on in my life that couldimpact the microbiome? So as a
practitioner who I do lots ofstool testing. I do lots of

(56:01):
microbiome analysis. We can geta sense of things like digestive
capacity, or, do you havesufficient, you know, stomach
acid? Do you what do we have todo to create interventions from
diet to lifestyle tosupplements, to start to shift
your microbiome into a moreresilient state? And so I think,
in my opinion, like I strugglewith some of the direct to

(56:23):
consumer labs because they canbe misinterpreted. This is much
more complicated. This is muchmore nuanced, and which is why I
think there are incrediblecompanies out there that have
incredible resources forpractitioners. I think these are
tests that you know should begeared towards practitioners,
because we know how to interpretit and then to create a plan.

(56:43):
Because, like I said, it's notpoint and shoot, it's not it's
just, it's not so binary, right?And I think that that's what's
hard, and it is a snapshot. So Ipersonally use lots of stool
testing in my practice. It'ssometimes where I start, because
it can just give me an idea ofhow dysbiotic, especially if
we've got lots of pathogenicbacteria, Proteobacteria, these

(57:05):
bacteria that we know containcertain components, like
lipopolysaccharides, which aresort of these endotoxins that
are contained on our gramnegative bacteria that can, if
you have intestinalpermeability, can begin to wreak
havoc and start to driveinflammation to these various
organ systems. We havesupplements. We've got
strategies that we can help bindthose or remove those. So I

(57:29):
think stool testing can give usa direction, and can also give
us insight into potentiallyfurther testing. If you have
certain consortium of bacteriathat may be more more
predominant or prevalent, say inIBD, and you're experiencing GI
symptoms, and you haven't seen aGI doctor yet. Well, hey, maybe
you do need to go get scopedbecause you've got a high amount
of, say, this fusobacterium thatwe know is extremely

(57:50):
inflammatory. So I think it'sits own field. And I say that
wholeheartedly. You know, assomeone who's spent a lot of
time in this that you can usethese tests in an extremely
valuable way. And then we canalso use them where maybe it
gives some diet influence, orgives some supplement influence.
And it's just not as simple asthat, right?

Yeah, I think what happens is, is that people
get the direct to consumertests, and even maybe some
clinicians do the same thing,and they see something like
these keystone species. Let'suse Akkermansia muciniphila like
it's low. So I need to giveachromatia, right? And now
there's a probiotic, or thebifidobacteria is low, so I need

(58:30):
to give bifidobacteria, orlactobacillus is low, so I'm
going to give lactobacillus, andthat becomes a strategy. And
what I think you and I wouldboth probably agree on is the
microbiome gives us a sense ofmaybe we've got problems, but
the bacteria grows. The bacteriathat's growing or not growing is

(58:52):
a result of what's happeningwith the terrain, like your
life, your lifestyle, whatyou're putting in there, the
amount of inflammation, the typeof food you're putting in
determines what grows there. Andso it's not as simple as, oh, I
don't have low lactobacillus orlow akkermansia, so I'll just
take that as a probiotic andthat's going to fix it. That is

(59:13):
a patch strategy that may nothave the impact that you want,
because just because you putthose bacteria in there as a
supplement doesn't mean thatthey're going to colonize the
tissue, and it's going to changethe terrain the way we want it
to, right, right? And

I think that's the important thing to understand,
and for many clinicians, too, isshifting this mindset of like,
probiotics are really targeted.It's like medicine. They're
targeted to what you're tryingto improve and support because
there's dysfunction takingplace. So for I'll give an
example. I work for a company,resbiotic, and we have a lung

(59:47):
probiotic, really fascinating,especially because sort of the
lung microbiome areas more newerin the in the It wasn't even
part of the Human MicrobiomeProject. We thought the lungs
were sterile. They're not. Butif. You have a, let's say, you
know, you have a dysfunctionalgut microbiome, and this is
potentially driving changes tothe lungs, reduced lung function

(01:00:08):
testing capacity we have, andwe've identified, and we've
studied specific respiratorybenefiting strains that can help
support the production of shortchain fatty acids. And through
this modulation of themicrobiome, improve the
functional capacity or outputin, say, the lungs. And I think
that that's how we have to thinkof probiotics, and that's really

(01:00:28):
how we have to think of some ofthis support is it's targeted. I
think, in my honest opinion,truly gone are the days of sort
of this all in one generalprobiotic. I think we have the
ability to study strainsintimately and intricately, to
understand their function andcreate very powerful and
efficacious products that targetthose very specific needs. And I

(01:00:49):
truly think, because they're notcolonizing, they're not seeding
the gut. In fact, there's a lotof researchers, big researchers,
out there that are trying tounderstand why certain bacteria
will colonize and say, oneperson's microbiome and not
another's, of course, theterrain being the biggest
influence of that, your diet andall this. But even those things

(01:01:10):
aside, like, why can you see saysomething like akkermansia
colonized in one person and notthe other? We don't. We don't
have that knowledge yet. Wedon't have, I mean, maybe some
people do, and they're doing thestudies to try to, to try to
show that, but we don't. I mean,we've done human clinical trials
on our lung probiotic, and wesaw those strains stick around,

(01:01:31):
but that was only for a certainperiod of time. You know, at
what point then do they start todisappear? And I think that
that's just the movement we'regoing to see. We know there are
various strains that aretargeted toward antibiotic
associated diarrhea, whereas youmight take them then for lung
health, and they don't doanything right?

Eric Balcavage (01:01:51):
So I think that's important. So I just want
to re emphasize it. It doesn'tmean that a probiotic can't be
beneficial for you. So theperson who's going, Hey, I took
this probiotic and my gas isbetter. I took my probiotic and
I don't have loose stoolsanymore. I'm not saying that.
You're not saying that. Whatwe're saying is this is it's
typically not a long term healthstrategy. Just to say the only

(01:02:12):
thing I need to do when you ifyou take a probiotic and it
creates some positive change,and I use probiotics, you use
probiotics to create change.It's many times in an effort as
a temporary solution while we'readdressing the other things,
right? Hey, you're not, youdon't have a fiber rich diet.
And so yes, let's get some fiberin the system. Let's support the

(01:02:34):
growth of the bacteria. Maybeuse some of these short chain
producing probiotics with thefiber to see if we can create
the changes we want temporarily,while we continue to work on the
terrain and make it healthierfor things, these things to
grow.
So let's kind of dive into howthe the microbiome has an impact

(01:02:57):
on the intestinal healthoverall, and how problems in the
microbiome, and maybe what someof those mechanisms are that
might trigger thyroiddysregulation, immune
dysregulation and other andthyroiditis, Hashimotos and

(01:03:18):
other immune conditions. Howdoes that? How do we see this
happening? Because some people,like, I don't understand the
connection from my gut to myhypothyroid condition. So how
would you explain how that mightoccur?

Kara Siedman (01:03:33):
It is, it's very complicated, right? And it's
also really fascinating, becausewe are seeing components from
the gut show up in other areasof ice. So basically, what's
happening, we know we talkedabout, sort of these
characteristics of a healthymicrobiome, we start to lose
diversity. And specifically, welose diversity of these
beneficial these probioticspecies within the gut

(01:03:56):
microbiome. And that, you know,probiotics, these lactobacillus
and Bifido strains, you know,they bring acidity, which is how
they the environment that theylike, and your bad bugs, or
those neighbors you don't wantto live next to, they lower that
pH, and so creates a much morealkaline environment, which is
more friendly to thosepathogenic bacteria. So as you
start to lose those species, andwe create more pathogens, more

(01:04:18):
unhealthy bacteria, that's oneof the first things that starts
to degrade or break down, thatmucosal barrier, starts to knock
out those fence posts, becausewe're losing those constituents
that are there to help maintainthat, especially when it comes
to things like the production ofshort chain fatty acids, which
we know is very important.Butyrate being you know that
primary source of fuel for yourcolonocyte supports the gut

(01:04:39):
barrier. So as you lose thesespecies, we know that there are
certain types of bacteria, orcertain types of of I mentioned
earlier, these endotoxins,lipopolysaccharides, that you
know, are sort of waste productsare, you know, are on what's
known as gram negative bacteria,which is the predominant type of
bacteria. And I think wementioned this before in our

(01:05:00):
non-recorded podcast, you know,LPS's, I think, gets used
interestingly in theconversation. But, you know, LPs
in a sort of healthy microbiomeis normal. It's there, right?
And then I think there arecertain LPS is on certain types
of gram negative bacteria thatare less immuno have less, you

(01:05:23):
know, immune activation orimmune impacting
characteristics. But ultimately,if you if your fence post is
getting knocked out, and youhave lots of those LPS's,
especially those that are comingfrom more of that pathogenic
bacteria, then it gets intosystemic circulation, and now
can travel via all differenthighways in the body. Right? We

(01:05:47):
have our vagus nerve, we've gotour thoracic duct, we've got our
port get into bloodstream andessentially drive inflammatory
responses to really start tocascade. So LPS into systemic
circulation can now show up invarious parts of the body. We
see this connected to thyroiddysfunction. We now see this
connected to things likeAlzheimer's. They've done

(01:06:09):
autopsies, they've done studiesto show that there are high
amounts of LPS in certain areasof the brain. We see this in the
liver. We see this in the lungsand and this is a big part of
and the reason is, is becauseLPS will bind to our immune
cells and essentially getescorted. There's, you know, LPS

(01:06:29):
taxis that are known as LBP, butthey're LPS taxis that will
deliver LPS to these specificimmune complexes. You've
mentioned them, the TLR, fourcomplexes that essentially turn
on inflammation. So you startgetting this high production of
inflammatory cytokines,inflammatory signals like
interleukin six, TNF, alpha, andthen this is essentially what

(01:06:49):
starts to be the driver behindlow grade chronic inflammation.
And there's been numerousstudies in humans and animals
beyond I mean, one of myfavorite studies was actually
done in 2007 so kind of, at thestart of the micro Human
Microbiome Project by theAmerican Diabetes Association, a
very conventional group, right?Might I say that looked at, you

(01:07:10):
know, does, you know, chicken oregg? Is it the gut that's
driving, you know, obesity andinsulin resistance, or is it the
obesity and insulin resistancethat's driving? And they
actually found that thetriggering, sort of the trigger
of it all, was LPS, and this wasdone very early on. So this is
just kind of catapulted theresearch around

(01:07:32):
lipopolysaccharides and sothat's kind of the sort of main
mechanism. It's two fold. Youhave the reduction of the
beneficial components, shortchain fatty acids, and you have
a higher production or a higheramount of these endotoxins that
has, you know, creates sort ofthis immune activation and
inflammation to take base, totake place. And this can be in

(01:07:54):
various parts of the body. Nowit's unknown, like, Oh, you have
high LPS and you have gutdysfunction, so it's going to go
to your brain first? No, wejust, of course not. But that's
really one of the driversbetween, between, like, how gut
dysfunction can drive sort ofthyroiditis and and then, and
then it's reversed. So a lot ofthe conversation or

(01:08:15):
communication happens, majorityfrom, you know, gut to organ
system. So we know, like evengut to brain is 90% of the
signaling. But let's say you aresomeone who has autoimmune
thyroid disease graves orhypothyroidism, or you have COPD
or asthma that these sort of,you know, chronic inflammatory

(01:08:37):
conditions is also a driver ofintestinal permeability, also
drives dysfunction to the gut.So it's by it's bi directional,
and we see that, and we knowthat 70% of our immune systems
contained in the GI tract. Soonce you start to see that
breakdown, and have thatbreakdown in the mucosal
barrier, in the integrity of thegut, that you start to change

(01:08:58):
those immune responses that aretaking place. And essentially,
your immune system can'tdetermine what's Friend or foe,
and it just starts sending outall these smoke signals to all
aspects of the body, which iswhy, when you have autoimmune
conditions or you havedepression, you often have other
symptoms we like, even in thelung space, asthma looks

(01:09:20):
similarly from a gut perspectiveto IBD, and we see a lot of
similar symptoms coming up from,you know, people that have, say,
thyroid conditions and then alsohave GI issues, right? So that's
kind of that other downstreamimpact,

Yeah, yeah, critical. I mean, the right type
of bacteria helps produce theshort chain fatty acids that
help regulate the tightjunctions. And that's critical,
because it's the tight junctionsbreak down. More food,
particulate more of these,lipopolysaccharides, other
components of bacteria can be,move in, and you said
pathogenic. And I want to makesure I we clarify that a little

(01:09:58):
bit. It doesn't have to bepathogenic bacteria, bacteria
that shouldn't be in the GITract. It could be your
commensal bacteria, the bacteriathat should live in the GI
tract, but because particulateor the organisms are leaving the
GI tract and getting into a partof the body where they're not
normally seen, that can triggerthe immune and inflammatory
process. Another thing that'sreally important is how back

(01:10:22):
your gut bacteria and your gutflora influence your your your
bile acid physiology, and whenwe don't have appropriate bile
physiology, that also can havean impact on the tight
junctions, and it can have animpact on the immune system of
the GI tract, because bile acidsare direct antimicrobials at the

(01:10:44):
top end of the GI tract, andthey're indirect at the bottom
end of the GI tract. And theother way, component, and I
think you already alluded tothis, is that, you know,
organisms can translocate, andsome of these things, toxins,
can translocate. And it's notjust bloodstream, but the lymph
tissue and other mechanisms. Andthere has been some discussion

(01:11:05):
about the direct lymphconnection from the gut to the
thyroid, which I think isreally, really interesting,
because now you go, huh? Andit's been my argument that I
don't think thyroid physiologyis oftentimes broken as the as
the as the real reason it'sstarting, I think it's an
adaptive response to infection,cell stress and all these other

(01:11:26):
things.
I want to ask about this point,because this is something that I
hear and I see both sides of it,but there's this discussion on
on leaky gut, or intestinalpermeability, and how it's best
identified. Is it Zonulin in thestool? Is it antibodies to
Zonulin? What? What is theliterature say is the best way,

(01:11:49):
because for the listener, we canmeasure Actually, I'll let you
do it. You're the guest. I'lllet you discuss what Zonulin is,
why it's important, and how weuse Zonulin as an indicator of
intestinal permeability, or whatwe call leaky gut.

So there's a lot of conversation when it comes to
Zonulin. And so basically, it'sa protein, right? That's related
to the tight junctions and thepermeability between the tight
junctions. And there aredefinitely, and I think if you
talk to like different labcompanies and this that will
have varying opinion, it has ashort half life. So sometimes

(01:12:29):
it's not always the mostindicative marker in stool. It's
one thing that you can look atthat could potentially be
elevated, that could getindication. But this is why I
think it's also important tolook at the other components of
what we know creates adysfunctional gut barrier,
right? Loss of keystone species,loss of beneficial bacteria,

(01:12:50):
high amounts of, say,Proteobacteria or pathogenic
bacteria, or opportunisticbacteria that we know contain
lots of those gram negatives. SoI think it's one marker that
can, you know when it'schronically elevated,
potentially indicate increasedintestinal permeability, but
you've got to look at the wholesystem, and that's why, like it

(01:13:11):
goes back to what we weretalking about with testing. Is
even things like calprotectin orsecretory IgA, they're happening
as a result of the bacteria andwhat they are or are not doing.
And so you can't just look atthat and say, Oh, you have
intestinal permeability. Youhave to look at that Zonulin and

(01:13:32):
say, Okay, who else is there?Who's not there? Are they doing
what they're supposed to do?What are you feeding the
bacteria? And then create kindof this understanding of, well,
yes, it looks like you probablyhave intestinal permeability.
And so I think that's why it'sit's we use, sometimes these
stool Kevin markers as just thatsort of first light or first

(01:13:55):
sign that something's wrong ornot right, but we have to double
click into it to reallyunderstand what's driving those
changes, and is this somethingthat's chronically happening, or
is this a reflection ofsomething more acute, right? But
the truth be told, like when youlook at some of the statistics,
and I'm going to butcher this,because I think I can't really

(01:14:19):
remember, but I think it wassomething like 80% of people
have intestinal permeability,and it's the chronic intestinal
permeability, it's the longstanding dysfunction to the
microbiome that we start to seeand so so much of the
interventions that we do and thedietary changes is to build
resiliency, to, like youmentioned, to shift the terrain
so that 80/20 right you're doingthe right things, But 20% of the

(01:14:41):
things that you're not doing,the alcohol, the diet stuff,
it's not going to impact you.And I think that that's the
biggest goal. But yeah, I thinkwhen it comes to Zonulin, you
can't just take it as thisgospel that there's right. It
could also be just a what typeof inflammation. So again,
you've got to look at the biggerpicture to really you. I think,
get a sense of intestinalpermeability.

Yeah. So some for the listeners, some people,
if you get a stool test, a lotof stool tests will have fecal
Zonulin on there. Just becauseit's normal, doesn't, in my
opinion, mean you don't havepermeability. Okay, if it's
elevated, it's usually indicatesit's, this is a, this is a
peptide protein that's breakingdown and showing up in the
stool. The if there is, ifthere's damage to those

(01:15:24):
intestinal junctions, you'regoing to have more of it
probably showing up in thestool. Okay, regardless of of
whether we call it permeabilityor not, the likelihood that
you're going to have really highlevels and not have damage to
those tight junctions isprobably less right? It's so if
there's a higher levels in,there probably a good

(01:15:44):
indication, especially ifthere's highs or lows of
Secretory IgA, otherinflammatory markers. I know
people like to hang their hat.Well, I have leaky gut. Okay,
that's a that's another thingwhere somebody hangs their hat
on the diagnosis and you'recorrect in in I think
everybody's got a level ofpermeability. I kind of think
about the intestinal lining likea screen in my window right

(01:16:08):
teeny, tiny, little holes to letair in but keep all the bugs
out. And it's not a it's notwhether I have permeability or
don't have permeability, but thelevel of permeability. So yes,
we could look at the zonula andsay, Hey, there's really high
levels here, there's probablymore intestinal barrier
breakdown. We can also look atit in the blood and look for

(01:16:28):
antibodies for Zonulin, and thatmay have a bigger indication
when we see it that meaning,hey, we're getting the immune
system is making antibodies tothis. So there's likelihood,
there, again, more likelihood ofbreakdown, maybe some of those
the immune system is, is sensingsome of those that damps, what

(01:16:49):
we call damage associatedmolecular peptides showing up
and making antibodies as aresult. Whether it's actually
creating the damage or it's thecleanup crew is yet to maybe be
fully decided, but it does havebigger implications. Sometimes,
when we look at antibodymediated response, we definitely
would think about the gut andthe GI tract as a major source
of where that barrier breakdownis occurring. But we have other

(01:17:13):
tight junctions that could alsobe broke, being broken down,
right?

But if you look at that, you have those antibodies
in the blood, and you see highZonulin on a stool test, and you
see all this opportunistic, gramnegative pathogenic bacteria.
You have reduced short chainfatty acids production. Then you
can and someone's experiencingall these symptoms, and you can
most likely say that they'redealing with intestinal

(01:17:39):
permeability, chronicinflammation, and we have to
start to support that. And sothat's why I say I don't think
there's like a go to test. It'slooking at the consortium of
everything, symptoms, what we'redoing, right?

Yeah, and we really don't need the test to
convince somebody. We just need,hey, you got chronic signs and
symptoms, you got dysfunction.Let's start making some changes
here. I think the reason I likerunning these functional stool
tests is to help the personunderstand the why it's so
important. Hey, look, I know youthink you eat a healthy diet.
Let me show you what's going onhere. You have a problem. Even

(01:18:09):
though you're taking thatexpensive that probiotic, you
still have dysbiosis. It's notdoing what you think you're
you're taking lots ofakkermansia, your akkermansia is
still low. You've been takingit. How long? Two years? Yeah,
it's not doing what you thinkit's doing. You still you say
you're doing you have a perfectdiet and lifestyle, and you
still have tons of Giinflammation. So something's
going on here. Your pancreaticenzymes are insufficient. So

(01:18:31):
yes, the digestive enzyme you'retaking is probably beneficial,
but we should be asking why it'snot fixing the reason, like you
have reduced pancreatic output,we need to consider, is there
low t4 to t3 and that'simpacting the sphincter of Odai?
Is it because you have excessiveamounts of estrogen that are
causing that sphincter of I O Dto not relax and let digestive

(01:18:52):
enzymes and bile flow in there?So it gives us more data for the
individual to say. Why do I haveto change my diet. Here's the
reason this healthy diet andlifestyle you think you're doing
needs to change somehow.

That's it. And I 100% agree, and I even like I
would consult withpractitioners, and I'd say,
don't tell me about the patient.Let me see if I can use look at
the stool test and get a senseof what's going on with them.
And oftentimes you can, from asymptom standpoint, because of
the types of bacteria there,who's not there, and what
they're not or may not be doing,but I do, I think it helps, from

(01:19:30):
a from a patient standpoint, tosay, Hey, you think you're doing
something that's good for you,but we actually need to change
it up and do something better,because it's not working,
because of the fact that youdon't have these bacteria,
because of the fact that youknow, like, from a thyroid
perspective, right? 20% of t4 tot3 conversion happens in the

(01:19:52):
microbiome. Well, if you don'thave this right balance, then
those processes aren'thappening. Or even estrogen
metabolism, right? Like, if youhave bacteria, there. That are
basically putting thoseestrogens back into circulation.
We can see that, and then we canstart to get, I think, a little
bit better picture clinically,of how we then have to go about
our interventions, from diet tolifestyle to supplements.

Yeah, I think it gives actionable data for
change. I know I hear some loudvoices in our industry saying
these tests are no good. They'renot helpful, they're not
scientific. We don't they're notall validated, like I get it.
They're selling a product andthey're they may not use them,
but I would disagree with thatin a lot of cases. I think it

(01:20:38):
helps a patient understand whychange is necessary and why well
intentioned strategies areprobably not working, and helps
for actionable stuff. I want tohit on one. I

think it can even help. I just want to say I think
it can even help for anyclinician listening to hire,
figure out the hierarchy ofwhere do you need to start, and
so maybe we don't have to startthis probiotic first, and we
actually need to start withprebiotics and, you know,
certain binders or certaindigestive so I think it can just
kind of help lay the sort ofpath of like what you do because
we because we want to be mindfulabout that when we're working
with patients,

Especially when you start to really learn what
all the individual markers mean,versus just Going off a
protocol, right? Agree. So let'stouch on this, because it's
important. This is part of whatyou're involved in now. But

(01:21:29):
there is the hot trend right nowrevolves around GLP1 drugs and
GLP1, probiotics. Okay, lots ofcompanies coming out now that
say, Hey, if you just take myprobiotic, it's going to help
you lose weight. You'll lose 20pounds in four months. And this
is the secret. So let's talkabout a little bit about GLP1 in

(01:21:53):
the time we have left. What isit? What's the, how is it
generally made? What's the,maybe the influence of the of
the gut biome, and why are somany people being put on GLP1
medications? And what is thefact that everybody's trying to

(01:22:14):
get these GLP1's, and they doseem to have a change. What does
that tell us about that person'smicrobiome?

Yeah, I mean, I think it's, it's such an
important topic, and, you know,not to get on like, No, you
shouldn't or shouldn't. But evenin the thyroid, sensory this is
all connected. So, you know,you've got someone who's
struggling with weight ormetabolic dysfunction, they're
doing things right, they're onthe right medications, let's say
in the thyroid. You know, in thehypothyroid realm, most people
don't realize that glucagon,like peptide one, GLP one, is

(01:22:44):
produced in the GI tract. It'sproduced by your intestinal l
cells, and it's heavilyinfluenced by the microbial
signals that are taking place.And this is why, when we look at
this sort of gut x axis,metabolic concerns and metabolic
issues are constantly beinglinked back to dysfunction in
the gut microbiome. And we seethis, and research is really,

(01:23:06):
you know, we have verycompelling research around this.
But the difference is, is theGLP one that we naturally
produce, rises and falls inresponse to food, and it has a
very short half life, so it'slike two to, you know, you eat,
you get this rise, and it dropsinto in two to three minutes.
But it's two. We have GLP onereceptors all over the body,

(01:23:27):
brain, similar to thyroidreceptors, and if you're not
producing enough of that GLP oneendogenously, naturally, then
you're not getting that samesignal to those receptors. So,
hey, I'm full. Or, you know, thechange to your blood sugar that
you should if you're notproducing enough of it alone and
or, and, you know, your ownproduction of it. So I think

(01:23:50):
when it comes to not even justprobiotics or postbiotics, food
and other, you know, herbalcomponents have really shown
what can help support thatnatural production? I've
definitely been in the space ofthe microbiome space. I work for
a company. We have a GLP onepost biotic. Post biotics are
actually we used to think ofthem, or still think of them as

(01:24:12):
the sort of end product offermentation or butyrate, but
they're actually heat treated orheat inactivated probiotics. And
we know that when probioticsdie, think of them as like ghost
biotics or parabiotics. Theyactually retain very specific
function, and so the post bioticwe're using specifically
supports modulation of themicrobiome in producing and

(01:24:33):
supporting that natural GLP oneproduction. But it's not GLP one
when you take a GLP one agonist,a medication, you are taking
that natural hormone at 1000times the dose that your own
body produces, which is why it'sa once a week medication. So
you're taking it at Superphysiological levels, which is
why, and part of the reason forthe success, these have been

(01:24:55):
used forever. I've worked indiabetes, you know, since two
you know, back in 2010 they werebeing used. And it's just really
gotten popular, popularized forweight loss, because GLP one
naturally slows digestion. Itsignals fullness, right? It
supports your blood sugarregulation, but we're taking it
at much, much higher levels. Andso when it comes to any of these
sort of natural supplements andnatural components, whether it's

(01:25:17):
a probiotic or a post biotic oran herbal component. You're not
taking synthetic GLP one, youare supporting your own body's
production. And I do think, andI truly believe, that for
success in the metabolic space,whether or not you're on GLP one
medications or not, you have tofix the root, and a large part

(01:25:39):
of that is the microbiome, shortchain fatty acids, your
prebiotics, right? We talked alot about those fibers that
production of butyrate. Butyratebinds to specific receptors on
your intestinal l cells topromote the production of GLP.
One we know most people are noteating sufficient amounts of
fiber. 7% of Americans, in fact,are, and I would argue it's

(01:25:59):
probably even lower, are eatingsufficient amounts of fiber, and
so it just all loops back to allthese things that we've been
talking about for the past hour,of what's damaging the gut
microbiome. But I do see some ofthese, GLP one supporting
products out there and andespecially from a microbiome
standpoint, as just being partof the toolbox. There's a lot of

(01:26:22):
research going on now, of like,what can you do to have more
sustainable results? Because weknow that a lot of weight
reading occurs once youdiscontinue or stop taking the
medications. Well, if youhaven't fixed the microbiome, if
you haven't gotten to the rootof what's potentially driving,
you know, imbalances to thesenatural metabolic processes,
you're going to probably gainthe weight back. So I think it's

(01:26:43):
just part of the program. It'spart of the plan. And there's
been enough research now in thein the in the gastric bypass
space, in the weight loss space,to say, to show that if you
modulate and support the healthof the of the microbiome, you
build more resiliency in the gutmicrobiome, then you can have
more long term sustainableresults.

Yeah. And I think the one of the most
important points is there thatyou said is we make GLP one so
almost anybody who's overweightor obese and goes on a GLP one
medication and they're like,Hey, I'm losing weight, yes, but
you also the at the root of it,you probably have problems with

(01:27:24):
your gut health, your gut flora,and you're probably not
generating your natural amountsof GLP one to begin with. So I
think that's the key point. Ithink some people believe that
that it's a drug that their bodydoesn't already make, and we
already make it, but the factthat you're taking it and it
helps is great, because what itdoes is it turns off reduce. It

(01:27:49):
turns off the liver productionof glucose. So essentially, when
you're eating you're gettingnutrition in so GLP, one is
released by the GI tract to tellyour pancreas, like, hey, let's
shut down. And the liver and thepan, let's shut down.

Have these receptors everywhere, similar to
our thyroid, so there'smiscommunication when your
body's not producing enough, or,you know, these microbial
signals are not strong enough tosupport that production, then
all those receptors aren'talerted. So each of these
various processes can getdisrupted.

Yeah, and so if you, if you're, if you're, if
you don't address the gut, theissue, the RE, the reason, what
created the disruption ofterrain, which creating the
dysbiosis, and you just take themedication, it is, you're going
to lose some weight. But unlessyou're really working with
somebody who knows what the heckthey're doing with these

(01:28:44):
medications, you may wind upskinnier, but potentially
skinny, fat with less with moremuscle loss. You're leaner, you
think you're in greater shape,but at the end of the day,
you've got less muscle mass. Sowhen you stop taking it if you
do the likelihood and you starteating more, because you won't

(01:29:06):
have the suppressive effect ofthe GLP one. Now you have less
muscle mass to burn it, and youprobably still have a level of
dysbiosis and dysfunction inyour gut that you just have
kicked that can down the roadand still needs to be addressed.

You know, I think everyone's always looking for
that magic bullet. And I thinkGLP one medications are pretty
incredible in what we are seeingthem do and what some of the
research is showing, but there'snot a one size fits all model.
You have to do it all. Itdoesn't mean you have to do
everything perfect, but you haveto work on the diet. You have to
work on your physical activity.You have to lift weights, you

(01:29:42):
have to work on your stress, andit's still part of a whole body
plan, like most othermedications, too. And so I think
we're seeing great results.We're seeing really incredible
things, but you still have toput in the work. You still have
to do the things that are goodfor you if you want to have
sustainable results.

Yeah, I think it goes back to what we were
talking about maybe before, andit's a tool in the toolbox, but
it's not the tool. So for ifyou're relying on this to be the
only tool, you're probably gonnaYou may be disappointed,
download down the linesomewhere.
So Kara, we're at the end ofthat our process. You probably
got stuff to do. I got stuff todo. We actually recorded this
one. So this one's going to goout ASAP, because it was meant

(01:30:22):
to be, I think, next Tuesday. Sothat's it's going to go out
pretty quickly. Final commentsfrom you. Where can people learn
more about you and what you do?And any final comments?

Yeah, no, I appreciate you having us on. And
I think hopefully what listenerswill take away is your
microbiome is really this? It'skind of like the next frontier
when it comes to overall healthand improving health, whether
it's your thyroid, whether it'syour metabolic health. And there
are really great tools, fromdiet to supplements to
medications, and they're allpart of that toolbox, like you
said. And so I work for acompany called resbiotic. We're

(01:30:57):
a biotech company that's usingour own strains doing a lot of
the pre clinical work. I thinkwhen it comes to supplements,
efficacy is important, andclinical research is really how
you prove that and show that. Socheck us out at resbiotic. We
have a few various products. Wehave our GLP one post biotic. We
have a really cool prebiotic aswell. You can find me on on

(01:31:17):
social media. Kara Seidmanalways happy to answer
questions. If anyone has.

awesome Well, I appreciate you coming on the
thyroid Answers podcast. I willlet you get back to your life,
and maybe we'll have you back onin the future to discuss
something else revolving themicrobiome.

Love it. Thank you so much.

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Episode 204: How The Microbiome Impacts Your health, Immune System, and Thyroid Physiology

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