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February 22, 2025 48 mins

In this edition of the Wellness Connection MD podcast Dr. McMinn and Coach Lindsay take you on a thought-provoking journey through the critical role of yeast overgrowth, especially in the context of the gut microbiome, echoing the wisdom of Hippocrates that "all diseases begin in the gut."  We’ll take a deep dive into this controversial and important topic as a possible hidden culprit behind fatigue, fibromyalgia, brain fog, mood swings, irritability, headaches, joint pain, chronic sinusitis, autoimmune disease, food allergies, gas, bloating, diarrhea, constipation, IBS, GERD, and even stubborn weight gain. Join us as we reveal scientific evidence and compelling success stories that challenge conventional wisdom about yeast overgrowth and provide hope for those who've hit dead ends with traditional treatments. Discover the various mechanisms by which yeast in the gut microbiome wreaks havoc not only in our gut, but throughout our entire body. Discover why understanding your gut microbiome might be the game changer in your wellness journey.

Like most traditionally trained doctors, Dr. McMinn started his journey as a non-believer when it comes to yeast overgrowth. However, after witnessing the profound effects that his yeast protocol had on his patients, he could no longer deny the importance of treating yeast overgrowth for selected patients. He has now become a passionate advocate for considering yeast overgrowth in the context of the broader context of creating a balanced and healthy gut microbiome. He shares his McMinn Yeast Protocol with you and encourages providers to consider treating yeast overgrowth for patients who fit the clinical picture, especially for those desperate patients for whom standard traditional therapies have not worked. 

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Episode Transcript

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Speaker 1 (00:03):
Welcome to the Wellness Connection MD podcast.
We're excited to have you withus Today.
We're going to take a deep diveinto a somewhat controversial
subject, and that is yeastovergrowth.
We're going to bring you solidscience that supports the
existence of yeast overgrowthand also explain how it relates
to many disease processes.
Then we'll share with you theprotocol that we used at McMinn
Clinic with great success totreat selected patients who

(00:24):
presented with symptoms possiblyrelated to yeast overgrowth,
such as chronic fatigue,fibromyalgia, brain fog, mood
swings, sugar cravings, chronicinflammation, gas bloating, ibs,
weight gain and sinus issues,just to name a few.
A yeast protocol can be a totalgame changer for many patients
for whom nothing else has worked.
We hope you enjoy the show.

Speaker 2 (00:47):
Welcome to the Wellness Connection MD podcast
with Dr McMinn and Coach Lindsay, where we bring you the latest
up-to-date, evidence-basedinformation on a wide variety of
health and wellness topics,along with practical take-home
solutions.
Dr McMinn is an integrated andfunctional MD and Lindsay
Matthews is a registered nurseand IIN-certified health coach.

(01:08):
Together, our goal is to helpyou optimize your health and
wellness in mind, body andspirit.
To see a list of all of ourpodcasts, visit mcminnmdcom and
to stay up to date on the latesttopics, be sure to subscribe to
our podcast on your favoritepodcast player so that you'll be
notified when future episodescome out.
The discussions contained inthis podcast are for educational

(01:30):
purposes only and are notintended to diagnose or treat
any disease.
Please do not apply any of thisinformation without approval
from your personal doctor.
And now on to the show with DrMcMinn and Coach Lindsey.

Speaker 1 (01:45):
Hello and welcome to the Wellness Connection MD
podcast with Dr McMinn and CoachLindsey.
Hello and welcome to theWellness Connection MD podcast
with Dr McMinn and Coach Lindsey, the evidence-based podcast
with all things wellness, wherewe bring you honest,
commercial-free, unbiased,up-to-date and evidence-based
information, along withpractical solutions to empower
you to overcome your healthcarechallenges and to optimize your
wellness in mind, body andspirit, and to become a great

(02:06):
captain of your ship when itcomes to your health and
wellness.
We thank you so much forjoining us today.
I'm Dr Jim McMinn and I'm herewith our co-host, registered
nurse, extraordinaire andcertified health coach, ms
Lindsay Matthews.
Good morning, coach.

Speaker 3 (02:19):
Good morning, Dr Mack , and good morning to all you
listeners.
We're excited to be back on theshow with you.

Speaker 1 (02:26):
Well, coach, we're going to stick out our neck a
little bit today and talk aboutanother subject that tends to be
a bit controversial.
In fact, it's a topic that thevast majority of doctors would
probably say doesn't even exist,and that is the subject of
yeast overgrowth.
However, we're going to take alook at the science today on the
show and to talk about our ownvast clinical experience
addressing this issue at theMcMinn Clinic.

Speaker 3 (02:46):
over the years, but before we get into it, we do
have just a couple of thosebrief housekeeping duties to
take care of.
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Speaker 1 (03:06):
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(03:27):
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Speaker 3 (03:34):
You can also make a contribution to the show
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Speaker 1 (03:45):
And please don't forget to subscribe to the show
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We thank you so much.

Speaker 3 (03:52):
And, without further ado, let's dig into the
interesting topic of yeastovergrowth.
And let's start out byclarifying that what we are
talking about here is a yeastovergrowth in the microbiome,
mainly the gut microbiome.
So we're not talking aboutfrank systemic candidiasis,
which is when you getoverwhelming amounts of the

(04:14):
fungal species actually intoyour bloodstream, causing
life-threatening infection.
That's a different ballgame.

Speaker 1 (04:22):
And also just to let you know that now and then we
may substitute the wordscandidate or fungus for yeast.

Speaker 3 (04:28):
You know, dr Mack, the subject of yeast overgrowth
reminds me of anothercontroversial topic, but it's
related, and that's leaky gut.
Alternative providers have beentalking about leaky gut for
years.
But you know, big medicinereally was just saying from the
beginning that that's just nottrue, it doesn't exist.
And they were saying all of usalternative providers were

(04:52):
believing in hogwash to talkabout leaky gut.

Speaker 1 (04:55):
But now, Coach, we all know that leaky gut is the
real deal.
Every major medical institutionnow recognizes it Harvard, Mayo
, Cleveland Clinic and JohnsHopkins, just to name a few.
And there is a ton of researchgoing on to look into this
because it has a huge impact onmany types of disease.
But big medicines pride won'tlet them come right out and use

(05:15):
the words leaky gut or admitthat the hippie alternative
doctors were right.
So, just to save face, theycall it something more
highfalutin, which is increasedintestinal permeability.
But to be clear, leaky gut andincreased intestinal
permeability are the exact samething.
Now I hate to split hairs here,but since they continue to deny
leaky gut, I need to clarifysomething Leaky gut is one thing

(05:38):
and again, it's just anincreased intestinal
permeability.
But leaky gut syndrome isanother issue and I do not use
the term leaky gut syndrome.
And, to be clear, I'm notsaying that there is a discrete
syndrome of symptoms that iscreated by this phenomenon.
I'm just stating the obvioustruth that under certain
circumstances, we have increasedintestinal permeability, which,

(05:58):
once again, is the exact samething as leaky gut.

Speaker 3 (06:01):
So the gut's intended to be somewhat permeable, and
that's how important nutrientsget into our system.
They're transported rightthrough that gut wall.
Listeners, you could thinkabout it like a sieve that you
use to drain your freshly boiledpasta.
Your sieve should have smallholes in it so that the water
can get through, like thenutrients going through the gut

(06:23):
lining, but the holes should besmall enough that the pasta
can't get through itself.
If the holes are too big, thepasta goes right through.
Then you've got a problem onyour hands.
So you want some small holesare normal, but the big ones
aren't.

Speaker 1 (06:36):
Amazing what the gut does to have the intelligence to
let the right things throughbut to not let the bad stuff
through.
So anyway, that's how thatworks.
But likewise your gut shouldlet the nutrients through, but
should filter out bacteria,protein fragments, yeast and all
sorts of other unwantedcomponents.
If these go through, then thatcreates all sorts of serious
havoc, not just locally but allthroughout your body, which

(06:58):
we'll discuss in just a bit inthe context of yeast.

Speaker 3 (07:01):
So we got off track there a little bit, since this
podcast isn't truly about leakygut, it's about yeast overgrowth
.
However, there is a connectionthere and we also just want to
use the leaky gut topic toillustrate the point that big
medicine doesn't always get itright and sometimes the people
out in the real world are wayout ahead of big medicine.

(07:21):
You know, for example, Dr Mack,like the moms in Lyme,
Connecticut who kept saying thattheir kids were sick and the
doctors just told them theyworried too much and only later
to discover Lyme disease.

Speaker 1 (07:32):
Yeah, that's a great story, and every now and then
the alternative doctors turn outto be right as well.
But what's really important is,at the end of the day, we're
all on the same team.

Speaker 3 (07:41):
Yes.

Speaker 1 (07:42):
And we're all trying to cure disease and to help
people get healthy.
So today we'll take a look atthe evidence and to match that
with our many years of clinicalexperience and try to make a
case for yeast overgrowth as acause of disease and for the
utilization of a yeast protocolto get these folks back on track
.
So take a listen and ultimatelyyou can judge for yourself.

Speaker 3 (08:00):
And, by the way, these kind of situations like
with leaky gut and yeastovergrowth.
It reminds me of the old sayingit goes something like this all
great truth goes through threephases First it's ridiculed,
then it's violently attacked andthen finally it's accepted that
the earth was flat, and if yousaid it wasn't, then you were

(08:23):
hanged or crucified.

Speaker 1 (08:24):
Right yes, and then ultimately now we take it as
self-evident.
Of course it's not flat, butanyway.
Well, Coach, at this point weare not at the accepted as
self-evident stage yet withyeast overgrowth, but certainly
we have been through theridiculed and violently attacked
stages.
Well, we'll see where it goesfrom here and hopefully folks
will listen to the science andcome around on this issue.

(08:44):
Coach, my personal mantra whenit comes to this kind of stuff
has always been to beopen-minded but always skeptical
.
I'm willing to consider thingsthat are outside the box,
especially for patients for whominside-the-box thinking has
miserably failed, but I alwayshave my radar screen up for BS,

(09:06):
especially when it seems likesomeone is just trying to sell a
product on the basis of Mikeylikes it type evidence or, at
the end of the day, it's got toadd up to me.
I need to see some scientificevidence or some clinical
evidence to back it up and thenthe bottom line is it's got to
work for that patient sitting infront of me.
In the case of yeast overgrowth, I actually started out firmly
in the non-believer camp.
Nowhere in medical school orresidency had I ever been taught

(09:26):
that Right you?

Speaker 3 (09:30):
know similar experience, dr Mack.
In all my nursing training andmy various jobs as a nurse, it
was never mentioned.
So what changed your mind?
How did you flip that switch?

Speaker 1 (09:42):
You know, coach, it's really kind of interesting.
As I've said on the podcastmany times, the number one
complaint of my patients overthe years was low energy or
fatigue and it was really thesuccess that I had with
utilizing the use protocol fortreating fatigue that firmly
convinced me of the clinicalsignificance of use overgrowth
and the value of using a useprotocol.
I've used the protocol hundredsof times over the years and I

(10:09):
never had any significantproblems with it and I had many
patients who benefited from it,sometimes dramatically.
Many patients said to me,doctor, I never got better till
we treated the yeast.
I've heard that over and over,coach.

Speaker 3 (10:16):
And you know the whole low energy problem has
reached epidemic proportions.
Clearly, doctors and nurses, wedon't learn much about treating
low energy in our training Innursing school.
I never had a course or lectureor read a book on low energy.
And it's the last complaintthat I'm sure doctors want to
hear from their patients intheir little 15-minute

(10:37):
appointment slots.
Because fatigue, just it takesup too much time, it's
exhausting and you just nevercan get to the bottom of it.
The solution is almost neversimple.

Speaker 1 (10:49):
Yeah, coach, and the complaint of low energy is
usually accompanied by lots ofother complaints like brain fog,
can't sleep, weight gain, lowlibido, all kind of stuff.
And so you're trying to cramthat all into a 15-minute visit,
and the only way to do itreally is to get out your script
pad, and at the end of the daythe patient walks out with a
prescription for a sleeping pilland antidepressant and who
knows what else.

Speaker 3 (11:06):
Right.

Speaker 1 (11:07):
So most doctors will do a few labs, which are usually
all normal, and then they tellthe patient that all your labs
are normal and therefore there'snothing wrong with you.
They're basically telling youthat's all in your head.
Or the doctor pats them on theback and tells them oh, you're
just getting old or you're toostressed out and so get used to
it.
Lindsay, if I recall, you andTyler have heard that a time or
two, haven't you, Coach, backwhen Tyler was getting sick?

Speaker 3 (11:29):
You know we sure did, and I don't know that it was
intentional, but it kind of feltlike being gaslighted when you
know something's wrong, buteverywhere you go you're just
hearing it's normal, this isnormal, or it's just anxiety.
And you know that there's morethan that going on.
And that's what we experiencedwith my husband, tyler, when he
got sick and went to see all thedoctors.

(11:51):
We went to all the specialistsand ultimately, after at least a
year and a half of searching,it turned out to be dysautonomia
.
And we heard just from manydoctors that hey, all these
things are normal.
And it just felt dishearteningand almost like you just wonder
if you're going crazy and youfeel like you're not believed.

(12:12):
But really it's just like theydidn't have the tools in the
toolbox and really we would havemuch preferred if people had
said well, we don't know what'scausing your problem, versus
there's nothing wrong here, whenwe know that clearly
something's wrong.

Speaker 1 (12:26):
Right, right, when you can't get out of bed
something's wrong right Anyway,but you know that's when
patients reach this point, coach, that they showed up at my
clinic with theirdifficult-to-treat diseases like
chronic fatigue syndrome orfibromyalgia, and they were
miserable and at the end oftheir rope they made it very
clear to me that we were theirlast hope.

Speaker 3 (12:46):
Chronic fatigue syndrome can have a really
profound impact on every aspectof the life of these patients
that were coming in the door.
You know, if you have no energy, you can't be the person that
you want to be the employee, thespouse, the parent, the friend.
It just affects every aspect ofyour life.

Speaker 1 (13:04):
Yeah, I've witnessed that so many times with my
patients.
And so all that to say.
That's where yeast overgrowthfirst appeared on my radar
screen and I decided that thesepatients had suffered long
enough, coach, and that the buckstops right here, right now, at
my desk.
So I read every study I couldget a hold of, every book, every
article I could find on thesubject of fatigue.

(13:24):
I even took an excellent courseon fatigue and I became what I
jokingly call a fatigologist.

Speaker 3 (13:29):
I love that.

Speaker 1 (13:31):
The best book on the market that I found at the time
was a wonderful book by aboard-certified internist called
Fatigue to Fantastic.
It was Dr Jacob Teitelbaumwrote the book and he personally
had suffered with chronicfatigue himself during medical
school.
Heidelbaum wrote the book andhe personally had suffered with
chronic fatigue himself duringmedical schools, so he dedicated
his whole long career todiagnosing and treating fatigue
and Coach.
I found him to be trustworthy,thorough, compassionate,

(13:53):
experienced, evidence-based andoutcomes-oriented.

Speaker 3 (13:58):
He's retired now but he's still active online if you
want to check him out.
I remember the big yellow bookon the shelf in the office.
Dr Mack, you always order thosebooks by bulk and we gave away
the book to our fatigue patients.
You know I just you're the onlydoc that I know who routinely
gives away books.
Dr Mack, you're really investedin empowerment.

Speaker 1 (14:18):
Well, you know, because I realized, okay,
they're not going to buy thebook, I would buy it by bulk, so
it didn't cost me that much.
And I figured if I just gavethem the book then they would
have a better understanding ofwhat's going on with their
bodies and if they understoodand had some real hope for
recovery then I would get betterbuy-in and they were more
likely to be committed to theprocess of getting better.

(14:38):
And because another thing,coach.
So they've been to all theseother doctors who say there's
nothing wrong with you, and theycome to see me and I say you've
got something like yeastovergrowth, for instance, and so
they're torn, they're confused.

Speaker 3 (14:59):
And so if they see in the book well, ok, this is the
real deal, then they're morelikely to trust me and believe
me and be committed to theprocess.
And so it's in that book whereDr Teitelbaum popularized the
SHINE protocol S-H-I-N-E SHINEfor fatigue, and that's a
mnemonic S stands for sleep, hfor hormones, I for infection, n
stands for nutrition and then Estands for exercise.
But OK, so I'm looking at allthose letters.

(15:20):
I don't see a Y.
There's no yeast in there, dr.

Speaker 1 (15:23):
Mack, but it's kind of hidden in there.
Coach, in the SHINE protocol,the I is just a little bit
tricky.
It can stand for infectionslike, for instance, lyme disease
or COVID, for instance, whichcan definitely cause fatigue.
Or it could be more subtle, forinstance, alterations in the
bugs that make up your gut.
Microbiome, including yeast,also fall under the I in the

(15:43):
SHINE protocol.

Speaker 3 (15:44):
And when one considers alterations in the gut
microbiome, which we calldysbiosis, that's where yeast
overgrowth comes in.
So, as we'll discuss, it causesmajor fatigue, but many other
symptoms and diseases can alsobe associated with yeast
overgrowth.

Speaker 1 (16:02):
That's right, Coach.
So let's start with the basicsand work our way up and try to
make a case for considering andtreating yeast overgrowth in
selected patients.

Speaker 3 (16:08):
No better place than Dr Mack to start with the gut
microbiome up and try to make acase for considering and
treating yeast overgrowth inselected patients.
No better place than Dr Mack tostart with the gut microbiome.
And we did an entire podcast onthe gut microbiome which was
entitled the Gut Health Series,and episode three was back in
June of 2018.

Speaker 1 (16:22):
Man it's hard to believe we've been doing it that
long in the coach it is.
I love it.

Speaker 3 (16:26):
So, listeners, we encourage you to go back and
check out that one, that episode.
So, since we've alreadydiscussed it, we're not going to
repeat the details on themicrobiome today, except to say
that the unequivocal, solidscientific evidence now
recognizes that we have thisamazing role that the gut
microbiome plays in our guthealth and in our overall health
.
We went to a conference at amajor university on the

(16:49):
microbiome and it's justmind-blowing what an effect it
has on our overall health.

Speaker 1 (16:55):
Yeah, I remember there were big-shot scientists
from all over the country andthey were really into it, and so
I think it's definitelyunequivocally the real deal.
Now it's interesting that wayback 2,000 years ago, coach
Hippocrates, who's the father ofmodern medicine, was all over
gut health when he said that,quote all diseases begin in the

(17:15):
gut.
Isn't that amazing, coach, thathe would say that like 2,000
years ago and that he was ableto connect the dots way back
then without any really modernscience, but still I think
clinically he kind of had ahandle on what was going on then
modern science, but still Ithink clinically he kind of had
a handle on what was going onthen.
But these days, unless you'vebeen living in a cave or under a
rock for the last 20 years, youknow that the gut microbiome

(17:38):
plays a crucial role indetermining the status not only
of our gut health but of ouroverall health.
So as a starting point, I hopewe can all just agree on the
basic concept that there is thisthing called the gut microbiome
and it's hugely important foroverall human health, and
hopefully we don't have to provethat to anybody at this stage
of the game.
I just don't want to waste timeon that, on this podcast, okay.

Speaker 3 (17:53):
Right.
Yes, we are slow to change,aren't we?

Speaker 1 (17:56):
We are slow to change , for sure.

Speaker 3 (17:57):
Although the microbiome is one of the hottest
topics in medical research,it's hardly ever mentioned in
the doctor's offices these days.
Listeners, when was the lasttime your doctor ever mentioned
your microbiome?
And you know if it's like me,the correct answer is 99% of you
would probably say never.

Speaker 1 (18:13):
I'm thinking, you know, I've had some wonderful
doctors over here.
Nobody has ever talked aboutthe microbiome.
In fact, I've had patients whohad serious gut issues who went
to gut specialists in thecommunity also, but at the major
university and they nevermentioned their microbiome.
It just blows my mind, coach.
Yes, it seems like a realdisconnect and I just don't
understand it.
Agreed.

Speaker 3 (18:33):
Yes.
So let's take a look at whatour gut microbiome comprises.
It's mainly composed ofbacteria, viruses, parasites and
yeast oh, that's right, yeast.
So yeast is a normal part ofyour gut microbiome for
everybody.
And, just like with bacteria,there's good yeast and then

(18:53):
there's bad yeast.
Good bacteria, bad bacteria.
The good yeast plays animportant role in your digestion
and how your immune systemmodulates and in your overall
microbial balance.
So the bad yeast is really badand they can get after you in so
many ways.

Speaker 1 (19:10):
Under normal circumstances, the good bugs
maintain control of the gutmicrobiome and the good bugs
keep the bad bugs in check, andeverything is hunky-dory.
And when things are going well,there's this beautiful
symbiotic relationship thatexists between the bugs and the
rest of the body.
In fact, the microbiome carriesout many important functions
and we literally could not evenlive without them.

Speaker 3 (19:30):
Ideally, the ratio and proportion of all these bugs
remains fairly constant andeverything runs smoothly.
However, there can bedisruptions that come along and
stir things up, altering thecomposition of your gut flora,
and so that condition itself iscalled dysbiosis and that
dysbiosis goes on to createhavoc throughout our entire

(19:52):
bodies.

Speaker 1 (19:53):
So, Coach, there are many things that can alter the
gut microbiome, resulting in arelative overgrowth of yeast,
but the big ones that we'llmention here are the use of
antibiotics, especiallylong-term use of gut-active
broad-spectrum antibiotics,which are actually quite common,
and the poor diet, especiallywith lots of sugar or processed
food.
Other triggers of yeastovergrowth include a weakened

(20:14):
immune system, chronic stress,hormonal imbalance, low stomach
acid and high blood sugar ordiabetes.

Speaker 3 (20:21):
There was a study from the European Journal of
Clinical Microbiology andInfectious Diseases that was
entitled A Prospective Study ofthe Impact of Broad-Spectrum
Antibiotics on Yeast Flora ofthe Human Gut.
So they looked at fourdifferent common antibiotics and
found that the gut colonizationby yeast was increased whenever

(20:42):
these antibiotics were used.
So likewise also, several otherstudies have demonstrated that
a high sugar diet can alsoincrease yeast colonization in
the human gut.

Speaker 1 (20:54):
You know, coach, we could really stop the podcast
right there and just say thatproves that there's yeast
overgrowth, right Right, that'ssolid science.
Yes, but we'll continue on.
And so, while yeast is a normaland necessary part of the gut
microbiome, maintaining ahealthy balance is the key.
And when we get out of balance,then there's often a heavy
price to be paid, resulting inpoor health.
For instance, let's say thatyou're floating along through

(21:16):
the river of life and everythingis groovy, but then, for
instance, you get a sinusinfection.
So you go to your doctor andshe puts you on Augmentin, which
is a commonly used antibioticfor sinusitis.
Well, augmentin is a powerful,broad-spectrum antibiotic, which
means that it takes a shotgunapproach to bacteria, so it's
likely to wipe out many of thebacteria in your sinuses, the
good ones and the bad ones.

Speaker 3 (21:37):
And here's the problem.
These antibiotics also wipe outkajillions of bacteria in your
gut microbiome, significantlyaltering the number and kinds of
bacteria that you have in there, and some recent studies found
that after a two-week course ofAugmentin, some gut bacterial
groups don't fully recover, evenafter two to four years Two

(22:01):
weeks.
Yeah, I know they're notrecovering from two to four
years later.

Speaker 1 (22:04):
Yeah, yeah, you know, coach, I remember way back then
I this was when I was, I guess,in my 20s I had chronic
sinusitis for a couple of years.
I was on antibiotics for mostof those two years and boy you
think about the impact on mymicrobiome.
And of course, thereafter I hadchronic diarrhea for a long
time.
So, duh, it makes sense, right?

Speaker 3 (22:24):
Yes, big connection.
Some experts claim that yourgut microbiome never will quite
make it back to the diversitythat it had before even taking
antibiotics.

Speaker 1 (22:34):
Yeah, I think that may be true, but here's the real
rub when it comes to our topictoday.
These powerful antibioticsdon't even think about going
after yeast.
They're just not designed to.
And since it's the bacteriathat keep the yeast growth in
check and they're now wiped outand greatly weakened by the
antibiotics, then the yeastparty begins and they
proliferate like crazy andbecome a relatively more

(22:55):
predominant organism.
And voila, that's an example ofhow we get yeast overgrowth.
It's like when the cat's away,the mice will play.
When the bacteria are gone,boom, the yeast take over.

Speaker 3 (23:05):
And let's just say that, like most people, you also
happen to be eating thestandard American diet, that sad
diet loaded with sugar andprocessed foods, which
specifically feeds yeast.
Well, I hope that you can seethat this situation, it creates
the perfect storm for the yeastto thrive and create the yeast
overgrowth situation.

Speaker 1 (23:26):
And this yeast overgrowth can lead to serious
issues in the gut, immune system, endocrine system and sinuses,
as well as the skin, the brainand far beyond, including
chronic fatigue syndrome andfibromyalgia that we've already
been talking about.

Speaker 3 (23:39):
Besides fatigue, many other common symptoms may be
associated with yeast overgrowth, specifically digestive
symptoms like gas bloating,diarrhea, constipation,
irritable bowel syndrome-likesymptoms, food sensitivities
especially if you're sensitiveto sugar or fermented foods and
indigestion just in general.

Speaker 1 (23:59):
Now a little bit more on the effects of yeast
overgrowth on gut health.
In 2012, a study found thatpeople with irritable bowel
syndrome had significantlyhigher levels of yeast in their
gut compared to healthyindividuals, and a 2019 study
found that Canada can disruptthe lining of the gut,
increasing permeability whichwe'll call leaky gut and leading
to systemic inflammation.

(24:19):
Another 2021 study in thejournal Gut Microbes found that
yeast metabolites interact withthe immune system, promoting
inflammation and worsening gutconditions like Crohn's disease.
So, as you can see, the scienceshows us that yeast can wreak
havoc on the gut in many ways.

Speaker 3 (24:36):
Also neurological and mental health symptoms are
associated with yeast, likebrain fog, memory problems,
anxiety, depression, fatigue.

Speaker 1 (24:44):
And looking at yeast impact on the immune system and
other systemic effects.
Yeast can cause systemicinflammation which may manifest
as joint pain or muscle aches,which we often call fibromyalgia
.

Speaker 3 (24:55):
Yeast has also been linked to several autoimmune
diseases like celiac disease,sjogren's, psoriasis, eczema,
inflammatory bowel lupus andautoimmune thyroid disease,
which could include Hashimoto'sand Graves' disease.

Speaker 1 (25:10):
Interestingly, chronic yeast overgrowth can
also cause stubborn weight gain.
This may be due to severalmechanisms, but one factor is
that, via the gut-brainconnection, yeast overgrowth
causes sugar cravings.
That's right.
Isn't it interesting, coach,that your microbiome makes you
crave what it wants?
There's a great book years agoI think it was called Gulp about
this issue.
And of course, yeast wantssugar.

Speaker 3 (25:32):
Yes, and you know, come to think of it, it makes me
think of that character, thecookie monster.
He must have had yeastovergrowth Me want cookies,
gotta have that sugar.

Speaker 1 (25:42):
Give me sugar.
Gotta have sugar.
Anyway, he was a pretty grumpyguy.
Finally on the symptom list issinus infections and chronic
sinus congestion.
A study from the prestigiousMayo Clinic found yeast in the
mucus of 96% of patients withchronic sinusitis.
The Mayo researchers proposedthat most chronic sinus
infections might actually becaused by an immune response to

(26:03):
the yeast.
Wow Coach, 96%.
That's huge, yeah, so you know,Coach, I had some patients with
chronic sinusitis issues overthe years who actually got
better after the yeast protocol.

Speaker 3 (26:12):
Isn't that interesting that is, that is,
yeast is just a much bigger dealthan most people realize.
Let's circle back around andfocus on the issue of chronic
fatigue that we kind of startedwith there.
A 2023 observational study thatinvolved 800,000 people found
that folks with a prior candidainfection had a 39% higher

(26:36):
chance of developing chronicfatigue syndrome, and that's a
large-scale study that reallyprovided significant evidence
for this potential link betweencandida overgrowth and fatigue.

Speaker 1 (26:47):
And then Coach.
Then we have what we callantibody studies.
A study back in 2014demonstrated that patients with
chronic fatigue syndrome hadsignificantly higher candida
antibody levels compared withhealthy controls.

Speaker 3 (26:59):
Then we've got some neurotransmitter studies.
A study by Rao in 2009 foundthat patients with candidiasis
had significantly lower levelsof serotonin and dopamine
compared to healthy controls.
So that shows that candidaovergrowth may interfere with
neurotransmitter function,potentially contributing to

(27:19):
fatigue and other chronicfatigue syndrome symptoms.

Speaker 1 (27:23):
And next up, we have metabolic studies.
Research has shown that candidaovergrowth may lead to nutrient
deficiencies, particularlyvitamins B1, b2, and iron, and
the authors suggest that thesedeficiencies could be
contributing to the fatigue.

Speaker 3 (27:35):
And then, finally, we have more of the gut microbiome
studies.
Several studies have foundassociations between candidiasis
and conditions oftenaccompanied by fatigue.
The authors concluded thatthese findings suggest a
potential role for gut dysbiosisin the development of fatigue.
The authors concluded thatthese findings suggest a
potential role for gut dysbiosisin the development of fatigue.

Speaker 1 (27:53):
Now the reason we're talking about these different
types of studies we want folksto understand that we're not
shooting from the hip when itcomes to this yeast overgrowth
issue.
As I said from the get-go, it'svery controversial, but I think
once again, the science supportsit, looking at it from many
different points of view, andthere are also different what we
call mechanisms of action bywhich yeast overgrowth may
result in disease.

(28:14):
One of these mechanisms istoxin production, and one of the
main toxins produced by yeastis called acetaldehyde, which is
a chemical byproduct of themetabolism of sugar by the yeast
.
It builds up in the bloodstream and has many potential
unwanted effects, includingdamaging DNA and potentially
promoting the growth of cancer.

Speaker 3 (28:32):
Acetaldehyde also inhibits neuronal information
transmission, leading to brainfog, cognitive impairment,
decreased dopamine or low drive.
It creates a deficiency ofthiamine your B1, which can
affect brain and nerve function,and it can also cause feelings
of intoxication, vertigo, lossof equilibrium and fatigue.

Speaker 1 (28:56):
There you go.
Some other toxins produced byyeast metabolism include ammonia
, uric acid, propionic acid andoxalic acid, potentially
contributing to low energy andoverall poor health.

Speaker 3 (29:08):
So the next mechanism by which yeast does its dirty
work is the gut barrier or gutlining Disruption there, which
again we refer to as leaky gut.
The yeast itself helps toinitiate this process.
By invading the cells that linethe gut.
The yeast causes damage tothese cells via a peptide toxin

(29:28):
produced by the yeast calledcandidolysin.
This damage leads to a decreasein the integrity of the gut
lining, causing leaky gut.

Speaker 1 (29:37):
And this allows undigested food particles,
toxins, pathogens, including theyeast itself, to enter the
bloodstream, causing a chronicimmune reaction, inflammation
and food sensitivities.
Chronic immune reaction,inflammation and food
sensitivities.
Studies have shown increasedintestinal permeability to be an
important key factor in thedevelopment of numerous
autoimmune diseases, as well asother immune and
inflammation-related diseasesthroughout the body.

Speaker 3 (29:59):
Yeast has a unique ability to change shape,
transforming from a roundedyeast cell into an elongated
hyphal cell.
These elongated cells can moreeasily permeate the gut lining
and then go on to attack otherorgans like skin, mouth, ears,
thyroid, reproductive organs andeven the brain.
You know, it strikes me that,as we're talking about how yeast

(30:20):
works, it's like this masterwarfare.
Yeah, yeah yeah, shift changeshapes go through infiltrate.

Speaker 1 (30:29):
Yeah, well, there is kind of a microbial warfare
going on in our bodies for sure.
Yeah, yeah, and it gets moreinteresting, as we'll talk about
in just a moment.
But yeast also disrupts theprotective mucus layer of the
gut, creating opportunities forbiofilms to form layer of the
gut.
Creating opportunities forbiofilms to form Biofilms are
really interesting complexmicrobial communities that work
together and communicate withone another to secrete a

(30:49):
slime-type substance that actsas a shield to protect the
microbial community from otherbugs and from the effects of
antibiotics.

Speaker 3 (30:56):
So these biofilms in the gut can have several harmful
effects on human health.
They can make treatment of gutinfections more challenging by
increasing bacterial resistanceto antibiotics and allowing
pathogens to persist andrepopulate even after antibiotic
treatment.
Biofilms also allow yeast topersist and evade the immune

(31:17):
system.
And then, lastly, the biofilmscan trap toxins, leading to
prolonged toxin exposure then,lastly, the biofilms can trap
toxins, leading to prolongedtoxin exposure.

Speaker 1 (31:28):
The next mechanism of action by which yeast wreaks
its havoc is the disruption ofthe gut microbiome itself, which
creates a condition that wecall dysbiosis, and after that,
the next mechanism of action isnutrient malabsorption.
Besides blocking absorption,yeast also competes with the
host for nutrients, and thesenutrient deficiencies can
contribute to fatigue and othersymptoms.

Speaker 3 (31:45):
Yeast also contributes to hormone
production and regulation.
Therefore overgrowth of yeastmay lead to hormonal imbalances.
So some Candida species canactually produce estrogen-like
compounds, leading to the wholeestrogen dominance type
situation, and then exposure tothat estrogen increases the
virulence of some types of yeast.

Speaker 1 (32:07):
Our next mechanism is immune system dysregulation.
Yeast creates chronic immuneactivation, which leads to
inflammation and then to fatigue.
Yeast also suppresses T cellfunction, which is a type of
immune cell, potentiallyincreasing susceptibility to
infections.
Some individuals may actuallydevelop sensitivities to Canada
antigens themselves, and yeastalso alters Th17 immune response

(32:30):
, an important part of theimmune system that regulates
autoimmunity.

Speaker 3 (32:34):
Yeast overgrowth also disrupts the endocannabinoid
system.
This is a network of receptorsand molecules and enzymes that
work together to regulatevarious bodily functions, and
this particularly affects ourstress response and produces an
anxiety-like state.

Speaker 1 (32:50):
East.
Overgrowth can also impair thefunction of mitochondria, which
are the energy factories of thecells.
This can lead to reduced energyproduction at the cellular
level and also contribute tofatigue.

Speaker 3 (33:00):
Overgrowth, as it contributes to fatigue and other
symptoms, level and alsocontribute to fatigue.
Overgrowth, as it contributesto fatigue and other symptoms,
relates also to the wholeadrenal exhaustion picture and
adrenal fatigue, which isanother controversial topic, but
we did do an entire podcast onthat back in 2023.
So you may want to go back andcheck out that adrenal fatigue
podcast.

Speaker 1 (33:18):
So, basically, the leaky gut created by the yeast
overgrowth causes chronic immuneactivation and systemic
inflammation.
This activates the adrenalstress system, which eventually
malfunctions, contributing tolow energy and other symptoms of
adrenal fatigue.

Speaker 3 (33:31):
And the last mechanisms that we'll mention is
neurotransmitter imbalance andthe direct effects of yeast on
the brain.
So yeast overgrowth can affectbrain chemistry directly via the
active gut-brain axis.
So since most serotonin isproduced in the gut, yeast
overgrowth can interfere withits production.
Yeast overgrowth may alsoresult in a GABA reduction,

(33:54):
potentially leading to anxietyand sleep disturbances.

Speaker 1 (33:58):
And Coach, while we're talking about the brain,
there's one more topic thatwe'll briefly mention, which is
really new and exciting in thearea of research, and that is
looking at the possible effectsof yeast on neurodegenerative
diseases such as Alzheimer'sdisease.
Recent studies have providedcompelling evidence for the
presence of yeast in the brainsof Alzheimer's disease patients.
For instance, a recent study2024, revealed numerous fungal

(34:21):
species in the brain tissue ofAlzheimer's disease patients on
autopsy, and this fungalmaterial has been observed both
intra and extracellularly inneurons from Alzheimer's disease
patients.

Speaker 3 (34:33):
A 2020 study revealed that patients with mild
cognitive impairment, oftenprecursing to Alzheimer's
disease, have specific fungalsignatures in their gut
microbiome, and this suggeststhat certain fungi in the gut
may be associated with cognitivedecline and may potentially
contribute to Alzheimer'sdevelopment.

Speaker 1 (34:54):
Well, coach, if you think about it, how does yeast
get into the brain?
As we've already established,we can have yeast overgrowth in
the gut microbiome via manydifferent mechanisms.
We also talked about how theyeast in the gut attacks the
intestinal lining and can morphinto hyphal shapes and squeeze
through the leaky gut, and thenit can get into the bloodstream,
essentially creating asubclinical candidemia.

(35:16):
Then the yeast secretes anenzyme called aspartic protease,
which helps the yeast topenetrate the blood-brain
barrier and actually enter thebrain itself.

Speaker 3 (35:26):
And then, once in the brain, the yeast activates
mechanisms that generate amyloidbeta-like peptides, which is
the classic signature ofAlzheimer's disease pathology.
And also, once in the brain, itactivates microglial cells,
which then cause neuralinflammation, which is one of
the hallmarks of allneurodegenerative diseases.

Speaker 1 (35:48):
Studies have observed that individuals with
Alzheimer's disease have arelative gut yeast overgrowth
when compared to healthynon-Alzheimer's individuals.
I'm just saying, Coach, it'sreally getting interesting.

Speaker 3 (35:58):
Yes, so the presence of the fungi in Alzheimer's
brains is now a well-establishedscientific fact.
We are still in the earlystages of the scientific
investigation into thisphenomenon, so, as a causal
relationship goes, it stillremains under investigation.

Speaker 1 (36:16):
Association does not always equal causation, so at
this point we can't say thatyeast is causing Alzheimer's
disease.
But it's kind of interesting,and we can at least say that
there's an association betweenthe two.
Right, and so we'll have towait and see where the research
leads us in this exciting area.
So stay tuned.

Speaker 3 (36:34):
So, as we wrap this up, hopefully listeners, you can
see that yeast overgrowth cancontribute to a wide array of
symptoms and diseases throughmultiple mechanisms affecting
many aspects of our health.

Speaker 1 (36:47):
But you know, Coach, the science is super important
and we tried to build our caseupon science, and I'm a
scientist at heart.
At the end of the day, show methe data or show me the evidence
but what's really important tome is does treating the yeast
overgrowth help my patient?
That's what's really important.
So now that we got some scienceout of the way, let's just take
a moment to share our clinicalexperience on this subject.

(37:08):
Let's face it the in-the-boxapproach from their other
excellent physicians simply hadnot worked for my chronic
fatigue patients.
So it was time for me to thinkoutside of the box in a
responsible, first-do-no-harmkind of way in order to get
these miserable and desperatepatients feeling better.
So, after being deluged withcomplaints of fatigue from my
patients, I decided to try DrTeitelbaum's Shine Protocol that

(37:31):
we mentioned earlier.
Actually, I used a protocol.
I call it Shine Plus, since Iadded a few more things to the
protocol.

Speaker 3 (37:36):
And over the years we found that there really aren't
any great lab tests to tell youwho is going to respond well to
the yeast protocol.
There are a few labs that youcan do, but we never really
found them to be that reliableor that helpful.

Speaker 1 (37:51):
So it really boils down to clinical presentation
when deciding to use a yeastprotocol or not.
Some tips that suggest a yeastprotocol might be helpful
include the fatigue, the brainfog, especially the use of
antibiotics.
Include the fatigue, the brainfog, especially the use of
antibiotics, especiallybroad-spectrum antibiotics or
gut-active antibiotics likeCipro, levaquin, cephalosporins,
augmentin and IV antibiotics.

Speaker 3 (38:09):
Other tips included.
If the patient had poor diet,especially lots of sweets, they
had lots of sugar cravings.
Other things that tipped us offas risk factors like we're an
itchy anus, yeast-associatedskin rash, chronic sinus issues,
high alcohol intake, diabetesand weakened immune system.
Or just, you know, stick outtheir tongue and you see this

(38:32):
white coating on the tongue.
We call that oral thrush.
That was also a tip too.

Speaker 1 (38:38):
You know, coach, it's really interesting.
Some people just seem to bedownright yeasty.
They've had fungal skin rash,white coating on their tongue,
fungal nails, and they just seemto be eating up with fungus,
and some of them say they'vebeen like that all their life.
It's kind of interesting, coach.

Speaker 3 (38:52):
So we use the yeast protocol on selected patients,
and the good news is that thevast majority of these difficult
to treat patients got betterand usually a lot better.
It was sometimes actually quiteamazing.
I really saw it many times withmy own eyes working with you,
dr McMahon.

Speaker 1 (39:09):
And, as you know, coach, I've been retired from
clinical practice for a coupleyears now.
But I recently reached out anddiscussed the yeast protocol
results with my former officemanager and medical assistant,
and here's what she had to say.
Quote in the 10 years that Iworked with Dr McMahon, I
listened to the stories ofhundreds of women who had the
same complaints that I didWeight.
They just couldn't lose itBloating all the time, fatigue

(39:33):
for no apparent reason,irritability, excessive gas.
They would sit there and saythat they have tried everything
and nothing worked.
They've tried every diet outthere and nothing worked.
They said that they exerciseevery day and ate all the right
foods and still felt like crap.
We totally understood howfrustrated they were and that
they needed a solution.
The yeast protocol was notsomething we recommended to

(39:54):
everybody, so usually thepatients that decided to tackle
the yeast protocol were willingto do anything to feel better.
But I can say with greatconfidence that 98% of our
patients that did the yeastprotocol came back and felt so
much better.
Some only lost a few pounds andsome lost more.
But it wasn't just about theweight.
It was that they were sleepingbetter and they felt better and

(40:15):
their skin looked better andtheir stomach wasn't bloated
anymore.
It was totally worth the 10weeks of a rigid regimen and for
the most part, most of thepatients were able to stick to a
pretty good routine after thatand were able to keep their
weight off and continue to feelgood.
End quote.

Speaker 3 (40:31):
Wow, that's quite a testimonial, Doc.
So the clinical bottom line weused the protocol hundreds of
times on selected patients.
Other than some brief,manageable yeast die-off
symptoms, we didn't really haveany significant downside effects
with it and we had manyexcellent success stories that
emerged from using the yeastprotocol.

Speaker 1 (40:52):
And you know, coach, as I said earlier, I'm a
scientist at heart and althoughI think we've made a pretty good
case for yeast overgrowth andfor the use of the yeast
protocol, I still wish we couldhave more consensus on this
issue in the medical communityso that these patients won't get
gaslighted by their providerswhen they mention yeast
overgrowth.
Remember, I went into this as anon-believer and I do not have
a dog in this fight.
I don't sell any magic McMahonyeast tonic.

(41:15):
But over the years I built myown body of evidence by treating
hundreds of these folks and theoutcomes were unequivocal.
The yeast protocol helped thevast majority of patients,
sometimes when nothing else didso.
I have come around on thisissue from a non-believer to a
passionate advocate as adedicated provider who went to
work every day to help people.

(41:35):
I'm glad I had the use protocolin my therapeutic toolbox and I
hope that other providers willkeep an open mind and embrace
the science on this issue andgive their patients a chance to
have a new lease on life.

Speaker 3 (41:46):
So for those patients out there who are suffering
with things like fatigue,fibromyalgia, brain fog, gas,
bloating, low mood, weight gain,those sugar cravings and some
of the other symptoms that we'vetalked about here, you might
want to consider trying a yeastprotocol talked about here.
You might want to considertrying a yeast protocol.

(42:07):
It acts kind of like a gutreset to give you a fresh start
to rebuild towards a healthiermicrobiome.
And, as we've said many timeson the show, good health starts
in the gut and there is agut-everything connection.
So as your gut gets better,then many of your other symptoms
will usually get better too.

Speaker 1 (42:23):
So, Coach, let's wrap this up by explaining exactly
how to get after the yeast.
There are many ways you canattack the yeast, starting with
diet, which, of course, shouldbe a low-sugar diet.
There are also many herbal andantifungal remedies out there.
You can try both as singleherbs but also in combination
products, and I'll have adocument for you at mcmdcom
entitled Yeast Herbs listingthese herbs and some combo

(42:45):
formulas for you that might behelpful.

Speaker 3 (42:48):
It may also be helpful to take probiotics,
cultured and fermented foods anda good competing yeast called
Saccharomyces boulardii.
Also, some indirect measuresmay be helpful, like supporting
your gut lining with things likeglutamine, zinc and aloe vera.

Speaker 1 (43:04):
And reducing gut inflammation with things like
omega-3s, curcumin and alow-inflammatory diet.
A couple of excellent comboproducts that we have used over
the years for gut inflammationinclude Inflamacor by
OrthoMolecular andUltra-Inflamax by Metagenics.

Speaker 3 (43:18):
It may also be helpful to directly address the
leaky gut, if present, through agood gut restoration protocol,
and we'll have a document atmcminnmdcom for you called Leaky
Gut, to give you some tips onthat.

Speaker 1 (43:32):
However, over the years, after trying many
therapeutic options, such as theherbs we just mentioned, we
found that, in order toaccomplish our goal of getting
these patients healthy again,the most effective treatment for
these folks who weresignificantly symptomatic and
they were sick of being sick andwho wanted to get better sooner
than later, was by using ouryeast protocol, which included a
combination of low-sugar dietalong with nystatin and diflucan

(43:55):
.
Your own provider may have hisor her own protocol, and that's
fine too.
However, if you're interestedin the protocol that we use,
then you can find it atmcmindmdcom in the documents
section called McMind YeastProtocol.
However, listen up, this isvery important.
Do not do this protocol on yourown.
You must do it in cooperationwith a qualified medical

(44:15):
provider.

Speaker 3 (44:16):
And a quick word about the diet.
Don't go crazy over the diet.
There's a lot of misinformationabout yeast diets out there in
books and online and many of theyeast diets that you'll find
they're so difficult that you asa patient can't possibly keep
it up, and so a lot of times wejust would see patients just
quit and all is lost.
So just the goal should be keepit simple and the main thing is

(44:39):
to really reduce your sugar, tocut that out.
And the main point ultimatelythe key is not just killing the
yeast.
It's about restoring thishealthy microbial balance and
creating better overall guthealth.

Speaker 1 (44:53):
So, coach, it's time to wrap this up.
I think we made a clear casefor the existence and importance
of yeast overgrowth, supportedby scientific evidence, and
since we hang our hat onpractical solutions, we've also
shared with you our yeastprotocol, which you have found
to be extremely effective forcombating this problem.
When you look at the scientificevidence that supports the
concept of yeast overgrowth as acontributing factor to symptoms

(45:13):
and disease and, moreimportantly, when you add my
clinical experience withhundreds of patients who
benefited from the yeastprotocol when nothing else had
worked, then it seems absolutelyclear to me that a
well-designed, properlymonitored yeast protocol is
appropriate and potentiallyextremely helpful for patients
who fit the clinical picture ofyeast overgrowth.
And also, coach, just give me aminute to clear up one

(45:36):
misunderstanding.
One thing I think is adeal-breaker for big medicine
and why they don't accept yeastovergrowth as being a real
phenomenon, is the use of theword syndrome.
This is similar to the leakygut syndrome issue that I talked
about earlier.
Notice that throughout thepodcast, I have used the phrase
yeast overgrowth and not yeastovergrowth syndrome.
I would agree with the criticsthat there's no concise,

(45:59):
universally agreed upon clinicalpresentation that constitutes a
classic syndrome.
However, if we can stick withthe term yeast overgrowth and
stick with the science, thenperhaps we can find some common
ground and move forward to helpthese suffering patients.
Hopefully that somewhatexplains the divide and clears
up some of the confusion.

Speaker 3 (46:18):
Well, I think that about does it for this
discussion of yeast overgrowth.
Thank you, listeners, forlistening and we hope that we
were able to share somethingwith you that was interesting
and helpful, and that's why wedo the show.

Speaker 1 (46:31):
And please do take a minute to rate us on iTunes.
These reviews really do make adifference for us.
Also, if you like the podcast,take a moment today to let a
friend or family member knowabout the podcast.

Speaker 3 (46:41):
Yes, and thanks in advance for helping us spread
the word about evidence-based,holistic, functional and
integrative medicine.
You won't find a moreevidence-based, unbiased podcast
on wellness anywhere out thereon the web.
We do our homework on thesetopics and we shoot it straight
with you.
We're not trying to sell youanything.

Speaker 1 (46:59):
If you'd like to reach out to us to comment on
the show or to makerecommendations for future
topics, you can reach me atdrmcminn at yahoocom.
Well, coach, can you leave uswith one of your brilliant Coach
, lindsay pearls of wisdom.

Speaker 3 (47:12):
Thanks, dr Mack.
You know I think I would justlove to leave listeners just
with image and just thinkingabout your gut as a garden and
with this yeast, think aboutlike an overgrown garden.

Speaker 1 (47:22):
Too many weeds.

Speaker 3 (47:23):
Yeah, too many weeds, and so sometimes you got to go
in and you got to do somemassive pruning and some massive
work.
But you also got to go in withthe mindset of restoring that
balance and with this tendernessof a garden and taking care of
your body in a nurturing way.
And so I just want to encouragepeople, as you're thinking
about this also, you know, stepback and take that long-term

(47:45):
perspective.
So, whatever you decide to dowith your intensive overgrown
reset, doing that, also come inwith the mindset of how do I
create and cultivate a balanced,thriving garden in my gut.

Speaker 1 (47:59):
Well, that's great Coach.
Thank you so much for sharingand thank y'all for listening.
This is Dr McMinn.

Speaker 3 (48:04):
And this is Coach Lindsay Take care and be well.
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